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Feasibility and Preliminary Efficacy of Tailored Yoga in Survivors of Head and Neck Cancer: A Pilot Study.

Fri, 2019-03-29 07:26
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Feasibility and Preliminary Efficacy of Tailored Yoga in Survivors of Head and Neck Cancer: A Pilot Study.

Integr Cancer Ther. 2018 09;17(3):774-784

Authors: Adair M, Murphy B, Yarlagadda S, Deng J, Dietrich MS, Ridner SH

Abstract
PURPOSE: Treatment for head and neck cancer (HNC) results in long-term toxicities and increased physical and psychosocial survivor burden. There are a limited number of treatments for these late effects. Yoga postures, breath work, relaxation, and meditation, may improve these late effects. The purpose of this study was to examine the feasibility of a tailored yoga program in HNC survivors and obtain preliminary efficacy data.
METHODS: This was a randomized wait-list control study of yoga-naive HNC survivors who were >3 months post-cancer treatment. Baseline data were collected. Participants were randomized to either an 8-week hatha yoga intervention group or a wait-list group. Feasibility and efficacy data were collected. At 4 and 8 weeks, patients underwent a repeat assessment of health. Wait-list control group participants were offered the yoga program after data collection. Descriptive statistics evaluated feasibility. Mixed effects general linear models were used to generate estimates of the efficacy outcomes.
RESULTS: Seventy-three individuals were screened and 40 were eligible. All eligible individuals consented and enrolled. Five of the intervention group discontinued early and none in the wait-list control group. Feasibility was affirmed as participants were recruited and retained in the study, there were no adverse events, fidelity to protocol was demonstrated, and satisfaction rates were high. Efficacy measures indicated potential benefit for shoulder range of motion ( d = 0.57-0.86, P < .05), pain ( d = 0.67-0.90, P ≤ .005), and anxiety ( d = 0.59, P = .015).
CONCLUSION: A tailored hatha yoga program is feasible and potentially efficacious for HNC survivors. Preliminary data supports further investigation of yoga in this population is needed.

PMID: 29355046 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Non-pharmacological interventions for chronic pain in multiple sclerosis.

Thu, 2019-03-28 07:22
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Non-pharmacological interventions for chronic pain in multiple sclerosis.

Cochrane Database Syst Rev. 2018 12 19;12:CD012622

Authors: Amatya B, Young J, Khan F

Abstract
BACKGROUND: Chronic pain is common and significantly impacts on the lives of persons with multiple sclerosis (pwMS). Various types of non-pharmacological interventions are widely used, both in hospital and ambulatory/mobility settings to improve pain control in pwMS, but the effectiveness and safety of many non-pharmacological modalities is still unknown.
OBJECTIVES: This review aimed to investigate the effectiveness and safety of non-pharmacological therapies for the management of chronic pain in pwMS. Specific questions to be addressed by this review include the following.Are non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) effective in reducing chronic pain in pwMS?What type of non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) are effective (least and most effective) and in what setting, in reducing chronic pain in pwMS?
SEARCH METHODS: A literature search was performed using the specialised register of the Cochrane MS and Rare Diseases of the Central Nervous System Review Group, using the Cochrane MS Group Trials Register which contains CENTRAL, MEDLINE, Embase, CINAHL, LILACUS, Clinical trials.gov and the World Health Organization International Clinical Trials Registry Platform on 10 December 2017. Handsearching of relevant journals and screening of reference lists of relevant studies was carried out.
SELECTION CRITERIA: All published randomised controlled trials (RCTs)and cross-over studies that compared non-pharmacological therapies with a control intervention for managing chronic pain in pwMS were included. Clinical controlled trials (CCTs) were eligible for inclusion.
DATA COLLECTION AND ANALYSIS: All three review authors independently selected studies, extracted data and assessed the methodological quality of the studies using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool for best-evidence synthesis. Pooling data for meta-analysis was not possible due to methodological, clinical and statistically heterogeneity of the included studies.
MAIN RESULTS: Overall, 10 RCTs with 565 participants which investigated different non-pharmacological interventions for the management of chronic pain in MS fulfilled the review inclusion criteria. The non-pharmacological interventions evaluated included: transcutaneous electrical nerve stimulation (TENS), psychotherapy (telephone self-management, hypnosis and electroencephalogram (EEG) biofeedback), transcranial random noise stimulation (tRNS), transcranial direct stimulation (tDCS), hydrotherapy (Ai Chi) and reflexology.There is very low-level evidence for the use of non-pharmacological interventions for chronic pain such as TENS, Ai Chi, tDCS, tRNS, telephone-delivered self-management program, EEG biofeedback and reflexology in pain intensity in pwMS. Although there were improved changes in pain scores and secondary outcomes (such as fatigue, psychological symptoms, spasm in some interventions), these were limited by methodological biases within the studies.
AUTHORS' CONCLUSIONS: Despite the use of a wide range of non-pharmacological interventions for the treatment of chronic pain in pwMS, the evidence for these interventions is still limited or insufficient, or both. More studies with robust methodology and greater numbers of participants are needed to justify the effect of these interventions for the management of chronic pain in pwMS.

