Quality of Life

Tai Chi Practice is a Cost-Effective Treatment to Reduce Falls in Older Adults

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Tai Chi Practice is a Cost-Effective Treatment to Reduce Falls in Older Adults

 

By John M. de Castro, Ph.D.

 

“Across multiple studies, Tai chi appears to reduce risk of falling by 20 to 45 percent and is considered one of the best exercises available for ambulatory older adults with balance concerns.” – Peter Wayne

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the frequency of falls in the elderly. It is not known, however, if Tai Chi training is more or less cost-effective than other exercises for reducing falls in the elderly.

 

In today’s Research News article “Cost-Effectiveness of a Therapeutic Tai Ji Quan Fall Prevention Intervention for Older Adults at High Risk of Falling.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696718/), Li and colleagues recruited community-based elderly individuals (over 70 years of age) who had experienced at least one fall in the last year and randomly assigned them to one of three conditions; Tai Chi practice, multimodal (mixed) exercises, or stretching. The exercises occurred in twice weekly, 60-minute sessions, for 24 weeks. They were measured before and after training for falls, health related quality of life, health index, quality-adjusted life-years (QALYs), and health-related service utilization expenses.

 

They found that Tai Chi practice resulted in significantly greater reduction in falls and increase in quality-adjusted life-years (QALYs) than either the multimodal or stretching exercises. The costs of implementing the 3 programs were equivalent. The total health-related utilization cost was $1,958 per participant for Tai Chi, compared with $2,583 for multimodal and $2,131 for stretching. Tai Chi produced greater reductions in falls at a lower cost and resulted in lower health care costs results in in incremental costs of $850 per additional fall prevented and $27,614 per additional QALY gained.

 

These results suggest that Tai Chi practice is a safe, effective, and cost-effective means of reducing falls in the elderly. Falls when they occur in the elderly can be quite devastating and can produce major injuries that can even lead to death. So, their prevention is very important not just for reducing health care costs but for the longevity and quality of life of the individual.

 

So, Tai Chi practice is a cost-effective treatment to reduce falls in older adults.

 

“Falling in adults age 65 and older is significantly associated with loss of independence, premature mortality and big health care costs.” – Peter Harmer

 

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

 

Li, F., Harmer, P., Eckstrom, E., Fitzgerald, K., Akers, L., Chou, L. S., … Winters-Stone, K. (2019). Cost-Effectiveness of a Therapeutic Tai Ji Quan Fall Prevention Intervention for Older Adults at High Risk of Falling. The journals of gerontology. Series A, Biological sciences and medical sciences, 74(9), 1504–1510. doi:10.1093/gerona/glz008

 

Abstract

Background

Data on the cost-effectiveness of proven fall prevention exercise interventions are limited. We aimed to establish the cost-effectiveness of Tai Ji Quan: Moving for Better Balance (TJQMBB) compared with a conventional exercise intervention for older adults at high risk of falling.

Methods

We conducted a trial-based cost-effectiveness analysis involving 670 older adults who had a history of falling or impaired mobility. Participants received one of three interventions—TJQMBB, multimodal exercise, or stretching exercise (control)—each of which was implemented twice weekly for 24 weeks. The primary cost-effectiveness measure was the incremental cost per additional fall prevented, comparing TJQMBB and multimodal exercise to Stretching and TJQMBB to multimodal exercise, with a secondary measure of incremental cost per additional quality-adjusted life-year (QALY) gained. The intervention was conducted between February 2015 and January 2018, and cost-effectiveness was estimated from a health care system perspective over a 6-month time horizon.

