Arthritis

Improve Functional Fitness in the Elderly with Knee Osteoarthritis with Tai Chi

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Improve Functional Fitness in the Elderly with Knee Osteoarthritis with Tai Chi

 

By John M. de Castro, Ph.D.

 

“patients over 65 years of age with knee osteoarthritis (OA) who engage in regular Tai Chi exercise improve physical function and experience less pain.” – Science Daily

 

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

 

There are no cures for knee osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary practices that involve gentle knee movements may be useful for treatment.

 

Mindfulness practices such as Tai Chi and Qigong and yoga have been shown to reduce the physical symptoms of knee osteoarthritis. Tai Chi practice, has been shown to be a safe and effective treatment for a wide variety of physical and psychological conditions, including arthritis. Much of the research involves controlled laboratory studies. It needs to be demonstrated that Tai Chi practice is an effective treatment for knee osteoarthritis of the community-dwelling elderly.

 

In today’s Research News article “Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325845/ ) Chen and colleagues recruited a sample of community-dwelling otherwise healthy elderly (age >65 years) individuals diagnosed with knee osteoarthritis. They were randomly assigned them to a 60 minutes twice a week for 12 week program of either health education or Sun style Tai Chi practice. They were measured before and after the 12-week practice period for functional fitness including the 30-s chair stand, 30-s arm curl, 2-min step, chair sit-and-reach, back-scratch flexibility, single-leg stand, functional reach, 8-foot up-and-go, and 10-m walk tests.

 

They found that in comparison to baseline and the health education group, the group that practiced Tai Chi  had significant improvements in the 30-s chair stand, 30-s arm curl, 2-min step, chair sit-and-reach, single-leg stand, functional reach, and 8-foot up-and-go. Hence, Tai Chi practice increases functional fitness in the community-dwelling elderly with knee osteoarthritis. This should translate in improved movement with less pain and increased quality of life in these community-dwelling elderly individuals.

 

So, improve functional fitness in the elderly with knee osteoarthritis with Tai Chi.

 

“research shows an ancient form of exercise called Tai Chi might offer hope to combat arthritis pain in seniors.” – Julie Podewitz

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Chen, P. Y., Song, C. Y., Yen, H. Y., Lin, P. C., Chen, S. R., Lu, L. H., Tien, C. L., Wang, X. M., & Lin, C. H. (2021). Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial. BMC geriatrics, 21(1), 449. https://doi.org/10.1186/s12877-021-02390-9

 

Abstract

Background

Degenerative osteoarthritis (OA) often leads to pain and stiffness of the affected joints, which may affect the physical performance and decrease the quality of life of people with degenerative knee OA. Compared to traditional exercise, tai chi is a safe exercise with slow movements which can facilitate physical functioning and psychological well being, and might be suitable for improving the physical activities of older adults with knee OA. Therefore, this study investigated the impacts of tai chi exercise on the functional fitness of community-dwelling older adults with degenerative knee OA.

Methods

Sixty-eight community-dwelling older adults with knee OA were recruited from the local community to participate in this randomized controlled clinical trial. All subjects were randomly assigned to either an TCE group that practiced tai chi exercise (TCE) (n = 36) or a control group (CON) (n = 32) that received regular health education programs twice per week for 12 weeks. Outcome measurements were determined using functional fitness tests before and after the intervention, including a 30-s chair stand (number of repeats), 30-s arm-curl (number of repeats), 2-min step (number of steps), chair sit-and-reach (reaching distance, cm), back-scratch flexibility (distance between hands, cm), single-leg stand (time, s), functional reach (reaching distance, cm), 8-foot up-and-go (time, s), and 10-m walk tests (time, s). Pre-post comparisons of functional fitness were analyzed using the ANCOVA test with SPSS software version 18.0.

