Mind-Body Medicine Research Update

Mind-Body Medicine Research Update


The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial. Disabil Rehabil. 2011 Sep 29.  By Tousignant M, Corriveau H, Roy PM, Desrosiers J, Dubuc N, Hébert R, Tremblay-Boudreault V, Beaudoin AJ. From Research Centre on Aging, Sherbrooke Geriatric University Institute, Faculty of Medicine and Health Sciences, University of Sherbrooke , Sherbrooke , Canada.

Purpose: To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. Method: The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Results: Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). Conclusion: The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program. .


Complementary Use of Tai Chi Chih Augments Escitalopram Treatment of Geriatric Depression: A Randomized Controlled Trial. Am J Geriatr Psychiatry. 2011 Oct;19(10):839-850. By Lavretsky H, Alstein LL, Olmstead RE, Ercoli LM, Riparetti-Brown M, Cyr NS, Irwin MR. From the Department of Psychiatry and Biobehavioral Sciences and the Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.

BACKGROUND:  Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy. In this study, we ask whether a mind-body exercise, Tai Chi Chih (TCC), added to escitalopram will augment the treatment of geriatric depression designed to achieve symptomatic remission and improvements in health functioning and cognitive performance. METHODS:  One hundred twelve older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. Seventy-three partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either 1) TCC for 2 hours per week or 2) health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-related quality of life, cognition, and inflammation at baseline and during 14-week follow-up. RESULTS: Subjects in the escitalopram and TCC condition were more likely to show greater reduction of depressive symptoms and to achieve a depression remission as compared with those receiving escitalopram and HE. Subjects in the escitalopram and TCC condition also showed significantly greater improvements in 36-Item Short Form Health Survey physical functioning and cognitive tests and a decline in the inflammatory marker, C-reactive protein, compared with the control group. CONCLUSION:  Complementary use of a mind-body exercise, such as TCC, may provide additional improvements of clinical outcomes in the pharmacologic treatment of geriatric depression.


Effects of 12-week Tai Chi training on soleus H-reflex and muscle strength in older adults: a pilot study. Eur J Appl Physiol. 2011 Sep 27.  By  Chen YS, Crowley Z, Zhou S, Cartwright C. from  School of Health and Human Sciences, Southern Cross University, P.O. Box 157, Lismore, NSW, 2480, Australia.

The purpose of this study was to determine the effects of 12-week Tai Chi (TC) training on the soleus (SOL) H-reflex modulation and plantarflexion muscle strength in older adults. Twenty volunteers were assigned into training (N = 14; 72.2 ± 3.7 years of age) and control (N = 6; 74.2 ± 6.1 years of age) groups. The participants in the TC group practiced Yang style TC 1 h per session, 3 sessions per week, for 12 weeks, guided by a qualified TC instructor. The ratio of the maximal peak-to-peak amplitude of SOL H-reflex (H (max)) to M-wave (M (max)) was determined during bipedal standing under four sensory conditions: stable surface and eyes open (SO), stable surface and eyes closed (SC), unstable surface and eyes open (UO), and unstable surface and eyes closed (UC). The maximal isometric plantarflexion muscle strength was also assessed by using a dynamometer. The results showed that the SOL H (max)/M (max) ratio increased significantly after the 12 weeks of TC training under the SC (37.0%), UO (33.3%) and UC (36.0%) conditions (P < 0.05). The maximal plantarflexion strength also improved significantly after training (19.8%; P < 0.05). In contrast, the control group showed no significant changes in all measurements after the 12 weeks.



Community-based Yang-Style Tai Chi is safe and feasible in chronic stroke: a pilot study. Clin Rehabil. 2011 Sep 21. By Taylor-Piliae RE, Coull BM. From College of Nursing, University of Arizona, USA.

OBJECTIVE: Examine the safety and feasibility of a 12-week Tai Chi intervention among stroke survivors. DESIGN: Two-group, prospective pilot study with random allocation. SETTING:  Outpatient rehabilitation facility. SUBJECTS: Stroke survivors ≥50 years and at ≥three months post-stroke. INTERVENTIONS: Tai Chi subjects attended group-based Yang Style classes three times/week for 12-weeks, while Usual Care subjects received weekly phone calls along with written materials/resources for participating in community-based physical activity.  OUTCOME MEASURES: Indicators of study safety and feasibility included recruitment rates, intervention adherence, falls or adverse events, study satisfaction, drop-outs, and adequacy of the outcomes measures. RESULTS:  Interested persons pre-screened by phone (n = 69) were on average 68 years old, (SD = 13) years old, 48% (n = 33) women, 94% (n = 65) were at least three months post-stroke. A total of 28 subjects aged 69 (SD = 11) years enrolled in this pilot study. Intervention adherence rates were very high (≥92%). There were no falls or other adverse events. The dose of Tai Chi exercise (≥150 minutes/week) was well tolerated. Overall study satisfaction was high (8.3 (SD = 1.9); 1 = not satisfied, 10 = most satisfied), while drop-outs (n = 3, 11%) were unrelated to study intervention. Score distributions for the outcome measures were approximately normal, sensitive to change, and seemed to favor the Tai Chi intervention.  CONCLUSIONS:  Tai Chi is a safe, community-based exercise program for stroke survivors. Our data suggest that recruitment and retention of an adequate sample is feasible, and that in a full-scale study 52 subjects/group are needed to detect statistically significant between group differences (alpha = 0.05, power = 0.80).


