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NCBI: db=pubmed; Term=mind-body therapies[MeSH Terms]
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The influence of misinformation manipulations on evaluative conditioning.

Thu, 2019-05-09 08:29
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The influence of misinformation manipulations on evaluative conditioning.

Acta Psychol (Amst). 2019 Mar;194:28-36

Authors: Benedict T, Richter J, Gast A

Abstract
We tested the influence of misinformation on evaluative conditioning (EC) by giving false information about the contingencies between CS and US stimuli after a conditioning procedure. This was done by asking participants questions about the USs while inaccurately suggesting that some CSs had been paired with a US that had the opposite valence than the US it had actually been paired with. For CS-US pairs from other conditions, accurate suggestions or no suggestions at all were given to participants. This manipulation significantly moderated EC effects. For pairs that were combined with inaccurate information we found a reversed EC effect, while we found a standard EC effect for both pairs combined with no suggestions and pairs combined with accurate suggestions. Additional analyses showed that the misinformation manipulation also moderated memory for the pairs. These results show that misinformation manipulations cannot only influence explicit memory but also attitudes. Furthermore, and in line with some theories of EC, they support the relevance of explicit memory for EC effects.

PMID: 30731394 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Discarding personal possessions increases psychophysiological activation in patients with hoarding disorder.

Thu, 2019-05-09 08:29
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Discarding personal possessions increases psychophysiological activation in patients with hoarding disorder.

Psychiatry Res. 2019 02;272:499-506

Authors: Levy HC, Nett A, Tolin DF

Abstract
Difficulty discarding is the core behavioral symptom of hoarding disorder (HD). Patients with HD report greater subjective distress when discarding their own possessions as compared to others' possessions. To date, no prior studies have examined psychophysiological activation, an objective measure of anxious arousal, during discarding among individuals with HD. The current study assessed psychophysiological responses during a baseline resting period and two discarding tasks, one involving personal possessions and the other involving matched control ("experimenter-owned") items in 52 patients with a primary diagnosis of HD. Results showed that, compared to discarding control items, discarding personal possessions increased skin conductance and heart rate and decreased end tidal carbon dioxide. There were no differences in heart rate variability, respiratory sinus arrhythmia, and respiration rate between the two discarding tasks. Despite the fact that discarding increased psychophysiological arousal, self-reported HD symptoms (including difficulty discarding) failed to predict psychophysiological responses during the discarding tasks. The findings suggest that there may be discordance between objective and subjective measures of hoarding-related distress, and are discussed in terms of incorporating psychophysiological measures into the assessment and treatment of HD.

PMID: 30616116 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Divergent effects of brief contemplative practices in response to an acute stressor: A randomized controlled trial of brief breath awareness, loving-kindness, gratitude or an attention control practice.

Thu, 2019-05-09 08:29
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Divergent effects of brief contemplative practices in response to an acute stressor: A randomized controlled trial of brief breath awareness, loving-kindness, gratitude or an attention control practice.

PLoS One. 2018;13(12):e0207765

Authors: Hirshberg MJ, Goldberg SB, Schaefer SM, Flook L, Findley D, Davidson RJ

Abstract
Mindfulness practices are increasingly being utilized as a method for cultivating well-being. The term mindfulness is often used as an umbrella for a variety of different practices and many mindfulness-based interventions (MBIs) contain multiple styles of practice. Despite the diversity of practices within MBIs, few studies have investigated whether constituent practices produce specific effects. We randomized 156 undergraduates to one of four brief practices: breath awareness, loving-kindness, gratitude, or to an attention control condition. We assessed practice effects on affect following brief training, and effects on affect and behavior after provocation with a stressor (i.e., Cold pressor test). Results indicate that gratitude training significantly improved positive affect compared to breath awareness (d = 0.58) and loving-kindness led to significantly greater reductions in implicit negative affect compared to the control condition (d = 0.59) immediately after brief practice. In spite of gains in positive affect, the gratitude group demonstrated increased reactivity to the stressor, reporting the CPT as significantly more aversive than the control condition (d = 0.46) and showing significantly greater increases in negative affect compared to the breath awareness, loving-kindness, and control groups (ds = 0.55, 0.60, 0.65, respectively). Greater gains in implicit positive affect following gratitude training predicted decreased post-stressor likability ratings of novel neutral faces compared to breath awareness, loving-kindness, and control groups (ds = - 0.39, -0.40, -0.33, respectively) as well. Moreover, the gratitude group was significantly less likely to donate time than the loving-kindness group in an ecologically valid opportunity to provide unrewarded support. These data suggest that different styles of contemplative practice may produce different effects in the context of brief, introductory practice and these differences may be heightened by stress. Implications for the study of contemplative practices are discussed.

