Improve Low Back Pain with Walking and Mind-Body Practices

Improve Low Back Pain with Walking and Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mindfulness training teaches us to be aware of, and accept, moment-to-moment physical sensations of discomfort, while letting go of our usual negative reactions. So instead of spending hours each day thinking about how much we hate our back pain, worrying about our prognosis, and seeking relief, we learn how to be with the pain — paying attention to how it actually feels at each moment and relaxing our tendency to tense up against it, while observing our worried or distressed thoughts and feelings coming and going.” – Ronald Siegel

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back painYoga practice has been shown to have a myriad of health benefits. These include relief of chronic painYoga practice has also been shown to be effective for the relief of chronic low-back pain.  Other mind-body  practices such as Tai Chi  improves spinal health and reduces pain. The evidence is accumulating, so, it would seem reasonable to summarize what has been learned regarding the ability of mind-body practices to treat chronic low back pain.

 

In today’s Research News article “Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458239/ ) Nduwimana and colleagues reviewed, summarized, and performed a meta-analysis of the published randomized controlled trials comparing the effectiveness of m1nd-body practices and walking for the relief of chronic low back pain. They identified 31 published trials containing a total of 3193 participants.

 

They report that the published research found that both walking and m1nd-body practices were effective in significantly reducing low back pain. Of the m1nd-body practices, yoga was particularly effective not only reducing pain but also producing significant reductions in activity limitations resulting from low back pain. On the short-term (up to 3 months) yoga produced significant pain reductions while on the intermediate-term (3 to 6 months), walking produced significant pain reductions.

 

These results are important as low back pain is ubiquitous and produces not only discomfort but also limitations on the ability of patients to conduct their lives. So, its relief greatly reduces the suffering and improves the quality of life. The comparison of mind-body practices to walking is important as both are exercises and their relative effectiveness assessed. The results suggest that yoga practice has better short-term effectiveness while walking appears to be better for the intermediate term. This further suggests that future research should explore the effectiveness of the combination of mind-body practices and walking in the treatment of low back pain.

 

So, improve low back pain with walking and mind-body practices.

 

Mindbody treatments (designed to change these attitudes, feeling, and beliefs about pain) can measurably reduce back pain over time.” – Curable

 

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

 

Nduwimana, I., Nindorera, F., Thonnard, J. L., & Kossi, O. (2020). Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials. Medicine, 99(35), e21969. https://doi.org/10.1097/MD.0000000000021969

 

Abstract

Purpose:

Walking and mind-body therapies (MBTs) are commonly recommended to relieve pain and improve function in patients with chronic low back pain (CLBP). The purpose of this study was to compare the effectiveness of walking and MBTs in CLBP.

Methods:

We included randomized controlled trials (RCTs) comparing walking or MBTs to any other intervention or control in adults with CLBP. Studies were identified through PubMed, Cochrane Library, PsycINFO, Scopus, and ScienceDirect databases. The research was limited to studies published in English and French between January 2008 and December 2018. Two reviewers independently selected the studies, extracted data, and assessed studies quality using the Physiotherapy Evidence Database (PEDro) scale. Statistical analyses were performed under a random-effects model. We analyzed pain and activity limitation, with the calculation of standardized mean differences and 95% confidence intervals for the different treatment effects.

Results:

Thirty one randomized controlled trials involving 3193 participants were analyzed. Walking was as effective as control interventions in the short-term and slightly superior in the intermediate term with respect to pain (Standardized mean differences (SMD)  = –0.34; 95% CI, –0.65 to –0.03; P = .03) and activity limitation (SMD = –0.30; 95% CI, –0.50 to –0.10; P = .003). In contrast, yoga was more effective than control interventions in the short term in terms of pain (SMD = –1.47; 95% CI, –2.26 to –0.68; P = .0003) and activity limitation (SMD = –1.17; 95% CI, –1.80 to –0.55; P = .0002). Yoga was no longer superior to the control interventions for pain at the 6-month follow-up.

Conclusion:

MBTs, especially yoga, seem to be more effective in the short term, and walking seems to be more effective in the intermediate term, for the relief of pain and activity limitation in patients with CLBP. A combination of walking and MBTs fits the biopsychosocial model and might be valuable therapy for CLBP throughout follow-up due to combined effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458239/

 

Reduce the Symptoms of Schizophrenia with Mind-Body Practices

Reduce the Symptoms of Schizophrenia with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Research shows that some mindfulness-based interventions for psychotic symptoms can afford people a greater acceptance and insight into their experiences. They can also reduce the symptoms of anxiety and depression which often accompany, and may exacerbate, psychotic disorders.” – Adrianna Mendrek

 

Schizophrenia is the most common form of psychosis. Its effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Also, there is accumulating research that mindfulness and yoga practices may be beneficial for patients with major mental illnesses. Tai Chi and Qigong  practices have also been shown to improve the symptoms of schizophrenia. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about mind-body practices as treatments for schizophrenia.