PMID: 30567012 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara.

Thu, 2019-03-28 07:22
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Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara.

BMC Pregnancy Childbirth. 2018 Jul 03;18(1):275

Authors: Zhao Y, Zou L, Xiao M, Tang W, Niu HY, Qiao FY

Abstract
BACKGROUND: To investigate the effect of different delivery modes and related obstetric factors on the short-term strength of the pelvic floor muscle after delivery in Chinese primipara.
METHODS: A total of 4769 healthy Chinese primiparas at postpartum 6-8 weeks were interviewed. According to the difference of delivery mode, the selected primiparas were divided into 2 groups, including cesarean delivery group containing 2020 and vaginal delivery group containing 2749. All the vaginal deliveries were further divided into 3 groups, including episiotomy group containing 2279, perineal laceration group containing 398, and forceps assisted group containing72. The scales of their pelvic floor muscle (PFM) strengths were examined by specially trained personnel using digital palpation (Modified Oxford scale:0-5 grade). According to participants' willingness, if the PFM strength was weak (0 or 1 grade), at-home PFM training would be recommended and an electrical stimulation combined with biofeedback therapy would be conducted for them in hospital. Twelve weeks after delivery, the PFM strength would be measured again. For statistical analysis, t-test, one-way variance analysis, Chi-square analysis, Kruskal-Wallis test H, Mann-Whitney U test and Wilcoxon test were carried out.
RESULTS: The PFM strength in cesarean delivery group was higher than in vaginal delivery group (p < 0.05). Among 3 vaginal delivery groups, the PFM strength in perineal laceration group was the highest (p < 0.05); however, there was no difference in PFM strength between episiotomy group and forceps assisted group (p>0.05). After accepting PFM training at home and therapy in hospital, 305 women showed increased PFM strength (p < 0.05).
CONCLUSIONS: Vaginal delivery is an independent risk factor causing the damage of PFM, and episiotomy may cause injury of PFM. Through PFM training at home and therapy in hospital, those damage will resume as soon as possible in the short-time period after delivery.

PMID: 29970030 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Does electromyographic biofeedback improve exercise effects in hemiplegic patients? A pilot randomized controlled trial.

Wed, 2019-03-27 07:19
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Does electromyographic biofeedback improve exercise effects in hemiplegic patients? A pilot randomized controlled trial.

J Rehabil Med. 2019 Feb 01;51(2):109-112

Authors: Arpa S, Ozcakir S

Abstract
OBJECTIVE: The aim of this pilot randomized study was to assess the efficacy potential of an electromyo-graphic biofeedback-assisted exercise programme on clinical and functional outcomes of hemiplegic patients in comparison with sham electromyogra-phic biofeedback.
PATIENTS AND METHODS: Thirty-four patients with hemiplegia were randomized into 2 groups. Both groups participated in an inpatient rehabilitation programme including exercise interventions and ambulation training 5 days a week for 2 weeks. Lower extremity exercises were performed via electromyogra-phic biofeedback in Group 1 (n = 17), while a sham technique was used for patients in Group 2 (n = 17). Range of motion, spasticity, muscle strength, func-tional level and walking speed were assessed before and after treatment. Follow-up was performed at 1 and 3 months after treatment.
RESULTS: Significant improvements were found for range of motion, muscle strength, Barthel Index and 10-m walking time in both groups.
CONCLUSION: This study suggests that exercise with or without electromyographic biofeedback is effective for improving clinical and functional parameters in hemiplegic patients. Larger studies are needed to determine whether electromyographic biofeedback-assisted exercises provide additional benefits.

PMID: 30667510 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Perceived reciprocity and relationship satisfaction: Age and relationship category matter.

Wed, 2019-03-27 07:19
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Perceived reciprocity and relationship satisfaction: Age and relationship category matter.

Psychol Aging. 2018 08;33(5):713-727

Authors: Braun T, Rohr MK, Wagner J, Kunzmann U

Abstract
Past work suggests that perceived reciprocity in social relationships declines with age. Although positive associations between perceived reciprocity and relationship satisfaction have been documented, relationship satisfaction seems to remain relatively stable over the life-span. Addressing this seemingly contradictory pattern of findings, we predicted that perceived reciprocity may become less important to relationship satisfaction with age and that this association differs across various relationship categories (i.e., spousal, communal, and exchange relationships). We tested these predictions applying multilevel models to cross-sectional and longitudinal data of middle-aged and older adults from the Interdisciplinary Longitudinal Study of Aging (ILSE). Consistent with past work, perceived reciprocity was lower in older than middle-aged adults and declined over time, while relationship satisfaction did not differ between age groups and increased over time. Inconsistent with our prediction, the association between perceived reciprocity and relationship satisfaction was stronger in older than middle-aged adults in our cross-sectional analyses. By contrast, the longitudinal analyses that were based on only older adults were consistent with our prediction: the association between perceived reciprocity and relationship satisfaction decreased over time. Additionally, the association between perceived reciprocity and relationship satisfaction differed between relationship categories, being particularly strong in spousal relationships and less in communal and exchange relationships. In general, our results suggest that both, age and relationship category, need to be considered when investigating perceived reciprocity and relationship satisfaction from an adult life-span perspective. (PsycINFO Database Record

PMID: 29985011 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Targeting the affective brain-a randomized controlled trial of real-time fMRI neurofeedback in patients with depression.