PMID: 30540772 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Are there adverse effects associated with mindfulness?

Thu, 2019-05-09 08:29
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Are there adverse effects associated with mindfulness?

Aust N Z J Psychiatry. 2017 Oct;51(10):977-979

Authors: Van Gordon W, Shonin E, Garcia-Campayo J

PMID: 28669200 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Efficacy of rhythmical massage in comparison to heart rate variability biofeedback in patients with dysmenorrhea-A randomized, controlled trial.

Wed, 2019-05-08 08:27
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Efficacy of rhythmical massage in comparison to heart rate variability biofeedback in patients with dysmenorrhea-A randomized, controlled trial.

Complement Ther Med. 2019 Feb;42:438-444

Authors: Vagedes J, Fazeli A, Boening A, Helmert E, Berger B, Martin D

Abstract
BACKGROUND: 20-90% of all women suffer from dysmenorrhea. Standard therapy of primary dysmenorrhea (PD) are NSAIDs and oral contraceptives, effective but not without possible side effects.
OBJECTIVE: To examine the efficacy of rhythmical massage (Anthroposophic Medicine) and heart rate variability biofeedback compared to usual care (control group) on pain intensity in women with primary dysmenorrhea.
METHODS: This was a three-arm randomized controlled study. Both interventions (rhythmical massage once a week or HRV biofeedback 15 min daily) were carried out over a period of three months. The third group (control) applied usual care. The primary outcome were between-group differences in mean pain intensity (detected by a Numeric Rating Scale, NRS) during menstruation after three months (post-assessment, t2). Secondary outcomes were the use of analgesics, quality of life (SF-12) and heart rate variability.
RESULTS: The study involved 60 women, mean age 29.7 years, SD 8.0 (n = 23 rhythmical massage, n = 20 biofeedback, n = 17 control). For the primary outcome there was a significant difference between the groups after three months (p = .005). Bonferroni adjusted post-hoc tests revealed a significant difference between rhythmical massage and control group (mean difference: -1.61; 95 CI: -2.77/-0.44; p = .004; ES: -0.80). No significant differences were found between rhythmical massage and biofeedback (mean difference: -0.71; 95 CI: -1.82/ 0.40; p = .361; ES: -0.34) and between biofeedback and control group (mean difference: -0.90; 95 CI: -2.10/-0.30; p = .211; ES: -0.51). For the secondary outcomes no significant differences were found between the groups at t2. The drop-out rate was higher in the biofeedback group (n = 6) than in the massage (n = 2) or the control group (n = 4).
CONCLUSION: Preliminary evidence suggests that rhythmical massage might improve pain intensity after 12 weeks compared to usual care.

PMID: 30670280 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

A randomized placebo-controlled study of aromatherapy for the treatment of postoperative nausea and vomiting.

Wed, 2019-05-08 08:27
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A randomized placebo-controlled study of aromatherapy for the treatment of postoperative nausea and vomiting.

Complement Ther Med. 2019 Feb;42:417-421

Authors: Karaman S, Karaman T, Tapar H, Dogru S, Suren M

Abstract
OBJECTIVE: The purpose of this study was to compare the aromatherapy treatment effects on PONV patients using ginger, lavender and rose oils and a placebo.
DESIGN: A randomized 4-armed placebo controlled study.
SETTING: Gaziosmanpasa University, School of Medicine, Health Research and Application Center.
INTERVENTION: The total of 184 patients were randomized into 4 groups: Aromatherapy with lavender essential oil (Lavender group), with rose essential oil (Rose group), with ginger essential oil (Ginger group) or with pure water (Placebo group).
MAIN OUTCOME MEASURES: Postoperative nausea (0-3 Likert type; 0=no nausea, 1=some, 2=a lot, 3=severe) and vomiting scores (0-3 Likert type; 0=no vomiting, 1 = 1 time, 2 = 2 or 3 time, 3 = 4 times and up) and antiemetic medication requirement.
RESULTS: The nausea scores at 15 min were statistically significantly different between the groups (p = 0.00). The postoperative nausea scores improved in 20 (43.5%) subjects in the placebo group, 38 (82.6%) subjects in the lavender group, 22 (47.8%) subjects in the rose group and 30 (65.2%) subjects in the ginger group (p = 0.00). There were statistically significant differences between the groups with regard to the vomiting and antiemetic drug requirements (p = 0.00).
CONCLUSION: The aromatherapy can be used as an alternative or complementary method for managing PONV. Specifically, the ginger and lavender essential oils were superior to the rose oil and pure water for the aromatherapy treatments. However, further studies with larger sample sizes are necessary to confirm these results.

