Improve Circulation with Tai Chi

January 2, 2017 psyjdc Leave a comment

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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. And you can get started even if you aren’t in top shape or the best of health.” – Harvard Women’s Health Watch

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.

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack” (Centers for Disease Control). Rheumatoid arthritis is associated with high levels of inflammation and inflammation damages blood vessels. It can lead to hardening of the arteries (arteriosclerosis) which in turn leads to cardiovascular disease. So, there is a need for treatments to reduce inflammation and hardening of the arteries in rheumatoid arthritis (RA) patients.

Contemplative practices have been shown to be helpful for heart health particularly those that are also exercises such as tai chi and yoga. Tai chi is an ancient contemplative practice involving slow motion smooth mindful movement. The reason that it has continued to be practiced by millions for centuries is that it has major mental and physical benefits including a reduction in the inflammatory response. Modern research is verifying these benefits. Mindful movement practice has been shown to improve balance, self-concept, and attention span, reduce falls, boost the immune system and helps to relieve symptoms of arthritis, asthma, Parkinson’s disease, insomnia, even improve cancer recovery, and improve recovery from heart failure. So, it makes sense to further explore the effectiveness of Tai Chi practice for hardening of the arteries in rheumatoid arthritis (RA) patients.

In today’s Research News article “The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1440063292684259/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718020/

Shin and colleagues recruited female rheumatoid arthritis patients (average 64 years old) and randomly assigned them to either receive 3 months of Tai Chi training or education about rheumatoid arthritis, its effects and methods of control. At the end of training they found that, in comparison to the education group, the Tai Chi group had a significant (32%) improvements in the ability of the blood vessels to dilatate in response to blood flows, (6%) reduction in arterial stiffness, and a significant decrease in total cholesterol. They found that the effectiveness of Tai Chi to improve the blood vessels was independent of its effects on cholesterol.

These results are impressive and important. Tai Chi exercise was effective in reducing the hardening of the arteries and blood cholesterol levels that normally are problematic with rheumatoid arthritis. This suggests that Tai Chi practice may reduce the cardiovascular disease which is a potentially fatal consequence of rheumatoid arthritis. Importantly, since rheumatoid arthritis impairs movement, Tai Chi is a very gentle practice, it is safe for a wide range of individuals, including the elderly and patients compromised by other illnesses including rheumatoid arthritis. So, tai chi is an excellent light exercise program that can improve hardening of the arteries and cholesterol levels and potentially reduce the risk of cardiovascular disease and death in rheumatoid arthritis patients.

So, improve circulation with Tai Chi.

CMCS – Center for Mindfulness and Contemplative Studies

“Qi gong and tai chi are relaxing ways to improve your flexibility and balance. Both are great ways to stay active and vital. The gentle, flowing movements are easy on the joints.” – Melinda Ratini

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

Study Summary

Shin, J.-H., Lee, Y., Kim, S. G., Choi, B. Y., Lee, H.-S., & Bang, S.-Y. (2015). The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis. Arthritis Research & Therapy, 17, 380. http://doi.org/10.1186/s13075-015-0893-x

Abstract

Background: Rheumatoid arthritis (RA) has been known to be associated with increased risk of cardiovascular disease (CVD). The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA.

Method: In total, 56 female patients with RA were assigned to either a Tai Chi exercise group (29 patients) receiving a 3-month exercise intervention once a week or a control group (27 patients) receiving general information about the benefits of exercise. All participants were assessed at baseline and at 3 months for RA disease activity (Disease Activity Score 28 and Routine Assessment of Patient Index Data 3), functional disability (Health Assessment Questionnaire), CVD risk factors (blood pressure, lipids profile, body composition, and smoking), and three atherosclerotic measurements: carotid intima-media thickness, flow-mediated dilatation (FMD), and brachial-ankle pulse wave velocity (baPWV).