Wed, 2019-03-27 07:19
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Targeting the affective brain-a randomized controlled trial of real-time fMRI neurofeedback in patients with depression.

Neuropsychopharmacology. 2018 12;43(13):2578-2585

Authors: Mehler DMA, Sokunbi MO, Habes I, Barawi K, Subramanian L, Range M, Evans J, Hood K, Lührs M, Keedwell P, Goebel R, Linden DEJ

Abstract
Functional magnetic resonance imaging neurofeedback (fMRI-NF) training of areas involved in emotion processing can reduce depressive symptoms by over 40% on the Hamilton Depression Rating Scale (HDRS). However, it remains unclear if this efficacy is specific to feedback from emotion-regulating regions. We tested in a single-blind, randomized, controlled trial if upregulation of emotion areas (NFE) yields superior efficacy compared to upregulation of a control region activated by visual scenes (NFS). Forty-three moderately to severely depressed medicated patients were randomly assigned to five sessions augmentation treatment of either NFE or NFS training. At primary outcome (week 12) no significant group mean HDRS difference was found (B = -0.415 [95% CI -4.847 to 4.016], p = 0.848) for the 32 completers (16 per group). However, across groups depressive symptoms decreased by 43%, and 38% of patients remitted. These improvements lasted until follow-up (week 18). Both groups upregulated target regions to a similar extent. Further, clinical improvement was correlated with an increase in self-efficacy scores. However, the interpretation of clinical improvements remains limited due to lack of a sham-control group. We thus surveyed effects reported for accepted augmentation therapies in depression. Data indicated that our findings exceed expected regression to the mean and placebo effects that have been reported for drug trials and other sham-controlled high-technology interventions. Taken together, we suggest that the experience of successful self-regulation during fMRI-NF training may be therapeutic. We conclude that if fMRI-NF is effective for depression, self-regulation training of higher visual areas may provide an effective alternative.

PMID: 29967368 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Adverse Childhood Experiences and Child Health Outcomes: Comparing Cumulative Risk and Latent Class Approaches.

Wed, 2019-03-27 07:19
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Adverse Childhood Experiences and Child Health Outcomes: Comparing Cumulative Risk and Latent Class Approaches.

Matern Child Health J. 2018 03;22(3):288-297

Authors: Lanier P, Maguire-Jack K, Lombardi B, Frey J, Rose RA

Abstract
Objectives This study seeks to further the work exploring adverse childhood experiences (ACEs) by proposing a novel approach to understanding the impact of ACEs through applying advanced analytical methods to examine whether combinations of ACEs differentially impact child health outcomes. Methods Using National Survey of Children's Health data, we use latent class analysis to estimate associations between classes of ACEs and child health outcomes. Results Class membership predicts child poor health, with differences found for specific ACE combinations. A subgroup of children exposed to poverty and parental mental illness are at higher risk for special healthcare needs than all other groups, including children exposed to 3 or more ACEs. Conclusions Different combinations of ACEs carry different risk for child health. Interventions tailored to specific ACEs and ACE combinations are likely to have a greater effect on improving child health. Our findings suggest children who experience specific ACE combinations (e.g., poverty and parental mental illness) are at particularly high risk for poor health outcomes. Therefore, clinicians should routinely assess for ACEs to identify children exposed to the most problematic ACE combinations; once identified, these children should be given priority for supportive interventions tailored to their specific ACE exposure and needs.

PMID: 28929420 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Using conversation analysis to inform role play and simulated interaction in communications skills training for healthcare professionals: identifying avenues for further development through a scoping review.

Tue, 2019-03-26 07:16
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Using conversation analysis to inform role play and simulated interaction in communications skills training for healthcare professionals: identifying avenues for further development through a scoping review.

