Improve Fibromyalgia with Tai Chi

November 1, 2017 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Compared with patients who received wellness education and stretching exercises, those who practiced tai chi saw their fibromyalgia become much less severe. They also slept better, felt better, had less pain, had more energy, and had better physical and mental health.” – Chenchen Wang

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

There are no completely effective treatments for fibromyalgia. Drugs and lifestyle changes are recommended but produce only limited symptomatic relief but also can produce unwanted side effects. Alternatively, mindfulness practices have been shown to be effective in reducing pain from fibromyalgia. 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. In addition, Tai Chi has been shown to reduce pain in patients with spinal cord injury. Hence, Tai Chi may be an excellent treatment for the symptoms of fibromyalgia.

In today’s Research News article “A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571653/, Jones and colleagues recruited fibromyalgia sufferers and randomly assigned them to either practice Tai Chi or receive education on fibromyalgia from physicians, dieticians, and counselors for 90 minutes, twice a week, for 12 weeks. Homework and home practice was also prescribed. The participants were measured before and after the 12-week treatment period for fibromyalgia impact, including fatigue, morning tiredness, stiffness, depression, anxiety, work ability, and physical function

They found that the Tai Chi group in comparison to baseline and the education group had significant decreases in fibromyalgia impact, pain, sleep quality, self-efficacy, functional mobility, and balance. There were also significant reductions in pain, and improvements in sleep quality, self-efficacy, functional mobility, and balance. Importantly, none of the participants dropped out from the Tai Chi group. Hence, Tai Chi was found to be well tolerated and acceptable, and to produce clinically significant improvements in the symptoms of fibromyalgia.

Tai Chi can significantly improve the suffering from fibromyalgia while being acceptable for practice for patients in pain. It has no known negative side effects, is inexpensive and convenient to practice, and can be practiced alone or in groups. It appears to not only improve the psychological symptoms that can be produced by other mindfulness practices, but can also improve physical mobility including balance. Hence, Tai Chi would appear to be a nearly ideal treatment for fibromyalgia, either alone or in combination with other treatments.

So, improve fibromyalgia with Tai Chi.

“Aside from reductions in pain, patients in the tai chi group reported improvements in mood, quality of life, sleep, self-efficacy and exercise capacity. The potential efficacy and lack of adverse effects now make it reasonable for physicians to support patients’ interest in exploring these types of exercises, even if it is too early to take out a prescription pad and write ‘tai chi,’” – Gloria Yeh

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

Jones, K. D., Sherman, C. A., Mist, S. D., Carson, J. W., Bennett, R. M., & Li, F. (2012). A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients. Clinical Rheumatology, 31(8), 1205–1214. http://doi.org/10.1007/s10067-012-1996-2

Abstract

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia (FM). The purpose of this study was to further investigate earlier findings and add a focus on functional mobility. We conducted a parallel-group randomized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control. Participants met in small groups twice weekly for 90 min over 12 weeks. The primary endpoint was symptom reduction and improvement in self-report physical function, as measured by the Fibromyalgia Impact Questionnaire (FIQ), from baseline to 12 weeks. Secondary endpoints included pain severity and interference (Brief Pain Inventory (BPI), sleep (Pittsburg sleep Inventory), self-efficacy, and functional mobility. Of the 101 randomly assigned subjects (mean age 54 years, 93 % female), those in the Tai chi condition compared with the education condition demonstrated clinically and statistically significant improvements in FIQ scores (16.5 vs. 3.1, p=0.0002), BPI pain severity (1.2 vs. 0.4, p=0.0008), BPI pain interference (2.1 vs. 0.6, p=0.0000), sleep (2.0 vs. −0.03, p=0.0003), and self-efficacy for pain control (9.2 vs. −1.5, p=0.0001). Functional mobility variables including timed get up and go (−.9 vs. −.3, p=0.0001), static balance (7.5 vs. −0.3, p= 0.0001), and dynamic balance (1.6 vs. 0.3, p=0.0001) were significantly improved with Tai chi compared with education control. No adverse events were noted. Twelve weeks of Tai chi, practice twice weekly, provided worthwhile improvement in common FM symptoms including pain and physical function including mobility. Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571653/

Improve Opiate Relief of Low Back Pain with Mindfulness

October 25, 2017 psyjdc Leave a comment

Improve Opiate Relief of Low Back Pain with Mindfulness

By John M. de Castro, Ph.D.

“I’ve been doing research on back pain for 30 years. The biggest revolution has been the understanding that it’s not just a physical problem with physical solutions. It’s a biopsychosocial problem.” – Daniel Cherkin

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. The pain interferes with daily living and with work, interfering with productivity and creating absences. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years.

