Asthma

Improve Asthma Symptoms with Mindfulness

psyjdc Leave a comment

Improve Asthma Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Asthma is treatable and well can be controlled.” —Cathy Freeman

 

Asthma is a chronic disease of the lungs that involves a persistent inflammation of the airways. When the inflammation worsens, it makes it more difficult for air to move in and out of the lungs provoking coughing, wheezing, shortness of breath and chest tightness. It is estimated that 300 million people worldwide and 30 million people in the U.S. suffer from asthma and the incidence appears to be growing. Asthma is not fatal and those with moderate asthma have an equivalent life expectancy to those that don’t. There is no cure for asthma. So, it is a chronic disease that must be coped with throughout the lifetime. Treatments are aimed at symptomatic relief. Most frequently drugs, anti-inflammatory hormones, and inhalers are used to help control the inflammation. Mindfulness training has been shown to improve the symptoms of Asthma.

 

In today’s Research News article “Clinically relevant effects of Mindfulness-Based Stress Reduction in individuals with asthma.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513112/ ) Higgins and colleagues recruited asthma patients and randomly assigned them to either a wait-list control condition or to receive an 8-weekly 2.5 hour sessions of Mindfulness-Based Stress Reduction (MBSR)  consisting of meditation, yoga, body scan, and group discussion. The participants were measured before, midpoint, after and every month for 6 months for asthma control, asthma severity, airway inflammation, anxiety, depression, perceived stress, symptoms and severity, and mindfulness.

 

They found that in comparison to baseline and the control group, the MBSR had significantly improved mindfulness and asthma control and significantly reduced symptom distress and airway inflammation. Hence, MBSR produced significant improvements in asthma symptoms and the patients ability to control the symptoms.

 

So, improve asthma with mindfulness.

 

“Asthma would not keep me from enjoying life.I beat asthma everyday.” —Unknown

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Higgins ET, Davidson RJ, Busse WW, Klaus DR, Bednarek GT, Goldman RI, Sachs J, Rosenkranz MA. Clinically relevant effects of Mindfulness-Based Stress Reduction in individuals with asthma. Brain Behav Immun Health. 2022 Sep 14;25:100509. doi: 10.1016/j.bbih.2022.100509. PMID: 36177306; PMCID: PMC9513112.

 

Abstract

Background

Psychological distress and comorbid psychopathology contribute to exacerbation risk in patients with asthma. Thus, interventions designed to reduce stress and improve emotion regulation, such as Mindfulness-Based Stress Reduction (MBSR), may augment standard care. Few studies have addressed this question and a paucity of data exists to determine the ability of MBSR to impact clinical outcomes in asthma.

Methods

This randomized controlled trial investigated effects of MBSR training on asthma control and airway inflammation, in relation to psychological symptoms, in adults with asthma. Participants were randomized to an 8-week MBSR training (n = 35) or wait-list control group (n = 34). Clinically relevant asthma assessments, including Asthma Control Questionnaire and inflammatory biomarkers, were collected at baseline and six approximately-monthly follow-ups. Self-reported mindfulness, distress, depression, and anxiety symptoms were assessed at baseline, post-intervention, and study completion. Chronic stress level was determined at baseline only.

Results

Asthma control improved significantly in individuals randomized to MBSR, relative to wait-list controls (p = .01; effect size d = 0.76), which was maintained at 4mo post-intervention. 32% of MBSR participants achieved a clinically significant improvement, based on the ACQ6 Minimally Important Difference, relative to 12% of wait-list participants. Moreover, MBSR-related improvement in asthma control was associated with a reduction in distress (p = .043) and the intervention was most efficacious for those with the highest baseline depressive symptoms (p = .023). Importantly, MBSR also reduced levels of exhaled nitric oxide, a biomarker of airway inflammation, relative to wait-list controls (p < .05).