BMC Med Educ. 2018 Nov 19;18(1):267

Authors: Pilnick A, Trusson D, Beeke S, O'Brien R, Goldberg S, Harwood RH

Abstract
BACKGROUND: This paper responds to previously published debate in this journal around the use of sociolinguistic methods in communication skills training (CST), which has raised the significant question of how far consultations with simulated patients reflect real clinical encounters. This debate concluded with a suggestion that sociolinguistic methods offer an alternative analytic lens for evaluating CST. We demonstrate here that the utility of sociolinguistic methods in CST is not limited to critique, but also presents an important tool for development and delivery.
METHODS: Following a scoping review of the use of role play and simulated interaction in CST for healthcare professionals, we consider the use of the specific sociolinguistic approach of conversation analysis (CA), which has been applied to the study of health communication in a wide range of settings, as well as to the development of training.
DISCUSSION: Role play and simulated interaction have been criticised by both clinicians and sociolinguists for a lack of authenticity as compared to real life interactions. However they contain a number of aspects which healthcare professionals report finding particularly useful: the need to think on one's feet in real time, as in actual interaction with patients; the ability to receive feedback on the simulation; and the ability to watch and reflect on how others approach the same simulation task in real time. Since sociolinguistic approaches can help to identify inauthenticity in role play and simulation, they can also be used to improve authenticity. Analysis of real-life interactions using sociolinguistic methods, and CA in particular, can identify actual interactional practices that are used by particular patient groups. These practices can then be used to inform the training of actors simulating patients. In addition, the emphasis of CA on talk as joint activity means that proper account can be taken of the way in which simulated interaction is co-constructed between simulator and trainee. We suggest that as well as identifying potential weaknesses in current role play and simulation practice, conversation analysis offers the potential to enhance and develop the authenticity of these training methods.

PMID: 30453956 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Long-term Tai Chi practitioners have superior body stability under dual task condition during stair ascent.

Tue, 2019-03-26 07:16
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Long-term Tai Chi practitioners have superior body stability under dual task condition during stair ascent.

Gait Posture. 2018 10;66:124-129

Authors: Song Q, Li L, Zhang C, Sun W, Mao D

Abstract
BACKGROUND: Stair walking contributed to 26% of self-reported falls and become the leading cause of accidental death for the elderly. The risk of fall increases while performing a cognitive task, like talking and/or reasoning.
RESEARCH QUESTION: Our work aimed to found out whether body stability under physical-cognitive dual task(DT) condition during stair ascent is superior among long-term Tai Chi (TC) practitioners.
METHODS: Fifteen healthy, elderly long-term TC practitioners and fifteen no exercise(NE) practitioners were asked to walking ascent the stairs under single task(ST) and DT conditions in this cross-sectional study. Vicon motion analysis system and Kistler force plates were used synchronously to collect data. Ninety-five% confidence intervals, effect size and statistical power were calculated for each dependent variable to confirm significant difference.
RESULTS: Compared with NE practitioners, TC practitioners had a lower head inclination angle, trunk inclination angle, hip angle, laterial impulse and center of mass-center of pressure(COM-COP)ap/ml separation, a higher ankle angle and loading rate under DT condition; TC practitioners had a lower head inclination angle, trunk inclination angle, higher ankle angle, loading rate and COM-COPml separation under ST condition. Compared with under ST condition, TC practitioners increased in minimum foot clearance, NE practitioners increased in laterial impulse and COM-COPml separation under DT condition. Under DT condition, body stability decreased among NE practitioners, while TC practitioners remained unchanged.
SIGNIFICANCE: At present, there is no drug therapy proven to delay preclinical cognitive deterioration, it would be great helpful for the elderly if TC was been proved to improve their performance under cognitive related conditions.

PMID: 30176380 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Baduanjin exercise for patients with ischemic heart failure on phase-II cardiac rehabilitation (BEAR trial): study protocol for a prospective randomized controlled trial.

Tue, 2019-03-26 07:16
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Baduanjin exercise for patients with ischemic heart failure on phase-II cardiac rehabilitation (BEAR trial): study protocol for a prospective randomized controlled trial.

Trials. 2018 Jul 16;19(1):381

Authors: Yu M, Li S, Li S, Li J, Xu H, Chen K

Abstract
BACKGROUND: Preliminary evidence based on clinical observations suggests that meditative exercise may offer potential benefits for patients with chronic heart failure (CHF). Cardiac rehabilitation (CR), as a class-IA indication in clinical practice guidelines, has been established as an effective strategy to improve quality of life and prognosis of CHF patients. Baduanjin exercise is an important component of traditional Chinese Qigong exercises. However, its benefits for CHF have not been rigorously tested. We sought to investigate whether Baduanjin, as an adjunct to standard care, improves cardiopulmonary function, exercise tolerance, and quality of life in patients with CHF caused by coronary artery disease (CAD).
METHODS/DESIGN: In this randomized controlled trial, 120 patients will be randomly allocated in a 1:1 ratio to Baduanjin exercise combined with conventional exercise of CR (Baduanjin exercise group) or conventional exercise of CR alone (conventional exercise group). In addition to conventional physical activity, participants in the Baduanjin exercise group will participate in a 45-min Baduanjin exercise training session twice a week, for 12 weeks. The primary outcome is walking distance in the 6-min Walk Test (6MWT), and the secondary outcomes are peak oxygen uptake (VO2 peak), ventilatory anerobic threshold (VAT), The minute ventilation to carbon dioxide production relationship (VE/VCO2 slope), left ventricular end-diastolic volume index (LVEDVi), left ventricular ejection fraction (LVEF), quality of life assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), amino-terminal pro-brain natriuretic peptide (NT-proBNP), hs-CRP, heart rate variability (HRV), New York Heart Association (NYHA) classification, and major adverse cardiovascular events.
DISCUSSION: This is the first trial to evaluate the effects of a Baduanjin exercise-based CR program on cardiopulmonary function and exercise tolerance in ischemic CHF patients. If successful, it will prove the value of Baduanjin exercise in improving cardiopulmonary function and exercise tolerance in patients with ischemic heart failure on phase-II CR, and may further develop a Chinese Qigong exercise-based CR framework.
TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03229681 . Registered retrospectively on 23 July 2017.