There have been few attempts to study the combination of opiate treatment with mindfulness training for the treatment of chronic low back pain. In today’s Research News article “Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991566/, Zgierska and colleagues examine their combination. They recruited patients with chronic low back pain who have been taking daily opiates for at least 3 months and randomly assigned them to either continue opiate treatment or to continue it in combination with mindfulness training. Mindfulness training consisted of once a week for 8 weeks, 2-hour sessions with training in breath meditation, walking meditation, loving kindness meditation, and body scan. Participants were also required to practice at home. Before and after treatment and 18 weeks later the patients were measured for pain severity, physical function (disability), and opioid intake and side effects. After treatment, they also completed measures of adherence to the treatment protocol and satisfaction with the treatment.

They found that there were significant decreases in pain severity and pain sensitivity in the mindfulness treatment group at the 18-week follow-up. No adverse events were reported and opioid use declined slightly albeit not significantly. None of the participants withdrew from the study and there was a 91% adherence to treatment protocol rate. Additionally, participants were satisfied with the intervention and generally planned to continue practice.

These results are very exciting and suggest that mindfulness training is an acceptable, safe, and effective supplement to opioid treatment for pain relief in chronic back pain patients. Given that the patients were already on pain killers, this was a remarkable effect of mindfulness training. It is thought that mindfulness training reduces pain by interrupting the patients’ psychological reactions to pain. Mindfulness is known to improve emotion regulation, and reduce stress effects, fear, worry, and anxiety all of which can amplify pain. By eliminating these factors that magnify the pain, mindfulness practice reduces the patients’ overall pain level.

So, improve opiate relief of low back pain with mindfulness.

“We are accumulating evidence that meditation’s effects on pain can be realized with very short training. A fast-acting, non-pharmacological, inexpensive treatment for chronic pain? That might be a pill everyone can swallow.” – Stephani Sutherland

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Zgierska, A. E., Burzinski, C. A., Cox, J., Kloke, J., Singles, J., Mirgain, S., … Bačkonja, M. (2016). Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy. Journal of Alternative and Complementary Medicine, 22(8), 610–620. http://doi.org/10.1089/acm.2015.0314

Abstract

Objective: Although mindfulness meditation (MM) is increasingly used for chronic pain treatment, limited evidence supports its clinical application for opioid-treated chronic low back pain (CLBP). The goal of this study was to determine feasibility, acceptability, and safety of an MM-based intervention in patients with CLBP requiring daily opioid therapy.

Design: 26-week pilot randomized controlled trial comparing MM-based intervention, combined with usual care, to usual care alone.

Setting: Outpatient.

Patients: Adults with CLBP treated with ≥30 mg of morphine-equivalent dose (MED) per day for 3 months or longer.

Interventions: Targeted MM-based intervention consisted of eight weekly 2-hour group sessions and home practice (30 minutes/d, 6 days/wk) during the study. “Usual care” for opioid-treated CLBP was provided to participants by their regular clinicians.

Outcome measures: Feasibility and acceptability of the MM intervention were assessed by adherence to intervention protocol and treatment satisfaction among experimental participants. Safety was evaluated by inquiry about side effects/adverse events and opioid dose among all study participants.

Results: Thirty-five participants enrolled during the 10-week recruitment period. The mean age (±standard deviation) was 51.8 ± 9.7 years; the patients were predominantly female, with substantial CLBP-related pain and disability, and treated with 148.3 ± 129.2 mg of MED per day. All participants completed baseline assessments; none missed both follow-up assessments or withdrew. Among experimental participants (n = 21), 19 attended 1 or more intervention sessions and 14 attended 4 or more. They reported, on average, 164.0 ± 122.1 minutes of formal practice per week during the 26-week study and 103.5 ± 111.5 minutes of brief, informal practice per week. Seventeen patients evaluated the intervention, indicating satisfaction; their qualitative responses described the course as useful for pain management (n = 10) and for improving pain coping skills (n = 8). No serious adverse events or safety concerns occurred among the study participants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991566/

Reduce Pain in Children with Mind-Body Practices

October 23, 2017 psyjdc Leave a comment

Reduce Pain in Children with Mind-Body Practices

By John M. de Castro, Ph.D.

“Guided imagery is a meditative process that uses visualization and imagination to bring awareness to the mind-body connection. Children can easily access this healing process because they’re naturally imaginative. By relaxing into a vivid story they gain tools to deal with stress, pain or difficult feelings.” – Catherine Gillespie-Lopes

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Sadly, about a quarter to a third of children experience chronic pain. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. The use of drugs in children is even more complicated and potentially directly harmful or could damage the developing brain. So, there is a great need to find safe and effective ways to lower the psychological distress and improve children’s ability to cope with the pain.

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. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. These include meditation, yoga, tai chi, qigong, biofeedback, progressive muscle relaxation, guided imagery, hypnosis, acupuncture, and deep breathing exercises. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults. But there is very little systematic study of the application of these practices for the treatment of chronic pain in children.

