contemplative practice

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/

 

Relieve Pain with Brief Mindfulness-Based Interventions

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Relieve Pain with Brief Mindfulness-Based Interventions

 

By John M. de Castro, Ph.D.

 

“The mechanisms behind how mindfulness reduces pain . . . continue to include mindfulness meditation’s ability to provide pain relief by cultivating the ability to parse between the objective sensory dimension of pain, and the more subjective judgement that we attach to the pain that constructs the way we experience it.” – Jennifer Wolkin

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. What is not known is the most effective approach to teaching mindfulness for the treatment of both acute and chronic pain. There are very brief mindfulness trainings that are practical methods, requiring minimal time and effort, for inducing mindfulness. The question is are they effective for reducing pain.

 

In today’s Research News article “Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437625/ ) McClintock and colleagues review and summarize the published research literature on the effective of Brief Mindfulness-Based Interventions (BMBI), with total contact time of less than 1.5 hours, for the treatment of pain. They identified 20 published research studies.

 

They report that 11 of 19 quantitative studies reported that Brief Mindfulness-Based Interventions (BMBI) resulted in significant reductions in pain intensity or unpleasantness. But BMBIs less than 5 minutes or delivered by audio recording did not produce consistent results. On the other hand, when the BMBI was longer than 5 minutes and were delivered through direct participant-provider contact, there was a consistent significant reduction in pain intensity or unpleasantness This was true for both clinical and non-clinical participants.

 

It should be kept in mind that these findings relate to very brief mindfulness interventions. Longer interventions consistently produce reductions in pain regardless of whether the intervention is delivered in person or over the internet. But the present findings are interesting and potentially significant because of the brevity of the interventions. These Brief Mindfulness-Based Interventions (BMBI) can be provided quickly and conveniently without a long-term commitment by the patient or the provider. This makes them inexpensive and acceptable to a wide range of patients. This allows for widespread use of mindfulness to relieve the suffering of pain patients.

 

So, relieve pain with brief mindfulness-based interventions.

 

“the goal of those [mindfulness] practices is typically not to remove pain entirely, but to change your relationship with it so that you are able to experience relief and healing in the middle of uncomfortable physical sensations.” – Andrea Uptmor

 

 

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

 

Andrew S. McClintock, Shannon M. McCarrick, Eric L. Garland, Fadel Zeidan, Aleksandra E. Zgierska. Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review. J Altern Complement Med. 2019 Mar 1; 25(3): 265–278. Published online 2019 Mar 9. doi: 10.1089/acm.2018.0351

 

Abstract

Objectives: Nonpharmacologic approaches have been characterized as the preferred means to treat chronic noncancer pain by the Centers for Disease Control and Prevention. There is evidence that mindfulness-based interventions (MBIs) are effective for pain management, yet the typical MBI may not be feasible across many clinical settings due to resource and time constraints. Brief MBIs (BMBIs) could prove to be more feasible and pragmatic for safe treatment of pain. The aim of the present article is to systematically review evidence of BMBI’s effects on acute and chronic pain outcomes in humans.

Methods: A literature search was conducted using PubMed, PsycINFO, and Google Scholar and by examining the references of retrieved articles. Articles written in English, published up to August 16, 2017, and reporting on the effects of a BMBI (i.e., total contact time <1.5 h, with mindfulness as the primary therapeutic technique) on a pain-related outcome (i.e., pain outcome, pain affect, pain-related function/quality of life, or medication-related outcome) were eligible for inclusion. Two authors independently extracted the data and assessed risk of bias.

Results: Twenty studies meeting eligibility criteria were identified. Studies used qualitative (n = 1), within-group (n = 3), or randomized controlled trial (n = 16) designs and were conducted with clinical (n = 6) or nonclinical (i.e., experimentally-induced pain; n = 14) samples. Of the 25 BMBIs tested across the 20 studies, 13 were delivered with audio/video recording only, and 12 were delivered by a provider (participant–provider contact ranged from 3 to 80 min). Existing evidence was limited and inconclusive overall. Nevertheless, BMBIs delivered in a particular format—by a provider and lasting more than 5 min—showed some promise in the management of acute pain.

Conclusions: More rigorous large scale studies conducted with pain populations are needed before unequivocally recommending BMBI as a first-line treatment for acute or chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437625/

 

Improve Inflammation and Depression with Mild Cognitive Impairment with Mindfulness

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Improve Inflammation and Depression with Mild Cognitive Impairment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“adults with mild cognitive impairment who practice mindfulness meditation could experience a boost in cognitive reserve.” – Monica Beyer

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly frequently have problems with attention, thinking, and memory, known as mild cognitive impairment. An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue.