 

In today’s Research News article “Effects of Mind-Body Exercises on Schizophrenia: A Systematic Review With Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457019/ ) Wei and colleagues review, summarize and perform a meta-analysis of the published controlled research studies of the effectiveness of mind-body practices to improve the symptoms of schizophrenia. They included Tai Chi, Qigong, yoga, and other mindful movement practices. They identified 13 studies (11 randomized controlled trials) employing a total of 1159 patients with schizophrenia.

 

They report that the published studies found that mind-body practices produced significant improvements of both the positive and negative symptoms of schizophrenia and also depression. In addition, the greater the number of weekly mind-body sessions the greater the improvement in the positive symptoms and the greater the duration of the mind-body sessions the greater the improvements in the negative symptoms.

 

These results are impressive as schizophrenia is difficult to treat. But the results show that mind-body practices are safe and effective treatments that improve not only the positive and negative symptoms of schizophrenia but also the frequently co-occurring depression. There also appears to be a dose response effect such that the greater the frequency and duration of mind-body practices the greater the benefits. This suggests that mind-body practices should be recommended as a part of the treatment for schizophrenia.

 

So, reduce the symptoms of schizophrenia with mind-body practices.

 

yoga therapy is of particular benefit for those with schizophrenia . .  in lessening state anxiety and increasing subjective wellbeing, while also reducing both positive and negative symptoms and improving quality of life.” – Minded Institute

 

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

 

Wei, G. X., Yang, L., Imm, K., Loprinzi, P. D., Smith, L., Zhang, X., & Yu, Q. (2020). Effects of Mind-Body Exercises on Schizophrenia: A Systematic Review With Meta-Analysis. Frontiers in psychiatry, 11, 819. https://doi.org/10.3389/fpsyt.2020.00819

 

Abstract

Background

Mind–body exercises (MBEs) have been widely accepted as a complementary therapy for the patients with low exercise tolerance. Currently, the number of experimental studies investigating the effect of MBEs for improving symptoms in people with schizophrenia is increasing. However, results are inconsistent.

Methods

We systematically reviewed and meta-analyzed the effects of mind–body exercises on schizophrenia. Seven electronic databases (Pubmed, Web of Science, PsycINFO, Embase, Cochrane Central Register of Controlled Trials [CENTRAL], CNKI and Wangfang) were screened through October 2019 and risks of bias of included studies were assessed in Review Manager 5.3.

Results

Meta-analysis on 13 studies with 1,159 patients showed moderately significant effects in favor of mind–body exercise intervention to improve positive symptoms (SMD = 0.31; 95% CI 0.01 to 0.60; p = 0.04), negative symptoms (SMD = 0.37; 95% CI 0.14 to 0.60; p = 0.002), and depression (SMD = 0.88; 95% CI 0.63 to 1.13; p<0.00001). Meta-regression analysis revealed that the improvement in positive symptoms was positively associated with the frequency of intervention (p = 0.04), while a marginally significant correlation was observed between the improved negative symptoms and duration of each session (p = 0.06).

Conclusions

This meta-analysis supports the therapeutic effects of MBEs to aid in the treatment of schizophrenia. Further studies need to incorporate rigorous design and large sample size to identify the optimal type and dose of mind–body exercise to inform clinical practices on MBEs’ recommendations for the management of schizophrenia symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457019/

 

Improve the Physical and Psychological Well-Being of Cancer Survivors with Mind-Body Practices

Improve the Physical and Psychological Well-Being of Cancer Survivors with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mind-body techniques such as meditation, yoga, tai chi, and qigong have been found to lower distress and lead to improvements in different aspects of quality of life. . .  to help patients manage the psychosocial challenges of diagnosis and treatment of cancer.” – Alejandro Chaoul

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbancefear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. There have been a number of research studies conducted on the effectiveness of mind-body practices for the relief of the physical and mental symptoms of cancer survivors. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Effects of Mind-Body Exercise in Cancer Survivors: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487122/ ) Duan and colleagues

review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mind-body practices for the treatment of cancer survivors. They found 15 published controlled clinical trials including a total of 1461 patients.

 

They report that the published controlled clinical trials found that mind-body practices produced significant increases in physical fitness and sleep quality and decreases in fatigue, depression, anxiety, and body mass index. Of the different mind-body practices Tai Chi practice appears to be superior in decreasing fatigue and sleep problems, Qigong practice appears to be superior in increasing physical fitness, while yoga practice appears to be superior in decreasing depression and anxiety.

