Mind-Body Research Update

Research Update

Mind- Body Research Update

Compiled by Kevin Chen

Qigong Exercise On Immunity And Infections

The effect of qigong exercise on immunity and infections: a systematic review of controlled trials.

American Journal of Chinese Medicine. 2012;40(6):1143-56. By Wang CW, et al. from Centre on Behavioral Health, University of Hong Kong, HKSAR, China.

To summarize and critically evaluate the clinical evidence of the effect of qigong exercise on immunity and its efficacy in the prevention or treatment of infectious diseases, 13 databases were searched through January 2011, and all controlled clinical trials of qigong exercise on immunity and infections were included.  Quality and validity of the included studies were evaluated using standard scales. Seven studies including two randomized controlled trials (RCTs), two controlled clinical trials (CCTs) and three retrospective observational studies (ROSs) met the inclusion criteria. One study focused on functional measures of immunity (antigen-induced immunity) and six studies on enumerative parameters of immunity. No study on clinical symptoms relevant to infectious diseases could be identified.  Overall, the included studies suggested favorable effects of qigong exercise on immunity, but the quality of research for most of the studies examined in this review was poor. Further rigorously designed studies are required, which should adhere to accepted standards of methodology for clinical trials.

Tai Chi for Schizophrenia

 Tai-chi for residential patients with schizophrenia on movement coordination, negative symptoms, and functioning: a pilot randomized controlled trial.

Evidence Based Complementary & Alternative Medicine.  2012;2012:923925. Epub 2012 Nov 24. By Ho RT et al. Department of Social Work and Social Administration, University of Hong Kong, Hong Kong .

Objective: Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their non-institutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia.  Methods: A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention. Results: Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi.  Conclusions: This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services.


Deep Breathing and Respiration/Heart Rate

 Influence of deep breathing exercise on spontaneous respiratory rate and heart rate variability: a randomized controlled trial in healthy subjects. 

Indian Journal of Physiology & Pharmacology. 2012 Jan-Mar;56(1):80-7.

By  Tharion E et al. from Dept of Physiology, Christian Medical College, Vellore, Tamil Nadu , India.

Studies show that yogic type of breathing exercises reduces the spontaneous respiratory rate. However, there are no conclusive studies on the effects of breathing exercise on heart rate variability. We investigated the effects of non-yogic breathing exercise on respiratory rate and heart rate variability. Healthy subjects (21-33 years, both genders) were randomized into the intervention group (n=18), which performed daily deep breathin gexercise at 6 breaths/min (0.1 Hz) for one month, and a control group (n=18) which did not perform any breathing exercise. Baseline respiratory rate and short-term heart rate variability indices were assessed in both groups. Reassessment was done after one month and the change in the parameters from baseline was computed for each group. Comparison of the absolute changes [median (inter-quartile ranges)] of the parameters between the intervention and control group showed a significant difference in the spontaneous respiratory rate [intervention group -2.50, control group 0.00, cycles/min, P<0.001], mean arterial pressure [ -0.67, vs. 0.67, mmHg, P<0.05], high frequency power [278.50  vs.  -1.00, ms2 P<0.05] and sum of low and high frequency powers [512.00, vs  51.00, ms2, P<0.05]. Neither the mean of the RR intervals nor the parameters reflecting sympatho-vagal balance were significantly different across the groups. In conclusion, the changes produced by simple deep slow breathing exercise in the respiratory rate and cardiac autonomic modulation of the intervention group were significant, when compared to the changes in the control group. Thus practice of deep slow breathing exercise improves heart rate variability in healthy subjects, without altering their cardiac autonomic balance. These findings have implications in the use of deep breathing exercises to improve cardiac autonomic control in subjects known to have reduced heart rate variability.

Tai Chi vs. Physical Therapy for Preventing Falls

Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial. 

Disability & Rehabilitation. 2012 Nov 20. [Epub ahead of print] by  Tousignant M, et al. from Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Université de Sherbrooke , Sherbrooke, Québec , Canada.

foot massagePurpose: To compare the effectiveness of supervised Tai Chi exercises versus the conventional physical therapy exercises in a personalized rehabilitation program in terms of the incidence and severity of falls in a frail older population. Method: The participants were frail older adults living in the community, admitted to the day hospital program in Sherbrooke, Quebec, Canada (n = 152). They were randomized to receive a 15-week intervention, either by supervised Tai Chi exercises (n = 76) or conventional physical therapy (n = 76). Fall incidence and severity were assessed using both the calendar technique and phone interviews once a month during 12 months following the end of the intervention. Other variables were collected at baseline to compare the two groups: age, comorbidity, balance, sensory interaction on balance, and self-rated health. Results: Both interventions demonstrated a protective effect on falls but Tai Chi showed a greater one (RR = 0.74; 95% CI = 0.56-0.98) as compared to conventional physical therapy exercises. Conclusions: Supervised Tai Chi exercises as part of a rehabilitation program seem to be a more effective alternative to the conventional physical therapy exercises for this specific population.

