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. 2012 Aug 15;2012(8):CD007566. doi: 10.1002/14651858.CD007566.pub2

Banasik 2011.

Study characteristics
Methods Study design: RCT
Number randomized: 18; 9 to the exercise group and 9 to the control group
Study start and stop dates: not reported
Length of intervention: 8 weeks
Length of follow‐up: to end of the intervention
Participants Type cancer: breast cancer, stages II to IV
Time since cancer diagnosis: not reported
Time beyond active treatment: at least 2 months' post‐treatment 
Inclusion criteria:
  • none


Eligibility criterion related to interest or ability to exercise, or both:
  • physical condition that prevented participation in yoga


Exclusion criteria:
  • receiving Hercepton (trastuzumab) therapy (an immune modifier)

  • pregnant or lactating

  • past or current history of another neoplasm

  • active serious infection or immune deficiency

  • history of psychiatric disorders requiring use of psycho‐active medications

  • documented alcohol or drug abuse

  • current steroid therapy or other known immunomodulating medications


Gender: female
Current age, mean (SD) years:
  • exercise group: 63.33 (6.9) years

  • control group: 62.4 (7.3) years


Age at cancer diagnosis: not reported
Ethnicity/race: 100% Caucasian
Education level: not reported
SES, (n):
  • Exercise group: less than USD10,000 (0); USD10,000 to USD30,000 (2); USD30,000 to USD50,000 (2); USD50,000 to USD75,000 (3); > USD75,000 (2)

  • Control group: less than USD10,000 (1); USD10,000 to USD30,000 (2); USD30,000 to USD50,000 (4); USD50,000 to USD75,000 (1); > USD75,000 (1)


Employment status: not reported
Comorbidities: not reported
Past exercise history: not reported
On hormone therapy: not reported
Interventions 9 participants assigned to the exercise intervention, including:
  • iyengar yoga, which balances physical demands with safety. The poses are taken slowly using props as necessary to maintain proper alignment and form. The active yoga used was primarily physical in nature and included poses traditionally found in beginning Iyengar classes. The sessions were more physically demanding than those of restorative or gentle yoga, with progressively difficult poses, including increased duration of weight‐bearing on the arms, as individuals abilities improved. The focus of yoga practice was on training and accepting the physical form of the body and there was no specific component of meditation


Type exercise (aerobic/anaerobic): aerobic
Intensity of experimental exercise intervention: mild
Frequency: twice per week
Duration of individual sessions: 90 minutes
Duration of exercise program: 8 weeks
Total number of exercise sessions: 16
Format: group
Facility: facility
Professionally led: professionally led by expert Iyengar yoga instructors
9 participants assigned to control group, including:
  • instructions to continue regular routine with offer of an opportunity for yoga program participation at the end of the study period


Adherence: 7 women in the yoga group who completed the study attended an average of 14 of 16 possible yoga sessions (87.5%) with a range of 12 to 15 sessions
Contamination of control group: not reported
Outcomes Outcomes include QoL, measured using the FACT‐B and subscales, including:
  • physical, social/family, emotional, and functional subscales

  • additional breast cancer concerns

  • fatigue score


Outcomes were measured at baseline and at 8 weeks:
  • exercise group: n = 9 at baseline, n = 7 at 8 weeks

  • control group: n = 9 at baseline, n = 7 at 8 weeks


Subgroup analysis: not reported
Adverse events: no cancer recurrences or adverse events reported
Notes Country: US
Funding: University of Washington Center for Women's Health and Gender Research, Washington State University Cancer Prevention and Research Center, and the Washington State University College of Nursing
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk The generation of the random sequence was not described
Allocation concealment (selection bias) Unclear risk Whether the treatment assignment was concealed from study personnel and participants was not described
Blinding of participants and personnel (performance bias)
All outcomes High risk Owing to the nature of the intervention, it was not possible to blind the participants; however, it is unclear whether the outcome was influenced by a lack of masking
Blinding of outcome assessment (detection bias)
All outcomes High risk Study personnel and outcome assessors were not masked or blinded to the study interventions
Incomplete outcome data (attrition bias)
All outcomes High risk There was no ITT analysis and it is unclear how missing data were handled. 2 participants in each group withdrew and no reason was given for withdrawal
Selective reporting (reporting bias) Low risk There appears to be no selective reporting of outcomes
Other bias High risk The small sample size and lack of description of the recruitment and selection of study participants could give rise to additional biases