 

These results are important in that they demonstrate that mind-body practices are effective in relieving the psychological and physical symptoms present in cancer survivors. These findings are generalizable in that a wide variety of types of cancers with a wide variety of patients were included. This suggests that mind-body practices are applicable to relieving the suffering of cancer survivors in general.

 

The review suggested, however, that different mind-body practices may be superior in addressing specific symptoms. Qigong appears to be best for improving physical fitness, Tai Chi appears to be best for reducing sleep problems and fatigue, and yoga appears to be best for alleviating mental disorders. So, tailoring the program for the greatest problems experienced by specific cancer patients may maximize the benefits for the individual patient.

 

So, improve the physical and psychological well-being of cancer survivors with mind-body practices.

 

Life with cancer can be stressful. . . Mind-body medicine helps you relax and buffer some of these effects. It can also help you manage your condition better.” – WebMD

 

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

 

Duan, L., Xu, Y., & Li, M. (2020). Effects of Mind-Body Exercise in Cancer Survivors: A Systematic Review and Meta-Analysis. Evidence-based Complementary and Alternative Medicine : eCAM, 2020, 7607161. https://doi.org/10.1155/2020/7607161

 

Abstract

Objective

Mind-body exercise may have potential benefits for cancer survivors according to previous studies. We performed a systematic review and meta-analysis to summarize the published evidence and evaluate the safety and efficacy of mind-body exercise on general quality of life (QOL) and symptom management in cancer survivors.

Methods

Four English language databases were systematically searched for existing randomized controlled trials (RCTs) of mind-body exercise in cancer survivors from database inception through October 23, 2019. Methodological quality was appraised with the Cochrane Risk of Bias tool. A meta-analysis of comparative effects was performed using the Review Manager v.5.3 software.

Results

Fifteen studies encompassing 1461 patients were included. Analysis results showed that mind-body exercise could have a statistically significant effect on the outcomes of physical fitness, fatigue, sleep quality, depression, anxiety, and BMI, while effects on general QOL and stress were not statistically significant (all p > 0.05). No serious adverse events were reported.

Conclusions

The current evidence demonstrates that mind-body exercise is relatively safe and modestly effective for symptom management in cancer survivors. Furthermore, randomized trials with larger sample sizes and of higher methodological quality are needed to confirm these results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487122/

 

Reduce Inflammation in Psychiatric Patients with Mindfulness

Reduce Inflammation in Psychiatric Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness practice was not directly linked to lower inflammation levels, but that it may have bolstered stress resilience among at-risk adults by preventing an increase in inflammatory biomarker levels.” – Grace Bullock

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. In the elderly it is associated with the onset of dementia.

 

Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent. Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. In addition, mindfulness training, has been shown to be effective in treating psychiatric disorders. It is possible that mindfulness acts, in part, to improve psychiatric disorders by decreasing inflammation in these patients.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/), Sanada and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness-based interventions in reducing biomarkers of the inflammatory response in psychiatric patients. They discovered 10 published research studies with a total of 998 participants. They included patients diagnosed with anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD.

 

They report that the published research studies found that mindfulness-based interventions improved the levels of a variety of biomarkers of inflammation with a variety of psychiatric problems. These included event-related potentials, methylation of serotonin transporter genes, IL-6, TNF-α, and adrenocorticotropic hormone. These biomarkers suggest that psychiatric disorders are associated with mild levels of inflammation and that mindfulness-based interventions reduce the levels of these biomarkers.

 

Hence the published research literature suggests that mindfulness-based interventions are effective in reducing the levels of inflammation in psychiatric patients and improving their health status. These results provide an explanation for the effectiveness of mindfulness for the improvement of anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD. They did not report on the mechanisms by which mindfulness reduces inflammation. But high on the list of possibilities has to be the ability of mindfulness training to reduce the physiological and psychological responses to stress as stress can increase inflammatory responses.

 

So, reduce inflammation in psychiatric patients with mindfulness.

 

mindfulness techniques may be more effective in relieving inflammatory symptoms than other activities that promote well-being.” – ScienceDaily

 

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

 

Sanada, K., Montero-Marin, J., Barceló-Soler, A., Ikuse, D., Ota, M., Hirata, A., Yoshizawa, A., Hatanaka, R., Valero, M. S., Demarzo, M., Campayo, J. G., & Iwanami, A. (2020). Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review. International journal of molecular sciences, 21(7), 2484. https://doi.org/10.3390/ijms21072484

 