Results: FMD, representative of endothelial function, significantly increased in the Tai Chi exercise group (initial 5.85 ± 2.05 versus 3 months 7.75 ± 2.53 %) compared with the control group (initial 6.31 ± 2.12 versus 3 months 5.78 ± 2.13 %) (P = 1.76 × 10−3). Moreover, baPWV, representative of arterial stiffness, significantly decreased in the Tai Chi exercise group (initial 1693.7 ± 348.3 versus 3 months 1600.1 ± 291.0 cm/s) compared with the control group (initial 1740.3 ± 185.3 versus 3 months 1792.8 ± 326.1 cm/s) (P = 1.57 × 10−2). In addition, total cholesterol decreased significantly in the Tai Chi exercise group compared with the control group (−7.8 ± 15.5 versus 2.9 ± 12.2 mg/dl, P = 2.72 × 10−2); other changes in RA-related characteristics were not significantly different between the two groups. Tai Chi exercise remained significantly associated with improved endothelial function (FMD; P = 4.32 × 10−3) and arterial stiffness (baPWV; P = 2.22 × 10−2) after adjustment for improvement in total cholesterol level.

Conclusion: Tai Chi exercise improved endothelial dysfunction and arterial stiffness in elderly women with RA, suggesting that it can be a useful behavioral strategy for CVD prevention in patients with RA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718020/

Reduce the Pain of Knee Osteoarthritis with Tai Chi

December 21, 2016 psyjdc Leave a comment

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By John M. de Castro, Ph.D.

“tai chi provides benefit by improving muscle strength and coordination, which leads to better joint stability. In addition, the mind-body aspects and breath control promote mental calmness, which may help to break the cycle of arthritis pain.” – Harvard Health

Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. It involves the whole joint, including articular cartilage, meniscus, ligament, and peri-articular muscle. 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 appears to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary 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 mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. Tai Chi would seem on the surface to be perfect treatment as it involves slow gentle movement of the limbs and mindfulness and has been shown to be beneficial for a wide range of conditions. Indeed, it has been shown to reduce the physical symptoms of knee osteoarthritis. So, it would seem reasonable to look further into the effectiveness of Tai Chi, in treating knee osteoarthritis.

In today’s Research News article “A Supplemental Report to a Randomized Cluster Trial of a 20-Week Sun-Style Tai Chi for Osteoarthritic Knee Pain in Elders with Cognitive Impairment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1426470794043509/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725717/

Tsai and colleagues performed a multicenter randomized controlled trial of the effectiveness of Tai Chi for the treatment of the pain from knee osteoarthritis. They recruited elderly (aged 60 and over) patients with knee osteoarthritis who also had cognitive impairment and randomly assigned them to either practice Tai Chi for 3 40-minute sessions per week for 20 weeks or a control condition that received attention control education on an identical schedule. Before and after training and four times during training the patients were measured for pain, pain behaviors, and analgesic intake.

They found over training Tai Chi practice produced a significant reduction in pain and analgesic intake that increased in magnitude over time. There was also a significant reduction in pain behaviors. The effects were not affected by the degree of cognitive impairment. Unfortunately, there was no follow-up evaluation to determine if the effects last beyond the times of active practice. They also did not have another exercise for comparison. So, it can’t be determined if the gentle exercise or the mindfulness properties of Tai Chi were effective.

These are interesting results that extend the findings that Tai Chi is an effective treatment for the pain of knee osteoarthritis. They also demonstrated that Tai Chi was effective regardless of cognitive impairment. Since, the ancient gentle practice of Tai Chi is completely safe, can be used with the elderly and sickly, and is inexpensive to administer, it would appear to be an excellent treatment for knee osteoarthritis sufferers.

So, reduce the pain of knee osteoarthritis with tai chi.

“Tai chi helps patients preserve and improve function by increasing strength, flexibility and coordination while avoiding aggravation of arthritic pain and inflammation. Tai chi is a particularly appealing form of exercise, as it is very low impact and emphasizes balance, coordination and strength. Tai chi is safe and has been shown to reduce falls in the elderly.” – Matthew Hepinstall

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Tsai, P.-F., Chang, J. Y., Beck, C., Kuo, Y.-F., Keefe, F. J., & Rosengren, K. (2015). A Supplemental Report to a Randomized Cluster Trial of a 20-Week Sun-Style Tai Chi for Osteoarthritic Knee Pain in Elders with Cognitive Impairment. Complementary Therapies in Medicine, 23(4), 570–576. http://doi.org/10.1016/j.ctim.2015.06.001

Abstract

Objective: This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders’ level of cognitive function was related to the outcomes of the TC program.

