Month: December 2020

Reduce Challenging Behaviors of Adults with Intellectual Disabilities with Mindfulness

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Reduce Challenging Behaviors of Adults with Intellectual Disabilities with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness may represent an effective psychoeducational approach for some. . .People with an intellectual disability.” – Tammy-Lee Currie

 

Intellectual disabilities involve below average intelligence and relatively slow learning. They are quite common, affecting an estimated 10% of individuals worldwide. These disabilities present problems for the individual in learning mathematics, reading and writing. These difficulties, in turn, affect performance in other academic disciplines. The presence of intellectual disabilities can have serious consequences for the psychological well-being of the individual, including their self-esteem and social skills. In addition, anxiety, depression, and conduct disorders often accompany learning disabilities.

 

Individuals with intellectual disorders often have challenging behaviors including aggression, disruptive and socially inappropriate behaviors, self‐injury and withdrawal behaviors. The challenging behaviors not only reduce the quality of life of the individual but also puts them at higher risk of abuse, neglect, deprivation, institutionalization, and restraints.  In addition, caregivers may have to deal with verbal and physical abuse. Obviously, there is a need for therapies that can reduce these behaviors. Mindfulness training may be useful. It has been shown to improve the behavior of individuals with intellectual disabilities. But there is a need to summarize what has been learned about various intervention that do not use drugs.

 

In today’s Research News article “Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384078/ ) Bruinsma and colleagues review, summarize, and perform a meta-analysis of the effectiveness of non-pharmacological treatments in reducing challenging behaviors in adults with intellectual disabilities. They identified 22 published research studies.

 

They report that the published research found that there was an overall significant reduction in challenging behaviors produced by non-pharmacological treatments with moderate effect sizes. These effects were found to be lasting, producing improvements 3 to 18 months after the interventions. They also found that interventions that employed behavioral interventions, cognitive behavioral therapy, environment mediated interventions, and randomized controlled trials did not produce superior results compared to all other interventions. But when the intervention contained mindfulness there was a significantly greater reduction in challenging behaviors compared to all other interventions.

 

These results are interesting and suggest that a variety of different non-pharmacological treatments reduce challenging behaviors in adults with intellectual disabilities. But interventions that teach mindfulness produce superior results. The authors did not speculate as to how mindfulness training amplifies the effectiveness of the interventions. But mindfulness training has been shown to produce relaxation, calmness, improvements in emotion regulation, and reductions in responsiveness to stress and these effects may well underlie the ability of mindfulness training to reduce the challenging behaviors.

 

The ability of mindfulness training to produce greater reductions in challenging behaviors is very important for the well-being of these adults with intellectual disabilities as these challenging behaviors are problematic. They have damaging, disruptive, and negative effects on the individuals themselves and those around them. The more that these behaviors can be reduced the better for all concerned. Since interventions that contain mindfulness training produce the greatest reductions. They should be the treatments of choice.

 

So, reduce challenging behaviors of adults with intellectual disabilities with mindfulness.

 

“mindfulness meditation helps people with intellectual disabilities and autism spectrum disorder reduce their mental and physical problems. . . mindfulness meditation was effective for reducing aggression, both physical and verbal.” – Yoon-Suk Hwang

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Bruinsma, E., van den Hoofdakker, B. J., Groenman, A. P., Hoekstra, P. J., de Kuijper, G. M., Klaver, M., & de Bildt, A. A. (2020). Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis. Journal of intellectual disability research : JIDR, 64(8), 561–578. https://doi.org/10.1111/jir.12736

 

Abstract

Background

Non‐pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta‐analysis is to update the existing evidence, to investigate long‐term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness.

Method

An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi‐experimental designs were included. We performed an overall random‐effect meta‐analysis and subgroup analyses.

Results

We found a significant moderate overall effect of non‐pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352–0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs.

Conclusions

Non‐pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384078/

 

Improve Mental Health with Mindfulness

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Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.” – Mental Health Foundation

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children, to adolescents, to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

There is a vast array of techniques for the development of mindfulness. It is important to establish the most efficacious techniques and their dosages for the treatment of common mental illnesses. It is particularly important, for reasons of affordability, to employ techniques that qualify for insurance reimbursement.

