Mind-Body Medicine Research Update

[Mind-Body Medicine Research Update]

Functional and Psychosocial Effects of Health Qigong in Patients with COPD: A Randomized Controlled Trial.   J Altern Complement Med. 2011 Mar;17(3):243-51. by Ng BH, Tsang HW, Jones AY, So CT, Mok TY. From Centre for East-Meets-West, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.  Abstract: Context: The initial gain from a Pulmonary Rehabilitation Program (PRP) among patients with chronic obstructive pulmonary disease (COPD) begins to fade away 6 months after the completion of a rehabilitation program. One possible reason may be due to the poor compliance of the patients to the existing forms of home exercise program (e.g., walking, weight training activities, etc.). Objectives: This study tested the efficacy of health qigong (HQG), a traditional Chinese exercise, as an adjunct home exercise program in optimizing the gains obtained from PRP until 6 months after discharge. Design: This was a randomized controlled trial (RCT) on a mind-body exercise intervention. Participants: Eighty (80) patients with COPD receiving conventional PRP pulmonary rehabilitation program were randomized to the HQG intervention group (n = 40) and control group (n = 40). Outcome measures: Assessments were undertaken by blinded assessors at baseline, discharge from training, and follow-up (FU) at 3 and 6 months. Primary outcomes involved functional capacity scales and secondary outcomes involved quality-of-life scales. Results: Intention-to-treat analysis identified trends of improvement in all outcome measures in the HQG group, whereas lesser improvement and trends of deteriorations were identified in the control group. Ancillary analysis using a per-protocol method, however, identified significantly better improvements in functional capacity measures among the HQG at the 6-month FU. Conclusions: This RCT provided some evidence to support the positive effect of HQG as an adjunct home exercise for rehabilitation among people with COPD and to support further related research.

Effect of meditation on stress-induced changes in cognitive functions. J Altern Complement Med. 2011 Mar;17(3):207-12. by Mohan A, Sharma R, Bijlani RL. From  Department of Physiology, All India Institute of Medical Sciences , New Delhi, India .
Abstract: Objectives: The objective of this study was to study the effects of meditation on stress-induced changes in cognitive functions. Methods: The study was conducted on 32 healthy adult male student volunteers who had never practiced meditation before the study. The study consisted of practicing 20 minutes of guided meditation and administration of psychologic stress to the subjects. The psychologic stress was administered to the subjects by asking them to play a (preselected) stressful computer game. The subjects were asked to meditate either before or after the administration of psychologic stress. For the control group measurements, the subjects were asked to wait quietly for an equivalent period of meditation time. Outcome measures: The outcome measures were galvanic skin response (GSR), heart rate (HR), electromyography (EMG), sympathetic reactivity (QTc/QS2 ratio), cortisol, and acute psychologic stress scores. The central nervous system functions were assessed using Wechsler memory scale and visual-choice reaction time (VCRT). These parameters were measured both at the beginning and at the end of the intervention, using a pre-post experimental test design. Results: Computer game stress was associated with a significant increase in physiologic (GSR, EMG, HR, QTc/QS2) and psychologic (acute stress questionnaire scores) markers of stress. Meditation was associated with relaxation (significant decrease in GSR, EMG, QTc/QS2, and acute stress questionnaire scores). Meditation, if practiced before the stressful event, reduced the adverse effects of stress. Memory quotient significantly increased, whereas cortisol level decreased after both stress and meditation. VCRT showed no significant change. Conclusions: Practice of meditation produced a relaxation response even in the young adult subjects who had never practiced meditation before. The practice of meditation reduced the physiologic stress responses without taking away the beneficial effect of stress, namely, improved memory scores.