PMID: 30670276 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Psychophysical and psychophysiological effects of heat stimulation by electric moxibustion.

Wed, 2019-05-08 08:27
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Psychophysical and psychophysiological effects of heat stimulation by electric moxibustion.

Complement Ther Med. 2019 Feb;42:400-405

Authors: Kang B, Jung WM, Lee H, Chae Y

Abstract
OBJECTIVES: Traditional moxibustion might be not safe due to the excessive heat stimulation or toxic chemical components involved. Electric moxibustion (EM), which has been recently developed as an alternative, offers adjustable and constant heat stimulation. This study aimed to investigate the psychophysical and psychophysiological responses to EM heat stimulation.
METHODS: Twenty-seven healthy volunteers received two different levels of heat stimulation using EM. High-temperature (HT) and medium-temperature (MT) heat stimulations were randomly delivered at the TE5 acupoint on the left or right arm. Participants rated the intensity and the spatial information of the heat sensations immediately after each EM stimulation. Local blood flow around the acupoint was measured with Laser Doppler perfusion imaging before and after heat stimulation.
RESULTS: Both HT-EM and MT-EM induced considerable heat sensations and enhanced local blood flow around the acupoints. HT-EM resulted in greater heat sensation compared to MT-EM. HT-EM induced a higher increase in local blood flow around the stimulation site compared to MT-EM. No remarkable adverse effects were noted.
CONCLUSION: Two different levels of EM heat stimulation induced two different levels of heat sensations and enhanced local blood flow. This preliminary study suggests that the newly developed EM can be further applied to examine the effectiveness of moxibustion in clinical trials.

PMID: 30670273 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Predictors of and barriers to adherence in a 16-week randomised controlled trial of Bikram yoga in stressed and sedentary adults.

Wed, 2019-05-08 08:27
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Predictors of and barriers to adherence in a 16-week randomised controlled trial of Bikram yoga in stressed and sedentary adults.

Complement Ther Med. 2019 Feb;42:374-380

Authors: Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS

Abstract
BACKGROUND: Bikram yoga may enhance health outcomes in healthy adults and those at risk for chronic disease, however, challenges remain in achieving optimal adherence to this practice. This study investigated factors influencing adherence to a 16-week Bikram yoga intervention in stressed and sedentary adults.
METHODS: Experimental group participants (n = 29) were instructed to attend 3-5 Bikram yoga classes weekly for 16 weeks. Baseline demographics, behaviours and health measures were investigated as predictors of adherence. Barriers were assessed via documentation of adverse events, and exit survey responses.
RESULTS: Participants (38.2 ± 10.1 years) were predominantly overweight-obese (83%), female (79%), and attended 27 ± 18 classes. Higher adherence was associated with older age (p = 0.094), less pain (p = 0.011), fewer physical limitations (p = 0.011), poorer blood lipid profile, and higher heart rate variability (HRV; total power, (p = 0.097)). In multi-variable analysis, three variables: age (β = 0.492, p = 0.006), HRV (β = 0.413, p = 0.021) and pain (β = 0.329, p = 0.048) remained predictors of adherence. Difficulty committing to the trial, lack of enjoyment and adverse events were barriers to adherence.
CONCLUSIONS: These findings should be considered in the development of future Bikram yoga trials to facilitate higher levels of adherence, which may enhance health outcomes and inform community practice. Future trials should investigate and address additional barriers and facilitators of Bikram yoga practice.

PMID: 30670270 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

A randomised controlled trial of Lavender (Lavandula Angustifolia) and Lemon Balm (Melissa Officinalis) essential oils for the treatment of agitated behaviour in older people with and without dementia.

Wed, 2019-05-08 08:27
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A randomised controlled trial of Lavender (Lavandula Angustifolia) and Lemon Balm (Melissa Officinalis) essential oils for the treatment of agitated behaviour in older people with and without dementia.