 

In today’s Research News article “Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: A Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009938/ ) Gawande and colleagues recruited adults with a non-severe mental health diagnosis and randomly assigned them to receive either a high or low dose mindfulness training. The high dose training consisted of 8 weeks of twice a week 1-hour mindfulness trainings along with daily 30-45 minutes of home practice. The mindfulness training was adapted from Mindfulness-Based Cognitive Therapy (MBCT) including meditation, trauma-informed practices, and self-compassion training. The low dose mindfulness training consisted of a single 60-minute introduction to mindfulness and encouragement to practice mindfulness. They were measured before and after training for anxiety, depression, perceived stress, disease self-efficacy, mindfulness, self-compassion, and perceived control of disease.

 

The most common disorders were anxiety disorders in 37% and depression in 32% of the participants. They found that in comparison to baseline the high dose mindfulness group had significant reductions in anxiety, depression, and perceived stress and significant increases in disease self-efficacy, mindfulness, and self-compassion. The low dose mindfulness group had only a significant reduction in perceived stress. The high dose mindfulness group had significant greater increases in mindfulness and self-compassion and decreases in anxiety than the low dose group. Importantly, the high dose mindfulness intervention was accepted for reimbursement by insurance companies.

 

The study is important in that it demonstrated that insurance would cover the high dose treatment. This is important for making the treatment affordable for insured clients. The study demonstrated as have a variety of other research studies that mindfulness training produces significant reductions in anxiety, depression, and perceived stress and significant increases in disease self-efficacy, mindfulness, and self-compassion. But the study had a unique control condition of a low dose mindfulness training. The high dose intervention produced significant improvements in mental illness disease symptoms that were for the most part better than those of the low dose. This establishes that participant expectancies and positive biases toward mindfulness training cannot account for the improvements. It also demonstrates that greater doses of mindfulness training produce greater benefits for patients with non-severe mental health issues.

 

So, improve mental health with mindfulness.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Gawande, R., Pine, E., Griswold, T., Creedon, T., Vallejo, Z., Rosenbaum, E., Lozada, A., & Schuman-Olivier, Z. (2019). Insurance-Reimbursable Mindfulness for Safety-Net Primary Care Patients: A Pilot Randomized Controlled Trial. Mindfulness, 10(9), 1744–1759. https://doi.org/10.1007/s12671-019-01116-8

 

Abstract

Objectives:

Mindfulness is effective for reducing anxiety and depression and increasing chronic disease self-management. An accessible, insurance-reimbursable model for implementation in patient-centered medical homes within US healthcare systems has promise for patients with multi-morbid conditions. Clarifying both the dose needed to impact anxiety, depression and self-management, and the design requirements for accessible primary care implementation, is essential.

Methods:

We tested feasibility, acceptability, and effectiveness of Mindfulness Training for Primary Care (MTPC), an 8-week, referral-based, insurance-reimbursable mindfulness program integrated within primary care, compared with a Low-Dose Comparator (LDC), consisting of a 60-minute mindfulness introduction plus referral to community and digital resources. Outcome measures were assessed at baseline and 8 weeks. MTPC is trauma-informed, incorporates mindfulness-oriented behavior change skills, and is designed to target anxiety, depression, stress, and chronic illness selfmanagement. Participants schedule a PCP visit to co-create a self-management action plan during week 6.

Results:

Primary care providers (PCP) referred 344 patients over 14 months. Eighty-one participants with DSM-V anxiety disorders, depressive disorders, trauma- and stress-related disorders participated in this pilot randomized-controlled comparative effectiveness trial [MTPC (n=54); LDC (n=27)]. These data suggest that MTPC was more effective than LDC for reducing anxiety (p=0.01), enhancing mindfulness (p=0.02) and self-compassion (p=0.001), and for catalyzing selfmanagement behavior change through action plan initiation (OR=4.34, p=0.03).

Conclusions:

MTPC was successfully integrated into a health system, was billed to insurance, and was acceptable to a diverse primary care population. Replication with a larger study and further accessibility adaptations are needed to confirm and expand these pilot results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009938/

 

Meditation and Exercise Practices can be Maintained Long-Term after Training Completion

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Meditation and Exercise Practices can be Maintained Long-Term after Training Completion

 

By John M. de Castro, Ph.D.