Method: Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at Weeks 1, 5, 9, 13, 17 and 21 (designated as Times 1-6). Pain behaviors and analgesic intake were also recorded at Times 1-6.

Results: At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=.008-.048). The beneficial effects of TC were not associated with cognitive ability.

Conclusion: These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725717/

Improve Knee Osteoarthritis with Tai Chi

October 29, 2016October 29, 2016 psyjdc 8 Comments

By John M. de Castro, Ph.D.

“adults with knee osteoarthritis-—the most common joint disease in midlife—saw up to three times greater improvement in both pain and joint function from biweekly hour-long tai chi sessions, compared with those who attended stretching and wellness classes. The flowing, meditative movements tone the muscles surrounding joints, enhance body awareness to reduce risk of injury, and improve alignment.” – Natalie Gingerich

Knee osteoarthritis is not localized to the cartilage alone but involves the whole joint, including articular cartilage, meniscus, ligament, and peri-articular muscle. It is painful and disabling. While age is a major risk factor for osteoarthritis of the knee, young people are not immune. It effects 5% of adults over 25 years of age and 12% of those over 65. 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 appears to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary 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 mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. So, it would seem reasonable to look further into the effectiveness of alternative and complementary practices, such as Tai Chi, in treating knee osteoarthritis.

In today’s Research News article “The Effects of Tai Chi Chuan on Improving Mind-Body Health for Knee Osteoarthritis Patients: A Systematic Review and Meta-Analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1364546776902578/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011213/?report=classic

Chang and colleagues review the published research literature (11 articles) on the effects of Tai Chi training on the physical and mental issues that accompany knee osteoarthritis. They found that Tai Chi practice significantly improved the physical symptoms of knee osteoarthritis including reduced perceived pain and stiffness, and lessened fear of falling, increased quadriceps muscle strength, enhanced lower extremity strength, improved walking, stair climbing, sitting to standing, and faster getting up and moving.

The mechanism of action for Tai Chi’s effects are not known. But, it could be the gentle slow movements of the knee or the anti-inflammatory effects of Tai Chi that may be responsible. The findings of this meta-analysis suggest that Tai Chi is an effective treatment for the physical effects of knee osteoarthritis. Since Tai Chi is safe, with few, if any, adverse effects, a gentle exercise appropriate for aging individuals, and inexpensive as it can easily be performed at home, and can be readily scaled for large groups without the necessary presence of a therapist, it is almost an ideal treatment.

So, improve knee osteoarthritis with tai chi.

“Tai Chi may be an especially applicable treatment for older adults…The physical component provides exercise consistent with current recommendations…range of motion, flexibility, muscle conditioning and aerobic cardiovascular exercise…the mental component could address the chronic pain state through effects on psychological well-being, life satisfaction, and perceptions of health.” – Mayo Clinic

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Wen-Dien Chang, Shuya Chen, Chia-Lun Lee, Hung-Yu Lin, Ping-Tung Lai. The Effects of Tai Chi Chuan on Improving Mind-Body Health for Knee Osteoarthritis Patients: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2016; 2016: 1813979. Published online 2016 Aug 21.

Abstract

Purpose. To conduct a meta-analysis and systematic review examining whether Tai Chi Chuan could have mental and physical benefits for patients with knee osteoarthritis. Methods. MEDLINE, PUBMED, EMBASE, and CINAHL databases were searched for relevant studies. Data of the studies were collected, and outcomes were classified using the International Classification of Functioning, Disability, and Health model. Effect sizes of the mental and physical components were determined, along with the recommendation grades of Philadelphia Panel Classification System for Tai Chi Chuan on knee osteoarthritis. Results. Eleven studies were selected and retrieved from the databases. The results of meta-analysis revealed that the effects of Tai Chi Chuan were observed for physical components in the body functions and structures domain. The effects favoring Tai Chi Chuan were observed in the physical component in the activities and participation domain. Insufficient data was included in the meta-analysis of the mental component.Conclusions. The review revealed that Tai Chi Chuan had beneficial outcomes for patients with knee osteoarthritis. The evidence-based results represented that it had small-to-moderate effects on body functions and structures, activities, and participation of physical component. However, there was insufficient evidence to support that Tai Chi Chuan had beneficial mental effect.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011213/?report=classic

Improve Arthritis with Tai Chi

August 18, 2016 psyjdc 2 Comments

By John M. de Castro, Ph.D.