 

Intervening early in patients with mild cognitive impairment may be able to delay or even prevent full blown dementia. So, it is important to study the effectiveness of mindfulness training on older adults with mild cognitive impairment to improve their psychological and physical well-being and cognitive performance.

 

In today’s Research News article “The Effect of Mindfulness-Based Stress Reduction (MBSR) on Depression, Cognition, and Immunity in Mild Cognitive Impairment: A Pilot Feasibility Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429186/ ) Marciniak and colleagues recruited older adults, over 55 years of age, who were diagnosed with mild cognitive impairment and randomly assigned them to receive 8 weekly 2.5-hour sessions of either Mindfulness-Based Stress Reduction (MBSR) or to cognitive training. Weekly training was accompanied by daily home practice. MBSR consisted in training of body scan, sitting meditation, mindful movement, working with difficulties, meditation with imagination, and discussion. Cognitive training focused on specific cognitive domains including memory, attention, and logical thinking. They were measured before and after training and 6 months later for cognitive functions, anxiety, depression and spiritual well-being. Blood was drawn before and after training and assayed for immune system cells.

 

They found that in comparison to baseline and the cognitive training group, the participants who received Mindfulness-Based Stress Reduction (MBSR) training had significantly lower depression levels both after training and 6 months later. The MBSR group also had improvements in psychomotor speed and significant decreases in resting monocyte activation immediately after training.

 

These are somewhat disappointing results as neither Mindfulness-Based Stress Reduction (MBSR) or cognitive training produced significant improvements in cognitive function. The study was rather small, however, with only 12 and 9 participants in the groups respectively. statistical power was lacking to detect differences. These results suggest that large changes in cognitive abilities are not produced in these patients by either MBSR or cognitive training.

 

Nevertheless, MBSR training did significantly improve depression in these elderly with mild cognitive impairment. MBSR has been shown to improve depression in a variety of different types of healthy and sick individuals. So, this result is not surprising but important as depression is a serious problem in the elderly, especially those with diminished cognitive capacity and that depression can produce further physical and psychological deterioration in the patients.

 

Importantly, Mindfulness-Based Stress Reduction (MBSR) appears to reduce immune monocyte activation. This suggests that MBSR may reduce inflammation. It has been previously shown to reduce inflammation in other groups. This is potentially important in that levels of inflammation are generally high in patients with mild cognitive impairment and chronic inflammation is a threat to the health and well-being of these patients. Reducing it with MBSR training may have long-term consequences for improved health in elderly patients with mild cognitive impairment.

 

So, improve inflammation and depression with mild cognitive impairment with mindfulness.

 

“A mindfulness intervention reduces inflammatory biomarkers that are associated with cognitive decline and dementia in older adults.” – Eric Dolan

 

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

 

Marciniak, R., Šumec, R., Vyhnálek, M., Bendíčková, K., Lázničková, P., Forte, G., Jeleník, A., Římalová, V., Frič, J., Hort, J., & Sheardová, K. (2020). The Effect of Mindfulness-Based Stress Reduction (MBSR) on Depression, Cognition, and Immunity in Mild Cognitive Impairment: A Pilot Feasibility Study. Clinical interventions in aging, 15, 1365–1381. https://doi.org/10.2147/CIA.S249196

 

Abstract

Background

Mindfulness-based programs have shown a promising effect on several health factors associated with increased risk of dementia and the conversion from mild cognitive impairment (MCI) to dementia such as depression, stress, cognitive decline, immune system and brain structural and functional changes. Studies on mindfulness in MCI subjects are sparse and frequently lack control intervention groups.

Objective

To determine the feasibility and the effect of mindfulness-based stress reduction (MBSR) practice on depression, cognition and immunity in MCI compared to cognitive training.

Methods

Twenty-eight MCI subjects were randomly assigned to two groups. MBSR group underwent 8-week MBSR program. Control group underwent 8-week cognitive training. Their cognitive and immunological profiles and level of depressive symptoms were examined at baseline, after each 8-week intervention (visit 2, V2) and six months after each intervention (visit 3, V3). MBSR participants completed feasibility questionnaire at V2.

Results

Twenty MCI patients completed the study (MBSR group n=12, control group n=8). MBSR group showed significant reduction in depressive symptoms at both V2 (p=0.03) and V3 (p=0.0461) compared to the baseline. There was a minimal effect on cognition – a group comparison analysis showed better psychomotor speed in the MBSR group compared to the control group at V2 (p=0.0493) but not at V3. There was a detectable change in immunological profiles in both groups, more pronounced in the MBSR group. Participants checked only positive/neutral answers concerning the attractivity/length of MBSR intervention. More severe cognitive decline (PVLT≤36) was associated with the lower adherence to home practice.