Results

Results revealed that participants’ functional fitness in the TCE group had significantly higher adjusted mean post-tests scores than that in the CON group after the intervention, including the 8-foot up-and-go (s) (mean difference [MD]=-2.92 [-3.93, -1.91], p = 2.39*10− 7), 30-s arm curl (MD = 4.75 (2.76, 6.73), p = 1.11*10− 5), 2-min step (MD = 36.94 [23.53, 50.36], p = 7.08*10− 7), 30-s chair stand (MD = 4.66 [2.97, 6.36], p = 6.96*10− 7), functional-reach (MD = 5.86 [3.52, 8.20], p = 4.72*10− 6), single-leg stand with eyes closed (MD = 3.44 [1.92, 4.97], p = 2.74*10− 5), chair sit-and-reach (MD = 3.93 [1.72, 6.15], p = 0.001), and single-leg stand with eyes opened (MD = 17.07 [6.29, 27.85], p = 0.002), with large effect sizes (η²=0.14 ~ 0.34).

Conclusions

Community-dwelling older adults with knee OA in the TCE group had better functional fitness performances after the 12-week tai chi intervention than those receiving only health education.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325845/

 

Tai Chi Practice Improves the Symptoms of Multiple Diseases

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Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

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 the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

“Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

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

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

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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/

 

Improve Rheumatoid Arthritis Symptoms with Yoga

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Improve Rheumatoid Arthritis Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

“Many people turn to yoga as a way to exercise gently, as well as to reduce tension and improve joint flexibility. Yoga also can help a person with arthritis build muscle strength and improve balance. In addition, yoga offers people with arthritis a form of exercise that is enjoyable enough to do regularly.” – Susan Bernstein

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis, symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.

 

Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which including yoga practice have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. It is reasonable to take time to summarize what has been learned regarding the effectiveness of yoga practice for the treatment of rheumatoid arthritis.

 

In today’s Research News article “Yoga for Treating Rheumatoid Arthritis: 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/PMC7732597/ ) Ye and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of yoga practice for the treatment of rheumatoid arthritis. They identified 10 published trials that included a total of 840 participants.

 

They report that the published studies found that yoga in comparison to controls produced a significant reduction in pain that was equivalent to the effects of drugs. Yoga with additional medication was found to improve physical function and reduce disease activity (swollen joints) to a greater extent than medication alone. Finally, yoga in comparison to controls produced a significant increase in grip strength.

 

The findings of the published research suggest that yoga practice is beneficial for patients with rheumatoid arthritis. It appears to reduce pain and joint swelling and improve physical function and grip strength. No adverse events were reported. Hence, yoga is recommended to patients with rheumatoid arthritis.

 

So, improve rheumatoid arthritis symptoms with yoga.

 

“yoga classes will provide the opportunity to strengthen muscles, improve flexibility, increase your awareness of body posture, relax using breathing exercises. These benefits can lead to less arthritis pain, increased joint range-of-motion, and better joint function.” – Ron Miller

 

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

 

Ye, X., Chen, Z., Shen, Z., Chen, G., & Xu, X. (2020). Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Frontiers in medicine, 7, 586665. https://doi.org/10.3389/fmed.2020.586665

 

Abstract

Purpose: Rheumatoid arthritis (RA) is a pervasive inflammatory autoimmune disease that seriously impairs human health and requires more effective non-pharmacologic treatment approaches. This study aims to systematically review and evaluate the efficacy of yoga for patients with RA.

Methods: Medline (through PubMed), Cochrane Library, EMBASE (through SCOPUS), and Web of Science database were screened through for articles published until 20 July 2020. Randomized controlled trials (RCTs) of yoga in patients with RA were included. Outcomes measures were pain, physical function, disease activity, inflammatory cytokines, and grip strength. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Result: Ten trials including 840 patients with RA aged 30–70 years were identified, with 86% female participants. Meta-analysis revealed a statistically significant overall effect in favor of yoga for physical function (HAQ-DI) (5 RCTs; SMD = −0.32, 95% CI −0.58 to −0.05, I2 = 15%, P = 0.02), disease activity (DAS-28) (4 RCTs; SMD = −0.38, 95% CI −0.71 to −0.06, I2 = 41%, P = 0.02) and grip strength (2 RCTs; SMD = 1.30, 95% CI 0.47–2.13, I2 = 63%, P = 0.002). No effects were found for pain, tender joints, swollen joints count or inflammatory cytokines (i.e., CRP, ESR, IL-6, and TNF-α).