PMID: 30012193 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Design and Validation of an FPGA-Based Configurable Transcranial Doppler Neurofeedback System for Chronic Pain Patients.

Tue, 2019-03-26 07:16
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Design and Validation of an FPGA-Based Configurable Transcranial Doppler Neurofeedback System for Chronic Pain Patients.

Sensors (Basel). 2018 Jul 14;18(7):

Authors: Rey B, Rodríguez A, Lloréns-Bufort E, Tembl J, Muñoz MÁ, Montoya P, Herrero-Bosch V, Monzo JM

Abstract
Neurofeedback is a self-regulation technique that can be applied to learn to voluntarily control cerebral activity in specific brain regions. In this work, a Transcranial Doppler-based configurable neurofeedback system is proposed and described. The hardware configuration is based on the Red Pitaya board, which gives great flexibility and processing power to the system. The parameter to be trained can be selected between several temporal, spectral, or complexity features from the cerebral blood flow velocity signal in different vessels. As previous studies have found alterations in these parameters in chronic pain patients, the system could be applied to help them to voluntarily control these parameters. Two protocols based on different temporal lengths of the training periods have been proposed and tested with six healthy subjects that were randomly assigned to one of the protocols at the beginning of the procedure. For the purposes of the testing, the trained parameter was the mean cerebral blood flow velocity in the aggregated data from the two anterior cerebral arteries. Results show that, using the proposed neurofeedback system, the two groups of healthy volunteers can learn to self-regulate a parameter from their brain activity in a reduced number of training sessions.

PMID: 30011900 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

The preliminary effects of laughter therapy on loneliness and death anxiety among older adults living in nursing homes: A nonrandomised pilot study.

Tue, 2019-03-26 07:16
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The preliminary effects of laughter therapy on loneliness and death anxiety among older adults living in nursing homes: A nonrandomised pilot study.

Int J Older People Nurs. 2018 Dec;13(4):e12206

Authors: Kuru Alıcı N, Zorba Bahceli P, Emiroğlu ON

Abstract
OBJECTIVES: This study evaluated the preliminary effect of laughter therapy on the level of loneliness and death anxiety of older adults.
METHODS: This was a quasi-experimental study with a nonequivalent control group pretest-posttest design. The study participants were older adults living in two nursing homes set up by foundations located in the capital of Turkey. A total of 50 older adults formed the intervention group (n = 20) and control group (n = 30). The intervention group received laughter therapy twice a week for 5 weeks. The control group received no intervention. Data were collected using a socio-demographic form, the De Jong Gierveld Loneliness Scale (DJGLS) and the Turkish Death Anxiety Scale (TDAS).
RESULTS: After laughter therapy, the DJGLS total and subscale (emotional and social loneliness) scores decreased among older adults in the intervention group (p < 0.005). While there were no significant differences for overall TDAS, death uncertainty and pain subscales scores between the intervention and control group after laughter therapy, there was a significant decrease in TDAS exposure subscale scores of the intervention group (p < 0.005).
DISCUSSION: The results suggest that laughter therapy can be used to decrease levels of loneliness and death anxiety among older adults living in nursing homes.
IMPLICATIONS FOR PRACTICE: Anxiety regarding death and loneliness are important issues that affect quality of life in older adults. This first pilot study demonstrates the beneficial effects of laughter therapy on loneliness and death anxiety in nursing home residents. Nurses can incorporate laughter therapy into routine programmes in nursing homes.

PMID: 30004172 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

A simplified 10-step Tai-chi programme to enable people with dementia to improve their motor performance: a feasibility study.

Tue, 2019-03-26 07:16
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A simplified 10-step Tai-chi programme to enable people with dementia to improve their motor performance: a feasibility study.

Clin Rehabil. 2018 Dec;32(12):1609-1623

Authors: Liu JYW, Kwan RYC, Lai CK, Hill KD

Abstract
OBJECTIVE:: To evaluate the feasibility and preliminary effects of a simplified 10-step Tai-chi programme to improve the motor performance of people with dementia.
DESIGN:: A two-arm, single-blinded cluster randomized controlled trial, registered with ClinicalTrials.gov (NCT03341091).
SETTING:: Community health centres.
PARTICIPANTS:: Twenty-six dyads of people with dementia and their family caregivers were recruited, with mean (SD) ages of 82.2 (7.43) and 51.3 (18.97), respectively.
INTERVENTIONS:: The experimental group underwent a 16 week 10-step simplified Tai-chi training programme, with additional measures to enhance engagement. The control group joined recreational activities organized by the centres.
MAIN OUTCOME MEASURE(S):: The feasibility assessment included recruitment, attrition, adherence to, and engagement in the Tai-chi programme. The preliminary effects were assessed by the participants' performance in mobility tests.
RESULTS:: Preliminary feasibility was established, with an acceptable recruitment rate of 58% (26 out of 45 assessed dyads) and a high attendance rate of 81% (25.88 out of 32 Tai-chi sessions). There was positive engagement in the training sessions, and no adverse incidents. However, five participants withdrew from the Tai-chi group, for a high attrition rate of 38%, and the mean home practice time decreased between weeks 8 and 16. In most of the motor performance tests, a slight but insignificant improvement was observed in the Tai-chi group compared to the control group.
CONCLUSION:: A tailored Tai-chi programme for people with dementia using a dyadic approach has been found to be feasible. However, stronger support must be provided to family caregivers to improve the participants' sustained participation.