Results

The total cost to deliver the TJQMBB intervention was $202,949 (an average of $906 per participant); for multimodal exercise, it was $223,849 ($1,004 per participant); and for Stretching, it was $210,468 ($903 per participant). Incremental cost-effectiveness ratios showed that the multimodal exercise was cost-effective ($850 per additional fall prevented; $27,614 per additional QALY gained) relative to Stretching; however, TJQMBB was the most economically dominant strategy (ie, having lower cost and being clinically more efficacious) compared with multimodal and stretching exercises with regard to cost per additional fall prevented and per additional QALY gained. TJQMBB had a 100% probability of being cost-effective, relative to Stretching, at a threshold of $500 per each additional fall prevented and $10,000 per additional QALY gained. Sensitivity analyses showed the robustness of the results when extreme cases, medical costs only, and missing data were considered.

Conclusions

Among community-dwelling older adults at high risk for falls, TJQMBB is a cost-effective means of reducing falls compared with conventional exercise approaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696718/

 

Overweight and Obese Yoga Practitioners have a Higher Quality of Life

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Overweight and Obese Yoga Practitioners have a Higher Quality of Life

 

By John M. de Castro, Ph.D.

 

“Doing yoga decreases stress, improves flexibility, and increases muscle tone and strength. People with larger bodies often have trouble with joint pain; yoga can help by improving the body’s alignment to reduce strain on joints by allowing the frame to bear more of the body’s weight.” – Ann Pizer

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (BMI > 25). Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.

 

Obviously, there is a need for effective treatments to obese individuals. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesity, alter eating behavior and improve health in obesity. This suggests that mindfulness training may be an effective treatment for overeating and obesity alone or in combination with other therapies. Yoga may be particularly beneficial for the obese as it is both a mindfulness practice and an exercise. Yoga practice has been shown to have a myriad of physical and psychological benefits. These include significant loss in weight and body mass index (BMI), resting metabolism, and body fat in obese women with Type 2 diabetes and improve health in the obese.

 

In today’s Research News article “Quality of Life in Yoga Experienced and Yoga Naïve Asian Indian Adults with Obesity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515061/), Telles and colleagues recruited overweight and obese (BMI>25) adults (aged 20-59 years) and assessed them for participation in yoga practice and their quality of life, including general self-esteem, enjoyment in physical activities, satisfactory social contacts, satisfaction concerning work, sexual pleasure, and focus on eating behavior.

 

They found that in comparison to non-participants in yoga practice, the yoga participants had significantly higher overall quality of life including higher levels of general self-esteem, enjoyment in physical activities, satisfactory social contacts, and satisfaction concerning work. Hence, participation in yoga practice was found to be associated with significantly higher quality of life in overweight and obese individuals.

 

These findings are correlational and causation cannot be determined. It is possible that yoga practice causes improved quality of life, or that people with high quality of life tend to engage in yoga practice, or that some other factor, e.g. affluence, large social network, results in higher levels of both. Nevertheless, it is clear that practicing yoga is associated with better, more enjoyable lives, that overweight and obese yoga practitioners have a higher quality of life.

 

“’I think yoga can be a wonderful form of movement that bigger-bodied people can adapt for themselves.’ For folks carrying more weight, low-impact exercises like yoga may be more comfortable than, say, running on the pavement.” – Laura McMullen

 

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

 

Telles, S., Sharma, S. K., Singh, A., Kala, N., Upadhyay, V., Arya, J., & Balkrishna, A. (2019). Quality of Life in Yoga Experienced and Yoga Naïve Asian Indian Adults with Obesity. Journal of obesity, 2019, 9895074. doi:10.1155/2019/9895074

 

Abstract

Background

Obesity adversely affects quality of life which then acts as a barrier to weight loss and weight loss maintenance. Hence, those interventions which positively influence the quality of life along with weight reduction are considered useful for sustained weight loss in persons with obesity. An earlier study showed better quality of life in obese adults who had experience of yoga compared to yoga naïve obese adults. However, the main limitation of the study was the small sample size (n=20 in each group).

Objective

The present study aimed to determine whether with larger sample sizes the quality of life would differ in yoga experienced compared to yoga naïve adults with obesity.