Abstract

Mindfulness-Based Interventions (MBIs) present positive effects on mental health in diverse populations. However, the detailed associations between MBIs and biomarkers in patients with psychiatric disorders remain poorly understood. The aim of this study was to examine the effects of MBIs on biomarkers in psychiatric illness used to summarise the effects of low-grade inflammation. A systematic review of PubMed, EMBASE, PsycINFO, and the Cochrane Library was conducted. Effect sizes (ESs) were determined by Hedges’ g and the number needed to treat (NNT). Heterogeneity was evaluated. A total of 10 trials with 998 participants were included. MBIs showed significant improvements in the event-related potential amplitudes in attention-deficit hyperactivity disorder, the methylation of serotonin transporter genes in post-traumatic stress disorder, the salivary levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) in depression, and the blood levels of adrenocorticotropic hormone (ACTH), IL-6, and TNF-α in generalised anxiety disorder. MBIs showed low but significant effects on health status related to biomarkers of low-grade inflammation (g = −0.21; 95% confidence interval (CI) –0.41 to −0.01; NNT = 8.47), with no heterogeneity (I2 = 0; 95% CI 0 to 79). More trials are needed to establish the impact of MBIs on biomarkers in psychiatric illness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/

 

Reduce Anxiety and Depression with COPD with Mind-Body practices

Reduce Anxiety and Depression with COPD with Mind-Body practices

 

By John M. de Castro, Ph.D.

 

We found that yoga can be a simple, cost-effective method that can help improve quality of life in patients with COPD.” – Randeep Guleria

 

Chronic Obstructive Pulmonary Diseases (COPD) are progressive lung diseases that obstruct airflow. The two main types of COPD are chronic bronchitis and emphysema. COPD is very serious being the third leading cause of death in the United States, over 140,000 deaths per year and the number of people dying from COPD is growing. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. COPD causes serious long-term disability and early death.

 

There is no cure for COPD. Treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Gentle mind-body exercise such as Yoga, Tai Chi and Qigong practices could improve COPD symptoms. Yoga has been shown to improve exercise tolerance and overall health and includes breathing exercises. Indeed, it has been shown that yoga practice improves the mental and physical health of patients with COPD. Mindful movement practices such Tai Chi and Qigong are ancient Chinese practices involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with COPD who lack the ability to engage in strenuous exercises to engage in these gentle mind-body practices.

 

In today’s Research News article “Mind-Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981896/), Li and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of mind-body practices on the symptoms of Chronic Obstructive Pulmonary Diseases (COPD).

 

They found 13 peer-reviewed randomized controlled trials; 7 employing Qigong, 3 Tai Chi, and 3 yoga. They report that the published research found that mind-body practices produced significant reductions in anxiety and depression in patients with Chronic Obstructive Pulmonary Diseases (COPD).

 

Mindfulness practices, in general have been found to reduce anxiety and depression. The present review extends this effectiveness to mind-body mindfulness practices with patients with COPD. The mechanisms by which these practices produce these effects are not known. But all these practices involve focusing on the present moment. Anxiety is produced by fear of the future while depression is produced by rumination about the past. While focusing on the present, anxiety and depression are eliminated. Obviously, training does not eliminate thinking about the past and future. But, it may reduce the amount of time spent outside the present moment and thereby reduce the overall levels of anxiety and depression.

 

So, Reduce Anxiety and Depression with COPD with Mind-Body practices.

 

The challenge for meditators with a history of asthma, COPD, or other breathing problems is that the seemingly simple process of breathing is entangled with fear, anxiety, and other difficult emotions.” – Susan Haejin Lee

 

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

 

Li, Z., Liu, S., Wang, L., & Smith, L. (2019). Mind-Body Exercise for Anxiety and Depression in COPD Patients: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(1), 22. https://doi.org/10.3390/ijerph17010022

 

Abstract

Objectives: Mind–body exercise has been generally recognized as a beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date, no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind–body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind–body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: Mind–body exercise (tai chi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD = −0.76, 95% CI −0.91 to −0.60, p = 0.04, I2 = 47.4%) and depression (SMD = −0.86, 95% CI −1.14 to −0.58, p = 0.000, I2 = 71.4%). Sub-group analysis indicated that, for anxiety, 30–60 min exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than a 10-year disease course. For depression, 2–3 times a week, 30–60 min each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years old and have less than a 10-year disease course. Conclusions: Mind–body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981896/

 

Improve the Aging Brain and Well-Being with Mindfulness Training

Improve the Aging Brain and Well-Being with Mindfulness Training

 

By John M. de Castro, Ph.D.

 

On average, the brains of long-term meditators were 7.5 years younger at age 50 than the brains of non-meditators, and an additional 1 month and 22 days younger for every year after 50.”Grace Bullock

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our cognitive (mental) abilities which decline with age including impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. Research has found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners. Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging.