Summary: The findings of this meta-analysis indicate that yoga may be beneficial for improving physical function, disease activity, and grip strength in patients with RA. However, the balance of evidence showed that yoga had no significant effect in improving pain, tender joints, swollen joints count, and inflammatory cytokines in patients suffering from RA. Considering methodological limitations, small sample size, and low-quality, we draw a very cautious conclusion in the results of the estimate of the effect. High-quality and large-scale RCTs are urgently needed in the future, and the real result may be substantially different.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732597/

 

Reduce Inflammatory Responses and Reduce Rheumatoid Arthritis Symptoms with Yoga

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Reduce Inflammatory Responses and Reduce Rheumatoid Arthritis Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga practice significantly decreases the severity of physical and psychological symptoms in patients with active rheumatoid arthritis.” – Science Daily

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis, symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.

 

Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. Indeed, yoga practice has been shown to be effective in treating arthritis. So, it makes sense to investigate the effects of yoga practice on the inflammatory response in patients with rheumatoid arthritis.

 

In today’s Research News article “Effect of an 8-Week Yoga-Based Lifestyle Intervention on Psycho-Neuro-Immune Axis, Disease Activity, and Perceived Quality of Life in Rheumatoid Arthritis Patients: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492675/ ) Gautam and colleagues recruited adult patients with rheumatoid arthritis and continued with their usual care. They were randomly assigned to either no-treatment or ashtanga yoga practice modified for patients with rheumatoid arthritis. They practiced 5 times per week for 2 hours for 8 weeks. The practice included postures, breathing exercises, meditation, relaxation, and personal lifestyle management. They were measured before and after training for disease activity and quality of life. They also had blood drawn and assayed for biochemical markers of inflammation.

 

They found that in comparison to baseline and the no-treatment group, the yoga group had a significant decrease in rheumatoid arthritis disease activity and a significant increase in their psychological and social quality of life, with greater effects occurring in women than in men. In addition, they found that yoga practice decreased the gene expressions of and levels of pro-inflammatory biochemical markers IL-6, TNF-α, and CTLA4, and a significant increase in TGF-β, an anti-inflammatory marker, suggesting reduced inflammation in the yoga group.

 

This study did not have an active control condition or a long-term follow-up and as such the results must be interpreted with caution. Future studies should include long-term follow-up and an active control condition such as aerobic exercise to determine if the results were due to exercise in general or specifically to yoga practice and whether the benefits were lasting. Nevertheless, the results replicate the findings of other research that yoga practice improves arthritis symptoms and reduces inflammatory responses. The results suggest that yoga practice reduces the inflammatory responses that promote the disease and thereby reduce the disease symptoms which in turn improves the patient’s quality of life. This is good news for these patients signaling that practicing yoga may help relieve their suffering and retard disease progression.

 

So, reduce inflammatory responses and reduce rheumatoid arthritis symptoms with yoga.

 

“People with various types of arthritis who practice yoga regularly can reduce joint pain, improve joint flexibility and function, and lower stress and tension to promote better sleep.“ – Susan Bernstein

 

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

 

Gautam, S., Kumar, M., Kumar, U., & Dada, R. (2020). Effect of an 8-Week Yoga-Based Lifestyle Intervention on Psycho-Neuro-Immune Axis, Disease Activity, and Perceived Quality of Life in Rheumatoid Arthritis Patients: A Randomized Controlled Trial. Frontiers in Psychology, 11, 2259. https://doi.org/10.3389/fpsyg.2020.02259

 