Methods

There were 596 Asian Indian obese adults (age range 20 to 59 years; group mean age ± SD; 43.9 ± 9.9 years): of whom (i) 298 were yoga experienced (154 females; group mean age ± SD; 44.0 ± 9.8 years) with a minimum of 1 month of experience in yoga practice and (ii) 298 were yoga naïve (154 females; group mean age ± SD; 43.8 ± 10.0 years). All the participants were assessed for quality of life using the Moorehead–Ardelt quality of life questionnaire II. Data were drawn from a larger nationwide trial which assessed the effects of yoga compared to nutritional advice on obesity over a one-year follow-up period (CTRI/2018/05/014077).

Results

There were higher participant-reported outcomes for four out of six aspects of quality of life in the yoga experienced compared to the yoga naïve (p < 0.008, based on t values of the least squares linear regression analyses, Bonferroni adjusted, and adjusted for age, gender, and BMI as covariates). These were enjoyment in physical activities, ability to work, self-esteem, and social satisfaction.

Conclusion

Obese adults with yoga experience appear to have better quality of life in specific aspects, compared to yoga naïve persons with a comparable degree of obesity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515061/

 

Improve Quality of Life in Women with Ovarian Removal with Mindfulness

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Improve Quality of Life in Women with Ovarian Removal with Mindfulness

 

By John M. de Castro, Ph.D.

 

“midlife women with higher mindfulness scores experienced fewer menopausal symptoms. These findings suggest that mindfulness may be a promising tool to help women reduce menopausal symptoms and overall stress.” – Richa Sood

 

Women who carry genetic markers, BRCA1 or BRCA2 mutation, have a very high risk of developing ovarian cancer. Often as a preventative measure, women opt to have their ovaries and fallopian tubes surgically removed (salpingo-oophorectomy). A consequence of this procedure is to produce the onset of menopausal symptoms. These include hot flashes, (n + Add New Category ight) sweats, vaginal dryness, loss of sexual desire, and pain during intercourse. Hormone treatments may reduce the symptom intensity but do not eliminate them.

 

Hence, there is a need to find alternative treatment to help relieve these troubling symptoms following ovary removal. Mindfulness training has been shown to help reduce the symptoms of natural meonpause. But it is not known whether mindfulness training might also help alleviate these symptoms in women after surgical removal of the ovaries.

 

In today’s Research News article “Mindfulness-based stress reduction for menopausal symptoms after risk-reducing salpingo-oophorectomy (PURSUE study): a randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587763/), van Driel and colleagues recruited women who carried the BRCA1 or BRCA2 mutation and had undergone surgical removal of their ovaries and fallopian tubes before the age of 52 years. They continued care as usual and were randomly assigned to receive an 8-week program of Mindfulness-Based Stress Reduction (MBSR) or no additional treatment. The MBSR program met for 2.5 hours once a week along with 30-45 minutes of daily home practice and consisted of discussion, meditation, yoga, and body scan practices. The women were measured before and after MBSR and 3 and 9 months later for menopausal-specific quality of life, sexual function, and sexual distress.

 

They found that in comparison to baseline and the usual care control group, the group that received MBSR training had significantly improved menopausal-specific quality of life, including improved vasomotor (i.e. burden caused by hot flushes, night sweats, and sweating in general) and physical symptoms (e.g. burden caused by stamina reduction, aches, and urination frequency) quality of life. These improvements were found immediately after MBSR training and 9 months later. No significant improvements were found for sexual function or distress.

In women

The study results suggest that MBSR training is a safe and effective treatment to produce long-term improvements in the menopausal quality of life in women who carry the BRCA1 or BRCA2 mutation and had undergone surgical removal of their ovaries and fallopian tubes. MBSR consists of a package of practices. It will remain for future research to determine which of these practices or which combination of practices are necessary and sufficient to produce the benefits.

 

So, improve quality of life in women with ovarian removal with mindfulness.