A review focused on the psychological effectiveness of tai chi on different populations. Evid Based Complement Alternat Med. 2012;2012:678107. Epub 2011 Jul 18. By Zhang L, Layne C, Lowder T, Liu J. from Department Of Physical Education, Shenzhen Polytechnic, Shenzhen 518055, China.

As a popular exercise form, Tai Chi (TC) has been investigated to determine its contributions to an active and healthy lifestyle. There are an increasing number of researchers who focus on exploring the potential physiological and psychological benefits of TC but only a few systematic reviews of these benefits to a variety of populations. The purpose of this paper is to comprehensively evaluate the reported psychological benefits associated with practicing TC. Although many investigators have reported possible psychological benefits of TC for children, young adults, older healthy adults, and for a variety of patient populations, many of the reports suffer one or more methodological flaws. These flaws include inadequate study design, including lack of control groups, small sample sizes, unsophisticated statistical techniques, or publication without rigorous peer review. After reviewing the results of the existing literature regarding the potential psychological benefits of TC, we recommend that future investigations be conducted with additional adherence to the traditional scientific process.



Effect of green tea and Tai Chi on bone health in postmenopausal osteopenic women: a 6-month randomized placebo-controlled trialOsteoporos Int. 2011 Jul 16. By  Shen CL, Chyu MC, Yeh JK, Zhang Y, Pence BC, Felton CK, Brismée JM, Arjmandi BH, Doctolero S, Wang JS. From  Department of Pathology, Texas Tech University Health Sciences Center, BB 198, 3601 4th street, Lubbock, TX, 79430-9097, USA, Leslie.Shen@ttuhsc.edu.

Postmenopausal women with osteopenia received green tea polyphenols (GTP) supplement and/or Tai Chi exercise for 6 months. Bone turnover biomarkers, calcium metabolism, and muscle strength were measured. This study showed that GTP supplementation and Tai Chi exercise increased bone formation biomarkers and improved bone turnover rate. Tai Chi exercise increased serum parathyroid hormone. GTP supplementation, Tai Chi exercise, and the combination of the two all improved muscle strength in postmenopausal women with osteopenia.  INTRODUCTION: This study evaluated the effect of GTP supplementation and Tai Chi (TC) exercise on serum markers of bone turnover (bone-specific alkaline phosphatase, BAP, and tartrate-resistant acid phosphatase, TRAP), calcium metabolism, and muscle strength in postmenopausal osteopenic women.  METHODS:  One hundred and seventy-one postmenopausal osteopenic women were randomly assigned to four groups: (1) placebo (500 mg starch/day), (2) GTP (500 mg GTP/day), (3) placebo + TC (placebo plus TC training at 60 min/session, three sessions/week), and (4) GTP + TC (GTP plus TC training). Overnight fasting blood and urine samples were collected at baseline, 1, 3, and 6 months for biomarker analyses. Muscle strength was evaluated at baseline, 3, and 6 months. One hundred and fifty subjects completed the 6-month study. RESULTS:  Significant increases in BAP level due to GTP intake (at 1 month) and TC (at 3 months) were observed. Significant increases in the change of BAP/TRAP ratio due to GTP (at 3 months) and TC (at 6 months) were also observed. Significant main effect of TC on the elevation in serum parathyroid hormone level was observed at 1 and 3 months. At 6 months, muscle strength significantly improved due to GTP, TC, and GTP + TC interventions. Neither GTP nor TC affected serum TRAP, serum and urinary calcium, and inorganic phosphate. CONCLUSION:  In summary, GTP supplementation and TC exercise increased BAP and improved BAP/TRAP ratio. TC exercise increased serum parathyroid hormone. GTP supplementation, TC exercise, and the combination of the two all improved muscle strength in postmenopausal women with osteopenia. http://www.springerlink.com/content/60268434q818l102


On the Relationship Between the Practice of Mindfulness Meditation and Personality-an Exploratory Analysis of the Mediating Role of Mindfulness Skills. Mindfulness (N Y). 2011 Sep;2(3):194-200. By van den Hurk PA, Wingens T, Giommi F, Barendregt HP, Speckens AE, van Schie HT.