In today’s Research News article “A Mind–Body Approach to Pediatric Pain Management.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483625/, Brown and colleagues review and summarize the published research literature on the use of mind-body techniques to treat pain in children. They found that there is clear evidence from the research that yoga practice and acupuncture are effective in the treatment of pain in both adults and children. On the other hand, they found that meditation, mindfulness training, and hypnosis are effective for treating pain in adults, but that there is a void of research for its application in children.

Hence the published research literature is encouraging. Where there have been studies, mind-body practices have been found to safely and effectively reduce chronic pain in both adults and children. A great advantage of these treatments is that they have little or no side effects other than positive ones and are thus a promising safe alternative to the use of dangerous drugs. But, there is obviously a need for much more research on the effectiveness of mind-body techniques for chronic pain in children.

So, reduce pain in children with mind-body practices.

“Mindfulness provides a more accurate perception of pain . . . For instance, you might think that you’re in pain all day. But bringing awareness to your pain might reveal that it actually peaks, valleys and completely subsides. One of Goldstein’s clients believed that his pain was constant throughout the day. But when he examined his pain, he realized it hits him about six times a day. This helped to lift his frustration and anxiety.” – Margarita Tartakovsky

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Brown, M. L., Rojas, E., & Gouda, S. (2017). A Mind–Body Approach to Pediatric Pain Management. Children, 4(6), 50. http://doi.org/10.3390/children4060050

Abstract

Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind–body techniques that are often used in the adult population for pain and symptom management. In addition to providing significant pain relief, several studies have reported reduced use of opioid medications when mind–body therapies are implemented. Mind–body medicine is another approach that can be used in children with both acute and chronic pain to improve pain management and quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483625/

Reduce Pain with Mindfulness

October 3, 2017 psyjdc Leave a comment

Reduce Pain with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness is an effective practice for approaching chronic pain. It teaches individuals to observe their pain, and be curious about it. And, while counterintuitive, it’s this very act of paying attention that can help your pain.” – Margarita Tartakovsky

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans and 1.5 billion people worldwide, have common chronic pain conditions. It is important to remember that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s pain signals should not be completely blocked or prevented. They need to be perceived. But, methods are needed to mitigate the pain and the psychological distress produced.

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. The situation in the U.S. with opioid overdoses has become so severe that it’s taken on epidemic proportions. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patient’s ability to cope with the pain. 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 perceived stress and the emotional reactions to pain may be helpful in pain management. Indeed, mindfulness practices have been shown to reduce the physiological and psychological responses to stress and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. As a result, mindfulness practices have been shown to be effective in treating pain.

In today’s Research News article “Mindfulness meditation–based pain relief: a mechanistic account.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941786/, Zeidan and Vago review the published research literature on the effectiveness of mindfulness practices in the treatment of pain. They report that the scientific research finds that mindfulness practices are safe and effective in treating perceived pain from a wide variety of conditions, including fibromyalgia, migraine, chronic pelvic pain, irritable bowel syndrome, and chronic low back pain.

Further, they report that the reduction in perceived pain appears to result from alterations of the nervous system. In particular, long-term meditators have significant increased activation of sensory processing–related brain regions (thalamus, insula) and reduced activation in brain areas that process the evaluation of pain (Medial Prefrontal Cortex), Orbital Frontal Cortex). There was also a significant relationship between meditative experience, lower perceived pain, and greater deactivation of the Medial Prefrontal Cortex / Orbital Frontal Cortex. Even after only brief meditation practice changes can be detected in brain areas that process pain stimuli (insula and anterior cingulate cortex) and the psychological appreciation of pain (Orbital Frontal Cortex).

These findings strongly suggest that in response to mindfulness practices multiple areas of the brain change, resulting in reduced subjective pain. These benefits can be obtained by short-term mindfulness practice but are further improved with long-term practice. Hence, mindfulness practices appear to be safe and effective alternative treatments to drugs and thereby may be useful in addressing the opioid epidemic.

So, reduce pain with mindfulness.

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it . . . Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” -Christiane Wolf

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

Zeidan, F., & Vago, D. (2016). Mindfulness meditation–based pain relief: a mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114–127. http://doi.org/10.1111/nyas.13153

Abstract

Pain is a multidimensional experience that involves sensory, cognitive, and affective factors. The constellation of interactions between these factors renders the treatment of chronic pain challenging and financially burdensome. Further, the widespread use of opioids to treat chronic pain has led to an opioid epidemic characterized by exponential growth in opioid misuse and addiction. The staggering statistics related to opioid use highlight the importance of developing, testing, and validating fast-acting nonpharmacological approaches to treat pain. Mindfulness meditation is a technique that has been found to significantly reduce pain in experimental and clinical settings. The present review delineates findings from recent studies demonstrating that mindfulness meditation significantly attenuates pain through multiple, unique mechanisms—an important consideration for the millions of chronic pain patients seeking narcotic-free, self-facilitated pain therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941786/

Relieve Back Pain with Yoga

September 18, 2017 psyjdc Leave a comment

Relieve Back Pain with Yoga

By John M. de Castro, Ph.D.