 

In today’s Research News article “Long-Term Physical Exercise and Mindfulness Practice in an Aging Population.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00358/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1293822_69_Psycho_20200407_arts_A), Tang and colleagues recruited healthy older participants who practiced for an hour a day 6 – 7 days a week for 12 years either physical exercise, aerobic walking, or integrated mind-body training, including body relaxation, mental imagery and mindfulness training. The participants underwent brain imaging with functional Magnetic Resonance Imaging (fMRI). They had their heart rate, respiration. and skin conductance recorded during a fitness exercise session. Salivary Secretory immunoglobulin A (sIgA), an index of mucosal immunity and Cortisol levels, an index of stress, were measured at rest, during stress, and during training. They also completed scales measuring general health and quality of life.

 

They found that the mindfulness group had significantly higher resting heart rate and respiration, high frequency heart rate variability, quality of life, and sIgA levels and significantly lower cortisol levels and skin conductance than the exercise group. In addition, they found that the mindfulness group compared to the exercise group had significantly larger brain striatum including the caudate and putamen and significantly greater functional connectivity between the dorsal anterior cingulate cortex and the striatum and also the insula.

 

These results are interesting and suggest that long-term mindfulness practice results in differences in the psychological, physical, and neural states compared to physical exercise. Psychological well-being improvement in the mindfulness group was suggested by the greater reported quality of life. Physiological improvements in the mindfulness group were suggested by greater relaxation as indexed by greater autonomic nervous system, parasympathetic activity and measured by heart rate variability and skin conductance and lower stress hormone, cortisol, levels. The greater volume of the striatum and greater connectivity with the dorsal anterior cingulate cortex also suggest greater physiological relaxation. The mindfulness group also showed greater immune system function as indexed by sIgA levels. On the other hand, the aerobic walking group demonstrated greater physical fitness as indexed by lower resting heart rate and respiration.

 

In sum, these findings suggest the long-term aerobic walking exercise is good for the physical fitness of older adults. But long-term mindfulness training is better for their overall psychological and physical well-being. These results correspond with other prior findings that shorter-term mindfulness practice results in greater autonomic relaxation, quality of life, and neuroplastic changes in brain systems and that this training reduces the physiological and psychological deterioration occurring with aging.

 

So, improve the aging brain and well-being with mindfulness training.

 

“Mind and body practices, in particular, including relaxation techniques and meditative exercise forms such as yoga, tai chi, and qi gong are being used by older Americans, both for fitness and relaxation, and because of perceived health benefits.” –  National Center for Complementayy and Integrative Health

 

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

 

Tang Y-Y, Fan Y, Lu Q, Tan L-H, Tang R, Kaplan RM, Pinho MC, Thomas BP, Chen K, Friston KJ and Reiman EM (2020) Long-Term Physical Exercise and Mindfulness Practice in an Aging Population. Front. Psychol. 11:358. doi: 10.3389/fpsyg.2020.00358

 

Abstract

Previous studies have shown that physical exercise and mindfulness meditation can both lead to improvement in physical and mental health. However, it is unclear whether these two forms of training share the same underlying mechanisms. We compared two groups of older adults with 10 years of mindfulness meditation (integrative body-mind training, IBMT) or physical exercise (PE) experience to demonstrate their effects on brain, physiology and behavior. Healthy older adults were randomly selected from a large community health project and the groups were compared on measures of quality of life, autonomic activity (heart rate, heart rate variability, skin conductance response, respiratory amplitude/rate), immune function (secretory Immunoglobulin A, sIgA), stress hormone (cortisol) and brain imaging (resting state functional connectivity, structural differences). In comparison with PE, we found significantly higher ratings for the IBMT group on dimensions of life quality. Parasympathetic activity indexed by skin conductance response and high-frequency heart rate variability also showed more favorable outcomes in the IBMT group. However, the PE group showed lower basal heart rate and greater chest respiratory amplitude. Basal sIgA level was significantly higher and cortisol concentration was lower in the IBMT group. Lastly, the IBMT group had stronger brain connectivity between the dorsal anterior cingulate cortex (dACC) and the striatum at resting state, as well as greater volume of gray matter in the striatum. Our results indicate that mindfulness meditation and physical exercise function in part by different mechanisms, with PE increasing physical fitness and IBMT inducing plasticity in the central nervous systems. These findings suggest combining physical and mental training may achieve better health and quality of life results for an aging population.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00358/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1293822_69_Psycho_20200407_arts_A

 

Improve the Symptoms of Parkinson’s Disease with Mind-Body Practices

Improve the Symptoms of Parkinson’s Disease with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

The mind-body connection recognizes that emotional, mental, and behavioral factors can directly affect our health, and mind-body techniques can improve quality of life and may help reduce symptoms of disease.” – Emily Downward

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi practice has been shown to improve the symptoms of Parkinson’s Disease. Hence, mind-body practices may be excellent treatments for the symptoms of Parkinson’s Disease.