Complement Ther Med. 2019 Feb;42:366-373

Authors: Watson K, Hatcher D, Good A

Abstract
OBJECTIVE: Lavender and Lemon Balm essential oils are popular in the management of older person agitation due to their ease of application, minimal side effects and low interaction with concurrent medications. This study addressed limitations in the literature to evaluate and compare effectiveness of Lavender and Lemon Balm essential oils on the agitated behaviour of older people with and without dementia living in residential aged care facilities [RACFs].
METHODS: Forty-nine nursing home residents with dementia (n=39) and without dementia (n=10) exhibiting agitation participated in this study. Participants were randomised to a counterbalanced, repeated measures design experiment that tests the treatments Lavender, Lemon Balm, and Placebo (Sunflower oil). Treatments were administered once daily for two-weeks followed by a two-week washout period before commencing the subsequent treatment. All participants trialed all three treatments over a 10-week period. Data were collected on the Neuropsychiatric Inventory (NPI) and Cohen-Mansfield Agitation Inventory (CMAI).
RESULTS: A significant difference was shown when essential oils effect were compared between the cognitive groups. Post hoc analysis reports Lemon Balm more effective in reducing NPI agitation (p = .04) and CMAI physical non-aggressive behaviour (PNAB) (p = .02) in residents without dementia. Lemon Balm less effective in reducing NPI irritability (p = 0.01) and Lavender more effective in reducing CMAI PNAB (p = 0.04) in dementia.
CONCLUSION: The findings support an opposing effect of Lemon Balm and Lavender in reducing agitated behaviour between the participant cognitive groups. There was no reduction in agitation with treatments when compared to placebo independent of cognitive groups.

PMID: 30670268 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Should acupuncture, biofeedback, massage, Qi gong, relaxation therapy, device-guided breathing, yoga and tai chi be used to reduce blood pressure?: Recommendations based on high-quality systematic reviews.

Wed, 2019-05-08 08:27
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Should acupuncture, biofeedback, massage, Qi gong, relaxation therapy, device-guided breathing, yoga and tai chi be used to reduce blood pressure?: Recommendations based on high-quality systematic reviews.

Complement Ther Med. 2019 Feb;42:322-331

Authors: Niu JF, Zhao XF, Hu HT, Wang JJ, Liu YL, Lu DH

Abstract
BACKGROUND: This review aims to rate the quality of evidence and the strength of recommendations in high-quality systematic reviews of non-drug therapies. Hypertensive patients who are resistant or non-adherent to antihypertensive drugs may be easier to manage if they choose alternative non-drug therapies for hypertension, based on this review.
METHODS: P: Adults (>18 years), except pregnant women, with essential hypertension. I: Cupping, moxibustion, acupuncture, acupoint stimulation, yoga, meditation, tai chi, Qi gong, Chinese massage, massage, spinal manipulation, biofeedback, device-guided breathing therapy, aromatherapy, music therapy, and relaxation approaches. C: 1. No treatment. 2. Sham therapy. 3. Conventional treatment, including antihypertensive drugs and lifestyle modification (e.g., exercise). O: 1. Change in the incidence of cardiovascular death. 2. Change in the incidence of myocardial infarction. 3. Change in the incidence of stroke. 4. Change in blood pressure (BP). 5. Efficacy rate of BP lowering. 6. Adverse effects (review specific). S: Systematic reviews of randomized controlled trials, including meta-analyses and assessments of the methodological quality/risk of bias.
INFORMATION SOURCES: Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane library, PubMed, Web of Science, China National Knowledge Infrastructure, and Chinese Scientific Journal Database were searched. The bibliographies of the included articles were also searched for relevant systematic reviews. GRADE criteria were used to rate the quality of evidence in systematic reviews considering 6 factors, including risk of bias.
RESULTS: This review ultimately included 13 systematic reviews of 14 non-drug therapies (acupuncture, wet cupping, Baduanjin, blood letting, auricular acupuncture, music, massage, Qi gong, moxibustion, relaxation therapies, biofeedback, device-guided breathing, yoga and tai chi) based on the inclusion criteria. The quality of evidence was generally low, and weak recommendations were given for most therapies except massage and acupuncture plus antihypertensive drug. Based on the analyzed evidence, massage and acupuncture plus antihypertensive drug could benefit people who want to lower their BP and do not have contraindications for massage and acupuncture plus antihypertensive drug.
DISCUSSION/STRENGTH: The GRADE approach makes this review a unique reference for people who are considering the grade of quality of evidence in systematic reviews, the balance of desirable and undesirable consequences and the strength of recommendations to decide which intervention should be used to reduce BP.
LIMITATIONS: Many non-drug therapies were excluded due to the low methodological quality of their systematic reviews, and only 14 therapies were evaluated in this review. As no patient-important outcomes were reviewed, surrogate outcomes were used to rate the strength of recommendations. This approach may cause a decrease in evidence quality according to GRADE, but we argue that this is appropriate in the context of this review.

PMID: 30670261 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Guided meditation as an adjunct to enhance postoperative recovery after cardiac surgery: study protocol for a prospective randomized controlled feasibility trial.