Mindfulness meditation (MM) has often been suggested to induce fundamental changes in the way events in life are experienced and dealt with, presumably leading to alterations in personality. However, the relationship between the practice of MM and personality has not been systematically studied. The aim of this study was to explore this relationship and to investigate the mediating role of mindfulness skills. Thirty-five experienced mindfulness meditators (age range, 31-75 years; meditation experience range, 0.25-35 years; mean, ∼13 years) and 35 age-, gender-, and ethnicity-matched controls (age range, 27-63 years) without any meditation experience completed a personality (NEO-FFI) and mindfulness (KIMS) questionnaire. The practice of MM was positively related to openness and extraversion and negatively related to neuroticism and conscientiousness. Thus, the results of the current study associate the practice of MM with higher levels of curiosity and receptivity to new experiences and experience of positive affect and with less proneness toward negative emotions and worrying and a reduced focus on achievements. Furthermore, the mediating role of specific mindfulness skills in the relationship between the practice of MM and personality traits was shown. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146707/


Effect of 3-Month Yoga on Oxidative Stress in Type 2 Diabetes With or Without Complications: A controlled clinical trialDiabetes Care. 2011 Oct;34(10):2208-10. Epub 2011 Aug 11. By Hegde SV, Adhikari P, Kotian S, Pinto VJ, D’Souza S, D’Souza V. from  Corresponding author: shreelaxmi.hegde@gmail.com.

OBJECTIVE To assess the effect of yoga on anthropometry, blood pressure, glycemic control, and oxidative stress in type 2 diabetic patients on standard care in comparison with standard care alone. RESEARCH DESIGN AND METHODS The study involved 123 patients stratified according to groups with microvascular complications, macrovascular complications, and peripheral neuropathy and without complications and assigned to receive either standard care or standard care along with additional yoga for 3 months. RESULTS In comparison with standard care alone, yoga resulted in significant reduction in BMI, glycemic control, and malondialdehyde and increase in glutathione and vitamin C. There were no differences in waist circumference, waist-to-hip ratio, blood pressure, vitamin E, or superoxide dismutase in the yoga group at follow-up. CONCLUSIONS Yoga can be used as an effective therapy in reducing oxidative stress in type 2 diabetes. Yoga in addition to standard care helps reduce BMI and improve glycemic control in type 2 diabetic patients.


Is yoga effective for pain? A systematic review of randomized clinical trials. Complement Ther Med. 2011 Oct;19(5):281-7.  By Posadzki P, Ernst E, Terry R, Lee MS. From Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, United Kingdom.

OBJECTIVE: The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for any type of pain. METHOD:  Seven databases were searched from their inception to February 2011. Randomized clinical trials were considered if they investigated yoga in patients with any type of pain and if they assessed pain as a primary outcome measure. The 5-point Jadad scale was used to assess methodological quality of studies. The selection of studies, data extraction and quality assessment were performed independently by two reviewers.  RESULTS: Ten randomized clinical trials (RCTs) met the inclusion criteria. Their methodological quality ranged between 1 and 4 on the Jadad scale. Nine RCTs suggested that yoga leads to a significantly greater reduction in pain than various control interventions such as standard care, self care, therapeutic exercises, relaxing yoga, touch and manipulation, or no intervention. One RCT failed to provide between group differences in pain scores. CONCLUSIONS: It is concluded that yoga has the potential for alleviating pain. However, definitive judgments are not possible


Effect of yoga on menopausal symptoms. Menopause Int. 2011 Sep;17(3):78-81 By Joshi S, Khandwe R, Bapat D, Deshmukh U.  Correspondence: Dr Sulabha Joshi. Email: sulabhaajoshi@gmail.com

OBJECTIVES: To observe the effect of yoga on menopausal symptoms using a prospective, randomized, controlled and interventional study. Main outcome measures Total Menopause Rating Scale (MRS) score and three subscale scores (somatovegetative, psychological and urogenital) were measured on day 1 and day 90 in the study group which performed yoga (asana, pranayam and meditation) under supervision for three months, and were compared with the control group that did not perform yoga. MRS has been designed to measure health-related quality of life of ageing women. It consists of 11 symptoms and three subscales. RESULTS: It was observed that on day 1 the scores in both the groups were comparable. On day 90, the scores in the yoga group showed a reduction in score on all the subscales, which was statistically significant. No significant difference was noted in the control group. CONCLUSION:  Yoga is effective in reducing menopausal symptoms and should be considered as alternative therapy for the management of menopausal symptoms.