 

In today’s Research News article “The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981975/), Jin and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mind-body practices for the relief of the symptoms of Parkinson’s Disease. They selected randomized controlled trials with Tai Chi, Qigong and Yoga practices for patients with Parkinson’s Disease over 40 years of age. They identified 22 studies with a total of 1199 participants, 18 of which employed Tai Chi and Qigong practices and 4 employed Yoga practice.

 

They report that the studies found that the mind-body practices produced significant improvements in overall Parkinson’s Disease motor function, walking ability, balance, depression, and quality of life. Hence, the published research studies demonstrate that mind-body practices significantly improve the physical and psychological symptoms of Parkinson’s Disease.

 

Tai Chi and Qigong practices have been demonstrated in prior research to improve balance, walking ability, depression, and quality of life in a variety of healthy and sick people. In addition yoga practice has been demonstrated to improve balance, walking ability, depression and quality of life in various populations. The present study extends these findings to patients with Parkinson’s Disease. These practices appear to be a safe and effective treatment to relieve the symptoms and suffering of patients with Parkinson’s Disease.

 

So, improve the symptoms of Parkinson’s Disease with mind-body practices.

 

Mindfulness-based interventions have the ability to reprogram brain conditioning and alter the ways in which we respond to the world. Parkinson’s patients can benefit immensely from this method as a means of decreasing stress and anxiety while slowly increasing quality of life.” – Alana Kessler

 

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

 

Jin, X., Wang, L., Liu, S., Zhu, L., Loprinzi, P. D., & Fan, X. (2019). The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-analysis. International journal of environmental research and public health, 17(1), 31. https://doi.org/10.3390/ijerph17010031

 

Abstract

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I2 = 29%), Balance (I2 = 16%) and QoL (I2 = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981975/

 

Improve Quality of Life in Breast Cancer Patients with Mind-Body Practices

Improve Quality of Life in Breast Cancer Patients with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

mindfulness makes a profound difference for breast cancer patients and survivors, both physically and mentally.” – Laura Dorwart

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. But over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. Breast cancer is very common with 1 out of every 8 women developing breast cancer sometime during their lives.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbancefear, and anxiety and depression. Mind-body practices have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. There has been a considerable amount of research conducted and it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “The Effect of Complementary and Alternative Medicines on Quality of Life in Patients with Breast Cancer: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017686/), Nayeri and colleagues review and summarize the published research studies of the effectiveness of mind-body practices for the treatment of breast cancer patients. They identified 28 clinical trials, 18 of which were randomized controlled clinical trials.

 

They report that 27 of the 28 trials found that mind-body practices result in significant improvement in the quality of life of women with breast cancer. The mind-body practices used included yoga, acupuncture, art therapy, music therapy, guided imagery, cognitive-behavioral stress management, and mental exercise techniques.

 

These findings are overwhelmingly positive suggesting that mind-body practices are safe and effective treatments to improve the quality of life of women living with breast cancer. This is particularly important as there are such a large number of women living with the current or residual symptoms of breast cancer and its treatment. These practices then are important for the relief of their suffering.

 

So, improve quality of life in breast cancer patients with mind-body practices.

 

The routine use of yoga, meditation, relaxation techniques, and passive music therapy to address common mental health concerns among patients with breast cancer is supported by high levels of evidence,” – Debu Tripathy

 

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

 

Nayeri, N. D., Bakhshi, F., Khosravi, A., & Najafi, Z. (2020). The Effect of Complementary and Alternative Medicines on Quality of Life in Patients with Breast Cancer: A Systematic Review. Indian journal of palliative care, 26(1), 95–104. https://doi.org/10.4103/IJPC.IJPC_183_19

 

Abstract

Background:

Breast cancer disease and its classic treatment lead to decrease in patients’ quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer.

Methods:

English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants’ characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind-body techniques.

Results:

During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind-body techniques. Twenty-seven studies showed improved QOL (P > 0.05).

Conclusion:

The findings may indicate the potential benefits of CAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017686/

 

Improve Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Youth with Mind-Body Practices

Improve Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Youth with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

mindfulness practice can help us pay attention better, resist distractions, be less impulsive, remember what we are doing in the moment, and regulate our own emotions, it is helpful whether we have ADHD or not. But it holds special interest for those with ADHD.” – Casey Dixon

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mind-body practices training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mind-body practices training are identical to those that are defective in ADHD,  attentionimpulse controlexecutive functionemotion control, and mood improvement. In addition, unlike drugs, they are relatively safe interventions that have minimal troublesome side effects. Since mind-body practices is so promising as treatments, it is important to step back and summarize what has been learned in the scientific research of the effectiveness of mindfulness training for ADHD.

 

In today’s Research News article “Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680862/), Barranco-Ruiz and colleagues review and summarize the published research studies of the effectiveness pf mind-body practices in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). They found 12 published randomized trials employing the mind-body practices of school based 8-week mindfulness trainings and yoga practices that were applied to children and adolescents of 5 to 18 years of age.