 

“Mindfulness cannot entirely remove the symptoms of menopause, but it can help you deal with them in a calmer and more compassionate way – and self compassion boosts mental health. Learning these simple techniques to focus our awareness, relax the body, and ride out the storm, (whether the storm is physical or emotional) can pay great dividends’” – Karita Cullen

 

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

 

van Driel, C., de Bock, G. H., Schroevers, M. J., & Mourits, M. J. (2019). Mindfulness-based stress reduction for menopausal symptoms after risk-reducing salpingo-oophorectomy (PURSUE study): a randomised controlled trial. BJOG : an international journal of obstetrics and gynaecology, 126(3), 402–411. doi:10.1111/1471-0528.15471

 

Abstract

Objective

To assess the short‐ and long‐term effects of mindfulness‐based stress reduction (MBSR) on the resulting quality of life, sexual functioning, and sexual distress after risk‐reducing salpingo‐oophorectomy (RRSO).

Design

Randomised controlled trial.

Setting

A specialised family cancer clinic of the university medical center Groningen.

Population

Sixty‐six women carriers of the BRCA1/2 mutation who developed at least two moderate‐to‐severe menopausal symptoms after RRSO.

Methods

Women were randomised to an 8‐week MBSR training programme or to care as usual (CAU).

Main outcome measures

Change in the Menopause‐Specific Quality of Life Questionnaire (MENQOL), the Female Sexual Function Index, and the Female Sexual Distress Scale, administered from baseline at 3, 6, and 12 months. Linear mixed modelling was applied to compare the effect of MBSR with CAU over time.

Results

At 3 and 12 months, there were statistically significant improvements in the MENQOL for the MBSR group compared with the CAU group (both P = 0.04). At 3 months, the mean MENQOL scores were 3.5 (95% confidence interval, 95% CI 3.0–3.9) and 3.8 (95% CI 3.3–4.2) for the MBSR and CAU groups, respectively; at 12 months, the corresponding values were 3.6 (95% CI 3.1–4.0) and 3.9 (95% CI 3.5–4.4). No significant differences were found between the MBSR and CAU groups in the other scores.

Conclusion

Mindfulness‐based stress reduction was effective at improving quality of life in the short‐ and long‐term for patients with menopausal symptoms after RRSO; however, it was not associated with an improvement in sexual functioning or distress.

Tweetable abstract

Mindfulness improves menopause‐related quality of life in women after risk‐reducing salpingo‐oophorectomy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587763/

Improve Physical and Psychological Symptoms and Quality of Life in People Living with HIV with Mind-Body Practices

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Improve Physical and Psychological Symptoms and Quality of Life in People Living with HIV with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Our bodies and minds are intimately connected. Living with HIV can be stressful and can challenge our emotional well-being. Similarly, stress and anxiety can affect our bodies. So maintaining “a healthy mind in a healthy body” is key.” – CATIE

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Mindfulness training has been found to be effective in treating chronic pain conditions. In addition, mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. The research and evidence is accumulating. Hence it makes sense to stop and summarize the research on the ability of mind-body practices to help relieve the symptoms of patients living with HIV.

 

In today’s Research News article “Mind-body practices for people living with HIV: a systematic scoping review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560810/ ), Ramirez-Garcia and colleagues review and summarize the published research studies of the effectiveness of mind-body practices for the treatment of the symptoms of HIV infection. “Mind-body practices include Tai Chi, Qigong, yoga, meditation, and all types of relaxation” training. They identified 84 published research studies.

 

They report that these studies found that for patients with HIV, Mindfulness-Based Stress Reduction (MBSR) decrease the physical symptoms and the side effects of the drug treatment, and improves the patient’s psychological state. They also report that Cognitive Behavioral Therapy and the combining at least three relaxation techniques decreases the patient’s physical and psychological symptoms, and increase quality of life and health. Yoga practice was also found to lower the patient’s blood pressure. Tai Chi, Qigong, and relaxation techniques were found to improve the patient’s physical and psychological condition.

 

Hence the accumulated research suggests that mind-body therapies in addition to antiretroviral treatment are safe and effective treatments to improve the health, well-being, and quality of life of patients living with HIV. This is important as these patients will be living for many years with the symptoms of HIV and the side effects of its treatment. The addition of mind-body practices can help make living with HIV more tolerable and improve the patients’ lives.