“With its integrative approach that strengthens the body while focusing the mind, tai chi addresses a range of physical and mental health issues—including bone strength, joint stability, cardiovascular health, immunity, and emotional well-being.” – Stephanie Watson

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. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers. Arthritis can have very negative psychological effects diminishing the individual’s self-image and may lead to depression, isolation, and withdrawal from friends and social activities Arthritis reduces the individual’s ability to function at work and may require modifications of work activities which can lead to financial difficulties. It even affects the individual’s physical appearance. In addition, due to complications associated with rheumatoid arthritis, particularly cardiovascular disease, the lifespan for people with rheumatoid arthritis may be shortened by 10 years.

It is obvious that there is a need for a safe and effective treatment to help rheumatoid arthritis sufferers cope with the disease and its consequences. Increasing exercise has been shown to increase flexibility and mobility but many form of exercise are difficult for the arthritis sufferer to engage in and many drop out. But all that may be needed is gentle movements of the joints. Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It has been shown to have many physical and psychological benefits, especially for the elderly. Because it is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for an elderly population. So, it would seem that tai chi practice would be well suited to treat arthritis in seniors.

In today’s Research News article “The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis.” See

summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718020/

Shin and colleagues examine the effectiveness of tai chi practice to help alleviate some of the cardiovascular symptoms of rheumatoid arthritis. They recruited elderly (over 50 years of age) women with rheumatoid arthritis and assigned them to two groups, a tai chi and an exercise information group. The tai chi participants engaged in a group tai chi exercise once a week for 60 min for 3 months at the hospital gymnasium. Measurements were taken before and after the 3-month practice period of rheumatoid arthritis symptoms and cardiovascular function. They found that the tai chi group had a significant decrease in plasma cholesterol and measures of atherosclerosis including significant decreases in arterial stiffness and flow mediated dilatation. Both of these measures are associated with the beginnings of cardiovascular disease.

These findings suggest that tai chi practice is beneficial in reducing cardiovascular risk factors associated with rheumatoid arthritis. These risk factors are likely due to the sedentary lifestyle of most rheumatoid arthritis sufferers and the gentle exercise of tai chi appears to be sufficient to begin to reverse some of these risk factors. This is very significant as cardiovascular disease associated with rheumatoid arthritis is serious and can lead to premature death. Since tai chi is safe and appropriate for seniors, it would appear to be an excellent treatment to reduce the cardiovascular disease risks associated with rheumatoid arthritis in the elderly.

So, improve arthritis with tai chi.

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718020/

Improve Arthritis Depression, Pain, and Disability with Mindfulness

July 23, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“People in pain often react automatically to [what’s going on]. “You think I feel pain, and then the body tightens and you have a flurry of other thoughts like Pain is ruining my life. Mindfulness allows you to notice this distress as it happens and to intentionally step back, shifting awareness to the body and adjusting it in a way that can bring ease.” – Steven Rosenzweig

The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers. It can have very negative psychological effects diminishing the individual’s self-image and may lead to depression, isolation, and withdrawal from friends and social activities. It even affects the individual’s physical appearance. As the quality of life deteriorates the individual can feel a loss of control and become anxious about the future. Stress can build and influence the individual’s attitude toward life and can lead to frustration, anger, and hopelessness. The physical disability produced by arthritis, reduces the individual’s ability to function at work and may require modifications of work activities. This can lead to financial difficulties. The normal chores at home may take much longer to accomplish and the individual may need the help of a relative or caregiver. Hence, it can produce stress on the entire family system.

There are no cures for arthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers, anti-inflammatory drugs, and corticosteroids. Recently, mindfulness practices have been found to be effective in coping with the symptoms of arthritis. In today’s Research News article “Chronic pain experience on depression and physical disability: The importance of acceptance and mindfulness-based processes in a sample with rheumatoid arthritis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1277531588937431/?type=3&theater

or below, Costa and colleagues studied the relationship between mindfulness, acceptance, disability, and depression in adult rheumatoid arthritis sufferers. They measure them for mindfulness, pain, pain acceptance, health impact of arthritis, depression, anxiety, and stress.