Abstract

Various external stressors and environmental challenges lead to the provocation of the immune system in autoimmune diseases like Rheumatoid arthritis (RA). The inappropriate immune response further triggers the cascade of inflammatory changes resulting in precipitation of symptoms and hampers quality of life (QOL). The underlying psycho-somatic component of the disease requires a holistic approach to its treatment dimension rather than the use of pharmacotherapy. The applicability of mind-body interventions has become essential in today’s fast-paced life. Yoga, a mind-body technique, alters the mind’s capacity to facilitate systemic functioning at multiple organ system levels. Hence, we conducted this study to evaluate the impact of 8 weeks of a yoga-based lifestyle intervention (YBLI) on psycho-neuro-immune markers, gene expression patterns, and QOL in RA patients on routine medical therapy. A total of 66 patients were randomized into two groups: yoga group or non-yoga group and were assessed for a panel of inflammatory cytokines (IL-6, IL-17A, TNF-α, and TGF-β), mind-body communicative markers (BDNF, DHEAS, β-endorphin, and sirtuin) and transcript levels of various genes (IL-6, TNF-α, NFKB1, TGF-β, and CTLA4). We assessed disease activity and QOL using the DAS28-ESR and WHOQOL-BREF questionnaire, respectively. Yoga group observed significant improvements in the levels of markers, which influenced the psycho-neuro-immune axis (p < 0.001) with an estimated effect size from small to medium range. In the yoga group, there was a significant reduction in DAS28-ESR (p < 0.001) and improvement seen in the physical health, psychological, social relationships domains (p < 0.001) of QOL, except environmental (p > 0.05). The yoga group showed downregulation of IL-6, TNF-α, and CTLA4 and upregulation of TGF-β. These results suggest that a decrease in disease activity after yoga practice is associated with a significant reduction in inflammatory cytokines, the elevation of mind-body communicative markers, and normalization of various transcript levels, which improved QOL. Thus the adoption of YBLI improves clinical outcome in RA, and decreases systemic inflammation by its beneficial effects on psycho-neuro-immune axis and normalization of dysregulated transcripts. Thus YBLI may be used for RA patients as an adjunctive therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492675/

 

Improve Knee Osteoarthritis with Mind-Body Exercises

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Improve Knee Osteoarthritis with Mind-Body Exercises

 

By John M. de Castro, Ph.D.

 

“Baduanjin exercise provided a safe and feasible treatment option for patients with knee OA, as well as offered reductions in pain, stiffness, and disability, which helped improve the patients’ quadriceps strength and aerobic ability.” – Bingchen An

 

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

 

There are no cures for knee osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee or hip replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and mind-body practices that involve gentle knee movements may be useful in for treatment. Indeed, yoga practice has been shown to be effective in treating arthritis and Tai Chi and Qigong have also been shown to reduce the physical symptoms of knee osteoarthritis. Baduanjin is a mind-body training that is very similar to Tai Chi and consists of 8 movements for limbs, body-trunk, and eye movements.  So, it would seem reasonable to explore the effectiveness of Baduanjin practice in treating knee osteoarthritis.

 

In today’s Research News article “Mindful Exercise (Baduanjin) as an Adjuvant Treatment for Older Adults (60 Years Old and Over) of Knee Osteoarthritis: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312696/) Ye and colleagues recruited adults over the age of 60 years who were diagnosed with knee osteoarthritis and had no experience with mind-body practices. All participants were provided with standard therapy consisting of acupuncture, massage, and moxibustion. They were randomly assigned to either no further treatment or to practice Baduanjin for 40 minutes, 3 times per week for 12 weeks. They were measured before during and after treatment for knee function, and postural control, including the length and perimeter area of center of pressure.

 

They found that in comparison to baseline and the control group, the group that practiced Baduanjin had significantly improved physical knee function and postural control and lower knee stiffness and pain. No adverse events occurred with Baduanjin practice. So, Baduanjin is a safe and effective treatment for knee osteoarthritis in older adults.

 

Some advantages of Baduanjin practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Baduanjin practice an excellent means to improve the symptoms of knee osteoarthritis in elderly individuals.

