Yoga

Yoga Improves Resident Physician Psychological Health But Doesn’t Appear to be Feasible and Acceptable.

psyjdc Leave a comment

Yoga Improves Resident Physician Psychological Health But Doesn’t Appear to be Feasible and Acceptable.

 

By John M. de Castro, Ph.D.

 

“Slammed by long and unpredictable hours, heavy clinical workloads, fatigue and limited professional control, many medical residents experience stress and even burnout. And surveys indicate this burnout can seriously impact physician well-being and patient care outcomes.” – Jennifer Huber

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Yoga is a mind-body practice that includes mindfulness and exercise. Yoga practice has been shown to improve the symptoms of burnout. But it is unclear whether it would be feasible and effective for resident physicians.

 

In today’s Research News article “Evaluation of a Yoga-Based Mind-Body Intervention for Resident Physicians: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961714/ ) Loewenthal and colleagues recruited resident physicians and randomly assigned them to a wait-list control condition or to receive 1-hour, once a week for 6-weeks yoga training with daily home practice. They completed a questionnaire regarding the feasibility of the program. They were also measured before and after training and 2-months later for psychological health, including mindfulness, resilience, perceived stress, professional fulfillment, depression, anxiety, sleep disturbance, and resident well-being.

 

The participants rated the feasibility and acceptability of the program as low and they averaged attending only 1.93 of the 6 sessions with no one completing all 6 sessions. They found that the yoga group had significant increases in mindfulness, resilience, professional fulfillment, and resident well-being and significant decreases in anxiety, perceived stress, and sleep disturbance. While the wait-list group did not.

 

These efficacy findings are similar to those reported in other studies that yoga training results in increases in mindfulness, resilience, and well-being and significant decreases in anxiety, perceived stress, and sleep disturbance. But the program was very disappointing in feasibility and acceptability. Resident physicians are pressed for time and stressed and may not have the time too attend classes and practice yoga. Other mindfulness programs, particularly those implemented online have been found to be feasible, acceptable, and effective for health care workers. They would appear to be preferable to yoga for resident physicians.

 

So, yoga improves resident physician psychological health but doesn’t appear to be feasible and acceptable.

 

“So often we treat others’ bodies and minds, yet often neglect our own. While we encourage our patients to roll out their mats and settle into their asanas, we can remember to do it ourselves. When we treat our stress and anxiety, we will be better able to treat our patients.” – Julia Michie Bruckner,

 

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

 

Loewenthal, J., Dyer, N. L., Lipsyc-Sharf, M., Borden, S., Mehta, D. H., Dusek, J. A., & Khalsa, S. (2021). Evaluation of a Yoga-Based Mind-Body Intervention for Resident Physicians: A Randomized Clinical Trial. Global advances in health and medicine, 10, 21649561211001038. https://doi.org/10.1177/21649561211001038

 

Abstract

Background and Objective

Mind-body interventions (MBIs) have been shown to be effective individual-level interventions for mitigating physician burnout, but there are no controlled studies of yoga-based MBIs in resident physicians. We assessed the feasibility of a yoga-based MBI called RISE (resilience, integration, self-awareness, engagement) for residents among multiple specialties and academic medical centers.

Methods

We conducted a waitlist controlled randomized clinical trial of the RISE program with residents from multiple specialty departments at three academic medical centers. The RISE program consisted of six weekly sessions with suggested home practice. Feasibility was assessed across six domains: demand, implementation, practicality, acceptability, adaptation, and integration. Self-reported measures of psychological health were collected at baseline, post-program, and two-month follow-up.

Results

Among 2,000 residents contacted, 75 were assessed for eligibility and 56 were enrolled. Forty-four participants completed the study and were included in analysis. On average, participants attended two of six sessions. Feasibility of in-person attendance was rated as 28.9 (SD 25.6) on a 100-point visual analogue scale. Participants rated feasibility as 69.2 (SD 26.0) if the program was offered virtually. Those who received RISE reported improvements in mindfulness, stress, burnout, and physician well-being from baseline to post-program, which were sustained at two-month follow-up.

Conclusion

This is the first controlled study of a yoga-based MBI in residents. While the program was not feasible as delivered in this pilot study, initial analyses showed improvement in multiple measures of psychological health. Residents reported that virtual delivery would increase feasibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961714/

 

Improve Adolescent Scoliosis with Select Yoga Poses

psyjdc Leave a comment

Improve Adolescent Scoliosis with Select Yoga Poses

 

By John M. de Castro, Ph.D.