They found, not surprisingly, that the greater the level of pain the greater the levels of disability and depression. Higher levels of both mindfulness, especially the non-reacting facet of mindfulness, and acceptance were found to be associated with lower levels of pain, disability and depression. Performing a mediational analysis, Costa and colleagues found that the effects of pain on depression were reduced by both acceptance and non-reacting while pain’s effects on disability was reduced by only acceptance.

The results show that being non-reactinge and accepting of experience were associated with lower levels of arthritis symptoms, with acceptance associated with lower levels of both depression and physical disability and mindful non-reacting to experience associated with lower levels of depression. Depression is amplified by rumination about past pain and worry about future pain. Mindfulness focuses the individual on the present moment and thereby reduces worry and rumination. This, to some extent explains, mindfulness’ association with lower depression. Accepting the situation is also important for pain management, as fighting against pain amplifies the pain. As a result, acceptance can reduce attempts to control the pain and thereby reduce the experience of pain and the resultant symptoms of depression and physical disability.

So, improve arthritis depression, pain, and disability with mindfulness and acceptance.

“mindfulness training, which teaches people to push away troublesome thoughts, helped improve well-being in people with rheumatoid arthritis and similar diseases. Patients . . . who received the training didn’t have less pain compared to those who didn’t, but they coped better, were less tired and showed less stress. “Yes, they still have pain, but they are able to manage their pain in more constructive ways,” – Randy Dotinga

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Joana Costa, José Pinto-Gouveia, and João Marôco. Chronic pain experience on depression and physical disability: The importance of acceptance and mindfulness-based processes in a sample with rheumatoid arthritis. J Health Psychol, 1359105316649785, first published on June 15, 2016

Abstract

The mediating effect of acceptance and mindfulness in the relationship between pain, depression, and physical disability was examined in 55 rheumatoid arthritis patients. Results showed that the relationship between pain and depression was mediated by both nonreact and acceptance. By contrast, the relationship between pain and physical disability was mediated by acceptance but not by nonreact. This study provides evidences that the influence of these processes is different on depression and on physical disability. These findings support models that take both general measures of mindfulness and content-specific measures of acceptance into account when conceptualizing rheumatoid arthritis. Theoretical and clinical implications are discussed.

Relieve Chronic Pain with Tai Chi

June 2, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Tai Chi has demonstrated usefulness in the prevention and treatment of certain problems such as back pain. Importantly, Tai Chi is non-invasive, relatively inexpensive, and gentle on the spine, so many people with back pain are starting to try it as an adjunct to (or sometimes instead of) traditional medical approaches to manage back pain. Furthermore, Tai Chi does not require any expensive equipment and can be practiced anywhere.” – Robert Humphreys

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. For many, however, pain is a constant in their lives. Chronic pain affects a wide swath of humanity. At least 100 million adult Americans have common chronic pain conditions. It affects more Americans than diabetes, heart disease and cancer combined. It is a significant public health problem as it’s the number one cause of disability and costs U.S. society an estimated $560-$635 billion annually. Quite frequently opioids are prescribed for chronic pain and prescription opioid overdoses kill more than 14,000 people annually.

Chronic pain accompanies a number of conditions. The most common form of chronic pain is low back pain affecting between 6% to 15% of the population. Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Fibromyalgia is a mysterious disorder whose causes are unknown. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. It is very common affecting over 5 million people in the U.S., about 2% of the population.

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to reduce stress responses and anxiety, and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable to project that mindfulness practices would be helpful in pain management. Indeed, these practices have been shown to be safe and beneficial in pain management. Both Yoga and mindfulness has been shown to specifically improve back pain. Gentle movements of the joints with exercise appears to be helpful in the treatment of osteoarthritis. This suggests that alternative and complementary practices that involve gentle movements may be useful for treatment. Indeed, yoga practice has been shown to be effective in treating arthritis and mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. So, it would seem reasonable to look further into the effectiveness of alternative and complementary practices in treating osteoarthritis.

In today’s Research News article “Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1242319075792016/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850460/

Kong and colleagues review the published research literature on the application of the ancient Chinese practice of Tai Chi, a mindful movement practice, on chronic pain. They found that the practice of Tai Chi reduced chronic pain significantly better than control conditions. These included osteoarthritis pain, low back pain, rheumatoid arthritis, and pain from herpes zoster. The results for fibromyalgia pain were not significant. Hence, they found that tai chi practice was a safe and effective treatment for most forms of chronic pain.