 

“Baduanjin exercise, a common form of Chinese Qigong exercise that consists of eight movements of low intensity, may have favourable effects for people with knee arthritis.” – Arthritis Digest

 

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

 

Ye, J., Zheng, Q., Zou, L., Yu, Q., Veronese, N., Grabovac, I., Stefanac, S., Tzeng, H. M., & Yu, J. J. (2020). Mindful Exercise (Baduanjin) as an Adjuvant Treatment for Older Adults (60 Years Old and Over) of Knee Osteoarthritis: A Randomized Controlled Trial. Evidence-based complementary and alternative medicine : eCAM, 2020, 9869161. https://doi.org/10.1155/2020/9869161

 

Abstract

Background

The postural stability is a major factor that helps prevent developing knee osteoarthritis with aging. The aim of this study was to investigate the effects of Baduanjin qigong on postural control and physical function in older adults with knee osteoarthritis.

Methods

Fifty-six individuals over 60 years of age with knee osteoarthritis were randomly assigned to either an experimental group (n = 28) or a control group (n = 28). Participants in the experimental group received a 12-week Baduanjin training, while those in the control group did not receive any additional physical exercise during the study period. The postural control was quantified by perimeter and ellipse area of center of pressure movement trajectory. The assessments were conducted three times (baseline, week 8, and week 12).

Results

The perimeter and ellipse area with both open- and closed-eyes conditions and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function were significantly improved at week eight in the experimental group (p < 0.005). The ellipse area with open-eyes condition, WOMAC index, and stiffness and physical function domains were significantly decreased after the 12 weeks of Baduanjin training compared to the control group (p < 0.005). Only the perimeter area with both open- and closed-eyes conditions was not statistically significant at week 12 in the intervention group (p > 0.005).

Conclusions

Baduanjin is an effective and adjuvant therapy for older adults with knee osteoarthritis. Regular Baduanjin training can improve postural control and WOMAC function of old individuals with knee osteoarthritis. More advanced techniques and biopsychological measurements are required for further understanding of Baduanjin exercise in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312696/

 

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

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

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Background

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

Objectives

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

Methods

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

Findings

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

Conclusion

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

Electronic supplementary material

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

Background

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

Objectives

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

Methods

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

Findings

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

Conclusion

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

Key Points

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

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

 

Improve Health with Qigong

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Improve Health with Qigong

 

By John M. de Castro, Ph.D.

 

“The health benefits from Qigong and Tai Chi comes about both by supporting the body’s natural tendency to return to balance and equilibrium and also gently yet profoundly creating strength, flexibility and balance in the muscles and joints through gentle flowing movements.” – Denise Nagel

 

Qigong and Tai Chi have been practiced for thousands of years with benefits for health and longevity. Qigong and Tai Chi training are designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Qigong practice been scrutinized with empirical research. It has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation, increase the number of cancer killing cells in the bloodstream and improve cardiovascular function.

 

Because Qigong is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. So, with indications of so many benefits it makes sense to step back and review the research on the effects of Qigong training on health and well-being.

 

In today’s Research News article “Beneficial Effects of Qigong Wuqinxi in the Improvement of Health Condition, Prevention, and Treatment of Chronic Diseases: Evidence from a Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220394/ ), Guo and colleagues review and summarize the published research literature on the effects of Qigong practice on physical and psychological health. They found 28 published research studies.

 

They report that the research finds that Qigong practice by healthy adults produces improvements in cognitive functions including concentration and attention, strengthens the immune system, improves body shape and size, physical function, and the cardiovascular system, improves mood and psychological well-being, improves lipid metabolism, slows physiological indicators of aging, and reduces inflammation. For clinical populations, they report that the research indicates that Qigong practice reduces depression, and improves osteoarthritis, including knee osteoarthritis, metabolic syndrome, and blood fat levels.