Wed, 2019-05-08 08:27
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Guided meditation as an adjunct to enhance postoperative recovery after cardiac surgery: study protocol for a prospective randomized controlled feasibility trial.

Trials. 2019 Jan 11;20(1):39

Authors: Packiasabapathy S, Susheela AT, Mueller A, Patxot M, Gasangwa DV, O'Gara B, Shaefi S, Marcantonio ER, Yeh GY, Subramaniam B

Abstract
BACKGROUND: Cardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept that includes preoperative interventions to potentially reduce postoperative complications. While most current prehabilitation interventions focus on optimizing physical health, mind-body interventions are an area of growing interest. Preoperative mind-body interventions such as Isha Kriya meditation, may hold significant potential to improve postsurgical outcomes.
METHODS: This is a prospective, randomized controlled feasibility trial. A total of 40 adult patients undergoing cardiac surgery will be randomized to one of three study groups. Participants randomized to either of the two intervention groups will receive meditative intervention: (1) commencing two weeks before surgery; or (2) commencing only from the day after surgery. Meditative intervention will last for four weeks after the surgery in these groups. Participants in the third control group will receive the current standard of care with no meditative intervention. All participants will undergo assessments using neurocognitive, sleep, depression, anxiety, and pain questionnaires at various time points in the perioperative period. Blood samples will be collected at baseline, preoperatively, and postoperatively to assess for inflammatory biomarkers. The primary aim of this trial is to assess the feasibility of implementing a perioperative meditative intervention program. Other objectives include studying the effect of meditation on postoperative pain, sleep, psychological wellbeing, cognitive function, and delirium. These will be used to calculate effect size to design future studies.
DISCUSSION: This study serves as the first step towards understanding the feasibility of implementing a mind-body intervention as a prehabilitative intervention to improve postoperative surgical outcomes after cardiac surgery.
TRIAL REGISTRATION: Clinicaltrials.gov, NCT03198039 . Registered on 23 June 2017.

PMID: 30635064 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Effects of home-based prescribed pulmonary exercise by patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial.

Wed, 2019-05-08 08:27
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Effects of home-based prescribed pulmonary exercise by patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial.

Trials. 2019 Jan 11;20(1):41

Authors: Liu X, Li P, Xiao L, Lu Y, Li N, Wang Z, Duan H, Li J, Wu W

Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) not only affects pulmonary function but also leads to skeletal muscle dysfunction. The various characteristics of different forms of traditional Chinese exercise lead to inconsistent clinical effects in COPD patients. Hence, the present study carefully combined and rearranged liuzijue, wuqinxi, baduanjin, and yijinjing into a pulmonary exercise program targeting COPD patients.
METHODS/DESIGN: This study is a single-blind, randomized controlled trial. A random number table will be generated by an independent person. Each number will be placed in a sealed opaque envelop to blind assignment. All outcome assessors will be blinded to group assignment. COPD patients between 40 and 80 years of age, with stable medical treatment and no regular participation in regular exercise in the last 6 months will be included. All participants will be recruited from the Respiratory Medicine Department of Yue-Yang Integrative Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. All participants will continue to follow their medical treatment. They will be randomly assigned to one of four groups in a 1:1:1:1 ratio: (1) usual care (control group, CG), (2) pulmonary exercise group (PG), (3) resistance exercise group (RG), or (4) combined pulmonary exercise and resistance exercise group (PRG). CG participants will receive medical treatment only. PG participants will perform 60 min of exercise twice a day 7 days a week for 3 months, with 1 day's exercise per week at hospital under guidance and supervision. RG participants will perform 60 min of resistance exercise once a day, three times a week for 3 months, with 1 day's exercise per week at hospital under guidance and supervision. PRG participants will perform 60 min of prescribed pulmonary exercise combined with resistance exercise for 3 months. The outcomes include the isokinetic strength of peripheral skeletal muscle, surface electromyography, 6-min walking distance, 30-s arm curl test, pulmonary function, respiratory muscle strength, dyspnea, body composition, physical activity, quality of life, and Chronic Disease Self-Efficacy Scale.
DISCUSSION: The results of this study will compensate for the current inadequate understanding of prescribed pulmonary exercise and may provide a new, simple, convenient, and effective home-based exercise intervention for COPD patients.
TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-1800017405 . Registered on 28 July 2018.

PMID: 30635038 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Safety and efficacy of short- and long-term inspiratory muscle training in late-onset Pompe disease (LOPD): a pilot study.

Wed, 2019-05-08 08:27
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Safety and efficacy of short- and long-term inspiratory muscle training in late-onset Pompe disease (LOPD): a pilot study.