 

So, improve physical and psychological symptoms and quality of life in people living with HIV with Mindbody practices.

 

“Living a healthy lifestyle can help you better control HIV and prevent the progression to AIDS. Eating a healthy diet and maintaining a healthy body weight, exercising regularly, practicing safe sex, and following your medicine regimen are all important steps in managing HIV.” – Johns Hopkins Health

 

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

 

Ramirez-Garcia, M. P., Gagnon, M. P., Colson, S., Côté, J., Flores-Aranda, J., & Dupont, M. (2019). Mind-body practices for people living with HIV: a systematic scoping review. BMC complementary and alternative medicine, 19(1), 125. doi:10.1186/s12906-019-2502-z

 

Abstract

Background

Mind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. Although there is substantial research on the efficacy of mind-body practices in people living with HIV, there is no summary of the available evidence on these practices. The aim of this scoping review is to map available evidence of mind-body practices in people living with HIV.

Methods

The Arksey and O’Malley (Int J Soc Res Methodol 8:19-32, 2005) methodological framework was used. A search of 16 peer-review and grey literature databases, websites, and relevant journals (1983–2015) was conducted. To identify relevant studies, two reviewers independently applied the inclusion criteria to all abstracts or full articles. Inclusion criteria were: participants were people living with HIV; the intervention was any mind-body practice; and the study design was any research study evaluating one or several of these practices. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second, as needed, using the criteria that Cochrane Collaboration recommends for systematic reviews of interventions (Higgins and Green, Cochrane handbook for systematic reviews of intervention. 2011). A tabular and narrative synthesis was carried out for each mind-body practice.

Results

One hundred thirty-six documents drawing on 84 studies met the inclusion criteria. The most widely studied mind-body practice was a combination of least three relaxation techniques (n = 20), followed in declining order by meditation (n = 17), progressive muscle relaxation (n = 10), yoga (n = 9) and hypnosis (n = 8). Slightly over half (47/84) of studies used a RCT design. The interventions were mainly (46/84) conducted in groups and most (51/84) included daily individual home practice. All but two studies were unblinded to participants.

Conclusion

The amount of available research on mind-body practices varies by practice. Almost half of the studies in this review were at high risk of bias. However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV. More rigorous studies are necessary to confirm the results of Tai Chi, Qigong, and some relaxation techniques.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560810/

 

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

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Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

 

By John M. de Castro, Ph.D.

 

“Exercise can increase blood flow to the hands and feet and may offer temporary relief from pain. People should discuss the exercises that are best for them with their doctor. Low-impact activities, such as swimming, low-impact aerobics, or yoga, are the safest options.” – Zawn Villines

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But, surviving cancer carries with it a number of problems. Painful Chemotherapy-induced peripheral neuropathy is a frequent side effect of cancer treatment. This Neuropathy is characterized by damage to the nervous system resulting from chemotherapy. Between 30-100% of patients can experience this neuropathy.  It can affect patients motor abilities including walking, and balance. But it can also affect driving, relationships, work, writing, exercise, sleep and sexual activity.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to help relieve chronic pain and be beneficial for cancer patients.  So, it makes sense to examine the ability of yoga practice to help relieve the symptoms of chemotherapy-induced peripheral neuropathy.

 

In today’s Research News article “Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/), Galantino and colleagues recruited cancer survivors who had completed all treatments but who had some degree of peripheral neuropathy. They participated in a 90 minute, twice a week for 8-weeks, Hatha yoga program including postures, breathwork, and meditation. They were also asked to practice at home. They were measured before and after treatment for motor functions, balance, lower extremity flexibility, pain, neurotoxicity, perceived stress, sleep quality, spiritual efficacy, fear of falling, vibration sense, and salivary cortisol. The participants were asked to record their reflections on their yoga practice in a diary.