 

Conclusions from these very exciting findings must be tempered as the research methodologies were often weak. More tightly controlled studies are needed. Regardless, these findings suggest that Qigong practice produces improved physical and psychological health in both healthy adults and people with mental and physical diseases. These are a remarkable set of benefits from this simple practice and suggest the reason why it has continued to be practiced by large numbers of people for hundreds of years. Hence, this simple, inexpensive, convenient, safe, and fun practice may improve the participants ability to successfully conduct their lives, improving health and well-being.

 

So, improve health with Qigong.

 

““A compelling body of research emerges when Tai Chi studies and the growing body of Qigong studies are combined. The evidence suggests that a wide range of health benefits accrue in response to these meditative movement forms.” – Dr. Mercola

 

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

 

Guo, Y., Xu, M., Wei, Z., Hu, Q., Chen, Y., Yan, J., & Wei, Y. (2018). Beneficial Effects of Qigong Wuqinxi in the Improvement of Health Condition, Prevention, and Treatment of Chronic Diseases: Evidence from a Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 3235950. doi:10.1155/2018/3235950

 

Abstract

Purpose

Qigong is a modality of traditional Chinese mind-body medicine that has been used to prevent and cure ailments, to improve health in China for thousands of years. Wuqinxi, a Chinese traditional Qigong that focuses on mind-body integration, is thought to be an effective exercise in promoting physical and mental wellbeing. Thus, we summarized the evidence and aim to unravel effects of Wuqinxi on health outcomes.

Methods

We performed a systematic review of Wuqinxi studies published in English or Chinese since 1979. Relevant English and Chinese language electronic data bases were used for literature search. The selection of studies, data extraction, and validation were performed independently by two reviewers.

Results

A total of 28 eligible studies were included in this review, among which three are 3 in English and 25 in Chinese. The studies included in this review involve three different experimental designs: (1) 16 RCTs; (2) 2 historical cohort studies; and (3) 10 pretest and posttest studies (PPS). Participants in this review are categorized as either healthy or clinical populations. The results from this systematic review support the notion that Wuqinxi may be effective as an adjunctive rehabilitation method for improving psychological and physiological wellbeing among different age of healthy populations in addition to alleviating and treating diseases among various clinical populations.

Conclusion

The results indicated that Wuqinxi has been thought to be beneficial to improve health and treat chronic diseases. However, the methodological problems in the majority of included studies make it difficult to draw firm conclusive statements. More methodologically rigorous designed large-scale RCTs with a long-term follow-up assessment should be further conducted to examine the effects of Wuqixi on health-related parameters and disease-specific measures in different health conditions. This systematic review lends insight for future studies on Wuqinxi and its potential application in preventive and rehabilitation medicine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220394/

 

Improve Physical and Mental Health with Musculoskeletal Disorders with Mindfulness Practices

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Improve Physical and Mental Health with Musculoskeletal Disorders with Mindfulness Practices

 

By John M. de Castro, Ph.D.

 

“Musculoskeletal disorders (MSDs) is the term given to a variety of painful conditions that affect the muscles, bones, and joints, which are a leading cause of long term sickness absence. . .MSDs are also at risk of developing symptoms of depression . . . Being off work for a significant period of time, whether due to an musculoskeletal disorder or other condition, can cause many other repercussions – including mental health issues.” – Fit for Work

 

Orthopedic Disorders consist of a wide range of problems that are concerned with muscles, ligaments and joints. Disorders are ailments, injuries or diseases that cause knee problems, whiplash, dislocated shoulder, torn cartilages, foot pain and fibromyalgia. The most common forms of orthopedic disorders are arthritis, and back and neck pain.

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers.

 

The most common forms of chronic pain are back and neck pain. Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. Back and neck pain interferes with daily living and with work, decreasing productivity and creating absences. Arthritis and back pain can have very negative psychological effects and may lead to depression, isolation, and withdrawal from friends and social activities.