“Lower back pain can be debilitating. Pain caused by ankylosing spondylitis (AS) may be especially severe. Conventional pain relief medications may cause uncomfortable side effects. If you’re looking for an alternative treatment, yoga may help. Yoga uses gentle stretching exercises to help relieve pain and increase flexibility. It helps stabilize your core to better support your spine.” – Annette McDermott

“Spondylitis is an inflammatory disease that, over time, can cause some of the vertebrae in your spine to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply” (Mayo Clinic). Spondylitis, also called cervical osteoarthritis, produces considerable pain and stiffness from the neck down to the lower back. It affects the vast majority of people over age 60. The causes of Spondylitis are unknown although there appears to be some involvement of the genes and sedentary lifestyles. There is no known cure. It is normally treated with drugs, physical therapy or surgery with the aim of relieving the symptoms.

Back pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, 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 improve emotion regulation producing more adaptive responses to emotions. Mindfulness practices also reduce worry and rumination reducing the psychological amplification of pain. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice is both an exercise and a mindfulness practice which has been shown to have a myriad of health benefits, including relief of chronic pain and relief of chronic low-back pain. So, it makes sense to explore the effectiveness of yoga practice for Spondylitis (cervical osteoarthritis).

In today’s Research News article “Effect of Selected Yogic Practices on Pain and Disability in Patients with Lumbar Spondylitis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433117/, Malik and colleagues recruited adult patients with Spondylitis that was diagnosed with X-rays and MRI scans and who were experiencing moderate to severe pain. They were randomly assigned to one of three groups, instant relieve practice group, short-term practice group, and long-term practice group. The yoga practice consisted 1 hour of joint exercises, backward bending, and short relaxation. The instant relieve practice group practiced just once. The short-term practice group practiced 6 days per week for a total of 15 days. The long-term practice group practiced 6 days per week for a total of 30 days. The patients were measured before and after completion of their assigned yoga practices with the Roland–Morris back pain and Disability Questionnaire.

They found that yoga practice resulted in a significant reduction in pain and disability with the more practice the greater the improvement. After the single session, there was a 23% reduction in pain and disability while after 15 days of practice there was a 51% reduction, and after 30 days of practice there was a 64% reduction. Hence yoga practice was effective in reducing the primary symptoms of Spondylitis (cervical osteoarthritis). It is speculated that the increased strength and flexibility produced by the yoga practice markedly reduced tension in the back, reducing pain and the resultant disability.

So, relieve back pain with yoga.

“Yoga is a natural and holistic remedy for cervical spondylosis. A regular practice of this ancient science leads to a flexible body, calm mind and a positive attitude towards life.” – Art of Living

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

Manik, R. K., Mahapatra, A. K., Gartia, R., Bansal, S., & Patnaik, A. (2017). Effect of Selected Yogic Practices on Pain and Disability in Patients with Lumbar Spondylitis. International Journal of Yoga, 10(2), 81–87. http://doi.org/10.4103/0973-6131.205516

Abstract

Aim:

The study was designed to find the effect of selected yogic practices on lumbar spondylitis.

Materials and Methods:

This was a prospective, randomized study without a control trial. A total of 172 participants with lumbar spondylitis (age 21–79 years) from the outpatient department (OPD) of neurosurgery, AIIMS, Bhubaneswar, were randomly assigned to receive yoga therapy. The module of selected yogic practices consisted of pawanamuktasana series 1 (loosening and strengthening), asana, pranayama, and relaxation techniques Yoga Nidra.

Statistics Analysis:

Within groups, comparison was done by paired t-test, and between groups, ANOVA test was carried out to determine the significant difference among the various groups under study. Correlation regression analysis was done to measure the degree of linear relationship between pre- and post-study for various groups.

Results:

Significant differences were observed with yoga therapy in instant relieve practice group, in short-term practice group, and in long-term practice group (LTPG) with better results in LTPG.

Conclusion:

Selected yoga therapy has got the better result in management of pain in lumbar spondylitis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433117/

Reduce Fear of Pain at Work and Musculoskeletal Pain with Mindfulness

June 20, 2017January 17, 2023 psyjdc Leave a comment

Reduce Fear of Pain at Work and Musculoskeletal Pain with Mindfulness

By John M. de Castro, Ph.D.

“a regular meditation practice is the best ongoing foundation for working with pain. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”). – Mindful

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have common chronic pain conditions. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patient’s ability to cope with the pain. 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 improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain.