New insights on therapeutic touch: a discussion of experimental methodology and design that resulted in significant effects on normal human cells and osteosarcoma.   Explore (NY). 2011 Jan-Feb;7(1):44-51. by  Monzillo E, Gronowicz G. from Hunter College, CUNY Hunter-Bellevue School of Nursing, New York, NY 10010, USA. Abstract: Our purpose is to discuss the study design and innovative approaches that led to finding significant effects of one energy medicine therapy, Therapeutic Touch (TT), on cells. In the original published studies, TT was shown to significantly increase human osteoblast DNA synthesis, differentiation, and mineralization; increase in a dose-dependent manner the growth of other human cell types; and decrease the differentiation and mineralization of a human osteosarcoma-derived cell line. A unique feature of the study’s methodology and design that contributed to the success of the findings was that a basic level of skill and maturity of the TT practitioner was quantified for producing observable and replicable outcomes in a test administered to all TT practitioners. Only those practitioners that passed the test were selected for the study. (2) The practitioners were required to keep a journal, which appeared to promote their ability to stay centered and replicate their treatments over months of cell experimentation. (3) The origin of the cells that the practitioners were treating was explained to them, although they were blinded to cell type during the experiments. (4) Only early passage cells were used to maintain a stable cell phenotype. (5) Standard protocols for performing TT in the room were followed to ensure reproducible conditions. (6) Placebo controls and untreated controls were used for each experiment. (7) The principal investigator and technicians performing the assays were blinded as to the experimental groups, and all assays and procedures were well established in the laboratory prior to the start of the TT experiments. The absence of studies on the human biofield from mainstream scientific literature is also discussed by describing the difficulties encountered in publishing. These roadblocks contribute to our lack of understanding of the human biofield and energy medicine modalities in science. In conclusion, this report seeks to encourage well-designed, evidence-based studies on the human biofield and the therapeutic potential of the human biofield.

Effects of Qigong in Promoting Health of the Wheelchair-Bound Older Adults in Long-Term Care Facilities. Biol Res Nurs. 2011 Mar 8. [Epub ahead of print] by Kuan SC, Chen KM, Wang C.   Abstract: Institutional wheelchair-bound older adults often do not get regular exercise and are prone to health problems. The aim of this study was to test the effects of a 12-week qigong exercise program on the physiological and psychological health of wheelchair-bound older adults in long-term care facilities. Study design was quasi-experimental, pre-post test, nonequivalent control group. Participants comprised a convenience sample of 72 wheelchair-bound older adults (qigong = 34; control = 38). The qigong group exercised 35 min/day, 5 days/week for 12 weeks. Measures for physical health (blood pressure, heart rate variability, and distal skin temperature) and psychological health (Brief Symptom Rating Scale-5) were collected before and during study Weeks 4, 8, and 12. The qigong group participants’ blood pressure, distal skin temperature, and psychological health were significantly improved (all p < .001). These findings suggest that qigong exercise is a suitable daily activity for elderly residents in long-term care facilities and may help in the control of blood pressure among older adults.

An evaluation of pulmonary parameters in two groups of subjects during Yoga practice. Nepal Med Coll J. 2010 Sep;12(3):180-2. by Ahmed QR, Sau SK, Kar SK. From Department of Physiology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India.   Abstract: The purpose of the present study was to investigate how far the short term practice of yoga (30 and 60 days) for an hour daily can improve the respiratory function. Male subjects (n=50, age 30-50 years) were randomly selected. Respiratory parameters (FVC, FEV1, PEFR, FEF(25-75%) and MVV) were determined by using a multifunctional computerized spirometer. Yoga (posture and pranayamas) practice for a month produced no significant improvement in pulmonary parameters. Nevertheless, when the subjects continued it for next 30 days, i.e., after 60 days significant changes were noted in FVC (p<0.001), FEV, (p<0.01) and PEFR (p<0.05). The result also revealed that amongst them 30 days yoga training resulted in a significant increase in FVC in elder group of people (age 41-50 yrs) where as in younger group (age 30-40 yrs) the changes were not so prominent. Result indicated that short term (30 days) yoga practice quickly improves respiratory functions in relatively elder people (age 41-50 yrs), when many of them in our tropical country suffer from primary level of respiratory problem. Regular practice of Yoga (posture and pranayamas) can prevent it by increasing the efficacy of respiratory muscles.

Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. Evid Based Complement Alternat Med. 2011;2011:659876. Epub 2011 Mar 9 by Lin KY, Hu YT, Chang KJ, Lin HF, Tsauo JY. From School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F, No. 17 Xuzhou Road, Taipei 100, Taiwan.

Abstract: Yoga is one of the most widely used complementary and alternative medicine therapies to manage illness. This meta-analysis aimed to determine the effects of yoga on psychological health, quality of life, and physical health of patients with cancer. Studies were identified through a systematic search of seven electronic databases and were selected if they used a randomized controlled trial design to examine the effects of yoga in patients with cancer. The quality of each article was rated by two of the authors using the PEDro Scale. Ten articles were selected; their PEDro scores ranged from 4 to 7. The yoga groups compared to waitlist control groups or supportive therapy groups showed significantly greater improvements in psychological health: anxiety (P = .009), depression (P = .002), distress (P = .003), and stress (P = .006). However, due to the mixed and low to fair quality and small number of studies conducted, the findings are preliminary and limited and should be confirmed through higher-quality, randomized controlled trials. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062158

Evaluation of a biofeedback-assisted meditation program as a stress management tool for hospital nurses: a pilot study. Explore (NY). 2011 Mar-Apr;7(2):110-2. By bCutshall SM, Wentworth LJ, Wahner-Roedler DL, Vincent A, Schmidt JE, Loehrer LL, Cha SS, Bauer BA. Department of Surgery, Mayo Clinic, Rochester, MN.