Conclusion

MBSR is well-accepted potentially promising intervention with positive effect on cognition, depressive symptoms and immunological profile.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429186/

 

Novelty Seeking Lowers the Ability of Mindfulness Training to Increase Self-Compassion.

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Novelty Seeking Lowers the Ability of Mindfulness Training to Increase Self-Compassion.

 

By John M. de Castro, Ph.D.

 

“Mindfulness is the foundation of self-compassion insofar as we can only respond self-compassionately when we know we are struggling.” – Pittman McGehee

 

One of the more remarkable aspects of Western culture is that in general people do not like themselves. We are constantly comparing ourselves to others and since there can only one best, virtually everyone falls short. So, we constantly criticize ourselves for not being the smartest, the swiftest, the strongest, the most liked, the most handsome or beautiful. If there wasn’t something wrong with us, then we would be the best. As a result, we become focused and obsessed with our flaws. This can lead to anxiety and worry and poorer mental health.

 

Mindfulness promotes experiencing and accepting ourselves as we are, which is a direct antidote to seeing ourselves in comparison to others and as we wish to be. In other words, mindfulness promotes self-compassion. Self-compassion involves being warm and understanding about ourselves rather than self-criticism. If we have that attitude, we will like ourselves more and suffer less. So, it is important to study what factors affect the ability of mindfulness training to increase self-compassion.

 

In today’s Research News article “More Purpose in Life and Less Novelty Seeking Predict Improvements in Self-Compassion During a Mindfulness-Based Intervention: The EXMIND Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146234/ ) Akase and colleagues recruited adult participants and randomly assigned them to receive either 8 weekly mindfulness training sessions or 4 weeks of mindfulness training followed by 4 weeks of existential approach. Both groups required daily home practice. The mindfulness training included raisin exercise, mindful breathing, body scan, walking meditation, and sitting meditation. The participants were measured before, at 4 weeks and after training for mindfulness, self-compassion, temperament, reading ability, depression, parental bonding, and purpose in life.

 

They found that mindfulness training produced significantly increased self-compassion at 4 weeks and significantly greater increased self-compassion at the end of training. They also found that the higher the levels at baseline of purpose in life and the lower the levels of novelty seeking the greater the change in self-compassion produced by mindfulness training. In addition, they found that the higher the levels of purpose in life, but not novelty seeking, the higher the levels of self-compassion.

 

The findings found as has been seen in previous research that mindfulness training improves self-compassion. This is important as higher levels of self-compassion are associated with better mental health, greater resistance to stress, and less burnout. The current study found also that the effectiveness of mindfulness training in increasing self-compassion was best in participants who were low in novelty seeking and high in purpose in life.

 

That self-compassion and purpose in life are related may be due to conceptual overlap between the two. Indeed, many of the questions in the scales measuring purpose in life and self-compassion are very similar. Novelty seeking, on the other hand, is not directly related to self-compassion, rather it appears to modulate the effectiveness of mindfulness training to improve self-compassion. It was speculated that novelty seeking makes it more difficult to disengage from spontaneous thoughts (mind wandering) during mindfulness exercises and thereby decreases the effectiveness of mindfulness training.

 

Hence, novelty seeking lowers the ability of mindfulness training to increase self-compassion.

 

“The growing movements of self-compassion and mindfulness are linked by the growing awareness and evidence from a huge body of research that indicate that treating ourselves (and others) with kindness not only feels better but also allows us to make healthy changes and face new challenges with more success.” – Samantha Price

 

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

 

Akase, M., Terao, T., Kawano, N., Sakai, A., Hatano, K., Shirahama, M., Hirakawa, H., Kohno, K., & Ishii, N. (2020). More Purpose in Life and Less Novelty Seeking Predict Improvements in Self-Compassion During a Mindfulness-Based Intervention: The EXMIND Study. Frontiers in psychiatry, 11, 252. https://doi.org/10.3389/fpsyt.2020.00252

 

Abstract

Objectives

Recently, a 4-week mindfulness-based intervention followed by a 4-week existential approach was found to be as effective for increasing self-compassion as an 8-week mindfulness-based intervention. The purpose of the present study was to identify the factors that predicted change in self-compassion during the 8-week mindfulness-based intervention.