 

“Yoga can be very helpful for those with scoliosis, particularly given the combination of flexibility and core stabilization needed to perform yoga poses properly.” – Sara Lindberg

 

Scoliosis is a sidewise curvature of the spine that occurs in about 3% of adolescents. It develops most frequently in a growth spurt just prior to puberty. Most cases are mild and can be treated with a brace to stop the curve from increasing. But more serious cases can be disabling and may be treated with surgery.

 

There is a need for safe and effective treatments for scoliosis. Yoga practice combines mindfulness practice with exercise and has been shown to have a myriad of health benefits including the relief of chronic low-back pain. Many forms of yoga focus on the proper alignment of the spine, which could directly address the spinal curvature of scoliosis. But care must be taken as some yoga poses have the potential to exacerbate the spinal curvature.

 

In today’s Research News article “Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis-A Nonrandomized Control Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917413/ )  Fishman recruited adolescents less than 21 years of age with scoliosis and had them either receive treatment as usual, or yoga practice employing the side-plank pose for a lumbar curve, the half-moon and floating side plank poses for a thoracic curve, and or a side-plank, half-moon, and floating side plank poses for a Thoracolumbar curve. The yoga group was instructed to practice daily for 5 months and hold each pose for as long as they could. Instruction occurred either in person or over the internet. X-rays were taken of their spines before and after treatment.

 

They found that in the yoga group 49% of the lumbar and thoracolumbar curves and 29% of the thoracic curves had significant improvement while none of the control group did. In person and internet instruction were equally effective but compliance was better with in person instruction.

 

These results suggest that practicing a select set of yoga poses appears to be effective in treating scoliosis in adolescents. It is important that the right poses are used. Many yoga poses could well exacerbate the problem. In this study the side-plank, half-moon, and floating side plank poses were found to produce significant improvements.

 

So, improve adolescent scoliosis with select yoga poses

 

 

“But yoga and scoliosis don’t necessarily go hand in hand. While many poses are perfectly safe for scoliotic spines — and some even provide proven benefits — many others can make the curves worse. To safely perform yoga for scoliosis relief, it’s important to differentiate between asanas that can help and those that pose a risk.” – Clayton Stitzel

 

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

 

Fishman L. M. (2021). Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis-A Nonrandomized Control Trial. Global advances in health and medicine, 10, 2164956120988259. https://doi.org/10.1177/2164956120988259

 

Abstract

Objective

Assess therapeutic value of specific yoga poses for thoracic and lumbar adolescent idiopathic scoliosis (AIS) taught in office or Internet.

Study Design

Nonrandomized control trial: Fifty-six adolescents (mean age 14.0 years; mean Risser 3.0) were recruited from our clinic; 41 did the side-plank, the half-moon and elevated side plank poses as appropriate (treatment group) and 15 did not (controls). Thirty curves were treated in office, 30 via Internet. Curve change was evaluated by blinded serial Cobb angles, and analyzed using Mann-Whitney U, paired t-tests and χ2.

Results

Mean lumbar and thoracolumbar Cobb angle change was −9.2 (95% CI = −11.8, −6.6) in the treatment group and 5.4 (95% CI = 1.7, 9.0) in controls. Both treatment group improvement and deterioration in controls were significant (treatment group: paired t-test t = −7.1, df = 40, p = .000; controls: t = 3.2, df = 12, p = .008). Mean thoracic Cobb angle change was −7.1 (95% CI = −13.1, −1.2) in the treatment group and 9.3 (95% CI = 4.5, 14.6) in controls. Both changes were significant (paired t-test t = −3.3, df = 21, p = .022 for treatment group; t = 4.5, df = 5, p = .006 for controls). Nine Internet patients were non-compliant vs. 6 office patients. Office patients improved 1.6 degrees/month or 5.5%/month; Internet patients improved .72 degrees/month or 3.3%/month.

Conclusion

These yoga poses show promise for reversing adolescent idiopathic scoliosis. Telemedicine had greater non-compliance and lower efficacy but still produced patient improvement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917413/

 

Reduce Employee Stress with Workplace Yoga

psyjdc Leave a comment

Reduce Employee Stress with Workplace Yoga

 

By John M. de Castro, Ph.D.