OBJECTIVE: To assess whether a self-directed, computer-guided meditation training program is useful for stress reduction in hospital nurses.  DESIGN: We prospectively evaluated participants before and after a month-long meditation program. The meditation program consisted of 15 computer sessions that used biofeedback to reinforce training. Participants were instructed to practice the intervention for 30 minutes per session, four times a week, for four weeks. Visual analogue scales were used to measure stress, anxiety, and quality of life (assessments were performed using Linear Analogue Self-Assessment [LASA], State Trait Anxiety Inventory [STAI], and Short-Form 36 [SF-36] questionnaires). Differences in scores from baseline to the study’s end were compared using the paired t test.  RESULTS: Eleven registered nurses not previously engaged in meditation were enrolled; eight completed the study. Intent-to-treat analysis showed significant improvement in stress management, as measured by SF-36 vitality subscale (P = .04), STAI (P = .03), LASA stress (P = .01), and LASA anxiety (P = .01). Nurses were highly satisfied with the meditation program, rating it 8.6 out of 10. CONCLUSIONS: The results of this pilot study suggest the feasibility and efficacy of a biofeedback-assisted, self-directed, meditation training program to help hospital nurses reduce their stress and anxiety. Optimal frequency of use of the program, as well as the duration of effects, should be addressed in future studies.

Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial. Explore (NY). 2011 Mar-Apr;7(2):76-87.  By Gross CR, Kreitzer MJ, Reilly-Spong M, Wall M, Winbush NY, Patterson R, Mahowald M, Cramer-Bornemann M. from College of Pharmacy, University of Minnesota, Minneapolis, MN; School of Nursing, University of Minnesota, Minneapolis, MN.

OBJECTIVE: The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia.  DESIGN: A randomized controlled trial was conducted.  SETTING: The study was conducted at a university health center.  PATIENTS: Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT). INTERVENTIONS: Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions.  MAIN OUTCOMES: The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only).  RESULTS: Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.

A mathematical model of effects on specific joints during practice of the Sun Salutation – A sequence of yoga postures. J Bodyw Mov Ther. 2011 Apr;15(2):201-8.  By  Omkar SN, Mour M, Das D. from Department of Aerospace Engineering, Indian Institute of Science, Bangalore 560012, India.

Abstract: The ‘Sun Salutation’ consists of a sequence of ten yoga postures, each posture counteracting the preceding one producing a balance between flexion and extension, performed with synchronized breathing and aerobic activity. As this sequence is often performed and recommended by many yoga practitioners, there is a need for the development of a biomechanical model to support its reported clinical benefits. This requires a detailed knowledge of the nature of the forces and moments at the various joints involved. A simple mathematical model based on rigid body mechanics is developed for each of the Sun Salutation postures. Dynamic moments with high magnitudes and rates, applied with unusual distribution patterns, optimal for osteogenesis, are found to occur. Also, the joints are subjected to submaximal loadings thus ensuring that none of the joints are overstressed.