J Neurol. 2019 Jan;266(1):133-147

Authors: Wenninger S, Greckl E, Babačić H, Stahl K, Schoser B

Abstract
BACKGROUND: In patients with late-onset Pompe disease, progressive respiratory muscle weakness with predominantly diaphragmatic involvement is a frequent finding at later stages of the disease. Respiratory muscle training (RMT) is an established therapy option for patients with several neuromuscular disorders including Duchenne muscular dystrophy. Forced voluntary muscle contractions of inspiration and/or expiration muscles enhance ventilation by increasing respiratory coordination, endurance, and strength. Efficacy of RMT in LOPD is rarely examined, and the clinical studies performed are difficult to compare because of different training programs and protocols. This impedes a useful statement and recommendation about the safety and efficacy of respiratory muscle training.
METHODS: We conducted a monocentric unblinded single-arm pilot study in patients with LOPD to evaluate the safety and efficacy of inspiratory muscle training (IMT). The primary objective was to determine the efficacy of a 6-week repetitive IMT with a gradual increase of inspiratory resistance, measured by MIP (maximum inspiratory pressure) in the upright position. For statistical analysis, we used an A-B-C single subject design. The 6-week training-period A was followed by a 6-week non-training period B and an optional training period of 40 weeks in period C. The total study duration for the periods A, B and C was 52 weeks. Throughout the study, spirometry assessments (FCV, FEV1) and measurements of respiratory strength (MIP, MEP) were performed at defined time points, as well as capillary oximetry and capnometry, motor function test and patient's questionnaires for quality of life and dyspnea, measured by St. George's Respiratory Questionnaire (SGRQ) and MMRC-Dyspnea scale. For the cross-sectional comparison, a paired two-sided t test, and for the longitudinal comparison, a two-sample, two-sided t test were used. When data were not normally distributed, a Wilcoxon-Mann-Whitney test was added. Finally, the annual decline in FVC and FEV1 before and after IMT was compared.
FINDINGS: 11 subjects were included in this pilot study. Overall, IMT was well tolerated. In four subjects, a total of six adverse events related to the study procedures were noticed. Training compliance was excellent in the first weeks of training, but declined continuously in the extension period. There was a significant increase in our primary outcome measure MIP within the 6-week period of frequent IMT with a mean of 15.7% (p =0.024; d =0.402). A significant increase was also seen after week 52 by a mean of + 26.4% (mean + 13.4 cmH2O, p =0.001, d =0.636). In the 6-week non-training interim-period (period B), the values remained stable, and there was no clinically meaningful decline in secondary outcome measures. The increase in MIP did not have any effect on secondary outcome measures like spirometry tests (FVC, FEV1), capillary blood gas analysis, motor function tests, patient's perceived quality of life or any significant change in dyspnea score.
CONCLUSIONS: Frequent IMT improves MIP and thereby stabilizes and decelerates the decline of the diaphragm strength. The gradual increase of inspiratory resistance is well tolerated without any increase of side effects, as long as IMT is supervised and resistance is individually adjusted to the patient's perceived grade of exhaustion. Although we could not detect a significant impact on secondary outcome measures, IMT should be offered to all LOPD patients, especially to those who demonstrate a progressive decline in respiratory muscle function or are unable to receive ERT.

PMID: 30430231 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Chronic Prostatitis and/or Chronic Pelvic Pain as a Psychoneuromuscular Disorder-A Meta-analysis.

Wed, 2019-05-08 08:27
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Chronic Prostatitis and/or Chronic Pelvic Pain as a Psychoneuromuscular Disorder-A Meta-analysis.

Urology. 2018 10;120:23-29

Authors: Anderson RU, Wise D, Nathanson BH

Abstract
OBJECTIVE: To evaluate effectiveness of physical therapy, biofeedback, and/or cognitive behavioral therapy for chronic prostatitis/chronic pelvic pain syndrome (CP and/or CPPS). This symptom complex has resisted resolution from conventional urologic treatment of the prostate, which includes antibiotics, alpha-blockers, and analgesics. Beginning in 1995, a new paradigm was introduced viewing CP and/or CPPS as a psychoneuromuscular disorder driven by protective pelvic floor guarding and psychosocial stress.
METHODS: A literature search (PubMed, Google Scholar, and the Cochran Library) was conducted from inception through December 2017 using key words related to CP and/or CPPS (eg, prostatitis and pelvic pain) with physical therapy (eg, myofascial trigger point release) and/or biofeedback or cognitive behavioral treatment. Studies were required to include pre- and post-treatment with the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI) scores.
RESULTS: Eight studies inclusive of 280 patients met primary inclusion criteria. Study sample sizes ranged from 8 to 116 men (mean = 35); treatment duration ranged from 8 to 26 weeks (mean = 14). Pretreatment mean CPSI scores ranged from 21.7 to 33.5. The nonstandardized weighted mean reduction of CPSI score from baseline was 8.8 points; 95% confidence interval (7.5, 11.1); P <.001. The I2 statistic = 18.5% indicating little heterogeneity between studies. A sensitivity analysis including an additional multimodal intervention study of with 100 patients produced similar findings.
CONCLUSION: Conventional medical treatment often fails to resolve CP and/or CPPS. A 6-point reduction in CPSI score is considered a clinically meaningful improvement of symptoms. This meta-analysis shows that treating CP and/or CPPS as a psychoneuromuscular disorder can significantly exceed this clinical threshold.