PMID: 29969916 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Strategies included in cognitive behavioral therapy programs to treat internalized disorders: a systematic review.

Tue, 2019-03-26 07:16
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Strategies included in cognitive behavioral therapy programs to treat internalized disorders: a systematic review.

Cogn Behav Ther. 2018 07;47(4):263-285

Authors: Fréchette-Simard C, Plante I, Bluteau J

Abstract
This review aimed to identify the strategies used in programs based on cognitive behavioral therapy (CBT) to prevent and treat symptoms of anxiety, depression, and internalized behaviors of children and adolescents. Based on an online search (ERIC, PsycInfo, Virtuose UQAM, and Google Scholar), 61 studies describing different cognitive behavioral programs were selected. Results showed that 40 strategies were implemented in at least one program. However, none of the strategies were systematically present in all programs, and only few were reported in more than 50% of the studies. Cognitive restructuring and problem-solving were the most popular strategies to treat depressive symptoms, whereas anxiety programs also generally included relaxation and exposure. Furthermore, six strategies were identified in a single anxiety program, whereas nine strategies were implemented in only one depression program. These results suggest that in anxiety and depression programs designed for children and adolescents, the label "CBT" encompasses a wide variety of programs with only few similar strategies. Such findings highlight the need to define a common basis for CBT programs, in order to better reflect CBT theory and to identify the effectiveness of the strategies included in these programs.

PMID: 29103355 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

[Effect of biofeedback therapy on metabolic syndrome under different levels of job stress].

Sat, 2019-03-23 07:07
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[Effect of biofeedback therapy on metabolic syndrome under different levels of job stress].

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2018 Oct 20;36(10):728-733

Authors: Wang YS, Liu ZD, Yue S, Wang WZ, Tian FS

Abstract
Objective: To investigate the effect of biofeedback therapy on metabolic syndrome (MS) and the effect of different levels of job stress on the outcome. Methods: The physicians in tertiary hospitals who were diagnosed with MS from January to December, 2016 were divided into biofeedback group and health education group according to different intervention methods, and moderate group, medium group, and high group according to different levels of job stress. A 6-month intervention was implemented from May to October, 2017. A two-way factorial design was used to analyze the main effect of biofeedback on physical and biochemical parameters and the interaction of biofeedback and job stress. Results: After 6 months of intervention, the patients in both the biofeedback group and the moderate group had significantly decreased waist circumference, body mass index, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and levels of triglyceride (TG) , total cholesterol, low-density lipoprotein cholesterol (LDL-C) , and fasting plasma glucose (FPG) and a significantly increased level of high-density lipoprotein cholesterol (HDL-C) (all P<0.05) ; the patients in both the health education group and the moderate group had significantly decreased SBP, DBP, and levels of TG, LDL-C, and FPG (P<0.05) . The factorial analysis of variance showed that there was a synergistic interaction between the intervention method and job stress level in SBP, DBP, TG, HDL-C, LDL-C, and FPG among MS patients (P<0.05) . The high group had significantly more improvements in all indices compared with the medium group and the moderate group (P<0.05) . Conclusion: Biofeedback therapy can effectively improve blood pressure, blood lipids, and blood glucose in MS patients, and is more effective for patients with high job stress level.

PMID: 30541190 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

'It definitely made a difference': A grounded theory study of yoga for pregnancy and women's self-efficacy for labour.

Sat, 2019-03-23 07:07
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'It definitely made a difference': A grounded theory study of yoga for pregnancy and women's self-efficacy for labour.

Midwifery. 2019 Jan;68:74-83

Authors: Campbell V, Nolan M

Abstract
OBJECTIVE: To explore women's experience of attending yoga for pregnancy classes in order to generate a theory about which aspects, if any, are effective in enhancing self-efficacy for labour and birth.
DESIGN: A longitudinal grounded theory study.
METHODS: Semi-structured interviews were undertaken with women before they started yoga for pregnancy classes, after they had attended at least six classes, and finally, postnatally. Interview transcripts were analysed using constructive grounded theory and a self-efficacy framework.
SETTING: Three yoga for pregnancy teachers' classes in England.
PARTICIPANTS: Twenty two women attending yoga for pregnancy classes.
FINDINGS: Analysis of interviews with women at three time points led to a propositional theory that yoga for pregnancy enhances women's self-efficacy for labour by building their confidence and competence through a combination of techniques. These include repeated practice of a variety of pain management strategies, use of affirming language and the telling of positive labour stories, underpinned by yoga practice to lower somatic response to stress.