Yoga therapy for developing emotional intelligence in mid-life managers. J Midlife Health. 2011 Jan;2(1):28-30. By Ganpat TS, Nagendra HR. from  Department of Yoga and Management, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University (Prashanti Kutiram), Bangalore, India.

BACKGROUND: Business executives’ lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to “excessive tension” and consequent deterioration in “executive efficiency”. OBJECTIVE: To assess emotional intelligent quotient (EQ) in managers undergoing yoga-based Self Management of Excessive Tension (SMET) program. MATERIALS AND METHODS: 72 managers participated in this study which is of “single group pre-post design.” The EQ test developed by Prof N. K. Chadha from University of Delhi was administered as pre and post the 5 days of SMET program. STATISTICAL ANALYSIS: Means, standard deviations, Kolmogorov-Smirnov test, and Wilcoxon signed rank test were used to analyze the data. RESULTS: The data analysis showed 72.02% significant increase (P<0.001) in EQ. CONCLUSION:  The results suggest that participation in a SMET program was associated with improvement in EQ and may have implications for “executive efficiency.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156497/


Impact of yoga on haemodynamic function in healthy medical students. West Indian Med J. 2011 Mar;60(2):148-52.  By  Parshad O, Richards A, Asnani M. from Department of Basic Medical Sciences, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.

OBJECTIVES:  Yoga improves cardiovascular health in both healthy individuals and those with diagnosed heart disease. This study compares changes in some cardiovascular parameters before and after the practice of Yoga in healthy medical students. METHODS:  Sixty-four healthy medical students (57 females and 7 males), mean age 21.3 +/- 2.6 years, attending a Special Study Module ‘Role of Dhyana Yoga in Stress Management’, participated in this study. Systolic (SYS) and Diastolic (DIA) blood pressure, Heart Rate (HR), Stroke Volume (SV), Cardiac output (CO), Total Peripheral Resistance (TPR), Interbeat Interval (IBI), Left Ventricular Ejection Time (LVET), Arterial Compliance (Cwk) and Ascending Aorta Impedance (Zao) were measured before and after six weeks of yogic exercises. Various exercises included asanas (Postures), pranayama (Breathing), and dhyana (Meditation). Data were analyzed using Stata for Windows. RESULTS:  Two-tailed paired t-test revealed that practice ofyoga caused significant increases in HR (p < 0.05), SV (p < 0.01), CO (p < 0.001) and Cwk (p < 0.01) and decreases in TPR (p < 0.001), IBI (p < 0.05) and Zao (p < 0.001) after practising yoga for 6 weeks as compared to before yoga practice. No significant differences were, however observed in SYS, DIA, Mean arterial blood pressure (MAP) and LVET CONCLUSIONS: Practice of yoga even for a short period showed ability to improve most of the cardiovascular functions. Regular practice of yoga for a longer period may further improve these functions and possibly result in improved management of their daily stress.


Immediate Effects of Reiki on Heart Rate Variability, Cortisol Levels, and Body Temperature in Health Care Professionals With Burnout. Biol Res Nurs. 2011 Aug 5. By Díaz-Rodríguez L, Arroyo-Morales M, Fernández-de-Las-Peñas C, García-Lafuente F, García-Royo C, Tomás-Rojas I.

Burnout is a work-related mental health impairment comprising three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Reiki aims to help replenish and rebalance the body’s energetic system, thus stimulating the healing process. The objective of this placebo-controlled, repeated measures, crossover, single-blind, randomized trial was to analyze the immediate effects of Reiki on heart rate variability (HRV), body temperature, and salivary flow rate and cortisol level in health care professionals with burnout syndrome (BS). Participants included 21 health care professionals with BS, who were asked to complete two visits to the laboratory with a 1-week interval between sessions. They were randomly assigned the order in which they would receive a Reiki session applied by an experienced therapist and a placebo treatment applied by a therapist with no knowledge of Reiki, who mimicked the Reiki treatment. Temperature, Holter ECG recordings (standard deviation of the normal-to-normal interval [SDNN], square root of mean squared differences of successive NN intervals [RMSSD], HRV index, low frequency component [LF], and high frequency component [HF]), salivary flow rate and cortisol levels were measured at baseline and postintervention by an assessor blinded to allocation group. SDNN and body temperature were significantly higher after the Reiki treatment than after the placebo. LF was significantly lower after the Reiki treatment. The decrease in the LF domain was associated with the increase in body temperature. These results suggest that Reiki has an effect on the parasympathetic nervous system when applied to health care professionals with BS.


[Compiled by Kevin W Chen]

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