Greater frequency and longer duration of yoga practice may more effectively reduce stress
Research Study At A Glance
The Research Question Asked
Does frequency and duration of yoga practice affect levels of stress and anxiety for breast cancer survivors?

Type of Study
Online survey

Study Participants (Sample)
35 total participants
Mean age was 54.83 years old
Average time after completion of acute treatments for breast cancer was 4.2 ± 2.8 years
Mean years of yoga experience was 6.6 years
Methods
Participants completed a series of questions regarding basic biographical data, specific breast cancer diagnosis, and their yoga duration and frequency. Study participants then completed the 10-item Perceived Stress Scale, the state anxiety subscale of the State-Trait Anxiety Inventory, and the Self-reported Health Scale.

Results
There was no significant difference in perceived stress or self-reported health between the low-dosage and high-dosage yoga groups. However, state anxiety was greater in the low-dosage yoga group compared to the high-dosage yoga group.

Conclusion
Higher frequency and duration of yoga practice may provide greater anxiety relief for breast cancer survivors.

 
 
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Background
After the acute phase of medical treatment, breast cancer survivors may still experience significant stress and anxiety related to recovery. Processing the fear and worry associated with first surviving, and then the after-effects of breast cancer is often a significant source of stress. Additionally, managing all the changes that have occurred during the post-treatment phase of returning to daily life can be a heavy psychological burden. During this phase of reintegration, patients often seek out support for general stress relief. Non-pharmacologic therapies may be recommended for supportive stress relief during this phase.

One complementary therapy often recommended to patients to support their psychological health after completing the acute phase of breast cancer treatment is yoga. Yoga has consistently been shown to reduce stress across different styles and populations. However, a frequent criticism of yoga studies is their lack of a detailed description of the specific yoga treatment used. Without details describing frequency, duration, and yoga techniques (postures, breathing, etc.) used in a study, it’s unclear what to recommend when medical professionals want to recommend yoga to their patients. For those reasons, the research team who designed the study we summarized here, chose to examine the relationship between yoga practice durations and frequency and the stress levels of breast cancer survivors.

Research question
Does frequency and duration of yoga practice affect levels of stress and anxiety for breast cancer survivors?

Research methods
Researchers recruited 35 women from online national cancer support group web forums. All participants were 18 years old or older. They had a previous history of yoga practice, either in studio classes or a home practice. All study participants also had a previous breast cancer diagnosis.

The research team asked participants to complete a series of questions to collect basic biographical data. Those questions asked their age, marital status, ethnicity, and specific breast cancer diagnosis (Stage 1, 2, 3, 4, or metastatic cancer). Researchers next asked a series of questions about participants’ yoga duration and frequency. Study participants then completed the 10-item Perceived Stress Scale and the state anxiety subscale of the State-Trait Anxiety Inventory. Additionally, participants self-reported their assessment of their overall physical health using the Self-reported Health Scale. They indicated their self-assessed physical health as very good, good, fair, bad, or very bad.

In order to analyze the data that they collected, the researchers used the yoga frequency and duration that each participant reported to calculate a yoga dosage. They then divided the range of yoga dosage across participants into a low-dosage group and a high-dosage data group. The low-dosage group included participants who reported ≤ 239 yoga hours. The high-dosage group included participants who reported ≥ 240 yoga hours.

Results
Among the 35 study participants, the mean age was 54.83 years, and their mean years of yoga experience was 6.6 years. The average time after completing the acute phase of breast cancer treatments for the study participants was 4.2 ± 2.8 years. The specific breast cancer diagnosis varied among participants. The largest number (48.6%) of study participants had received a stage 1 breast cancer diagnosis. A smaller group had been diagnosed with stage 2 breast cancer (37.1%). The smallest groups had been diagnosed with either stage 3 breast cancer (8.6%) or metastatic breast cancer (5.7%).

All study participants had an average level of perceived stress based on their scores from the 10-item Perceived Stress Scale. There was no significant difference in perceived stress or self-reported health between the low-dosage and high-dosage yoga groups. However, state anxiety, measured with the state anxiety subscale of the State-Trait Anxiety Inventory was greater in the low-dosage yoga group compared to the high-dosage yoga group.

Why is this relevant to yoga practitioners?
Research already shows strong support for yoga’s positive effects on reducing stress. As yoga practitioners, we’re likely aware of yoga’s stress-relieving effects from our own direct experience. However, even though we know we feel better when our yoga practice is part of our life, it’s easy to get busy with all of our other commitments and let the consistency of our yoga practice slide. The study we summarized here reminds us that the regularity of our yoga practice matters with respect to how we experience its benefits. It’s a good reminder to make a concerted effort to be consistent with our yoga practice if we want to experience all its positive effects.

 
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Conclusion
Yoga has stress-relieving and anxiety-reducing effects. This has been supported by research across yoga styles and for many different populations. However, based on the research we summarized here, a higher frequency and duration of yoga practice may have greater positive effects, particularly for breast cancer survivors.
Reference citation
Weitz, M.V., J.R. Bloch, Y. Birati, A. Rundio, K. Fisher, S. Byrne, L. Guerra. 2023. The relationship between yoga practice dosage and perceived stress, anxiety, and self-reported health among breast cancer survivors who practice yoga. Holistic Nursing Practice. 37(6):347-355.