 

“Maintaining your meditation practice after the course has finished is often a struggle. Without the structure of a follow-on course it’s easy to lose track, stop practising and get down-hearted and even give up.”

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. With impacts so great it is important to know how to maintain mindfulness practice over the long run.

 

Exercise can also improve emotions and their regulation.  But like mindfulness training it must be sustained over time. It is unclear, however, exactly what kind of training is essential to produce a sustainable mindfulness or exercise practice. People can differ greatly and it is also important to determine which people are most likely to sustain practice and which not.

 

In today’s Research News article “Predictors of Mindfulness Meditation and Exercise Practice, from MEPARI-2, a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959135/ ) Barrett and colleagues recruited meditation naïve, non-exercising adults who have had at least one cold per year. They were randomly assigned to either a wait-list control condition or to receive 8 weeks of training in either Mindfulness-Based Stress Reduction (MBSR) or progressive moderate intensity exercise. MBSR was taught in 8 weekly, 2.5 hour, sessions and employed discussion, breath following and body scan meditations, and yoga. progressive moderate intensity exercise was taught in weekly classes and was tailored to the individual employing a combination of walking, jogging, cycling, and exercise machines. Each program incorporated 20-45 minutes of daily practice. They were measured before and after training and every 2 months thereafter for a year for physical activity, mental and physical health, perceived stress, depression, exercise self-efficacy, mindful self-efficacy, positive and negative emotions, mindfulness, feeling loved, social support, and the big 5 personality traits of openness, conscientiousness, extraversion, agreeableness, and neuroticism. Throughout the program the participants reported their daily practice minutes.

 

They found that meditation in the meditation group and exercise in the exercise group was high after training and remained high over the subsequent 13 weeks. They also found that the higher the baseline measures of mental health, smoking, and the personality characteristic of openness and the lower the levels of depression, the greater the weekly average minutes of meditation practice. In addition, the higher the baseline measures of exercise, mindful self-efficacy, and overall physical activity and the lower the levels of perceived stress and neuroticism, the greater the weekly average minutes of exercise practice.

 

These results are remarkable and potentially important in that they demonstrated that meditation practice and exercise practice can be maintained over extended periods time after the completion of training. The authors speculate that the daily reports of practice may have contributed to the maintenance of practice. Maintenance of practice is important to maintain benefits. So, this suggests that with appropriate training and reporting, the benefits of meditation and exercise can be sustained.

 

It would appear that participant characteristics affected the likelihood of practice maintenance. For meditation participants who were smokers, had good mental health, had personalities characterized by openness and were low in depression were likely to maintain high levels of meditation practice while participants who at the beginning were exercisers with high self-efficacy and who were less stressed and neurotic were likely to maintain high levels of exercise practice.

 

So, meditation and exercise practices can be maintained long-term after training completion.

 

“Meditation reveals its gifts when practiced consistently and preferably daily. Our beings need to be conditioned spiritually much like fitness.” – Andrew Shykofski

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Barrett, B., Torres, E. R., Meyer, J., Barnet, J. H., & Brown, R. (2019). Predictors of Mindfulness Meditation and Exercise Practice, from MEPARI-2, a randomized controlled trial. Mindfulness, 10(9), 1842–1854. https://doi.org/10.1007/s12671-019-01137-3

 

Abstract

Objectives:

Health-supporting behaviors can be challenging to initiate and maintain. Data from the MEPARI-2 randomized trial were used to assess predictors of sustained exercise and meditation practice.

Methods:

Adults aged 30 to 69 years not exercising regularly and without prior meditation training were randomized to 8-week trainings in mindfulness meditation, moderate intensity exercise, or observational control, and monitored for 8 months. Exercise participants reported day-to-day minutes of moderate and vigorous activity; mindfulness meditation participants reported minutes of informal and formal practice. Demographic characteristics and psychosocial factors were assessed as predictors of practice. Growth mixture modeling was used to identify higher and lower practice subgroups.