PMID: 30396001 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Hatha yoga for acute, chronic and/or treatment-resistant mood and anxiety disorders: A systematic review and meta-analysis.

Sat, 2019-03-23 07:07
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Hatha yoga for acute, chronic and/or treatment-resistant mood and anxiety disorders: A systematic review and meta-analysis.

PLoS One. 2018;13(10):e0204925

Authors: Vollbehr NK, Bartels-Velthuis AA, Nauta MH, Castelein S, Steenhuis LA, Hoenders HJR, Ostafin BD

Abstract
BACKGROUND: The aim of this study was to systematically investigate the effectiveness of hatha yoga in treating acute, chronic and/or treatment-resistant mood and anxiety disorders.
METHODS: Medline, Cochrane Library, Current Controlled Trials, Clinical Trials.gov, NHR Centre for Reviews and Dissemination, PsycINFO and CINAHL were searched through June 2018. Randomized controlled trials with patients with mood and anxiety disorders were included. Main outcomes were continuous measures of severity of mood and anxiety symptoms. Cohen's d was calculated as a measure of effect size. Meta-analyses using a random effects model was applied to estimate direct comparisons between yoga and control conditions for depression and anxiety outcomes. Publication bias was visually inspected using funnel plots.
RESULTS: Eighteen studies were found, fourteen in acute patients and four in chronic patients. Most studies were of low quality. For depression outcomes, hatha yoga did not show a significant effect when compared to treatment as usual, an overall effect size of Cohen's d -0.64 (95% CI = -1.41, 0.13) or to all active control groups, Cohen's d -0.13 (95% CI = -0.49, 0.22). A sub-analysis showed that yoga had a significant effect on the reduction of depression compared to psychoeducation control groups, Cohen's d -0.52 (95% CI = -0.96, -0.08) but not to other active control groups, Cohen's d 0.28 (95% CI = -0.07, 0.63) For studies using a follow-up of six months or more, hatha yoga had no effect on the reduction of depression compared to active control groups, Cohen's d -0.14 (95% CI = -0.60, 0.33). Regarding anxiety, hatha yoga had no significant effect when compared to active control groups, Cohen's d -0.09 (95% CI = -0.47, 0.30). The I2 and Q-statistic revealed heterogeneity amongst comparisons. Qualitative analyses suggest some promise of hatha yoga for chronic populations.
CONCLUSIONS: The ability to draw firm conclusions is limited by the notable heterogeneity and low quality of most of the included studies. With this caveat in mind, the results of the current meta-analysis suggest that hatha yoga does not have effects on acute, chronic and/or treatment-resistant mood and anxiety disorders compared to treatment as usual or active control groups. However, when compared to psychoeducation, hatha yoga showed more reductions in depression. It is clear that more high-quality studies are needed to advance the field.

PMID: 30273409 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Effects of heart rate variability biofeedback during exposure to fear-provoking stimuli within spider-fearful individuals: study protocol for a randomized controlled trial.

Sat, 2019-03-23 07:07
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Effects of heart rate variability biofeedback during exposure to fear-provoking stimuli within spider-fearful individuals: study protocol for a randomized controlled trial.

Trials. 2018 Mar 16;19(1):184

Authors: Schäfer SK, Ihmig FR, Lara H KA, Neurohr F, Kiefer S, Staginnus M, Lass-Hennemann J, Michael T

Abstract
BACKGROUND: Specific phobias are among the most common anxiety disorders. Exposure therapy is the treatment of choice for specific phobias. However, not all patients respond equally well to it. Hence, current research focuses on therapeutic add-ons to increase and consolidate the effects of exposure therapy. One potential therapeutic add-on is biofeedback to increase heart rate variability (HRV). A recent meta-analysis shows beneficial effects of HRV biofeedback interventions on stress and anxiety symptoms. Therefore, the purpose of the current trial is to evaluate the effects of HRV biofeedback, which is practiced before and utilized during exposure, in spider-fearful individuals. Further, this trial is the first to differentiate between the effects of a HRV biofeedback intervention and those of a low-load working memory (WM) task.
METHODS: Eighty spider-fearful individuals participate in the study. All participants receive a training session in which they practice two tasks (HRV biofeedback and a motor pseudo-biofeedback task or two motor pseudo-biofeedback tasks). Afterwards, they train both tasks at home for 6 days. One week later, during the exposure session, they watch 16 1-min spider video clips. Participants are divided into four groups: group 1 practices the HRV biofeedback and one motor pseudo-task before exposure and utilizes HRV biofeedback during exposure. Group 2 receives the same training, but continues the pseudo-biofeedback task during exposure. Group 3 practices two pseudo-biofeedback tasks and continues one of them during exposure. Group 4 trains in two pseudo-biofeedback tasks and has no additional task during exposure. The primary outcome is fear of spiders (measured by the Fear of Spiders Questionnaire and the Behavioral Approach Test). Secondary outcomes are physiological measures based on electrodermal activity, electrocardiogram and respiration.
DISCUSSION: This RCT is the first one to investigate the effects of using a pre-trained HRV biofeedback during exposure in spider-fearful individuals. The study critically contrasts the effects of the biofeedback intervention with those of pseudo-tasks, which also require WM capacity, but which do not have a physiological base. If HRV biofeedback is effective in reducing fear of spiders, it would represent an easy-to-use tool to improve exposure-therapy outcomes.
TRIAL REGISTRATION: Deutsches Register Klinischer Studien, DRKS00012278 . Registered on 23 May 2017, amendment on 5 October 2017.