In today’s Research News article “Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity: Randomized controlled trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400305/, Jay and colleagues examine a fear avoidance model of pain where a vicious circle develops creating more pain. The individual when they start to move and feel pain, interpret the pain as potentially damaging and so alter their movements. This is counterproductive and can create more pain, producing more pain avoidance behaviors, producing even more pain, etc. To examine this idea, they recruited female laboratory assistants who were suffering from chronic musculoskeletal pain and randomly assigned them to receive either physical-cognitive-mindfulness training or to follow treatment-as-usual. Therapy consisted of 10 weeks of exercise, cognitive behavioral therapy, and mindfulness training. They were measured before and after training for pain intensity, pain frequency, and leisure time and work related pain fear avoidance.

They found that before training, as predicted, there were significant positive relationships between work pain fear avoidance and pain, particularly in the neck and shoulders, such that the greater the pain fear avoidance the greater the pain. They also found that in comparison to the treatment-as-usual control group that the physical-cognitive-mindfulness training group had significant improvements after training of over 50% in pain and in work related pain fear avoidance. Leisure time pain fear avoidance was not related to pain and not affected by the treatment.

The results suggest that work related pain fear avoidance is related to musculoskeletal pain intensity and that physical-cognitive-mindfulness training improves both. These relationships, however, are situation specific as leisure time pain fear avoidance was unrelated. It is unclear if the relationships between pain and pain fear avoidance are causal because of the correlative nature of the relationships. It is also unclear which, or which combinations, of the three components of the treatment was effective in reducing pain and pain fear avoidance. The results, however, are interesting and should be followed up with further research.

So, reduce fear of pain at work and musculoskeletal pain with mindfulness.

“Chronic pain is frustrating and debilitating. The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain (among other concerns).” – Margarita Tartakovsky

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

Jay, K., Brandt, M., Jakobsen, M. D., Sundstrup, E., Berthelsen, K. G., schraefel, mc, … Andersen, L. L. (2016). Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity: Randomized controlled trial. Medicine, 95(34), e3945. http://doi.org/10.1097/MD.0000000000003945

Abstract

People with chronic musculoskeletal pain often experience pain-related fear of movement and avoidance behavior. The Fear-Avoidance model proposes a possible mechanism at least partly explaining the development and maintenance of chronic pain. People who interpret pain during movement as being potentially harmful to the organism may initiate a vicious behavioral cycle by generating pain-related fear of movement accompanied by avoidance behavior and hyper-vigilance.

This study investigates whether an individually adapted multifactorial approach comprised of biopsychosocial elements, with a focus on physical exercise, mindfulness, and education on pain and behavior, can decrease work-related fear-avoidance beliefs.

As part of a large scale 10-week worksite randomized controlled intervention trial focusing on company initiatives to combat work-related musculoskeletal pain and stress, we evaluated fear-avoidance behavior in 112 female laboratory technicians with chronic neck, shoulder, upper back, lower back, elbow, and hand/wrist pain using the Fear-Avoidance Beliefs Questionnaire at baseline, before group allocation, and again at the post intervention follow-up 10 weeks later.

A significant group by time interaction was observed (P < 0.05) for work-related fear-avoidance beliefs. The between-group difference at follow-up was –2.2 (–4.0 to –0.5), corresponding to a small to medium effect size (Cohen’s d = 0.30).

Our study shows that work-related, but not leisure time activity-related, fear-avoidance beliefs, as assessed by the Fear-avoidance Beliefs Questionnaire, can be significantly reduced by 10 weeks of physical-cognitive-mindfulness training in female laboratory technicians with chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400305/

Improve Chronic Pain with Mindfulness

May 18, 2017 psyjdc Leave a comment

Improve Chronic Pain with Mindfulness

By John M. de Castro, Ph.D.

“The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain (among other concerns).” – Margarita Tartakovski

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have common chronic pain conditions. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids block pain, eliminating this important signal. They are, also, dangerous. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patient’s ability to cope with the pain.

Pain is both physical and mental, affected by damage to the body but also by the mind. The perception of pain can be amplified by the emotional reactions to it and also by attempts to fight or counteract it. Pain perception can be reduced by aerobic exercise and mental states, including placebo effects, attention, and conditioning. Additionally, mindfulness has been shown to reduce both chronic and acute pain. Importantly, mindfulness training is safe. So, mindfulness training may be an effective treatment to be used in combination with other treatments for chronic pain. Hence, it is important to study mindfulness practice effects on chronic pain and the psychological distress it produces.