 

There are many different treatments for pain, but few are both safe and effective for chronic musculoskeletal pain conditions. So, alternative treatments are needed. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of arthritis, low back pain and neck pain. In addition, mindfulness practices have been shown to improve mental health. So, it is likely that mindfulness practices will be effective for both the physical and mental health issues that accompany musculoskeletal disorders.

 

In today’s Research News article “Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196876/ ), Lorenc and colleagues review and summarize the published research studies on the effectiveness of mindfulness practices for the treatment of the psychological problems that accompany musculoskeletal disorders.

 

They summarize the evidence from 111 published research studies and report that these studies support the effectiveness of yoga for low back pain, and anxiety; Tai Chi for osteoarthritis, depression, anxiety, and sleep disorders; meditation for depression, anxiety, and sleep disorders; and mindfulness for stress and distress. There were no safety problems found with any of these mindfulness techniques.

 

This review indicates that there has accumulated a large body of evidence for the safety and effectiveness of mindfulness practices for the physical and mental health issues that accompany musculoskeletal disorders. Hence the published research to date supports the use of mindfulness practices in the package of treatments for musculoskeletal disorders.

 

So, improve physical and mental health with musculoskeletal disorders with mindfulness practices.

 

“Yoga has been used to alleviate musculoskeletal pain and has been associated with significant improvement in range of motion and function, decreased tenderness, lower levels of depressive symptoms, and decreased pain during activity in patients with musculoskeletal disorders.” – Ruth McCaffrey

 

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

 

Lorenc, A., Feder, G., MacPherson, H., Little, P., Mercer, S. W., & Sharp, D. (2018). Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions. BMJ open, 8(10), e020222. doi:10.1136/bmjopen-2017-020222

 

Abstract

Objective

To identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs).

Design

Scoping review of SRs.

Methods

We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring >50% on Assessing the Methodological Quality of Systematic Reviews (AMSTAR); quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, sample size and indication of cost-effectiveness and safety.

Results

We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK–MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind–body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety—only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data.

Conclusions

Only one SR studied MSK–MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196876/

 

Improve the Psychological State of Patients with Rheumatoid Arthritis with Mindfulness

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Improve the Psychological State of Patients with Rheumatoid Arthritis with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Drugs are effective for rheumatoid arthritis, but they don’t affect the stress pathways that are so fundamental to the condition. Stress symptoms activate inflammation and even heighten the perception of pain. “A mindfulness-based intervention, which targets the multiple components of the body’s stress response, can decrease overall pain severity and increase quality of life.” – Michael Irwin

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis, symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.

 

Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. In today’s Research News article “Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233984/ ), DiRenzo and colleagues review and summarize the published randomized clinical trials of mindfulness-based interventions for patients with rheumatoid arthritis.

 

They found only 5 published studies which produced inconclusive results regarding the effectiveness of mindfulness-based interventions on the physical symptoms of rheumatoid arthritis such as pain and inflammation. On the other hand, the research suggests that mindfulness-based interventions improve the psychological states of patients with rheumatoid arthritis including depression, anxiety, and psychological distress. The results, although inconclusive are sufficiently suggestive of positive outcomes that further research is warranted. It is clear that larger better controlled studies are needed before unambiguous conclusions can be reached.

 

So, improve the psychological state of patients with rheumatoid arthritis with mindfulness.

 

“The other thing I think is important to note about our study is that mindfulness meditation can be combined with any rheumatological therapy. It is truly complementary medicine in that sense, done in addition to pharmacological or other intervention. So, for physicians and patients who wonder what they can do to improve well-being, beyond taking medications, this study offers evidence for a beneficial approach to dealing with the psychological distress of RA.” – Elizabeth Pradhan

 

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

DiRenzo, D., Crespo-Bosque, M., Gould, N., Finan, P., Nanavati, J., & Bingham, C. O. (2018). Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis. Current rheumatology reports, 20(12), 75. doi:10.1007/s11926-018-0787-4

 

Abstract

Purpose of Review

To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA).

Recent Findings

We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (− 0.44 (− 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (− 0.58 (− 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement.

Summary

There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233984/