Conclusion

Supporting and extending extant evidence of mind-body relationships in asthma and the benefits of stress reduction for these patients, this is, to the best of our knowledge, the first RCT to demonstrate that training in MBSR improves clinically relevant asthma outcomes. MBSR may thus be a valuable addition to optimal asthma management, particularly for those with comorbid psychopathology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513112/

Mindfulness Improves Physical and Mental Well-Being

psyjdc Leave a comment

Mindfulness Improves Physical and Mental Well-Being

 

By John M. de Castro, Ph.D.

 

“scientists have found that practicing mindfulness is associated with changes in the structure and function of the brain as well as changes in our body’s response to stress, suggesting that this practice has important impacts on our physical and emotional health.” –  University of Minnesota

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children, to adolescents, to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Research on mindfulness effects on mental and physical health has exploded over the last few decades. So, it makes sense to pause and examine what has been learned. In today’s Research News article “Mindfulness-based interventions: an overall review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083197/ )  Zhang and colleagues reviewed and summarized the randomized controlled trials and meta-analyses of the effects of mindfulness-based practices on mental and physical health.

 

They report that the published research studies and meta-analyses found that mindfulness-based practices produced significant improvements in mental health including anxiety, depression, anger, prosocial behavior, loneliness, physiological and psychological indicators of stress, insomnia, eating disorders, addictions, psychoses, Post-Traumatic Stress Disorder (PTSD), attention-deficit hyperactivity disorder (ADHD), and autism. They also report that mindfulness-based practices produced significant improvements in physical health including pain, hypertension, cardiovascular disease, obesity, diabetes, cancer, asthma, chronic obstructive pulmonary disease (COPD), aggression, and violence.

 

In addition, mindfulness-based practices produced safe, cost-effective improvements in professional and healthcare settings, in schools, and in the workplace. Further they report that mindfulness-based practices produced significant changes in the structure and activity of the nervous system, improvements in immune functioning and physiological markers of stress.

 

The review of the published research has provided a compelling case for the utilization of mindfulness-based practices for a myriad of psychological and physical problems in humans of all ages with and without disease. The range and depth of effects are unprecedented making a strong case for the routine training in mindfulness for the improvement of their well-being.

 

So, mindfulness improves physical and mental well-being.

 

“engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.” – Jennifer Wolkin

 

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

 

Zhang, D., Lee, E., Mak, E., Ho, C. Y., & Wong, S. (2021). Mindfulness-based interventions: an overall review. British medical bulletin, ldab005. Advance online publication. https://doi.org/10.1093/bmb/ldab005

 

Abstract

Introduction

This is an overall review on mindfulness-based interventions (MBIs).

Sources of data

We identified studies in PubMed, EMBASE, CINAHL, PsycINFO, AMED, Web of Science and Google Scholar using keywords including ‘mindfulness’, ‘meditation’, and ‘review’, ‘meta-analysis’ or their variations.

Areas of agreement

MBIs are effective for improving many biopsychosocial conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms and prosocial behaviours. It is found to be beneficial in the healthcare settings, in schools and workplace but further research is warranted to look into its efficacy on different problems. MBIs are relatively safe, but ethical aspects should be considered. Mechanisms are suggested in both empirical and neurophysiological findings. Cost-effectiveness is found in treating some health conditions.

Areas of controversy

Inconclusive or only preliminary evidence on the effects of MBIs on PTSD, ADHD, ASD, eating disorders, loneliness and physical symptoms of cardiovascular diseases, diabetes, and respiratory conditions. Furthermore, some beneficial effects are not confirmed in subgroup populations. Cost-effectiveness is yet to confirm for many health conditions and populations.

Growing points

Many mindfulness systematic reviews and meta-analyses indicate low quality of included studies, hence high-quality studies with adequate sample size and longer follow-up period are needed.