Meditation Effects on Anxiety & Blood Pressure

 A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students.

Nurse Education Today. 2012 Dec 19. [Epub ahead of print]  by  Chen Y, et al. from School of Nursing, Southern Medical University, Guangzhou, China.

yoga 2

Background:  Previous studies suggested that mindfulness meditation effectively reduced stress-related anxiety and depression symptoms, but no research has evaluated the efficacy of mindfulness meditation in nurses and nursing students in China.  This study tried to evaluate the effects of brief mindfulness meditation on the anxiety and depression symptoms and autonomic nervous system activity in Chinese nursing students.   Methods: A randomized controlled trial was run in a medical university in Guangzhou, 105 nursing students were randomly approached by email and seventy-two responded. Sixty recruited students were randomized into meditation and control group (n=30 each) after screening and exclusion due to factors known to influence mood ratings and autonomic nervous system measures. The meditation group performed mindfulness meditation 30min daily for 7 consecutive days. The control group received no intervention except pre-post treatment measurements. The Self-Rating Anxiety Scale and Self-Rating Depression Scale were administered to participants, and heart rate and blood pressure were measured. Pre- and post-treatment data were analyzed using repeated-measures analysis of variance.  Results: Differences between pre- and post-treatment Self-Rating Anxiety Scale scores were significantly larger in the meditation group than in the control group, but no similar effect was observed for Self-Rating Depression Scale scores. Systolic blood pressure was reduced more after the intervention in the meditation group than in the control group, with an average reduction of 2.2mmHg. A moderate level of anxiety was associated with the maximum meditation effect.  Conclusions: Brief mindfulness meditation was beneficial for Chinese nursing students in reducing anxiety symptoms and lowering systolic blood pressure. Individuals with moderate anxiety are most likely to benefit from a short-term mindfulness meditation program.

Yoga for Menopause

 Effectiveness of yoga for menopausal symptoms: a systematic review and yogameta-analysis of randomized controlled trials.

Evidence Based Complementary & Alternative Medicine. 2012;2012:863905. Epub 2012 Nov 7. By  Cramer H, et al.  from Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany.

Objectives: To systematically review and meta-analyze the effectiveness of yoga for menopausal symptoms. Methods: Medline, Scopus, the Cochrane Library, and PsycINFO were screened through April 2012. Randomized controlled trials (RCTs) were included if they assessed the effect ofyoga on major menopausal symptoms, namely, (1) psychological symptoms, (2) somatic symptoms, (3) vasomotor symptoms, and/or (4) urogenital symptoms. For each outcome, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Two authors independently assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Results:  Five RCTs with 582 participants were included in the qualitative review, and 4 RCTs with 545 participants were included in the meta-analysis. There was moderate evidence for short-term effects on psychological symptoms (SMD = -0.37; 95% CI -0.67 to -0.07; P = 0.02). No evidence was found for total menopausal symptoms, somatic symptoms, vasomotor symptoms, or urogenital symptoms. Yoga was not associated with serious adverse events. Conclusion:  This systematic review found moderate evidence for short-term effectiveness of yoga for psychological symptoms in menopausal women. While more rigorous research is needed to underpin these results, yoga can be preliminarily recommended as an additional intervention for women who suffer from psychological complaints associated with menopause. http://www.hindawi.com/journals/ecam/2012/863905

Yoga for Enhanced Brain Function

 Yoga meditation practitioners exhibit greater gray matter volume and fewer reported cognitive failures: results of a preliminary voxel-based morphometric analysis. 

Evidence Based Complementary & Alternative Medicine. 2012;2012:821307. By Froeliger B, et al. from Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27708, USA.