In today’s Research News article “Mindfulness Meditation for Chronic Pain: 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/PMC5368208/?report=classic

Hilton and colleagues review and summarize the published research literature on the application of mindfulness training to treating chronic pain, pain lasting more than 3 months. They identified 38 randomized controlled trials that compared the effectiveness of mindfulness training to treatment as usual, support groups, education, stress management, or waitlist controls. They found that the published research reported small but significant reductions in pain after mindfulness training that were still present 3 months later. They also reported significant improvements in depression and quality of life.

Hence, the up-to-date research literature suggests that mindfulness training is a safe and effective treatment for chronic pain., both reducing the pain itself as well as depression and the pain produced impairments in quality of life. In general, they found that the studies tended to be of low quality. So, better designed studies are still needed. It is not known exactly how mindfulness training may reduce pain. But, it is suspected that it changes the mental components of pain improving emotional regulation, including reducing anxiety and worry about pain. This reduces the mind’s amplification of pain. Importantly, it still leaves the signal of pain intact. So, the individual, can respond to the pain adaptively, reducing further physical damage.

So, improve chronic pain with mindfulness.

“Mindfulness soothes the circuits that amplify … In effect, mindfulness teaches you how to turn down the volume control on your pain. And as you do so, any anxiety, stress and depression that you may be feeling begins to melt away too. Your body can then relax and begin to heal.” – Danny Penman

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

Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. http://doi.org/10.1007/s12160-016-9844-2

Abstract

Background

Chronic pain patients increasingly seek treatment through mindfulness meditation.

Purpose

This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults.

Method

We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use.

Results

Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life.

Conclusions

While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368208/?report=classic

Maintain a Yoga Practice to Improve Absences due to Back Pain

May 13, 2017 psyjdc Leave a comment

Maintain a Yoga Practice to Improve Absences due to Back Pain

By John M. de Castro, Ph.D.

“For people with lower back pain, stretching is very important. For example, stretching the hamstring muscles (in the back of the thigh) helps expand the motion in the pelvis, decreasing stress across the lower back. In addition, stretching with yoga increases blood flow, allowing nutrients to flow in, toxins to flow out, and overall nourishment of the muscles and soft tissues in the lower back.” – Fred Busch

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, 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 improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice is both an exercise and a mindfulness practice which has been shown to have a myriad of health benefits, including relief of chronic pain and relief of chronic low-back pain. So, it makes sense to further explore the effectiveness of exercise and yoga practice for chronic low back pain.

In today’s Research News article “Effects of yoga, strength training and advice on back pain: a randomized controlled trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372262/

Brämberg and colleagues recruited adult patients with non-disabling low back pain and randomly assigned them to a strength training exercise, kundalini yoga, or evidence-based education group. Strength training consisted of six weeks of 60-minute supervised strength training with encouragement to practice at least twice weekly at home. Kundalini yoga training consisted of six weeks of 60-minute supervised yoga sessions with meditations, breathing, and posture practice, with encouragement to practice at least twice weekly at home. Evidence-based education consisted of readings that encourage strategies for self-care, information on medication, sick leave and strategies for managing pain. All participants were measured before and after training and 6 and 12 months later for back and neck pain, absences from work, going to work in pain, and adherence to treatment.

They found that yoga had a significantly lower drop-out rate suggesting that it was better liked and tolerated than strength training or education. In addition, neck disability was significantly lower in the yoga and strength training groups than the education group, while back pain was significantly improved in the strength training group. Overall there were no significant group differences in absences from work. But, when the groups were separated into participants who adhered to the recommendations and exercised at least twice a week after training and those who practiced less, the adhering groups had significantly fewer absences, greater than 40% fewer, than the education group or the low adherence participants.

These are interesting results and suggest that exercise is helpful with low back pain and its consequences for work life. Yoga practice did not appear to produce superior results to strength training for pain or absences. This suggests that the exercise component of yoga practice is what is effective. But, yoga appeared to be preferred and better tolerated as fewer participants dropped out. The results also clearly indicate that continued practice is crucial. No matter what the exercise practice was, it had to be continued after active training in order to continue being effective.

So, maintain a yoga practice to improve absences due to back pain.

“And in a new, nationally representative survey from the Consumer Reports National Research Center of more than 3,500 adults, yoga (and tai chi, or the like) was helpful to almost 90 percent of the back-pain suffers who tried it. In comparison, 75 percent of people who saw a physical therapist and 64 percent who saw a primary care doctor said the advice or treatment they received gave them relief.” – Consumer Reports

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

Brämberg, E. B., Bergström, G., Jensen, I., Hagberg, J., & Kwak, L. (2017). Effects of yoga, strength training and advice on back pain: a randomized controlled trial. BMC Musculoskeletal Disorders, 18, 132. http://doi.org/10.1186/s12891-017-1497-1

Abstract

Background

Among the working population, non-specific low-back pain and neck pain are one of the most common reasons for sickness absenteeism. The aim was to evaluate the effects of an early intervention of yoga – compared with strength training or evidence-based advice – on sickness absenteeism, sickness presenteeism, back and neck pain and disability among a working population.