These are excellent results. They’re particularly encouraging as tai chi is a safe and very gentle practice that is applicable for all age groups including the elderly. It can also be practiced anywhere and after some initial instruction, without formal classes. In China it is frequently practiced either alone or in groups in public parks. But, it can also be practiced at home. So, it’s very inexpensive. Its safety, effectiveness, affordability, and convenience make tai chi practice an outstanding choice for the treatment of chronic pain.

So, relieve chronic pain with tai chi.

“Tai Chi is a form of exercise that has recently been gaining popularity as a way to relieve and/or manage back pain and neck pain. It is often easy to associate Tai Chi with groups of people in parks or gyms moving slowly and deliberately in synchronization. These people are using the same Tai Chi principles and movements created in ancient China and still practiced all around the world as a healing exercise.” – Robert Humphreys

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Kong, L. J., Lauche, R., Klose, P., Bu, J. H., Yang, X. C., Guo, C. Q., … Cheng, Y. W. (2016). Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Scientific Reports, 6, 25325. http://doi.org/10.1038/srep25325

Abstract

Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], −0.54; 95% confidence intervals [CI], −0.77 to −0.30; P < 0.05). The valid duration of Tai Chi practice for osteoarthritis may be more than 5 weeks. And there were some beneficial evidences regarding the effects of Tai Chi on immediate relief of chronic pain from low back pain (SMD, −0.81; 95% CI, −1.11 to −0.52; P < 0.05) and osteoporosis (SMD, −0.83; 95% CI, −1.37 to −0.28; P = 0.003). Therefore, clinicians may consider Tai Chi as a viable complementary and alternative medicine for chronic pain conditions.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850460/

Change the Depressed Brain with Meditation

April 26, 2016April 26, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Meditation isn’t a magic bullet for depression, as no treatment is, but it’s one of the tools that may help manage symptoms.” – Alice Walton

Depression is the most common mental illness affecting over 6% of the population. It is debilitating by producing any or all of a long list of symptoms including: feelings of sadness or unhappiness, change in appetite or weight, slowed thinking or speech, loss of interest in activities or social gatherings, fatigue, loss in energy, sleeplessness, feelings of guilt or anger over past failures, trouble concentrating, indecisiveness, anger or frustration for no distinct reason, thoughts of dying, death and suicide. The first line treatment is antidepressant drugs. But, depression can be difficult to treat. Of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. This leaves a third of all patients treated without success.

Mindfulness practices have been demonstrated to be beneficial for depression. They not only reduce depression levels in relatively normal people but also relieve depression in individual with major depression. They can even help in cases where drugs fail to relieve the depression. In addition, mindfulness practices can reduce the likelihood of a relapse after successful treatment for depression. In other words, mindfulness is an effective treatment either alone or in combination with drugs for depression.

In the last few decades it has become increasingly clear that the brain is very plastic and can be reshaped by what we do and what we experience. This has been called neuroplasticity. Contemplative practices have been shown to produce neuroplastic change altering the brain. They tend to increase the size, activity, and connectivity of areas of the brain that are important for attention, and emotion regulation while reducing the size, activity, and connectivity of areas of the brain that are involved in mind wandering and self-centered thinking, daydreaming, and rumination.

Mindfulness practices appear to take advantage of neuroplasticity to act upon the chemistry of the brain and brain electrical activity to help relieve depression. Hence, it makes sense that there should be further research on the effects of mindfulness on the brain and depression to better understand the mechanisms of action of mindfulness and potentially optimize treatment. In today’s Research News article “State and Training Effects of Mindfulness Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant Effect”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779536/

Yang and colleagues trained meditation naive college students for 8-weeks with a mindfulness program based upon a combination of Mindfulness Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT). Functional Magnetic Resonance Imaging (f-MRI) brain scans were performed before training and 40 days later both at rest and during meditation. The students emotional state and depression levels were also measured before and after training.