Hatha yoga techniques, including physical postures (asanas), breathing exercises (pranayama), and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent neuroplastic changes. Though prior studies have identified differences in gray matter volume (GMV) between long-term mindfulness practitioners and controls, no studies to date have reported on whether yoga meditation is associated with GMV differences. The present study investigated GMV differences between yoga meditation practitioners (YMP) and a matched control group (CG). The YMP group exhibited greater GM volume in frontal, limbic, temporal, occipital, and cerebellar regions; whereas the CG had no greater regional greater GMV. In addition, the YMP group reported significantly fewer cognitive failures on the Cognitive Failures Questionnaire (CFQ), the magnitude of which was positively correlated with GMV in numerous regions identified in the primary analysis. Lastly, GMV was positively correlated with the duration of yoga practice. Results from this preliminary study suggest that hatha yoga practice may be associated with the promotion of neuroplastic changes in executive brain systems, which may confer therapeutic benefits that accrue with repeated practice.


Mindfulness & Yoga Enhance Sleep

 Effect of mindfulness-based stress reduction on sleep quality: Results of a randomized trial among Danish breast cancer patients.

Acta Oncol. 2013 Jan 3. [Epub ahead of print] By Andersen SR,  et al.  From Danish Cancer Society Research Center , Survivorship, Copenhagen , Denmark.

The prevalence of sleep disturbance is high among cancer patients, and the sleep problems tend to last for years after the end of treatment. As part of a large RCT (MICA trial, NCT00990977) of the effect of mindfulness-based stress reduction (MBSR) on psychological and somatic symptoms among breast cancer patients, the aim of the current study was to evaluate the effect of MBSR on the secondary outcome, ‘sleep quality’. Material and methods. A total of 336 women operated on for breast cancer stage I-III 3-18 months previously were randomized to MBSR (n = 168) or treatment as usual (n = 168); both groups received standard clinical care. The intervention consisted of an eight-week MBSR program (psycho-education, meditation and gentle yoga). Sleep quality was assessed on the Medical Outcome Study sleep scale at baseline, after the intervention and at six- and 12-months’ follow-up. Results. The mean sleep problem scores were significantly lower in the MBSR group than in controls immediately after the intervention. Quantile regression analyses showed that the effect was statistically significant only for the participants represented by the lower percentile of change between baseline and post-intervention, i.e. those who had more sleep problems; the MBSR group had a significantly smaller increase in sleep problems than the control group. After the 12-month follow-up, there was no significant between-group effect of MBSR on sleep quality in intention-to-treat analyses. Conclusion. MBSR had a statistically significant effect on sleep quality just after the intervention but no long-term effect among breast cancer patients. Future trials in which participation is restricted to patients with significant sleep problems are recommended for evaluating the effect of MBSR on sleep quality.

Meditation Reduces Stress & Cognitive Functions

Immediate and long-term effects of meditation on acute stress reactivity, cognitive functions, and intelligence.

Alternative Therapies Health Medicine. 2012 Nov-Dec;18(6):46-53. By Singh YSharma RTalwar A. from Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.

Context: With the current globalization of the world’s economy and demands for enhanced performance, stress is present universally. Life’s stressful events and daily stresses cause both deleterious and cumulative effects on the human body. The practice of meditation might offer a way to relieve that stress.  The research team intended to study the effects of meditation on stress-induced changes in physiological parameters, cognitive functions, intelligence, and emotional quotients.  Methods:  The study was done in two phases, with a month between them.  Each participant served as his own control.  In phase 1, the researcher studied the effects of a stressor (10 minutes playing a computer game) on participants’ stress levels. In phase 2, the research team examined the effects of meditation on stress levels.  The research was done in a lab setting at the All India Institute of Medical Sciences (AIIMS).  The participants were 34 healthy male students. To study the effects of long-term meditation on stress levels, intelligence, emotional quotients, and cognitive functions participants meditated daily for 1 month, between phases 1 and 2.  To study the immediate effects of meditation on stress levels, participants meditated for 15 minutes after playing a computer game to induce stress. The measures included galvanic skin response (GSR), heart rate (HR), and salivary cortisol and administered tests for the intelligence and emotional quotients (IQ and EQ), acute and perceived stress (AS and PS), and cognitive functions (ie, the Sternberg memory test [short-term memory] and the Stroop test [cognitive flexibility]). Using a pre-post study design, the team performed this testing (1) prior to the start of the study (baseline); (2) in phase 1, after induced stress; (3) in part 1 of phase 2, after 1 month of daily meditation, and (4) in part 2 of phase 2, after induced stress, both before and after 15 minutes of meditation.