Results:

413 participants (75.8% female; mean (SD) age 49.7 (11.6) years) were randomized to exercise (137), mindfulness meditation (138), or control (138), with 390 (95%) completing the study. Seventy-nine percent of exercisers and 62% of meditators reported ≥150 minutes/week practice for at least half of the 37 weeks monitored. Self-reported minutes of mindfulness meditation and/or exercise practice were significantly (p<0.01) predicted by baseline levels of: general mental health, self-efficacy, perceived stress, depressive symptoms, openness, neuroticism, physical activity, smoking status, and number of social contacts. Growth mixture modeling identified subsets of people with moderate (100–200 min/week) and high (300–450 min/week) levels of self-reported practice for both mindfulness meditation (62% moderate; 38% high) and exercise (71% moderate; 29% high).

Conclusions:

In this sample, participants randomized to behavioral trainings reported high levels of practice sustained over 37 weeks. Baseline psychosocial measures predicted practice levels in expected directions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959135/

 

Meditation Changes the Brain Differently in Adolescents

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Meditation Changes the Brain Differently in Adolescents

 

By John M. de Castro, Ph.D.

 

“The benefits of meditation are many with few, if any, drawbacks. If your teen is struggling, it’d be worth it to give it a try.” – Tyler Jacobson

 

There has accumulated a large amount of research demonstrating that mindfulness has significant benefits for psychological, physical, and spiritual wellbeing. It even improves high level thinking known as executive function. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from thinking to mood and happiness to severe mental and physical illnesses. This raises the question of how mindfulness training could produce such widespread and varied benefits. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. The brains of adolescents are different from fully mature adult brains. They are dynamically growing and changing. It is unclear how mindfulness affects their maturing brains.

 

In today’s Research News article “Gray Matter Changes in Adolescents Participating in a Meditation Training.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456888/ ) Yuan and colleagues recruited adolescents aged 14 to 19 years and provided them with a 12 week training in mindfulness meditation. They and a control sample of adolescents underwent Magnetic Resonance Imaging (MRI) of their brains before and after training.

 

They found that after training there was a significant reduction in the volume of gray matter in the left thalamus, left putamen, and left posterior insula. There was no significant influence of age on the decreased volumes. Also, there were no significant increases in gray matter volume were found anywhere in the adolescents’ brains.

 

These results are very surprising. In adults, mindfulness training has been repeatedly shown to increase gray matter volume, not decrease it. The insula, in particular, has been shown to increase in volume after mindfulness training in adults. The insula is thought to underlie awareness of the internal state of the body. Since, mindfulness training usually increases this awareness, the increase in insula volume makes sense, but that it would decrease in volume in the adolescents does not.

 

During adolescents the brain is actively growing and changing. It is possible that mindfulness training affects the growing brain differently than after maturation in adulthood. This suggests that mindfulness may have different effects in adolescents than in adults. But this has not been shown to be the case. In fact, mindfulness training appears to have the same effects in adolescents as in adults. More research is needed to further investigate this phenomenon.

 

So, it would appear that meditation changes the brain differently in adolescents.

 

“It is well-documented that mindfulness helps to relieve depression and anxiety in adults.  A small but growing body of research shows that it may also improve adolescent resilience to stress through improved cognitive performance and emotional regulation.” – Malka Main

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Justin P. Yuan, Colm G. Connolly, Eva Henje, Leo P. Sugrue, Tony T. Yang, Duan Xu, Olga Tymofiyeva. Gray Matter Changes in Adolescents Participating in a Meditation Training. Front Hum Neurosci. 2020; 14: 319. Published online 2020 Aug 14. doi: 10.3389/fnhum.2020.00319

 

Abstract

Meditation has shown to benefit a wide range of conditions and symptoms, but the neural mechanisms underlying the practice remain unclear. Magnetic resonance imaging (MRI) studies have investigated the structural brain changes due to the practice by examining volume, density, or cortical thickness changes. However, these studies have focused on adults; meditation’s structural effects on the adolescent brain remain understudied. In this study, we investigated how meditation training affects the structure of the adolescent brain by scanning a group of 38 adolescents (16.48 ± 1.29 years) before and after participating in a 12-week meditation training. Subjects underwent Training for Awareness, Resilience, and Action (TARA), a program that mainly incorporates elements from mindfulness meditation and yoga-based practices. A subset of the adolescents also received an additional control scan 12 weeks before TARA. We conducted voxel-based morphometry (VBM) to assess gray matter volume changes pre- to post-training and during the control period. Subjects showed significant gray matter (GM) volume decreases in the left posterior insula and to a lesser extent in the left thalamus and left putamen after meditation training. There were no significant changes during the control period. Our results support previous findings that meditation affects regions associated with physical and emotional awareness. However, our results are different from previous morphometric studies in which meditation was associated with structural increases. We posit that this discrepancy may be due to the differences between the adolescent brain and the adult brain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456888/