 

“Practicing yoga at the workplace teaches employees to use relaxation techniques to reduce stress and risks of injury on the job. Yoga at the workplace is a convenient and practical outlet that improves work performance by relieving tension and job stress.” – Shira Taylor Gura

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological, social, and physical health. But, nearly 2/3 of employees worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Mindfulness has been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. Yoga practice has the extra benefits of not only being mindfulness training but also as an exercise. The research has been accumulation. So, it makes sense to step back and summarize what has been learned about the effects of yoga practice in the workplace on employee stress levels.

 

In today’s Research News article “Effectiveness of Workplace Yoga Interventions to Reduce Perceived Stress in Employees: 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/PMC7739364/ ) Valle and colleagues review, summarize, and perform a meta-analysis of the published controlled research studies of the effectiveness of yoga practice in the workplace for the stress levels and psychological health of employees.

 

They identified 6 controlled trials with a total of 487 participants. They report that these published trials found that yoga interventions in the workplace produced significant reductions in the stress levels of the employees. This replicates previous studies that practicing yoga reduces stress. It is important that the yoga classes were held at work. This makes participation much more convenient, making it more likely. As a result, yoga in the workplace may be a very effective means of reducing stress and thereby reducing employee burnout.

 

So, reduce employee stress with workplace yoga.

 

“Yoga postures, slow, deep, yogic breathing has also shown to elicit a relaxation response which could contribute to a reduction in stress in the workplace.” – Lisa Rappaport

 

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

 

Della Valle, E., Palermi, S., Aloe, I., Marcantonio, R., Spera, R., Montagnani, S., & Sirico, F. (2020). Effectiveness of Workplace Yoga Interventions to Reduce Perceived Stress in Employees: A Systematic Review and Meta-Analysis. Journal of functional morphology and kinesiology, 5(2), 33. https://doi.org/10.3390/jfmk5020033

 

Abstract

Work-related stress represents a relevant public health issue and solution strategies are mandatory. Yoga is a common approach to manage stress and its effectiveness has been extensively confirmed. Therefore, this study aims systematically to review the effectiveness of Yoga interventions carried out at workplace on work-related stress among employees and to assess their impact quantitatively. Springerlink, MEDLINE, PubMed, CINAHL, Web of Science, Scopus, Cochrane CENTRAL and PEDro databases were searched. Clinical trials comparing workplace Yoga interventions to control groups, and evaluating perceived stress as outcome measure, were assessed for eligibility. All forms and styles of Yoga were considered for the analysis. Out of 3392 initially identified, 6 studies were included in the meta-analysis; 266 participants practicing Yoga interventions at worksite were compared to 221 subjects in control group. Included studies showed “some concerns” about different domains of source of bias. Quantitative analysis showed an overall effect size of −0.67 [95% confidence interval (CI): −0.86, −0.49] in favor of Yoga intervention in reducing stress outcome measures. Hence, workplace Yoga interventions were more effective when compared to no treatment in work-related stress management. Further high-quality studies are needed to improve the validity of these results and to specify more characteristics of the Yoga intervention, such as style, volume, and frequency.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739364/

 

Improve Physical Fitness and Quality of Life of Substance Abusers with Mind-Body Practices

psyjdc Leave a comment

Improve Physical Fitness and Quality of Life of Substance Abusers with Mind-Body Practices.

 

By John M. de Castro, Ph.D.

 

“Available data suggest that mindfulness-based interventions may help significantly reduce the consumption of several substances including alcohol, cigarettes, opiates, and others.” – NCCIH Clinical Digest

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions. Mind-Body practices such as yoga has been found to be effective in treating substance abuse and Tai Chi practice has also been found to improve addiction recovery.

 

In today’s Research News article “Long-Term Effects of Mind-Body Exercises on the Physical Fitness and Quality of Life of Individuals With Substance Use Disorder-A Randomized Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775308/ ) Zhu and colleagues recruited men who were being treated for a substance use disorder (Amphetamines). They were randomly assigned to receive either 20 minutes, 3 times daily, 5 days per week, for 3 months of mind-body exercise or recreational activities. The mind-body exercises were selected from Tai Chi, Qigong, and Yoga movements. They were measured before and after training and 3 months later for physical fitness, physical, mental, social, and physical symptoms quality of life.