 

They found that 11 of the 12 reviewed studies reported significant improvements in Attention-Deficit/Hyperactivity Disorder (ADHD) following mind-body treatment in the youths. There were significant improvements in the symptoms of ADHD including significant increases in attention and planning, and significant decreases in inattention, hyperactivity, impulsivity, anxiety, shyness, social problems, perfectionism, inhibition, self-reported emotion dysregulation, and depressive symptoms.

 

These are impressive results. It has been previously shown with disparate healthy and ill populations that mindfulness training produces increases in attention and significant decreases in inattention, hyperactivity, impulsivity, anxiety, social problems, perfectionism, inhibition, emotion dysregulation, and depression. The present review extends these findings to children and adolescents. This is important as Attention-Deficit/Hyperactivity Disorder (ADHD) is highest among children and adolescents. These results suggest that mindfulness training and yoga practices are safe and effective in improving ADHD and its symptoms. Mind-body practices may be an excellent alternative to standard drug treatment.

 

So, improve Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in youth with mind-body practices.

 

Yoga has been shown to help improve ADHD symptoms. . . . Like mindfulness meditation, it ups dopamine levels and strengthens the prefrontal cortex. One study found that kids who practiced yoga moves for 20 minutes twice a week for 8 weeks improved on tests that measure attention and focus.” – WebMD

 

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

 

Barranco-Ruiz, Y., Etxabe, B. E., Ramírez-Vélez, R., & Villa-González, E. (2019). Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review. Medicina (Kaunas, Lithuania), 55(7), 325. doi:10.3390/medicina55070325

 

Abstract

Background and objectives: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. Mind–body therapies (MBTs) seem to be effective for improving health in different populations; however, whether a positive effect occurs in children and adolescents with ADHD is still controversial. The main aim of this systematic review was to analyse the interventions based on MBT aimed to improve the main ADHD symptoms in children and adolescents. Materials and Methods: A systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify MBT studies on children and adolescents (4–18 years) with a clinical diagnosis of ADHD. Study quality was evaluated by the NIH quality tool (U.S. National Institute of Health). Results: There were positive results in eleven out of twelve included studies regarding the effect of the MBT interventions on ADHD symptoms. With respect to ADHD symptoms, we observed differences across studies. In relation to the studies’ quality, eleven studies were rated “poor” and one was rated as “fair”. Conclusions: MBTs, such as yoga or mindfulness, could be positive strategies to mitigate ADHD symptoms in children and adolescents. However, further research with high-quality designs, with randomization, greater sample sizes, and more intensive supervised practice programs are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680862/

 

Improve Knee and Hip Osteoarthritis with Exercise and Mind-Body Practices

Improve Knee and Hip Osteoarthritis with Exercise and Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

studies suggest that specific mind-body therapies may help reduce pain and improve physical function in persons with osteoarthritis of the knee.” – Terry Selfe

 

Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. It is the leading cause of disability in the U.S., with about 43% of arthritis sufferers limited in mobility and about a third having limitations that affect their ability to perform their work. Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. Hip osteoarthritis effects 9% of adults. It is painful and disabling. Its causes are varied including, hereditary, injury including sports injuries, repetitive stress injuries, infection, or from being overweight.

 

There are no cures for knee or hip osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee or hip replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee or hip osteoarthritis. This suggests that alternative and mind-body practices that involve gentle knee movements may be useful in for treatment. Indeed, yoga practice has been shown to be effective in treating arthritis and Tai Chi and Qigong have also been shown to reduce the physical symptoms of knee osteoarthritis. So, it would seem reasonable to summarize the research into the effectiveness of mind-body practices relative to other exercises in treating knee or hip osteoarthritis.

 

In today’s Research News article “Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459784/), Goh and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of mind-body practices and exercise on knee or hip osteoarthritis. They found 103 controlled trials including a total of 9134 participants. Exercises were separated in strengthening, aerobic, and flexibility exercises and movements combined with mindfulness (e.g. yoga, Tai Chi, Qigong); mind-body practices. Most studies (76) compared these practices versus usual medical care.

 

They report that the published research studies found that in comparison to usual care, all exercises produced significant benefits including reduced pain, improved movement performance, self-reported motor abilities, and quality of life. These benefits were greater for knee osteoarthritis than for hip osteoarthritis. Of the various exercises they found that in general aerobic exercise produced the greatest benefits for pain and movement performance, while mind-body practices had equivalent benefit for pain and produced the greatest benefits for self-reported motor abilities.