PMID: 30056195 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Mindfulness in Residency: A Survey of Residents' Perceptions on the Utility and Efficacy of Mindfulness Meditation as a Stress-Reduction Tool.

Tue, 2019-05-07 08:24
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Mindfulness in Residency: A Survey of Residents' Perceptions on the Utility and Efficacy of Mindfulness Meditation as a Stress-Reduction Tool.

R I Med J (2013). 2019 Apr 01;102(3):29-33

Authors: Thorndike TDS, Monteiro JF, McGarry K

Abstract
PURPOSE: Mindfulness meditation can help reduce burnout in medical students and attendings, yet has not demonstrated efficacy in residents. The authors surveyed internal medicine residents to determine their prior experience with and interest in mindfulness meditation.
METHODS: An anonymous survey was given to 130 internal medicine residents at the Alpert Medical School at Brown University during the 2016-2017 academic year. The survey assessed prior experience, perceived efficacy, and interest in learning about mindfulness meditation.
RESULTS: Of 104 completed surveys, 61% reported prior use of mindfulness and 25% reported current weekly or greater use. Eighty-seven percent of residents believed mindfulness meditation would help with stress reduction, and 87% were interested in receiving mindfulness training.
CONCLUSIONS: Though a minority of residents currently practice mindfulness meditation, most believe it is an effective stress reduction tool and are interested in receiving further training. These results support the inclusion of mindfulness training within residency wellness initiatives.

PMID: 30943669 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

A comprehensive review of psychophysiological applications for ecological momentary assessment in psychiatric populations.

Tue, 2019-05-07 08:24
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A comprehensive review of psychophysiological applications for ecological momentary assessment in psychiatric populations.

Psychol Assess. 2019 Mar;31(3):304-317

Authors: Raugh IM, Chapman HC, Bartolomeo LA, Gonzalez C, Strauss GP

Abstract
Psychophysiological assessment is a core method used in psychopathology research that has led to important insights in relation to the etiology and maintenance of many disorders. However, laboratory psychophysiology has limited ecological validity. This limitation has resulted in the field moving toward ambulatory recordings of psychophysiology paired with ecological momentary assessment (EMA). This review uses the results of a comprehensive review of EMA psychophysiology studies to discuss applications, advantages, limitations, and future use of this methodology, including electrocardiography, blood pressure, electroencephalography, and more. Mobile psychophysiology has several advantages, including ecological validity, temporal precision, and concurrent evaluation of internally and externally generated contexts that influence physiological response. However, it is limited by the difficulty of conducting such studies and reduced experimental control. Future research using EMA psychophysiology should aim to record over longer periods, better integrate with everyday life, determine the utility of ecological momentary interventions based on psychophysiology, create guidelines for standardization, and aim to establish reliability and validity. EMA psychophysiology is a promising direction for the field and provides novel avenues for research and treatment of psychopathology, although methodological shortcomings must be addressed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

PMID: 30802116 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Impact of Yoga on Inflammatory Biomarkers: A Systematic Review.

Tue, 2019-05-07 08:24
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Impact of Yoga on Inflammatory Biomarkers: A Systematic Review.