 

They found that in comparison to baseline and the recreational activities group, the group that performed mind-body exercises had significant reductions in body mass index (BMI), systolic and diastolic blood pressure, and heart rate, and significant increases in sit-and-reach, cardiovascular endurance, and physical, mental, social, and physical symptoms quality of life. These improvements were present at the endo of training and 3 months later at follow-up.

 

The results are clear. Mind-body exercise significantly improved the physical fitness and psychological well-being of the participants. The form of exercise was unique containing components from Tai Chi, Qigong, and yoga practices. But previous research has demonstrated physical and psychological improvements in a variety of healthy and ill individuals with Tai Chi and Qigong and also yoga practices. So, it is not surprising that using selective components of these practices would also have these benefits. But the study is unique in applying these practices to men recovering from amphetamine abuse. Although not reported, it would be expected that these benefits would help them with recovery from substance use disorder.

 

So, improve physical fitness and quality of life of substance abusers with mind-body practices.

 

“What does this mean for treatment practice or for an addict in recovery? At their core, mind-body therapies improve overall mental and physical health while improving brain function.” – Constance Scharff

 

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

 

Zhu, D., Jiang, M., Xu, D., & Schöllhorn, W. I. (2020). Long-Term Effects of Mind-Body Exercises on the Physical Fitness and Quality of Life of Individuals With Substance Use Disorder-A Randomized Trial. Frontiers in psychiatry, 11, 528373. https://doi.org/10.3389/fpsyt.2020.528373

 

Abstract

Background: Mind-body exercises (MBE) are sequences of low to medium-intensity activities that benefit healthy performers physically and mentally. In contrast to the unmodified application of traditional tai chi, qi gong, or yoga in the healthy population, MBEs are typically tailored for individuals with substance abuse disorder (SUD). Despite numerous applications in practice, the detailed effects of tailor-made MBEs for SUD are unclear.

Objectives: This study aimed to analyze and compare changes in the physical fitness and quality of life of individuals with SUD that underwent conventional or tailor-made MBEs.

Methods: A total of 100 subjects obtained from the Shanghai Mandatory Detoxification and Rehabilitation Center with SUD were randomly assigned into two groups. The subjects in the experimental group (n = 50) practiced tailored MBE for 60 min a day, five times a week, for 3 months. The subjects (n = 50) in the control group were treated with conventional rehabilitation exercises with the same intervention protocol. The outcomes of fitness and quality of life for drug addiction were measured at the beginning and after 3 and 6 months by a questionnaire (QOL-DA). A two-way repeated measure analysis of variance was applied to compare the difference of treatments in the two groups.

Results: Statistically significant differences for the experimental group were found in systolic (p < 0.01, η2 = 0.124) and diastolic blood pressure (p < 0.01, η2 = 0.097), pulse (p < 0.01, η2 = 0.086), vital capacity (p < 0.05, η2 = 0.036), flexibility (p < 0.01, η2 = 0.143), and aerobic endurance (p < 0.01, η2 = 0.165). Results of the QOL-DA showed statistically significant differences between the experimental and control groups in total score (p < 0.01, η2 = 0.158) with greater effects on the former.

Conclusions: This study provided evidence that tailored MBE could lead to remarkable effects with regard to blood pressure, vital capacity, flexibility, and aerobic endurance in comparison with conventional rehabilitation methods.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775308/

 

Different Aspects of Yoga Practice Affect the Psychological Benefits

psyjdc Leave a comment

Different Aspects of Yoga Practice Affect the Psychological Benefits

 

By John M. de Castro, Ph.D.

 

“Most styles of yoga are based on the same basic yoga poses (called asanas), however the experience of one style can be radically different than another.” – DoYoga

 

Yoga training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But there are a wide variety of different yoga training techniques and practices. Although the benefits of yoga practices in general are well studied there is little scientific research comparing different components of yoga practices and the benefits.