After mindfulness training there was a 45% reduction in depression, a 21% reduction in trait anxiety, and a small reduction in tension. The brain was also found to be changed at rest after training. The changes were many and diverse. But arguably the most interesting change was a reduction in the functional connectivity between the pregenual anterior cingulate and dorsal medical prefrontal cortex. The anterior cingulate cortex is part of what is called the default mode network that is activated during mind wandering and emotionality. It is involved in major depression and the loss of emotionality, so called flat affect, that characterizes depression. On the other hand, the dorsal medical prefrontal cortex is involved in focused attention, cognitive control, and emotion regulation. These results are very complex and must be interpreted cautiously. But, it appears that meditation training reduces the ability of areas involved in depression from affecting areas involved in thought and emotion. This is a potential route for mindfulness affects in relieving depression.

Regardless, it’s clear that mindfulness can change the depressed brain.

“We can intentionally shape the direction of plasticity changes in our brain. By focusing on wholesome thoughts, for example, and directing our intentions in those ways, we can potentially influence the plasticity of our brains and shape them in ways that can be beneficial.” – Richie Davidson

CMCS – Center for Mindfulness and Contemplative Studies

Study Summary

Yang, C.-C., Barrós-Loscertales, A., Pinazo, D., Ventura-Campos, N., Borchardt, V., Bustamante, J.-C., … Walter, M. (2016). State and Training Effects of Mindfulness Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant Effect. Neural Plasticity, 2016, 9504642. http://doi.org/10.1155/2016/9504642

Abstract

The topic of investigating how mindfulness meditation training can have antidepressant effects via plastic changes in both resting state and meditation state brain activity is important in the rapidly emerging field of neuroplasticity. In the present study, we used a longitudinal design investigating resting state fMRI both before and after 40 days of meditation training in 13 novices. After training, we compared differences in network connectivity between rest and meditation using common resting state functional connectivity methods. Interregional methods were paired with local measures such as Regional Homogeneity. As expected, significant differences in functional connectivity both between states (rest versus meditation) and between time points (before versus after training) were observed. During meditation, the internal consistency in the precuneus and the temporoparietal junction increased, while the internal consistency of frontal brain regions decreased. A follow-up analysis of regional connectivity of the dorsal anterior cingulate cortex further revealed reduced connectivity with anterior insula during meditation. After meditation training, reduced resting state functional connectivity between the pregenual anterior cingulate and dorsal medical prefrontal cortex was observed. Most importantly, significantly reduced depression/anxiety scores were observed after training. Hence, these findings suggest that mindfulness meditation might be of therapeutic use by inducing plasticity related network changes altering the neuronal basis of affective disorders such as depression.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779536/

Improve Arthritis with Massage, Yoga, and Tai Chi

April 11, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Osteoarthritis is a degenerative joint disease which can lead to pain and swelling of your joints. Yoga is a great complimentary practice to help overcome knee osteoarthritis relief, as you’re strengthening and loosening your joints, and improving your overall well being.” – Minakshi Welukar

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. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Knee osteoarthritis is not localized to the cartilage alone but involves the whole joint, including articular cartilage, meniscus, ligament, and peri-articular muscle. It is painful and disabling. While age is a major risk factor for osteoarthritis of the knee, young people are not immune. It effects 5% of adults over 25 years of age and 12% of those over 65. 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 appears to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary 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 mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. So, it would seem reasonable to look further into the effectiveness of alternative and complementary practices in treating knee osteoarthritis.

In today’s Research News article “Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and tai chi: A review”

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Or see below

Tiffany Field reviews the literature on the application of three alternative and complementary practices, massage therapy, yoga, and tai chi, for the treatment of treating knee osteoarthritis. She reports that the literature finds fairly consistently that massage can help to relieve pain. It appears that pressure massage, involving skin displacement if more effective than light massage. She further reports that yoga practice has been routinely found to reduce pain and relieve accompanying depression and sleep problems in arthritis sufferers. Yoga practice appears to produce better results than simple light exercise. Finally, she reports that the ancient Chinese gentle slow movement practice of Tai Chi significantly decreased knee pain and improved movement characteristics including stride length, stride frequency and gait speed.