 

These results confirm that exercise is good for patients with hip or knee osteoarthritis, improving movement and quality of life and reducing pain. It appears that aerobic exercises and mind-body exercises produce the greatest benefits. This suggests that these practices be recommended for patients with hip or knee osteoarthritis to reduce their difficulties with movement and reduce their suffering.

 

So, improve knee and hip osteoarthritis with exercise and mind-body practices.

 

We don’t choose to have arthritis, but we can choose how to respond to and cope with it. By not allowing pain to define our lives, we can change how we view and relate to pain. That’s mindfulness – we are changing our feelings and thoughts around pain.” – Andrea Minick Rudolph

 

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

 

Goh, S. L., Persson, M., Stocks, J., Hou, Y., Welton, N. J., Lin, J., … Zhang, W. (2019). Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis. Sports medicine (Auckland, N.Z.), 49(5), 743–761. doi:10.1007/s40279-019-01082-0

 

Abstract

Background

Guidelines recommend exercise as a core treatment for osteoarthritis (OA). However, it is unclear which type of exercise is most effective, leading to inconsistency between different recommendations.

Objectives

The aim of this systematic review and network meta-analysis was to investigate the relative efficacy of different exercises (aerobic, mind–body, strengthening, flexibility/skill, or mixed) for improving pain, function, performance and quality of life (QoL) for knee and hip OA at, or nearest to, 8 weeks.

Methods

We searched nine electronic databases up until December 2017 for randomised controlled trials that compared exercise with usual care or with another exercise type. Bayesian network meta-analysis was used to estimate the relative effect size (ES) and corresponding 95% credibility interval (CrI) (PROSPERO registration: CRD42016033865).

Findings

We identified and analysed 103 trials (9134 participants). Aerobic exercise was most beneficial for pain (ES 1.11; 95% CrI 0.69, 1.54) and performance (1.05; 0.63, 1.48). Mind–body exercise, which had pain benefit equivalent to that of aerobic exercise (1.11; 0.63, 1.59), was the best for function (0.81; 0.27, 1.36). Strengthening and flexibility/skill exercises improved multiple outcomes at a moderate level. Mixed exercise was the least effective for all outcomes and had significantly less pain relief than aerobic and mind–body exercises. The trend was significant for pain (p = 0.01), but not for function (p = 0.07), performance (p = 0.06) or QoL (p = 0.65).

Conclusion

The effect of exercise varies according to the type of exercise and target outcome. Aerobic or mind–body exercise may be the best for pain and function improvements. Strengthening and flexibility/skill exercises may be used for multiple outcomes. Mixed exercise is the least effective and the reason for this merits further investigation.

Electronic supplementary material

The online version of this article (10.1007/s40279-019-01082-0) contains supplementary material, which is available to authorized users.

Background

Guidelines recommend exercise as a core treatment for osteoarthritis (OA). However, it is unclear which type of exercise is most effective, leading to inconsistency between different recommendations.

Objectives

The aim of this systematic review and network meta-analysis was to investigate the relative efficacy of different exercises (aerobic, mind–body, strengthening, flexibility/skill, or mixed) for improving pain, function, performance and quality of life (QoL) for knee and hip OA at, or nearest to, 8 weeks.

Methods

We searched nine electronic databases up until December 2017 for randomised controlled trials that compared exercise with usual care or with another exercise type. Bayesian network meta-analysis was used to estimate the relative effect size (ES) and corresponding 95% credibility interval (CrI) (PROSPERO registration: CRD42016033865).

Findings

We identified and analysed 103 trials (9134 participants). Aerobic exercise was most beneficial for pain (ES 1.11; 95% CrI 0.69, 1.54) and performance (1.05; 0.63, 1.48). Mind–body exercise, which had pain benefit equivalent to that of aerobic exercise (1.11; 0.63, 1.59), was the best for function (0.81; 0.27, 1.36). Strengthening and flexibility/skill exercises improved multiple outcomes at a moderate level. Mixed exercise was the least effective for all outcomes and had significantly less pain relief than aerobic and mind–body exercises. The trend was significant for pain (p = 0.01), but not for function (p = 0.07), performance (p = 0.06) or QoL (p = 0.65).

Conclusion

The effect of exercise varies according to the type of exercise and target outcome. Aerobic or mind–body exercise may be the best for pain and function improvements. Strengthening and flexibility/skill exercises may be used for multiple outcomes. Mixed exercise is the least effective and the reason for this merits further investigation.

Key Points

The effect of exercise in knee and hip osteoarthritis depends on type of exercise and outcome of interest.
Aerobic and mind–body exercises appear to be the two most effective exercise therapies for pain and function, whereas strengthening and flexibility exercises appear to be good for moderate improvement of multiple outcomes.
Mixed exercise is the least effective exercise. However, it may be used for patients who do not respond to other types of exercise therapy because it is still better than no exercise control for all four patient-centred outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459784/