 

In today’s Research News article “Exploring how different types of yoga change psychological resources and emotional well-being across a single session.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081324/ ) Park and colleagues recruited adults who had attended at least 5 yoga classes. There were 3 different practice sites engaged in a variety of types of yoga; Hatha yoga: Ashtanga, Baptiste, Bikram, Forrest, Iyengar, Kripalu, Kundalini, Pranayama, Restorative, Vinyasa Flow, and Yin. Before and after a 60-minute yoga class they were measured for psychological resources (mindfulness, body awareness, self-transcendence, peacefulness and contentment, social connectedness), and exercise induced feelings (positive emotions, revitalization, tranquility, and exhaustion). After the class they were measured for properties of yoga, physical taxation, and therapist warmth.

 

In comparison to before the yoga class, afterward there were significant increases exercise induced feelings (positive emotions, revitalization, tranquility, and decreased exhaustion), psychological resources (mindfulness, body awareness, self-transcendence, spirituality, and social connectedness). In addition, the greater the increase in positive emotions, revitalization, and tranquility, the greater the increase in mindfulness, self-transcendence, spirituality, and social connectedness. In addition, the greater the decrease in exhaustion the greater the increase in mindfulness, self-transcendence, spirituality, and social connectedness.

 

They also investigated different aspects of the yoga practice and their relationships to psychological resources and emotions. They found that the higher the levels of the restorative aspects of the yoga practice the greater the changes in self-transcendence, spirituality, and tranquility, the higher the levels of the breathwork aspects of the yoga practice the greater the changes in body awareness and self-transcendence, and the higher the levels of the therapist warmth the greater the changes in self-transcendence and positive engagement.

 

These results are correlative and need to be interpreted with caution. But they provide interesting clues as to how yoga practice may produce some of its benefits. It increases the psychological resources available to the participants and improves their emotions. They also showed that the larger the increases in psychological resources produced by yoga practice the greater the improvements in emotions. Finally, they showed that restorative and breathwork aspects of yoga practice and the therapist warmth were most related to improvements.

 

Much more research is needed. But this study suggests that yoga practice strengthens the psychological resources of the practitioners and these are related to improved emotions. It also demonstrates that certain aspects of yoga practice that are differently emphasized in different styles of yoga, particularly restorative and breathwork aspects of yoga practice and the therapist warmth, may contribute to yoga’s benefits.

 

So, different aspects of yoga practice affect the psychological benefits.

 

“figure out your intention—do you want to do yoga to improve your health; lessen stress; increase mindfulness; gain strength; lose weight or relieve pain? Once you have the answer to this question you will know the practice that is right for you.” – Femina

 

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

 

Park, C. L., Finkelstein-Fox, L., Groessl, E. J., Elwy, A. R., & Lee, S. Y. (2020). Exploring how different types of yoga change psychological resources and emotional well-being across a single session. Complementary therapies in medicine, 49, 102354. https://doi.org/10.1016/j.ctim.2020.102354

 

Abstract

Objectives:

Yoga demonstrates beneficial effects in many populations, yet our understanding of how yoga brings about these effects is quite limited. Among the proposed mechanisms of yoga are increasing psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) that may bring about salutary effects on emotional wellbeing. Further, yoga is a complex practice comprising meditation, active and restorative postures, and breathwork; however little is known about how different components may affect mechanisms. We aimed to determine how an acute session of yoga (and its specific components) related to pre- to post- session changes in proposed mechanisms (psychological resources) and whether those changes were associated with positive changes in emotions.

Design:

144 regular yoga practitioners completed measures of mindfulness, body consciousness, self-transcendence, social connectedness, spiritual peace, and exercise-induced emotions (positive engagement, revitalization, tranquility, exhaustion) immediately before and after a yoga session (N=11 sessions, each a different type of yoga). Perceived properties of each yoga session, exercise exertion and engagement with the yoga teacher were assessed immediately following the session.

Results:

Pre- to post- yoga, levels of positive emotions (engagement, tranquility and revitalization) increased while exhaustion decreased. Further, all psychological resources increased and closely tracked improved emotions. Additionally, aspects of the yoga session correlated with changes in psychological resources (mechanisms) and emotions.

Conclusions:

Yoga may influence multiple psychological mechanisms that influence emotional well-being. Further, different types of yoga may affect different mechanisms. Results can inform yoga interventions aiming to optimize effects through specific mechanisms such as mindfulness or spirituality.