The Effect of Add-On Yogic Prana Energization Technique (YPET) on Healing of Fresh Fractures: A Randomized Control Study.  J Altern Complement Med. 2011 Mar;17(3):253-8. Epub 2011 Mar 9. By Oswal P, Nagarathna R, Ebnezar J, Nagendra HR. from 1 Division of Yoga and Life-Sciences, Swami Vivekananda Yoga Research Foundation (SVYASA) , Bengaluru, India.   Abstract: Objectives: The objective was to study the effect of the add-on yogic prana energization technique (YPET) on healing of fresh fractures. Materials and methods: Thirty (30) patients (22 men and 8 women) between 18 and 55 years with simple extra-articular fractures of long and short bones were selected from the outpatient department of Ebnezar Orthopaedic Centre and Parimala Speciality Hospital, Bengaluru. They were randomized into yoga (n = 15) and control (n = 15) groups. Compound, complicated, pathologic fractures, old fractures, and those associated with dislocations were excluded. Both groups received the conventional plaster of paris immobilization of the fracture site as the primary treatment. The yoga group, in addition, practiced YPET twice a day (30 minutes/session) for 2 weeks using taped audio instructions after learning under supervision for 1 week. YPET is an advanced yoga relaxation practice that involves breath regulation, chanting, and visualization, which according to yogic science revitalizes the tissues by activating the subtle energies (prana) within the body. Both the groups were assessed on the 1st and 21st day by the Numerical Pain Rating Scale for pain (NRS), tenderness (0-4), swelling (0-4), fracture line density (1-4), and the bridging of cortices (1-4). Results: Two (2) groups were matched on all variables. The Wilcoxon test showed significant improvement in both groups on all variables. Pain reduction (NRS) was better (p = 0.001 Mann-Whitney test) in the YPET group (94.5%) than in the control group (58.6%); Tenderness reduced (p = 0.001) better in the YPET group (94.4 %) than in the control group (69.12%); Swelling reduced by 93% in the YPET group and by 69.4% in controls (between-groups p = 0.093, i.e., nonsignificant); increase in fracture line density was better (p = 0.001) in the YPET group (48%) than in the control group (18.25%). The number of cortices united was significantly better (p = 0.001) in the YPET group (81.4%) than in controls (39.7 %). Conclusions: Add-on yoga-based YPET accelerates fracture healing.

Using silver yoga exercises to promote physical and mental health of elders with dementia in long-term care facilities.   Int Psychogeriatr. 2011 Mar 9:1-9.  By Fan JT, Chen KM. from Department of Nursing, Fooyin University; Kaohsiung, Taiwan. Abstract: Background: This study aimed to test the effects of yoga exercises on the physical and mental health of elderly people with dementia living in long-term care facilities. Methods: A quasi-experimental, pretest-post-test design was used. A convenience sample of 68 residents in long-term care facilities in southern Taiwan, aged 60 years and above with mild to moderate dementia, was selected. An experimental group of 33 elders participated in a 12-week yoga training program of three 55-minute sessions a week; a control group of 35 elders maintained their usual daily activities. Data were collected before and after completing the 12-week study. Measurements included body composition, cardiopulmonary functions, body flexibility, muscle strength and endurance, balance, joints motion, depression, and problem behaviors. Results: The yoga-trained participants had better physical and mental health than those who did not participate, including lowered blood pressure, reduced respiration rate, strengthened cardiopulmonary fitness, enhanced body flexibility, improved muscle strength and endurance, improved balance, and increased joints motion (all p values < 0.05). In addition, the depression state (p < 0.001) and problem behaviors (p < 0.001) of these demented elders were significantly reduced. Conclusion: Yoga exercise has positive benefits for both the physical and mental health of elders with dementia living in long-term care facilities. It is recommended that yoga be included as one of the routine activities in these long-term care facilities.

Effects of two modes of exercise on physical fitness and endothelial function in the elderly: exercise with a flexible stick versus Tai Chi.  J Med Assoc Thai. 2011 Jan;94(1):123-32. by Suksom D, Siripatt A, Lapo P, Patumraj S. from Faculty of Sports Science, Chulalongkorn University, Bangkok, Thailand. daroonwanc@hotmail.com

OBJECTIVE: Determine the effects of exercise with flexible stick training on physical fitness and endothelial function and compare it with Tai Chi training.  MATERIAL AND METHOD: Thirty older women volunteered for the present study and were divided into EF group (EF: n=16; 70.3 + 2.5 yr) and TC group (TC: n=14; 69.5 +/- 4.5 yr). Both training groups performed training assigned protocol that consisted of 70% of maximal heart rate, 40 minutes per day, four days per week for 12 weeks. Health related physical fitness and biochemical data were assessed in all participants. Post-Occlusive Reactive Hyperemia (PORH) was used to monitor endothelial function by using a Laser-Doppler fluxmeter. RESULT: The health related physical fitness was significantly higher in the EF group (p < 0.05). Plasma malondialdehyde and von Willebrand factor, an indicator of free radical damage and endothelial dysfunction, respectively as well as cholesterol level were significantly lower (p < 0.05) in the EF group. The peak Laser-Doppler flux (LDF)/baseline LDE and recovery time were significantly improved after 12 weeks of EF training (p < 0.05). This was not observed after 12 weeks of TC training. CONCLUSION: EF, a Thai novel exercise that combined endurance and strength training was a more effective exercise modality than TC for improving physical fitness and endothelial function. It improved reactive oxygen species in the elderly.

 

[Compiled by Kevin W Chen]

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