Methods

Fifty-seven of the 61 completers of the 8-week mindfulness-based intervention provided baseline, 4-week, and 8-week self-compassion scale scores. The mean age of the 47 females and 10 males was 49.6 years. Pearson’s correlation coefficients were generated on the associations between the change of total self-compassion scale scores from baseline to 8 weeks with age; gender; and the baseline scores on the Temperament Evaluation of Memphis, Pisa and San Diego Auto-questionnaire, Temperament and Character Inventory (TCI), Mini-Mental State Examination, Japanese Adult Reading Test, Young Mania Rating Scale, Hamilton Rating Scale for Depression, Parental Bonding Instrument, and purpose in life (PIL). Multiple regression analysis was performed to identify the predictors of the change in total self-compassion scale scores.

Results

Novelty seeking (TCI) was significantly and negatively associated with the change in total self-compassion scale scores, whereas the PIL scores were significantly and positively associated with the change in total self-compassion scale scores. Novelty seeking was not significantly associated with baseline, 4-week, or 8-week total self-compassion scale scores, whereas the PIL scores were significantly and positively associated with baseline, 4-week, and 8-week total self-compassion scale scores. The limitation of the present study was a relatively small number of subjects which deterred a more sophisticated analysis of the pathways involved.

Conclusions

The present findings suggest that more PIL and less novelty seeking predict improvements in self-compassion during mindfulness-based interventions, although novelty seeking might substantially predict the improvement but self-compassion scale and PIL might somewhat conceptually overlap.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146234/

 

Improve Sleep and Reduce Insomnia with Mindfulness

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Improve Sleep and Reduce Insomnia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If insomnia is at the root of your sleepless nights, it may be worth trying meditation. The deep relaxation technique has been shown to increase sleep time, improve sleep quality, and make it easier to fall (and stay) asleep.” – Sleep Foundation

 

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.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. It would seem reasonable to expect that Acceptance and Commitment Therapy (ACT) might improve sleep and relieve insomnia. A number of studies have been performed. So, it makes sense to examine what has been learned.

 

In today’s Research News article “The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425538/ ) Salari and colleagues review and summarize the published research studies on the effects of Acceptance and Commitment Therapy (ACT) on sleep and insomnia.

 

They identified 19 published studies with a total of 1577 participants. They report that the published research found that Acceptance and Commitment Therapy (ACT) significantly improved sleep quality and reduced insomnia in healthy individuals and in patients with chronic insomnia. These benefits of ACT were still present up to a year after the completion of training.

 

Acceptance and Commitment Therapy (ACT) is a complex therapy and the studies do not identify which components or combination of components are necessary to produce the benefits. Nevertheless, the results clearly demonstrate that ACT is a safe and effective therapy for the improvement of sleep and the reduction in insomnia. This should have secondary effects of improving health and well-being

 

So, improve sleep and reduce insomnia with mindfulness.

 

“The idea is to create a reflex to more easily bring forth a sense of relaxation. That way, it’s easier to evoke the relaxation response at night when you can’t sleep.” – Herbert Benson

 

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

 

Salari, N., Khazaie, H., Hosseinian-Far, A., Khaledi-Paveh, B., Ghasemi, H., Mohammadi, M., & Shohaimi, S. (2020). The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review. BMC neurology, 20(1), 300. https://doi.org/10.1186/s12883-020-01883-1

 

Abstract

Background

Acceptance and Commitment Therapy (ACT), as a type of behavioral therapy, attempts to respond to changes in people’s performance and their relationship to events. ACT can affect sleep quality by providing techniques to enhance the flexibility of patients’ thoughts, yet maintaining mindfullness. Therefore, for the first time, a systematic review on the effects of ACT on sleep quality has been conducted.

Methods

This systematic review was performed to determine the effect of ACT on insomnia and sleep quality. To collect articles, the PubMed, Web of Science (WOS), Cochrane library, Embase, Scopus, Science Direct, ProQuest, Mag Iran, Irandoc, and Google Scholar databases were searched, without a lower time-limit, and until April 2020.

Results

Related articles were derived from 9 research repositories, with no lower time-limit and until April 2020. After assessing 1409 collected studies, 278 repetitive studies were excluded. Moreover, following the primary and secondary evaluations of the remaining articles, 1112 other studies were removed, and finally a total of 19 intervention studies were included in the systematic review process. Within the remaining articles, a sample of 1577 people had been assessed for insomnia and sleep quality.