The results of the reviewed studies are encouraging that massage therapy, and yoga and tai chi practices are effective in treating knee osteoarthritis. Yoga and tai chi have other characteristics that recommend them. They are both safe practices with very few, if any, adverse effects and importantly, they both can be practiced conveniently and inexpensively in groups or alone at home, thus allowing their widespread affordable application to sufferers. In addition, both yoga and tai chi practices have been shown to have a large number of other physical and psychological benefits. So, they would seem to be excellent alternative and complementary practices for the treatment of knee osteoarthritis.

So, improve arthritis with massage, yoga, and tai chi.

“Research suggests that a tailored yoga practice can help reduce pain and improve function in patients with knee osteoarthritis. Potential mechanisms include strengthening, improving flexibility, and altering gait biomechanics.” – Richa Mishra

CMCS – Center for Mindfulness and Contemplative Studies

Study Summary

Field T. Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and tai chi: A review. Complement Ther Clin Pract. 2016 Feb;22:87-92. doi: 10.1016/j.ctcp.2016.01.001. Epub 2016 Jan 14. Review.

Highlights

Massage therapy reduces knee osteoarthritis pain in the elderly.
Yoga reduces knee osteoarthritis pain in the elderly.
Tai chi reduces knee osteoarthritis pain in the elderly.

Abstract

Background and methods: This is a review of recently published research, both empirical studies and meta-analyses, on the effects of complementary therapies including massage therapy, yoga and tai chi on pain associated with knee osteoarthritis in the elderly.

Results: The massage therapy protocols have been effective in not only reducing pain but also in increasing range of motion, specifically when moderate pressure massage was used and when both the quadriceps and hamstrings were massaged. The yoga studies typically measured pain by the WOMAC. Most of those studies showed a clinically significant reduction in pain, especially the research that focused on poses (e.g. the Iyengar studies) as opposed to those that had integrated protocols (poses, breathing and meditation exercises). The tai chi studies also assessed pain by self-report on the WOMAC and showed significant reductions in pain. The tai chi studies were difficult to compare because of their highly variable protocols in terms of the frequency and duration of treatment.

Discussion: Larger, randomized control trials are needed on each of these therapies using more standardized protocols and more objective variables in addition to the self-reported WOMAC pain scale, for example, range-of-motion and observed range-of-motion pain. In addition, treatment comparison studies should be conducted so, for example, if the lower-cost yoga and tai chi were as effective as massage therapy, they might be used in combination with or as supplemental to massage therapy. Nonetheless, these therapies are at least reducing pain in knee osteoarthritis and they do not seem to have side effects.

Age Healthily – Yoga for Arthritis

August 14, 2015 psyjdc 8 Comments

Arthritis reduces the individual’s ability to function at work and may require modifications of work activities. This can lead to financial difficulties. The normal chores at home may take much longer to accomplish and the individual may need the help of a relative or caregiver. Hence, it can produce stress on the entire family system.

It is obvious that there is a need for a safe and effective treatment to help the suffer cope with the disease and its consequences. Increasing exercise has been shown to increase flexibility and mobility but many form of exercise are difficult for the arthritis sufferer to engage in and many drop out. Recently, yoga practice has been adapted for the treatment of arthritis sufferers.

In today’s Research News article “Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490021/

Moonaz and colleagues tested 8-weeks of yoga practice for the treatment of rheumatoid and osteoarthritis. They found that yoga improved physical activity and physical and psychological health, and the quality of life of the arthritis sufferers. Yoga increased walking capacity, flexibility, pain, general health, vitality and mental health including reduced depression and negative emotions. In addition the positive effects were still present 9 months later.

It appears that the positive effects of yoga on the psychological health of arthritis sufferers was due to the reduction in physical symptoms and their consequences. All of this, of course, increases perceived quality of life. In addition, participation rates for yoga were higher than those for other exercise programs. This suggests that yoga is not only safe and effective for the treatment of arthritis but it is also acceptable producing better adherence to the regimen.

In addition, yoga has been shown to help individual age healthily in other ways. It decreases cellular ageing

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http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-yoga-and-cellular-aging/

and protects the brain from age related degeneration

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http://contemplative-studies.org/wp/index.php/2015/07/17/age-healthily-protect-the-brain-with-yoga/

and decreases age related physical decline.

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http://contemplative-studies.org/wp/index.php/2015/07/17/age-healthily-yoga/

So, practice yoga to deal with arthritis and age healthily.

CMCS