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

Cohen 2004.

Study characteristics
Methods Study design: RCT
Number randomized: 39; 20 to the exercise group and 19 to the control group
Study start and stop dates: not reported
Length of intervention: 7 weeks
Length of follow‐up: 1 week, 1 month and 3 months after the last session
Participants Type cancer: lymphoma
  • exercise group: Stage 1, 22%; Stage II, 39%; Stage III, 17%; Stage IV, 22%

  • control group: Stage 1, 22%; Stage II, 33%; Stage III, 12%; Stage IV, 33%


Time since cancer diagnosis: not reported
Time beyond active treatment: not reported
Inclusion criteria:
  • lymphoma

  • receiving chemotherapy or had received it within the past 12 month

  • ≥ 18 years old

  • able to read and speak English


Eligibility criterion related to interest or ability to exercise, or both:
  • none reported


Exclusion criteria:
  • major psychotic illnesses


Gender: 12 female and 32 male
Current age, mean, 51 years
Age at cancer diagnosis: not reported
Ethnicity/race: not reported
Education level: not reported
SES: not reported
Employment status: not reported
Comorbidities: not reported
Past exercise history, n:
  • exercise group: 4

  • control group: 8


On hormone therapy, n:
  • exercise group: 1

  • control group: 2

Interventions 19 participants assigned to the Tibetan yoga exercise intervention, including:
  • controlled breathing and visualization

  • mindfulness

  • postures from the Tsa lung

  • preliminary set of postures from the Trul khor (sngon 'gro).


The exercises are simple motions done with specific breathing patterns
Type exercise (aerobic/anaerobic): aerobic
Intensity of experimental exercise intervention: mild
Frequency: once per week, with recommendation to practice techniques at home at least daily
Duration of individual session: not reported
Duration of exercise program: 7 weeks
Total number of exercise sessions: 7
Format: group and individual
Facility: tertiary care hospital and home
Professionally led: Tibetan yoga instructor
Adherence: all participants attended at least 1 yoga session; 6 (32%) attended all 7 sessions; 5 (26%) attended 5 or 6 sessions; 6 (32%) attended 2
or 3 sessions; and 2 (10%) attended only 1 session
Co‐intervention: none
Control group: 19 assigned to control group, consisting of
  • wait list


Contamination of control group: not reported
Outcomes Outcomes: QoL outcomes, including:
  • psychological distress, assessed using the Impact of Events Scale

  • anxiety, assessed using the Spielberger State Anxiety Inventory

  • depression, assessed using the CES‐D

  • fatigue, assessed using the Brief Fatigue Inventory

  • sleep, assessed using the PSQI


Outcomes were measured at baseline and 1 week, 1 month, and 3 months after the last yoga session:
  • exercise group: n = 20 at baseline, n = 19 at follow‐up (time of measure not reported)

  • control group: n = 19 at baseline, n = 19 at follow‐up (time of measure not reported)


Adverse events: not reported
Notes Country: US
Funding: Bruce S. Gelb Foundation
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk "Group assignment was conducted sequentially using minimization"
Allocation concealment (selection bias) Low risk "The allocation process was concealed from all investigators because all the relevant information was entered into a computer program and group assignment was determined by the program"
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 Although it was stated that only 1 study participant dropped out before the end of the study, data were presented only for 30 study participants, not 38 who completed the study
Selective reporting (reporting bias) Low risk There is no evidence of selective reporting of outcomes
Other bias Low risk The trial appears to be free of other problems that could put it at a high risk of bias