Methods

A randomized controlled trial was conducted on 159 participants with predominantly (90%) chronic back and neck pain. After screening, the participants were randomized to kundalini yoga, strength training or evidence-based advice. Primary outcome was sickness absenteeism. Secondary outcomes were sickness presenteeism, back and neck pain and disability. Self-reported questionnaires and SMS text messages were completed at baseline, 6 weeks, 6 and 12 months.

Results

The results did not indicate that kundalini yoga and strength training had any statistically significant effects on the primary outcome compared with evidence-based advice. An interaction effect was found between adherence to recommendations and sickness absenteeism, indicating larger significant effects among the adherers to kundalini yoga versus evidence-based advice: RR = 0.47 (CI 0.30; 0.74, p = 0.001), strength training versus evidence-based advice: RR = 0.60 (CI 0.38; 0.96, p = 0.032). Some significant differences were also found for the secondary outcomes to the advantage of kundalini yoga and strength training.

Conclusions

Guided exercise in the forms of kundalini yoga or strength training does not reduce sickness absenteeism more than evidence-based advice alone. However, secondary analyses reveal that among those who pursue kundalini yoga or strength training at least two times a week, a significantly reduction in sickness absenteeism was found. Methods to increase adherence to treatment recommendations should be further developed and applied in exercise interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372262/

Improve Knee Osteoarthritis with Traditional Chinese Exercise

April 8, 2017April 8, 2017 psyjdc Leave a comment

Improve Knee Osteoarthritis with Traditional Chinese Exercise

By John M. de Castro, Ph.D.

“For the uninitiated, tai chi may be a little daunting. The ancient Chinese exercise is hardly as mainstream as aerobics or the treadmill, but with its gentle, fluid movements and proven health benefits, it’s a natural arthritis workout.” – Mary Jo DiLonardo

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 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. This suggests that various forms of traditional Chinese exercises, such as Tai Chi, Qigong, and Baduanjin would be perfect treatments as they involve slow gentle movements of the limbs and mindfulness. Indeed, Tai Chi has been shown to reduce the physical symptoms of knee osteoarthritis. So, it would seem reasonable to look further into the effectiveness of traditional Chinese exercises in treating knee osteoarthritis.

In today’s Research News article “The Effects of Traditional Chinese Exercise in Treating Knee Osteoarthritis: 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/PMC5266306/

Zhang and colleagues review the published research literature on the effectiveness of traditional Chinese exercises on the symptoms of knee osteoarthritis. They found 8 published randomized controlled trials 7 of which employed Tai Chi and 1 employed Baduanjin as the exercise. Treatment varied in duration from 8 to 24 weeks with 12 weeks the most common duration. They found that the studies demonstrated that the traditional Chinese exercises produced significant short-term improvements of moderate effect sizes in knee pain, physical function, and joint stiffness.

These are interesting results that suggest that traditional Chinese exercises are safe and effective treatments for knee osteoarthritis. There is a need for more studies of the long-term effectiveness of these practices. Since, these ancient gentle practices are completely safe, can be used with the elderly and sickly, and are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, it would appear to be an excellent treatment for knee osteoarthritis sufferers.

So, improve knee osteoarthritis with traditional Chinese exercise.

“Today, the vast majority of people in the U.S. who practice tai chi do it for health reasons, not just intellectual curiosity. It’s low-impact, so your knees, ankles, and other joints don’t get overly stressed. “Almost everyone can do tai chi.” – Gene Nelson

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, Y., Huang, L., Su, Y., Zhan, Z., Li, Y., & Lai, X. (2017). The Effects of Traditional Chinese Exercise in Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis. PLoS ONE, 12(1), e0170237. http://doi.org/10.1371/journal.pone.0170237

Abstract

Background and Aims

Traditional Chinese exercise (TCE) includes a variety of exercise, which is being accepted by more and more people in the treatment of knee osteoarthritis (OA) from different countries. With the attendant, many clinical reports focus on it. Our meta-analysis aimed to systematically assess the effects of traditional Chinese exercise on pain, stiffness, physical function, quality of life, mental health and adverse events in people with knee osteoarthritis.

Methods

PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and Chinese Biomedical Literature Database (CBM) were searched from the time of their inception through April 2016 and risk of bias was independently assessed by two authors. Outcome measures included pain, physical functional, joint stiffness, quality of life, mental health and safety. For pooled outcomes, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Results

Eight randomized controlled trials with a sample size of 375 cases met the criteria to be included in the study indicating that high quality literature is lacking in this field. Results of the meta-analysis showed that short-term TCE could relieve pain (SMD: -0.77;95% CI: -1.13 to -0.41; P<0.0001), improve physical function (SMD -0.75; 95% CI: -0.98 to -0.52; P<0.00001), and alleviate stiffness (SMD: -0.56; 95%: CI -0.96 to -0.16; P<0.006), but had no significant effect on quality of life (SMD: 0.57; 95% CI: 0.17 to 0.97; P = 0.005), and mental health (SMD 4.12; 95% CI: -0.50 to 8.73; P = 0.08). Moreover, TCE was not associated with serious adverse events.