Highlights

  • To gain a better understanding of how yoga brings about beneficial effects, we examined changes in psychological resources and emotions across a single session of yoga.
  • All five psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) increased from pre-to-post yoga session, and all emotions (positive engagement, revitalization, tranquility and exhaustion) improved.
  • Further, improvements in emotions were associated with improvements in psychological resources.
  • Different styles of yoga were associated with differential improvements in psychological resources and emotions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081324/

 

Yoga Practitioners Have Better Psychological Health During the Covid-19 Lockdown

psyjdc Leave a comment

Yoga Practitioners Have Better Psychological Health During the Covid-19 Lockdown

 

By John M. de Castro, Ph.D.

 

“the well understood underlying mechanisms for the use of yoga for stress reduction and immune modulation shall be considered as the basis for its complimentary role in the management of an infectious condition like COVID-19.“ – H. R. Nagendra

 

Yoga practice has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Yoga practice is known to decrease the psychological and physical responses to stress. So, yoga practice may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic and lockdown.

 

In today’s Research News article “Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875402/ ) Sahni and colleagues recruited adults online during the Covid-19 lockdown. They separated the participants into three groups; those who practice yoga, other spiritual practices, and non-practitioners. The participants completed online measures of Covid-19 perceptions, depression, anxiety, perceived stress, general well-being, resilience, peace of mind, and emotion regulation.

 

They found that in comparison to the spiritual practices and non-practitioners, the yoga practitioners had a significantly higher level of Covid-19 perception of personal control, and significantly lower levels of illness concern and emotional impact of COVID19. In addition, the yoga practitioners had significantly lower levels of depression, anxiety, and perceived stress and significantly higher levels of peace of mind. well-being, and cognitive reappraisal strategies of emotion regulation. In general, they found that the longer that the yoga practitioners had practiced, the greater the benefits.

 

This study examined existing groups and there wasn’t random assignment. Hence, the findings could be due to systematic differences between people who choose to engage in yoga, other spiritual practices, or no practice. But previous controlled research has demonstrated that yoga practice causes decreased depression, anxiety, and perceived stress, and increased well-being. So, the difference seen here between groups probably represent the causal effects of yoga practice.

 

These results suggest that practicing yoga makes an individual more resistant to the deleterious psychological effects of the pandemic and the associated lockdown. It appears to improve the practitioners’ psychological well-being, peace of mind, attitude toward the pandemic, and ability to regulate emotions. In addition, the greater the amount of yoga practice, the greater the benefits. These yoga-produced abilities may well underlie yoga practice’s positive impact on various diseases.

 

So, yoga practitioners have better psychological health during the Covid-19 lockdown.

 

“COVID-19 has caused levels of stress and anxiety to skyrocket and it’s (understandably) taking a toll on people’s mental health. One thing that can help? Yoga.”- CorePower Yoga

 

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

 

Sahni, P. S., Singh, K., Sharma, N., & Garg, R. (2021). Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study. PloS one, 16(2), e0245214. https://doi.org/10.1371/journal.pone.0245214

 

Abstract

This cross-sectional research aims to study the effect of yoga practice on the illness perception, and wellbeing of healthy adults during 4–10 weeks of lockdown due to COVID19 outbreak. A total of 668 adults (64.7% males, M = 28.12 years, SD = 9.09 years) participated in the online survey. The participants were grouped as; yoga practitioners, other spiritual practitioners, and non-practitioners based on their responses to daily practices that they follow. Yoga practitioners were further examined based on the duration of practice as; long-term, mid-term and beginners. Multivariate analysis indicates that yoga practitioners had significantly lower depression, anxiety, & stress (DASS), and higher general wellbeing (SWGB) as well as higher peace of mind (POMS) than the other two groups. The results further revealed that the yoga practitioners significantly differed in the perception of personal control, illness concern and emotional impact of COVID19. However, there was no significant difference found for the measure of resilience (BRS) in this study. Yoga practitioners also significantly differed in the cognitive reappraisal strategy for regulating their emotions than the other two groups. Interestingly, it was found that beginners -those who had started practicing yoga only during the lockdown period reported no significant difference for general wellbeing and peace of mind when compared to the mid- term practitioner. Evidence supports that yoga was found as an effective self- management strategy to cope with stress, anxiety and depression, and maintain wellbeing during COVID19 lockdown.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875402/

 