Results: Induced stress from the computer game resulted in a significant increase in physiological markers of stress such as GSR and HR. In the short term, meditation was associated with a physiological relaxation response (significant decrease in GSR) and an improvement in scores on the Stroop test of reaction times. In the long-term, meditation brought significant improvements in IQ and scores for cognitive functions, whereas participants’ stress levels (GSR and AS) decreased. EQ, salivary cortisol, and HR showed no significant changes.  Conclusions:  The practice of meditation reduced psychological stress responses and improved cognitive functions, and the effects were pronounced with practice of meditation for a longer duration (1 month).

Tai Chi Reduces Side-Effects of Rheumatologic Diseases

Role of Tai Chi in the treatment of rheumatologic diseases.

Current Rheumatology Reports. 2012 Dec;14(6):598-603. By Wang C. from Division of Rheumatology, Tufts University School of Medicine, Boston,MA, USA. cwang2@tuftsmedicalcenter.org

Rheumatologic diseases (e.g., fibromyalgia, osteoarthritis, and rheumatoid arthritis) consist of a complex interplay between biologic and psychological aspects, resulting in therapeutically challenging chronic conditions to control. Encouraging evidence suggests that Tai Chi, a multi-component Chinese mind-body exercise, has multiple benefits for patients with a variety of chronic disorders, particularly those with musculoskeletal conditions. Thus, Tai Chi may modulate complex factors and improve health outcomes in patients with chronic rheumatologic conditions. As a form of physical exercise, Tai Chi enhances cardiovascular fitness, muscular strength, balance, and physical function. It also appears to be associated with reduced stress, anxiety, and depression, as well as improved quality of life. Thus, Tai Chi can be safely recommended to patients with fibromyalgia, osteoarthritis, and rheumatoid arthritis as a complementary and alternative medical approach to improve patient well-being. This review highlights the current body of knowledge about the role of this ancient Chinese mind-body medicine as an effective treatment of rheumatologic diseases to better inform clinical decision-making for our patients.

 Yoga Reduces Pain

Yoga for Functional Ability, Pain and Psychosocial Outcomes in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis.

Musculoskeletal Care. 2013 Jan 9. by  Ward L, et al.  from  Centre for Physiotherapy Research, University of Otago, Dunedin, New Zealand.

Objectives: Musculoskeletal conditions (MSCs) are the leading cause of disability and chronic pain in the developed world, impacting both functional ability and psychosocial health. The current review investigates the effectiveness of yoga on primary outcomes of functional ability, pain and psychosocial outcomes across a range of MSCs. Methods: A comprehensive search of 20 databases was conducted for full-text, randomized controlled trials of yoga in clinically diagnosed MSCs. Result: Seventeen studies met the inclusion criteria, involving 1,626 participants with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), kyphosis or fibromyalgia. Studies were quality rated, and analysed for the effect of yoga on primary outcomes, immediately post-intervention. Twelve studies were rated as good quality. Yoga interventions resulted in a clinically significant improvement in functional outcomes in mild-to-moderate LBP and fibromyalgia, and showed a trend to improvement in kyphosis. Yoga significantly improved pain in OA, RA and mild-to-severe LBP. Psychosocial outcomes were significantly improved in mild-to-moderate LBP and OA. Meta-analysis of good-quality studies showed a moderate treatment effect for yoga of -0.64 (95%CI -0.89 to -0.39) for functional outcomes and -0.61 (95%CI -0.97 to -0.26) for pain outcomes. Conclusions: Evidence suggests that yoga is an acceptable and safe intervention, which may result in clinically relevant improvements in pain and functional outcomes associated with a range of MSCs. Future analysis of outcomes which take into account the amount of yoga received by participants may provide insight into any putative duration or dosage effects of yoga interventions for MSCs. http://onlinelibrary.wiley.com/

Dr. Kevin Chen

Dr. Kevin Chen

Kevin W ChenPh.D. – is an associate professor at the Center for Integrative Medicine, University of Maryland.  Dr. Chen was educated in the universities of both China and the United States, and has years of experience and training in blending eastern and western perspectives, and in the practice of life-nurturing methods. As a long-time practitioner of Qigong Yang Sheng, he is one of the few scientists in the U.S. to have both hands-on knowledge of mind-body practice, and an active research career in mind-body medicine, which is funded through grants by the National Institutes of Health (NIH) and various foundations.  Dr. Chen devotes his career and life to the practice of Yang Sheng, and promotion of self-healing and mind-body-spirit integration through the non-profit organization, World Institute for Self Healing (WISH) (http://www.wishus.org).




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