Conclusions

Our systematic review revealed that short-term TCE was potentially beneficial in terms of reducing pain, improving physical function and alleviating stiffness. These results may suggest that TCE could prove useful as an adjuvant treatment for patients with knee OA. Further studies are urgently needed to confirm these results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266306/

Improve the Psychological Well-Being of Patients with Multiple Chronic Diseases with Yoga

March 4, 2017 psyjdc Leave a comment

Improve the Psychological Well-Being of Patients with Multiple Chronic Diseases with Yoga

By John M. de Castro, Ph.D.

“Yoga can be beneficial for individuals with disabilities or chronic health conditions through both the physical postures and breathwork. Each pose can be modified or adapted to meet the needs of the student. Yoga asanas can be performed while seated in a chair or wheelchair.” – National Center on Health, Physical Activity and Disability (NCHPAD)

The prevalence of chronic diseases has increased with population ageing with around 18% of the elderly having debilitating chronic diseases. “The most common diagnoses are diabetes, stroke, hypertension, cancer, arthritis, asthma, fractures, the presence of an artificial knee or hip, fatigue, multiple sclerosis, demyelinating diseases of the central nervous system, gonarthrosis, ataxia, COPD, dependence on renal dialysis, malignant neoplasm of breast/prostate, depressive episodes, and pure hypercholesterolemia” (Curtis et al., 2016) and dementia.

The situation, however, is much more complex as over half have an additional chronic disease (multimorbidity). This situation has been termed Complex Chronic Disease and Disability (CCDD). Although there are a myriad of combinations, the disease pairs that were significantly associated with the highest likelihood of disability contained dementia (dementia–hip fracture, dementia–cardiovascular disease, and dementia–depression). These individuals are very frail, often confined to bed or wheelchairs. They provide a difficult challenge for caregiving and treatments to help relieve their suffering are badly needed.

Yoga practice has been found to be effective for the prevention and treatment of a large array of chronic psychological and physical problems, even for the elderly in hospice, with cancer, COPD, Kidney Disease, anxiety and depression, and dementia. Hence, it would seem reasonable to hypothesize that yoga may be effective for patients with Complex Chronic Disease and Disability (CCDD). In today’s Research News article “Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223015/

Curtis and colleagues performed a pilot study of the effectiveness of yoga practice for male and female elderly (average age 63 years) in an institution with Complex Chronic Disease and Disability (CCDD). Most were in wheelchairs or had severe mobility issues.

The patients were provided with a Hatha Yoga program modified for practice in a sitting position, once a week for 8 weeks and were provided with recordings to guide personal daily practice. The practice included relaxation, body scan, and yoga postures. They were measured prior to, midway through, and after the practice for pain, pain catastrophizing, including rumination, magnification, and helplessness, perceived stress, anxiety and depression, perceived injustice, mindfulness, self-compassion, and spiritual well-being, including peace and meaning. They found that the yoga practice benefited the patients increasingly as the practice continued over the 8 weeks producing significant reduction in anxiety and pain magnification, and increases in self-compassion.

These are interesting results and suggest that yoga practice may be beneficial for chronically disabled patients with multiple diseases, improving their psychological well-being. This is a very difficult group to care for and treat and as such, the fact that yoga practice may be helpful, is exciting. It should be mentioned that this was a pilot study, without a control condition, and thus no firm conclusions can be reached. But, the results provide evidence and a rationale for conducting a large randomized controlled clinical trial in the future. A program that can help ease the suffering of these afflicted individuals would certainly be warmly welcomed both by the patients and the caregivers.

“Yoga therapy is very much about the whole person. It is complementary to physical therapy, but we take into account that back pain may be related to an emotional element, or it may be from lifestyle, some pattern that is not serving them, physical movement patterns or other patterns.” – Janice Gate

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

Curtis, K., Kuluski, K., Bechsgaard, G., Ridgway, J., & Katz, J. (2016). Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 6267879. http://doi.org/10.1155/2016/6267879

Abstract

Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital. Design. Single-cohort repeated measures design. Methods. Participants (N = 10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention. Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18) = 4.74, p < .05, and ηp2 = .35, (2) Self-Compassion Scale-Short Form, F(2,18) = 3.71, p < .05, and ηp2 = .29, and (3) Magnification subscale of the Pain Catastrophizing Scale, F(2,18) = 3. 66, p < .05, and ηp2 = .29. Discussion. The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223015/