PMID: 29548298 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

The Transcendental Meditation Program's Impact on the Symptoms of Post-traumatic Stress Disorder of Veterans: An Uncontrolled Pilot Study.

Sat, 2019-03-23 07:07
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The Transcendental Meditation Program's Impact on the Symptoms of Post-traumatic Stress Disorder of Veterans: An Uncontrolled Pilot Study.

Mil Med. 2018 01 01;183(1-2):e144-e150

Authors: Herron RE, Rees B

Abstract
Background: Current treatments for post-traumatic stress disorder (PTSD) are only partially effective. This study evaluated whether an extensively researched stress reduction method, the Transcendental Meditation (TM) technique, can reduce the PTSD symptoms of veterans. Previous research suggested that TM practice can decrease veterans' PTSD symptoms.
Methods: A one-group pretest-posttest design was used to evaluate the impact of TM practice on reducing PTSD symptoms. A convenience sample of 89 veterans completed PTSD Checklist-Civilian (PCL-5) questionnaires. Among those, 46 scored above 33, the threshold for provisional diagnosis of PTSD, and were included in this evaluation. The PCL-5 measured PTSD symptoms at baseline and 30 and 90 d after intervention. Regularity of TM practice was recorded. Paired sample t-tests were used to assess within-group changes from baseline to post-intervention periods. Analysis of variance was used to compare full-dose (two 20-min TM sessions per day) and half-dose (one 20-min TM session per day) groups.
Findings: After 1 mo of TM practice, all 46 veterans responded; their PCL-5 average decreased from 51.52 in the pre-intervention period to a post-intervention mean of 23.43, a decline of 28.09 points (-54.5%); standard deviation: 14.57; confidence interval: 23.76-32.41; and effect size: -1.93; p < 0.0001. The median PTSD scores declined from 52.5 to 22.5, a decrease of 30 points (-57%), while 40 veterans (87%) had clinically significant declines (>10 points) in PTSD symptoms, and 37 (80%) dropped below the clinical level (<33). At the 90 d posttest, 31 of the 46 responded and three more dropped below the 33 threshold. Intent-to-treat analyses revealed clinically and statistically significant effects. A dose-response effect suggested a causal relationship. The full-dose group exhibited larger mean declines in PTSD symptoms than the half-dose group. Averages of the 46 veterans' responses to 20 PCL-5 questions exhibited significant (p < 0.0001) declines from the pre-intervention period to the 30-d post-intervention assessment.
Discussion: Results indicated that TM practice reduced PTSD symptoms without re-experiencing trauma. Because of the magnitude of these results and dose-response effect, regression to the mean, spontaneous remission of symptoms, and placebo effects are unlikely explanations for the results. Major limitations were absence of random assignment and lack of a control group. Participants chose to start and continue TM practice and to complete PCL-5 questionnaires. Those who self-selected to enter this study may not be representative of all veterans who have PTSD. Those who did not complete follow-up questionnaires at 90 d may or may not have had the same results as those who responded. The design and sampling method affect the generalizability of the results to wider populations. When taking into account these results and all previous research on the TM technique in reducing psychological and physiological stress, the convergence of evidence suggests that TM practice may offer a promising adjunct or alternative method for treating PTSD. Because of the widely recognized need to identify effective new approaches for treating PTSD, randomized research with control groups is warranted to further investigate the effectiveness of TM practice as a treatment for PTSD.

PMID: 29401353 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

[Respiratory Rehabilitation to Reduce Respiratory Complications after Cardiovascular Surgery].

Sat, 2019-03-23 07:07
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[Respiratory Rehabilitation to Reduce Respiratory Complications after Cardiovascular Surgery].

Kyobu Geka. 2017 07;70(8):590-595

Authors: Suzuki Y, Saiki Y

Abstract
The number of cardiovascular surgical operations has been increasing, accompanied by an increase in the number of patients with an aging patient and various comorbidities. For this reason, the risk of respiratory complications after cardiovascular surgery is high, and ingenuity to alleviate this is necessary. We evaluated preoperative respiratory function and examined whether there is a difference in the onset of postoperative respiratory complications with or without respiratory rehabilitation from preoperative. As a result, the incidence of respiratory complications was significantly reduced in the group subjected to preoperative respiratory rehabilitation. Also, the intensive care unit stay was significantly shortened. From this, it is important to perform respiratory rehabilitation from preoperative time. And as a breathing exercise method, active cycle breathing technique is safe and highly effective.

PMID: 28790272 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

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