Areas timely for developing research

More research is needed on online mindfulness trainings and interventions to improve biopsychosocial health during the COVID-19 pandemic; Deeper understanding of the mechanisms of MBIs integrating both empirical and neurophysiological findings; Long-term compliance and effects of MBIs; and development of mindfulness plus (mindfulness+) or personalized mindfulness programs to elevate the effectiveness for different purposes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083197/

Help Relieve Asthma Symptoms with Yoga

psyjdc Leave a comment

Help Relieve Asthma Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga can help increase breath and body awareness, slow your respiratory rate, and promote calm and relieve stress — all of which are beneficial for people who have asthma.” – Judi Bar

 

Asthma is a chronic disease of the lungs that involves a persistent inflammation of the airways. When the inflammation worsens, it makes it more difficult for air to move in and out of the lungs provoking coughing, wheezing, shortness of breath and chest tightness. It is estimated that 300 million people worldwide and 30 million people in the U.S. suffer from asthma and the incidence appears to be growing. In the U.S.it is estimated to cost $60 billion per year in healthcare costs and lost productivity. Asthma is the most common chronic disease in the world among children with about 10% of children suffering from asthma.

 

Asthma is not fatal and those with moderate asthma have an equivalent life expectancy to those that don’t. There is no cure for asthma. So, it is a chronic disease that must be coped with throughout the lifetime. Treatments are aimed at symptomatic relief. Most frequently drugs, anti-inflammatory hormones, and inhalers are used to help control the inflammation. Exercise can be difficult with asthma and may actually precipitate an attack. This can be a problem as maintaining fitness with asthma can be difficult. A relatively gentle form of exercise, yoga practice can be practiced without heavy breathing and thus may not provoke asthma. In addition, breathing exercises like those incorporated into yoga practice are known to help control asthma. This suggests that yoga practice may be a helpful exercise for people with asthma.

 

In today’s Research News article “Yoga for asthma.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880926/), Yang and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice for the treatment of asthma. They found 15 randomized controlled trials (RCTs).

 

They report that the research found that yoga practice produced a significant improvement in the asthma patients’ symptoms, control of asthma, and quality of life and a significant reduction in asthma medication use. In terms of lung function, the research found that yoga practice produced significant improvements in forced vital capacity and peak expiratory flow rate.

 

Hence, yoga practice appears to be beneficial for asthma patients, improving lung function, asthma symptoms, drug use, and improving the patient’s quality of life. There were no recorded adverse events associated with the yoga practice. This is important as exercise is often difficult for asthma patients. Yoga practice appears to be feasible and well tolerated and beneficial for asthma patients.

 

So, help relieve asthma symptoms with yoga.

 

“Having asthma means it can be a struggle to breathe properly, but yoga involves learning how to breathe deeply in and out through the nose to filter the air, and find a natural, balanced breathing pattern. Over time this helps to increase lung capacity and gives you more control of your breathing day-to-day.” – Julia White

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Yang, Z. Y., Zhong, H. B., Mao, C., Yuan, J. Q., Huang, Y. F., Wu, X. Y., … Tang, J. L. (2016). Yoga for asthma. The Cochrane database of systematic reviews, 4(4), CD010346. doi:10.1002/14651858.CD010346.pub2

 

Abstract

Background

Asthma is a common chronic inflammatory disorder affecting about 300 million people worldwide. As a holistic therapy, yoga has the potential to relieve both the physical and psychological suffering of people with asthma, and its popularity has expanded globally. A number of clinical trials have been carried out to evaluate the effects of yoga practice, with inconsistent results.

Objectives

To assess the effects of yoga in people with asthma.

Search methods

We systematically searched the Cochrane Airways Group Register of Trials, which is derived from systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO, and handsearching of respiratory journals and meeting abstracts. We also searched PEDro. We searched ClinicalTrials.gov and the WHO ICTRP search portal. We searched all databases from their inception to 22 July 2015, and used no restriction on language of publication. We checked the reference lists of eligible studies and relevant review articles for additional studies. We attempted to contact investigators of eligible studies and experts in the field to learn of other published and unpublished studies.