 

Improve the Quality of Sleep with Tai Chi

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Improve the Quality of Sleep with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi significantly improved sleep quality for healthy patients and those with chronic health conditions. Their physical performance and psychological well being improved compared with the control group. Along with better sleep, came a reduction in pain. “ – Balanced Life

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving sleep. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439202/ ) Si and colleagues review, summarize, and perform a meta-analysis of published randomized controlled trials of the effectiveness of Tai Chi in improving sleep quality. They identified 25 published randomized controlled with adults as participants.

 

They report that the published research studies found that Tai Chi practiced produced a significant improvement in sleep quality with moderate effect size. They report that the optimum effects were produced by practices that lasted 60 to 90 minutes. Tai Chi was effective in both healthy and clinical populations but it had its greatest effects on sleep in healthy populations. In addition, Tai Chi practice produced large significant improvements in the sleep quality of Asian participants but not American participants.

 

Importantly, the largest effects were seen in studies with low methodological quality while 8 studies with the highest methodological quality did not observe significant improvements in sleep quality. The primary differences between low and high methodological quality studies revolved around how much the participants knew about the study and its intentions. This suggests that participant expectancy factors may be very important here.

 

That participant expectancies may be driving the results is further reflected in the fact that the largest effects were present in Asian participants while they were not significant in American participants. Tai Chi has been practiced in Asia for centuries and is believed to be very beneficial. It has only recently been practiced in America and Americans are generally ignorant or skeptical of its benefits. Hence, Asian participants would be expected to have the largest participant expectancies of positive benefits and they were the only population showing significant effects.

 

In summary, the results suggest that 60 to 90 minutes of Tai Chi practice produce improvements in sleep quality in healthy and clinical populations. But there is a strong suspicion that participant expectancies of Tai Chi efficacy my be responsible for the effects. There is a need, then, for more tightly controlled studies to determine if Tai Chi and not participant bias is responsible for the established benefits.

 

So, improve the quality of sleep with Tai Chi.

 

“Tai chi was reported useful in alleviating insomnia, and when combined with qigong, it improved sleep dysfunction and depression.“ – Christina Seluzicki

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Si, Y., Wang, C., Yin, H., Zheng, J., Guo, Y., Xu, G., & Ma, Y. (2020). Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-based complementary and alternative medicine : eCAM, 2020, 4710527. https://doi.org/10.1155/2020/4710527

Abstract

Background

This review aims to investigate the efficacy of Tai Chi Chuan on subjective sleep quality among adults.

Methods

We systematically searched PubMed, Embase, Cochrane Library, Scopus, CNKI (China National Knowledge Infrastructure), and the Wanfang Database from their inception to August 2019 and identified 25 eligible studies that were published in both English and Chinese.

Results

24 out of 25 studies were identified to be high-quality studies according to the PEDro scale. The pooled results confirmed that Tai Chi Chuan elicited moderate improvements in subjective sleep quality (SMD = −0.512, 95% CI [−0.767, −0.257], P < 0.001). Notably, Tai Chi Chuan yielded more significant effects on sleep quality among the healthy population (SMD = −0.684, 95% CI [−1.056, −0.311], P < 0.001) than the clinical population (SMD = −0.395, 95% CI [−0.742, −0.047], P=0.026) and more benefits among the Asian population (SMD = −0.977, 95% CI [−1.446, −0.508], P < 0.001) than the American population (SMD = −0.259, 95% CI [−0.624, 0.105], P=0.164). After controlling the methodological quality of studies, it has been noted that Asians could achieve the most significant sleep-promoting benefit when Tai Chi Chuan was practiced between 60 and 90 min per session.

Conclusions

Available data implied that subjective sleep quality was improved via Tai Chi training, but more thorough studies must be executed to ascertain our findings and optimize Tai Chi practices accordingly toward various populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439202/

 

Yoga is the Preferred Exercise for the Treatment of Type 2 Diabetes

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Yoga is the Preferred Exercise for the Treatment of Type 2 Diabetes

 

By John M. de Castro, Ph.D.