Conclusion

The results of this study indicate that ACT has a significant effect on primary and comorbid insomnia and sleep quality, and therefore, it can be used as an appropriate treatment method to control and improve insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425538/

 

Improve Low Back Pain and Its Effects with Yoga Practice

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Improve Low Back Pain and Its Effects with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“If you’re dealing with back pain, yoga may be just what the doctor ordered. Yoga is a mind-body therapy that’s often recommended to treat not only back pain but the stress that accompanies it. The appropriate poses can relax and strengthen your body.” – Emily Cronkleton

 

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 pain. Yoga practice combines mindfulness practice with exercise and has been shown to have a myriad of health benefits. Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. Indeed, yoga has been shown to relieve chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain. The research has been accumulating and it is useful to summarize what has been learned.

 

In today’s Research News article “Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: 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/PMC7462307/ ) Zhu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice in comparison to other exercises for low back pain. They identified 18 randomized controlled trials.

 

They report that the published research found that yoga practice, in comparison to baseline and no-exercise controls, produced significant reductions in pain and functional disability that was still present 6 months after the completion of training. At 12 months, there was still a significant difference in functional disability but not pain. In comparison to physical therapy, yoga produced significantly greater pain reduction but not functional disability immediately after treatment but this difference disappeared at 4 weeks after the completion of training. Yoga practice did not produce significant improvements in the patients’ quality of life.

 

These results suggest that yoga practice is effective in improving pain and functional disability in patients with low back pain. Yoga practice appears to be as effective but not superior to physical therapy. Hence, the published research to date suggests that low back pain can be successfully treated with either yoga practice or physical therapy.

 

So, improve low back pain and its effects with yoga practice.

 

“Achy back? Give yoga a go. Numerous studies have shown the power of the ancient practice, which emphasizes stretching, strength, and flexibility, to relieve back soreness and improve function.” – Annie Houser

 

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

 

Feilong Zhu, Ming Zhang, Dan Wang, Qianqin Hong, Cheng Zeng, Wei Che. Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2020; 15(9): e0238544. Published online 2020 Sep 1. doi: 10.1371/journal.pone.0238544

 

Abstract

Background

Chronic low back pain (CLBP) is a common and often disabling musculoskeletal condition. Yoga has been proven to be an effective therapy for chronic low back pain. However, there are still controversies about the effects of yoga at different follow-up periods and compared with other physical therapy exercises.

Objective

To critically compare the effects of yoga for patients with chronic low back pain on pain, disability, quality of life with non-exercise (e.g. usual care, education), physical therapy exercise.

Methods

This study was registered in PROSPERO, and the registration number was CRD42020159865. Randomized controlled trials (RCTs) of online databases included PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase which evaluated effects of yoga for patients with chronic low back pain on pain, disability, and quality of life were searched from inception time to November 1, 2019. Studies were eligible if they assessed at least one important outcome, namely pain, back-specific disability, quality of life. The Cochrane risk of bias tool was used to assess the methodological quality of included randomized controlled trials. The continuous outcomes were analyzed by calculating the mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) according to whether combining outcomes measured on different scales or not.

Results

A total of 18 randomized controlled trials were included in this meta-analysis. Yoga could significantly reduce pain at 4 to 8 weeks (MD = -0.83, 95% CI = -1.19 to -0.48, p<0.00001, I2 = 0%), 3 months (MD = -0.43, 95% CI = -0.64 to -0.23, p<0.0001, I2 = 0%), 6 to 7 months (MD = -0.56, 95% CI = -1.02 to -0.11, p = 0.02, I2 = 50%), and was not significant in 12 months (MD = -0.52, 95% CI = -1.64 to 0.59, p = 0.36, I2 = 87%) compared with non-exercise. Yoga was better than non-exercise on disability at 4 to 8 weeks (SMD = -0.30, 95% CI = -0.51 to -0.10, p = 0.003, I2 = 0%), 3 months (SMD = -0.31, 95% CI = -0.45 to -0.18, p<0.00001, I2 = 30%), 6 months (SMD = -0.38, 95% CI = -0.53 to -0.23, p<0.00001, I2 = 0%), 12 months (SMD = -0.33, 95% CI = -0.54 to -0.12, p = 0.002, I2 = 9%). There was no significant difference on pain, disability compared with physical therapy exercise group. Furthermore, it suggested that there was a non-significant difference on physical and mental quality of life between yoga and any other interventions.

Conclusion

This meta-analysis provided evidence from very low to moderate investigating the effectiveness of yoga for chronic low back pain patients at different time points. Yoga might decrease pain from short term to intermediate term and improve functional disability status from short term to long term compared with non-exercise (e.g. usual care, education). Yoga had the same effect on pain and disability as any other exercise or physical therapy. Yoga might not improve the physical and mental quality of life based on the result of a merging.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462307/