Selection criteria

We included randomised controlled trials (RCTs) that compared yoga with usual care (or no intervention) or sham intervention in people with asthma and reported at least one of the following outcomes: quality of life, asthma symptom score, asthma control, lung function measures, asthma medication usage, and adverse events.

Data collection and analysis

We extracted bibliographic information, characteristics of participants, characteristics of interventions and controls, characteristics of methodology, and results for the outcomes of our interest from eligible studies. For continuous outcomes, we used mean difference (MD) with 95% confidence interval (CI) to denote the treatment effects, if the outcomes were measured by the same scale across studies. Alternatively, if the outcomes were measured by different scales across studies, we used standardised mean difference (SMD) with 95% CI. For dichotomous outcomes, we used risk ratio (RR) with 95% CI to measure the treatment effects. We performed meta‐analysis with Review Manager 5.3. We used the fixed‐effect model to pool the data, unless there was substantial heterogeneity among studies, in which case we used the random‐effects model instead. For outcomes inappropriate or impossible to pool quantitatively, we conducted a descriptive analysis and summarised the findings narratively.

Main results

We included 15 RCTs with a total of 1048 participants. Most of the trials were conducted in India, followed by Europe and the United States. The majority of participants were adults of both sexes with mild to moderate asthma for six months to more than 23 years. Five studies included yoga breathing alone, while the other studies assessed yoga interventions that included breathing, posture, and meditation. Interventions lasted from two weeks to 54 months, for no more than six months in the majority of studies. The risk of bias was low across all domains in one study and unclear or high in at least one domain for the remainder.

There was some evidence that yoga may improve quality of life (MD in Asthma Quality of Life Questionnaire (AQLQ) score per item 0.57 units on a 7‐point scale, 95% CI 0.37 to 0.77; 5 studies; 375 participants), improve symptoms (SMD 0.37, 95% CI 0.09 to 0.65; 3 studies; 243 participants), and reduce medication usage (RR 5.35, 95% CI 1.29 to 22.11; 2 studies) in people with asthma. The MD for AQLQ score exceeded the minimal clinically important difference (MCID) of 0.5, but whether the mean changes exceeded the MCID for asthma symptoms is uncertain due to the lack of an established MCID in the severity scores used in the included studies. The effects of yoga on change from baseline forced expiratory volume in one second (MD 0.04 litres, 95% CI ‐0.10 to 0.19; 7 studies; 340 participants; I2 = 68%) were not statistically significant. Two studies indicated improved asthma control, but due to very significant heterogeneity (I2 = 98%) we did not pool data. No serious adverse events associated with yoga were reported, but the data on this outcome was limited.

Authors’ conclusions

We found moderate‐quality evidence that yoga probably leads to small improvements in quality of life and symptoms in people with asthma. There is more uncertainty about potential adverse effects of yoga and its impact on lung function and medication usage. RCTs with a large sample size and high methodological and reporting quality are needed to confirm the effects of yoga for asthma.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880926/

 

Improve Asthma in Children with Tai Chi

psyjdc Leave a comment

Improve Asthma in Children with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi/Qigong is eminently suitable and beneficial for asthma sufferers. As well as being non-exertive their practice teaches correct breathing and posture, which can help eliminate or decrease the severity of attacks. Benefits of Tai Chi for Asthmatics” – Living Chi

 

Asthma is a chronic disease of the lungs that involves a persistent inflammation of the airways. When the inflammation worsens, it makes it more difficult for air to move in and out of the lungs provoking coughing, wheezing, shortness of breath and chest tightness. It is estimated that 300 million people worldwide and 30 million people in the U.S. suffer from asthma and the incidence appears to be growing. In the U.S.it is estimated to cost $60 billion per year in healthcare costs and lost productivity. Asthma is the most common chronic disease in the world among children with about 10% of children suffering from asthma.