Improve Physiological Responses to Stress in Schools with Mind-Body Practices

psyjdc Leave a comment

Improve Physiological Responses to Stress in Schools with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mindfulness exercises have been shown to help students reduce stress and anxiety, gain conscious control over behaviors and attitudes, and improve focus.” – Robin L. Flanigan

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can get into the best schools and ultimately the best jobs. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress, depression, and anxiety which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the students’ responses to stress; to make them more resilient when high levels of stress occur. Mind-body practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. There is accumulating evidence of the effectiveness of mind-body practices on the students’ stress levels. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: 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/PMC7795448/ ) Strehli and colleagues review, summarize, and perform a meta-analysis of the published research studies on the ability of mind-body practices to lower physiological indicators of stress in schools. They included studies involving elementary school, high school, and college students.

 

They identified 26 published studies, 80% of which were yoga based. They report that the published research found that the mind-body practices resulted in significant decreases in heart rate, systolic and diastolic blood pressure, and stress hormone (cortisol) levels. These effects were stronger for the college students and less so for high school and elementary school children.

 

The results suggest that mind-body practices reduce the physiological indicators of stress in school children and adolescents. This fits with previous findings with a variety of groups that mindfulness practices reduce the physiological responses to stress. This is thought to result from increases in balance in the autonomic nervous system. Regardless the published research literature suggests that mind-body practices are beneficial for school students, particularly college students, reducing their levels of stress.

 

So, improve physiological responses to stress in schools with mind-body practices.

 

“Students who engage in mindful movement activities can see a multitude of benefits, including increased strength and energy, better posture, reduced stress and improved attentiveness, self-confidence, self-awareness and self-care habits. Mind-body exercises also provide ways to build and strengthen relationships with others.” – Accredited Schools Online

 

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

 

Strehli, I., Burns, R. D., Bai, Y., Ziegenfuss, D. H., Block, M. E., & Brusseau, T. A. (2020). Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(1), 224. https://doi.org/10.3390/ijerph18010224

 

Abstract

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795448/

 

Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

psyjdc Leave a comment

Improve Psychological, Physiological, and Epigenetic Markers of Type 2 Diabetes with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Diabetes, like many other chronic diseases, can also affect the mind. Similarly the mind has great power to influence the body.” – Diabetes UK

 

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 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. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. Mindful movement practices such as Tai Chi and Qigong  and yoga are mindfulness practices that are also gentle exercises. There is accumulating research on the effectiveness of these mind-body practices for the treatment of Type 2 Diabetes. So, it makes sense to examine what has been learned.

 

In today’s Research News article “Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/ ) Yang and colleagues review and summarize the published research studies of the effects of mind-body practices on the symptoms of Type 2 Diabetes including epigenetic markers.

 

They report that moving meditation practices such as Tai Chi and Qigong  and yoga have been shown to significantly improve blood glucose, HbA1c, postprandial blood glucose, total cholesterol, and both low-density and high-density lipoprotein cholesterol. Mindfulness meditation has been shown to significantly improve HbA1c, diabetes-related distress, depression, and stress. In addition, mind-body interventions produce epigenetic changes reflected in DNA methylation modification. More study is needed but these epigenetic changes may underlie the improvements in Type 2 Diabetes produced by mind-body interventions.

 

Mind-body interventions have been repeatedly demonstrated to significantly reduce depression, anxiety and stress. These psychological states tend to aggravate Type 2 Diabetes. Since mind-mind-body practices reduce depression, anxiety and stress, they produce improvements in the symptoms of diabetes. In addition, mind-body practices produce physiological changes that can improve the symptoms of Type 2 Diabetes. These include activation of the parasympathetic (relaxation) nervous system, lower stress hormone (cortisol) secretion, reduced inflammation, and even reduced age based physiological changes.

 

These are remarkable findings that suggest that mind-body practices are effective in producing psychological and physiological changes that are very beneficial for the relief of the symptoms of Type 2 Diabetes. These benefits are reflected in changes on the epigenetic level that might ultimately be responsible for the benefits. Clearly, mind-body practices should be incorporated into Type 2 Diabetes treatment programs.

 

So, improve psychological, physiological, and epigenetic markers of type 2 diabetes with mind-body practices.

