RESULTS

The age, stages of disease, grade and node status were similar in the yoga and supportive therapy (control) groups [Table 1]. The mean years of education of the study sample was 12.49 ± 2.67 years, with a minimum of seven years and a maximum of 17 years of education. The mean overall age of the subjects was 49.2 ± 9.6 years in both groups. All subjects had adequate nutritional status with the majority of them having a body mass index (BMI) between 19–25
(57%) and the rest above 25 (43%).

Participants reported high levels of anxiety at baseline (before surgery). A paired samples t test done to assess the changes in anxiety state following surgery within groups showed a significant decrease in anxiety state following surgery in both control [t (35) = 6.69, P < 0.001,95% confidence interval, CI (4.9 to 10.6)] and yoga groups [t (32) = 6.41, P < 0.001, 95% CI (7.6 to 14.3]. Analysis of covariance using baseline anxiety states as a covariate showed a significant decrease in anxiety states following surgery [F (66) = 4.22, P = 0.04, 95%CI (-5.6 to -0.3)], in the yoga group as compared to controls. STAI trait scores were initially high in the period between diagnosis and surgery. A paired samples t test done to assess the changes in the anxiety trait following surgery within groups showed a significant decrease in the anxiety trait following surgery in both control [t (35) = 5.50, P < 0.001, 95% CI (4.9 to 10.6) ] and yoga groups [t (32) = 6.1, P < 0.001, 95% CI (5.8 to 11.7) ]. ANCOVA using baseline anxiety trait score showed significant decrease in the anxiety trait scores following surgery, [F (66) = 9.8, P = 0.002, 95% CI (-7.2 to -1.7)]. There was no significant within-group differences following surgery in the depression scores. Analysis of covariance using baseline depression scores as a covariate showed a significant decrease in depression following surgery [F (66) = 7.6, P = 0.008, 95% CI (-4.6 to -0.73)].

Measures of quality of life and stress symptoms [Table 3]

A paired samples t test showed a significant decrease in distress in the yoga group alone following surgery [t (32) = 2.1, P = 0.05, 95% CI (0.006 to 5.7)]. There was a significant decrease in symptom severity [F (66) = 12.8, P = 0.001, 95% CI (-5.1 to 1.4)] and distress [F (66) = 13.6, P < 0.01, 95% CI (-6.3 to -1.8)] in the yoga group as compared to the controls following surgery. There was no significant within-group differences following surgery in the quality of life scores. Analysis of covariance using baseline quality of life scores as a covariate showed significant improvements in quality of life following surgery [F(66) = 12.34, P = 0.01, 95% CI (4.7 to 19.8)] in the yoga group as compared to the controls.

Immune measures

Serum immunoglobulins [Table 4]

Subjects’ serum samples were assessed for Immunoglobulins G, M and A at baseline following surgery. A paired samples t test showed a significant increase in IgA levels following surgery in the control group [t (32) = -3.2, P = 0.005, 95% CI (-1.1 to -0.21] but no significant changes in the yoga group. Analysis of covariance using the baseline presurgery measure as a covariate also showed a significant decrease in IgA levels following surgery in the yoga group [F (62)=10.21, P =0.001] as compared to the controls. There was no significant within- and between- group changes in IgM and IgG levels.

T Lymphocyte subsets such as CD4+, CD8+ and CD56+ % were assessed before and after four weeks after surgery. A paired samples t test done to assess the changes in CD56 % following surgery within groups showed a significant decrease in CD56 % following surgery in the control group [t (32) = 3.57, P = 0.001), 95% CI (1.85 to 6.76)] but not in the yoga group. Analysis of variance done on these post- measures using the baseline measure of CD56 % as
a covariate showed significantly higher levels of CD56 % in the yoga group following surgery [F (62) = 5.78, P = 0.019] as compared to the controls. A paired samples t test done to assess the changes in CD4 % following surgery within groups showed a significant decrease in CD4 % counts following surgery in the control group [t (35)= 3.31, P = 0.002, 95% CI (1.62 to 6.72)] but not in the yoga group. Analysis of variance on post- measures using baseline measures of CD4 % as a covariate did not show any significant changes between groups following surgery. A paired samples t test done to assess the changes
in CD8 % following surgery within groups showed a significant decrease in CD8 % following surgery in the control group [t (34) = 3.46, P = 0.001, 95% CI (1.64 to 6.30)] but not in the yoga group. Analysis of variance on this post- measure using the baseline measure of CD8 % as a covariate did not show any significant changes between groups following surgery.

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