 

Asthma is not fatal and those with moderate asthma have an equivalent life expectancy to those that don’t. There is no cure for asthma. So, it is a chronic disease that must be coped with throughout the lifetime. Treatments are aimed at symptomatic relief. Most frequently drugs, anti-inflammatory hormones, and inhalers are used to help control the inflammation. Exercise can be difficult with asthma and may actually precipitate an attack. This can be a problem as maintaining fitness with asthma can be difficult. A gentle form of exercise, Tai Chi, does not require heavy breathing and thus does not provoke asthma. In addition, breathing exercises like those incorporated into Tai Chi practice are known to help control asthma. This suggests that Tai Chi may be a helpful exercise for people with asthma.

 

In today’s Research News article “.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406730/, Lin and colleagues recruited children with and without a diagnosis of mild, intermittent asthma (average age of 10.5). The children were instructed in Tai Chi for 60 minutes, once a week, for 12 weeks and were requested to practice every day at home assisted by supplied videos. They were measured before and after training for lung function, fractional exhaled nitric oxide (an indicator of airway inflammation), and asthma quality of life. They were compared to a group of similar children who did not practice Tai Chi.

 

They found that the groups that performed Tai Chi showed significant improvements in lung function and decreases in lung inflammation. In addition, the children with asthma showed significant improvements in asthma quality of life, including asthma symptoms, limitations on activity, and emotional function. It should be mentioned that the control children did not engage in any form of exercise, so, it is not clear that Tai Chi has any greater benefits than other exercises. It remains for future research to clarify this issue.

 

It is clear, however, that the gentle exercise of Tai Chi combined with its breathing exercises is of great benefit to children with asthma, improving breathing and their quality of life. The study only investigated children with mild and intermittent asthma. So, it remains for future research to demonstrate if Tai Chi practice is similarly beneficial for more severe cases of asthma. But these results are very encouraging as Tai Chi is gentle, safe, does not provoke asthmatic attacks, is inexpensive to teach, practice can be conveniently maintained at home, and it includes beneficial breathing exercises.

 

So, improve asthma in children with Tai Chi.

 

“Breathing, relaxation and exercise programs, have for many years, been a useful tool in asthma management. The problem is that breathing; relaxation and exercise are often practiced separately, making them a relatively disjointed and limited part of asthma management.” – Living 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 and on Twitter @MindfulResearch

 

Study Summary

 

Lin, H.-C., Lin, H.-P., Yu, H.-H., Wang, L.-C., Lee, J.-H., Lin, Y.-T., … Chiang, B.-L. (2017). Tai-Chi-Chuan Exercise Improves Pulmonary Function and Decreases Exhaled Nitric Oxide Level in Both Asthmatic and Nonasthmatic Children and Improves Quality of Life in Children with Asthma. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 6287642. http://doi.org/10.1155/2017/6287642

 

Abstract

Tai-Chi-Chuan (TCC) is an exercise of low-to-moderate intensity which is suitable for asthmatic patients. The aim of our study is to investigate improvements of the lung function, airway inflammation, and quality of life of asthmatic children after TCC. Participants included sixty-one elementary school students and they were divided into asthmatic (n = 29) and nonasthmatic (n = 32) groups by the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Among them, 20 asthmatic and 18 nonasthmatic children volunteered to participate in a 60-minute TCC exercise weekly for 12 weeks. Baseline and postintervention assessments included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), fractional exhaled nitric oxide (FeNO) level, and Standardised Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)). After intervention, the level of FeNO decreased significantly; PEFR and the FEV1/FVC also improved significantly in both asthmatic group and nonasthmatic group after TCC. The asthmatic children also had improved quality of life after TCC. The results indicated that TCC could improve the pulmonary function and decrease airway inflammation in both children with mild asthma and those without asthma. It also improves quality of life in mild asthmatic children. Nevertheless, further studies are required to determine the effect of TCC on children with moderate-to-severe asthma.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406730/