 

“meditation strategies can be useful adjunctive techniques to lifestyle modification and pharmacological management of diabetes and help improve patient wellbeing.” Gagan Priya

 

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

Yang, H. J., Koh, E., Sung, M. K., & Kang, H. (2021). Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. International journal of molecular sciences, 22(3), 1317. https://doi.org/10.3390/ijms22031317

 

Abstract

Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind–body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865217/

Reduce Migraine Symptoms with Yoga or Physical Therapy

psyjdc Leave a comment

Reduce Migraine Symptoms with Yoga or Physical Therapy

 

By John M. de Castro, Ph.D.

 

“Overall, yoga improved the cardiac autonomic balance. Disturbances in the autonomic nervous system and in the regulation of the circulatory system are associated with migraines. If balance is restored, the likelihood of a migraine is reduced.” – Debra Sullivan

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation, exercise, and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain. Yoga is both a mindfulness practice and an exercise. It has also been shown to help reduce pain. Hence, it may be effective in treating migraines.

 

In today’s Research News article “Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846311/ ) Mehta and colleagues recruited adult patients diagnosed with migraine headaches and randomly assigned them to either standard care or to receive standard care plus either yoga training or physical therapy. They were trained and then practiced at home daily for 3 months. Before training, at 1 and 2-months during training, and after training they were measured for headache pain and headache frequency and headache impact.

 

They found that all three groups had significant reductions in migraine frequency, severity (pain), and impact on life. Both yoga and physical therapy reduced frequency and impact on life to a significantly greater extent than standard care.

 

These findings suggest that either yoga or physical therapy when added to standard care for migraine headache produces significant additional improvements in the symptoms of migraine headaches. The fact that yoga and physical therapy did not differ in effectiveness suggests that the physical exercise provided by yoga is the reason for yoga’s effectiveness. These findings suggest that yoga practice or physical therapy should be added to the standard care for patients with Migraine headaches.

 

So, reduce migraine symptoms with yoga or physical therapy.

 

“Yoga’s postures, deep breathing and meditation . . . could be very helpful in both treating migraine and fighting the disability associated with migraine.” – American Migraine Foundation

 

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

 

Mehta, J. N., Parikh, S., Desai, S. D., Solanki, R. C., & G. Pathak, A. (2021). Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine. Journal of Neurosciences in Rural Practice, 12(1), 60–66. https://doi.org/10.1055/s-0040-1718842

 

Abstract

Objective  We aimed to evaluate and compare the effectiveness of physical and yoga therapies as an adjuvant therapy along with standard pharmacologic treatment in patients with migraine.

Materials and Methods  A total of 61 consenting patients diagnosed to have migraine were randomized into three groups to receive either standard treatment alone, physical therapy along with standard treatment, or yoga therapy along with standard treatment. The respective adjuvant intervention was taught to the respective group of patients and they were advised to perform it daily for 3 months with weekly telephonic reminders and review of their activity logs. Outcome measures assessed were headache frequency, Short-Form McGill Pain Questionnaire (SF-MPQ), and Headache Impact Test-6 (HIT-6) at recruitment and once every month for 3 months.

Statistical Analysis  Statistical analysis of the study was done by using Stata 14.1 software. All the descriptive statistics, paired t -test was used to compare the difference between pre and postintervention values of headache frequency, SF-MPQ, and HIT-6 score within all the three groups. Analysis of variance test and post hoc test were used to compare the differences between all groups for outcome measures ( p < 0.05).

Results  Headache frequency and the visual analog scale before intervention compared during each month intervals for 3 months in all the three groups were significantly decreased in all the three groups ( p < 0.005). Yoga or physical therapy as an adjuvant to standard treatment leads to a higher reduction in headache frequency and severity. Sensory and affective pain ratings of SF-MPQ and HIT-6 also showed a significant improvement at 1 to 3 months of treatment compared with baseline in all the three groups.

Conclusion  Either physical or yoga therapy as an adjuvant to standard pharmacologic treatment may further improve the quality of life and reduce headache frequency in patients with migraine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846311/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

psyjdc Leave a comment

Movement-Based Therapies are Affective for Rehabilitation from Disease

 

By John M. de Castro, Ph.D.

 

“Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

 

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

 

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

 

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

 

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

 

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

 

So,  movement-based therapies are affective for rehabilitation from disease.

 

“Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

 

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

 

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

 

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

  • Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
  • Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
  • Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
  • Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
  • Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/