 

“By increasing muscle mass through strengthening poses, yoga can improve your metabolism, helping you maintain a healthy body weight. Studies suggest that regular practice helps normalize blood pressure and cholesterol levels. By inducing a feeling of calm, yoga can lower the release of cortisol, a stress hor­mone that causes your body to release more glucose. Less unnecessary cortisol means fewer unnecessary elevations in blood sugar.” – Annie Kay

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes.

 

In today’s Research News article “Effect of Yoga and Exercise on Glycemic Control and Psychosocial Parameters in Type 2 Diabetes Mellitus: A Randomized Controlled Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336951/ ) Singh and Khandelwal recruited adult patients with Type 2 Diabetes and randomly assigned them to either an exercise or yoga practice group. Exercise was practiced for 30 minutes 5 days per week for 3 months and consisted of walking and moderate aerobic exercise combined with diet. The yoga group were trained in postures and breathing exercises for 2 weeks and then practiced at home for 3 months. They were measured before and after training for anxiety, depression, diabetes quality of life and self-efficacy. They also had blood drawn for assessment of glycemic control (HbA1c).

 

They found that following training both groups had significant decreases in anxiety, depression, and HbA1c and significant increases in diabetes quality of life and self-efficacy. But the yoga group had significantly better outcomes on all measures compared to the diet and exercise group.

 

These results suggest that practicing yoga is better for the psychological and physical health of patients with Type 2 Diabetes than non-yoga exercises. Yoga practice not only improved psychological health but also glycemic control suggesting better control of the disease. The fact that yoga was superior in effectiveness to non-yoga exercise is important as yoga is both a mindfulness practice and an exercise. So, the results suggest that adding mindfulness to exercise potentiates the programs effectiveness in treating patients with Type 2 Diabetes.

 

Hence, yoga is the preferred exercise for the treatment of Type 2 Diabetes.

 

“I recommend yoga primarily for stress management. Stress elevates blood sugar, which can lead to more diabetes complications. Yoga helps us center ourselves, and centering calms us and can help keep blood sugar levels balanced.” – Janet Zappe

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Vijay Pratap Singh, Bidita Khandelwal. Effect of Yoga and Exercise on Glycemic Control and Psychosocial Parameters in Type 2 Diabetes Mellitus: A Randomized Controlled Study. Int J Yoga. 2020 May-Aug; 13(2): 144–151. Published online 2020 May 1. doi: 10.4103/ijoy.IJOY_45_19

 

Abstract

Context (Background):

Type 2 diabetes has been strongly associated with psychosocial factors such as stress, anxiety, depression, and quality of life (QOL). There is not much evidence whether yoga can improve these factors and motivate individuals to engage in active lifestyle.

Aims:

This study aims to evaluate the effect of yoga and exercise over glycemic control, anxiety, depression, exercise self-efficacy (ESE), and QOL after 3-month program.

Methods:

Two hundred and twenty-seven individuals were randomly allocated to yoga group (YG) and exercise group. YG practiced yoga for 2 weeks under supervision and then carried out practice at home for 3 months. The exercise group practiced 30 min of brisk walking for 5 days a week.

Results:

On comparison among the groups, in YG, there was a mean change of 0.47 in glycated hemoglobin which was greater than mean reduction of 0.28 in the exercise group with P < 0.05. State anxiety reduced by 7.8 and trait anxiety reduced by 4.4 in YG (P < 0.05) in 3 months as compared to nonsignificant reductions of 3 and 1 in mean of state and trait anxiety scores in the exercise group (P > 0.05). There was a statistically significant reduction in depression score in both the groups, 8.6 in yoga and 4.0 in exercise, which was greater in YG. ESE improved by 19.2 in YG (P < 0.05), whereas it improved only 2.2 in the exercise group (P > 0.05). QOL improved by 23.7 in YG and 3.0 in the exercise group which was nonsignificant in the exercise group as compared to YG.

Conclusions:

Yoga is superior to exercise alone as a lifestyle modification program in improving glycemic control, anxiety, depression, and QOL as well as ESE.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336951/