Biol Res Nurs. 2019 03;21(2):198-209

Authors: Djalilova DM, Schulz PS, Berger AM, Case AJ, Kupzyk KA, Ross AC

Abstract
BACKGROUND: Many chronic conditions, including heart disease, cancer, and rheumatoid arthritis, are associated with underlying chronic inflammatory processes. Literature reviews have analyzed a variety of integrative therapies and their relationships with chronic inflammation. This systematic review is unique in reporting solely on yoga's relationship with inflammation. Its purpose was to synthesize current literature examining the impact of yoga interventions on inflammatory biomarkers in adults with chronic inflammatory-related disorders.
METHOD: Searches of several electronic databases were conducted. Inclusion criteria were (a) English language, (b) sample age >18 years old, (c) yoga interventions involving postures with or without yoga breathing and/or meditation, and (d) measured inflammatory biomarkers.
RESULTS: The final review included 15 primary studies. Of these, seven were rated as excellent and eight as average or fair. There was considerable variability in yoga types, components, frequency, session length, intervention duration, and intensity. The most common biomarkers measured were interleukin-6 ( n = 11), C-reactive protein ( n = 10), and tumor necrosis factor ( n = 8). Most studies reported positive effects on inflammatory biomarkers ( n = 11) from baseline to post yoga intervention. Analysis of the dose showed higher total dose (>1,000 min) resulted in greater improvements in inflammation.
CONCLUSION: This review suggests that yoga can be a viable intervention to reduce inflammation across a multitude of chronic conditions. Future studies with detailed descriptions of yoga interventions, measurement of new and well-established inflammatory biomarkers, and larger sample sizes are warranted to advance the science and corroborate results.

PMID: 30572710 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Altering alpha-frequency brain oscillations with rapid analog feedback-driven neurostimulation.

Tue, 2019-05-07 08:24
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Altering alpha-frequency brain oscillations with rapid analog feedback-driven neurostimulation.

PLoS One. 2018;13(12):e0207781

Authors: Widge AS, Boggess M, Rockhill AP, Mullen A, Sheopory S, Loonis R, Freeman DK, Miller EK

Abstract
Oscillations of the brain's local field potential (LFP) may coordinate neural ensembles and brain networks. It has been difficult to causally test this model or to translate its implications into treatments, because there are few reliable ways to alter LFP oscillations. We developed a closed-loop analog circuit to enhance brain oscillations by feeding them back into cortex through phase-locked transcranial electrical stimulation. We tested the system in a rhesus macaque with chronically implanted electrode arrays, targeting 8-15 Hz (alpha) oscillations. Ten seconds of stimulation increased alpha oscillatory power for up to 1 second after stimulation offset. In contrast, open-loop stimulation decreased alpha power. There was no effect in the neighboring 15-30 Hz (beta) LFP rhythm or on a neighboring array that did not participate in closed-loop feedback. Analog closed-loop neurostimulation might thus be a useful strategy for altering brain oscillations, both for basic research and the treatment of neuro-psychiatric disease.

PMID: 30517149 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Experiences of hatha yogic exercises among patients with obstructive pulmonary diseases: A qualitative study.

Tue, 2019-05-07 08:24
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Experiences of hatha yogic exercises among patients with obstructive pulmonary diseases: A qualitative study.

J Bodyw Mov Ther. 2018 Oct;22(4):896-903

Authors: Papp ME, Henriques M, Biguet G, Wändell PE, Nygren-Bonnier M

Abstract
BACKGROUND AND AIM: Obstructive pulmonary diseases can involve dyspnea and deconditioning. Hatha yogic exercises are a form of psychophysical attention-based activity. Research of experiences after participating in an adapted hatha yoga (YE) intervention remains limited. The aim of the present study was to explore the experiences of patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary disease) in a 12-week hatha yoga intervention (YE).
METHOD: Fifteen patients (10 women and 5 men, median age = 61, range: 44-76 years) who had participated in YE were interviewed after the intervention. Interview data were analyzed using qualitative content analysis.
RESULTS: Three main categories emerged: "To focus and be aware of oneself", "To gain new knowledge through practice" and "To master one's own situation". The overall theme "From limitation to opportunity - to experience breathing as a tool in daily life" illustrates a learning process on different levels. The participants described improved physical symptoms and breathing techniques, greater energy/stamina and body awareness along with a new sense of control over their breathing in different situations.
CONCLUSIONS: Patients with obstructive pulmonary diseases may strengthen their self-awareness and improve control of symptoms and learning new ways of breathing after practicing YE, which may provide a tool to control disease symptoms in daily life. Trial registration number NCT02233114.

PMID: 30368332 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

[Adolescents at play: the benefit of individual psychoanalytic psychodrama].

Tue, 2019-05-07 08:24
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[Adolescents at play: the benefit of individual psychoanalytic psychodrama].

Soins Psychiatr. 2017 Nov - Dec;38(313):31-33

Authors: Titia Rizzi A, Zimmerman C, Saada V, Moro MR

Abstract
An individual psychoanalytic psychodrama session with an adolescent treated at the Maison de Solenn shows the benefit of psychodrama role playing. Using the body, the imagination and 'pretend play', this therapy gives access to symbolisation and facilitates the care process.

PMID: 29173571 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

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