 

They found that at the completion of the yoga training the patients had significantly improved mobility, flexibility, balance, risk of falling, perceived pain, pain interference with life activities, sensory systems, muscular weakness, foot vibration sensitivity, and perceived stress. They did not find any adverse effects of the yoga practice on the patients. Qualitative analysis of the patient diaries revealed that the patients noted improvements in enhanced sensations in the extremities, that the yoga practice helped them in managing their symptoms, that the improvement in physical function allowed return to work and re-engagement in hobbies, greater ability to relax, and enjoyment of the social aspects of the yoga practice.

 

It should be noted that this was a small pilot study and there wasn’t a control condition so the results need to be interpreted with caution. But the results are very encouraging and suggest that a large randomized controlled trial is justified and needed to verify the efficacy of the yoga program. But prior to the program there was no improvement over time, so participation in the program likely produced the benefits. The benefits obtained in this study are significant and important contributing to the daily functions, mental and physical health of the patients.

 

Chemotherapy-induced peripheral neuropathy is painful, persistent, disruptive, and debilitating. The degree of improvement seen in the patients after yoga practice markedly improved their symptoms and greatly reduced their suffering. Importantly, after yoga practice the symptoms of peripheral neuropathy were greatly reduced allowing the patients to better function and to enjoy their lives.

 

So, improve mobility and quality of life in patients with chemotherapy-induced peripheral neuropathy with yoga.

 

“They may also benefit from exercise programs such as water exercise, a strength & balance class, Tai Chi, and yoga.  Although patients survived their cancer, giving them their quality of life back should be a priority for those that are suffering from CIPN.” – Pam McMillan

 

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

 

Galantino, M. L., Tiger, R., Brooks, J., Jang, S., & Wilson, K. (). Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors. Integrative cancer therapies, 18, 1534735419850627. doi:10.1177/1534735419850627

 

Abstract

Objective. Chemotherapy-induced peripheral neuropathy (CIPN) syndrome causes significant pain as an adverse effect of treatment, with few nonpharmacological interventions tested. A somatic yoga and meditation (SYM) intervention on functional outcomes and quality of life (QOL) was investigated. Design and methods. Individuals diagnosed with CIPN were enrolled in an open-label, single-arm, mixed-methods feasibility trial. Participants and Setting. In an outpatient rehabilitation center, ten participants with median age 64.4 years (47-81) attended 61% of the sessions with no adverse events. Intervention. SYM twice a week for 8 weeks for 1.5 hours, with home program and journaling. Main outcome measures. Primary functional outcomes included Sit and Reach (SR), Functional Reach (FR), and Timed Up and Go (TUG). Self-reported Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer Therapy—Neurotoxicity (FACT-GOG-NTX) were secondary CIPN outcomes. Biomarkers included salivary cortisol (stress) and bioesthesiometer (vibration). Results: Quantitative findings. Significant improvements were found in flexibility (SR; P = .006); balance (FR; P = .001) and fall risk (TUG; P = .004). PNQ improved significantly (P = .003) with other measures improving non-significantly. Qualitative findings. Five themes emerged: (1) vacillation of CIPN pain perception over time; (2) transferability of skills to daily activities; (3) improvement in physical function; (4) perceived relaxation as an effect of SYM; and (5) group engagement provided a social context for not feeling isolated with CIPN. Conclusion. Preliminary data suggest SYM may improve QOL, flexibility, and balance in cancer survivors with CIPN, with a fully powered randomized controlled trial indicated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/

 

Improve Symptoms and Quality of Life in Breast Cancer Patients with Yoga

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Improve Symptoms and Quality of Life in Breast Cancer Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that is also an exercise that has been shown to be beneficial for cancer patients. The research on yoga practice as a treatment for patients recovering from breast cancer has been accumulating. It is thus important to take a step back and summarize what has been learned.

 

In today’s Research News article “Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465041/), Cramer and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice as a treatment for patients recovering from breast cancer. They identified 24 published research studies, 17 of which compared yoga practice to no-treatment, while 4 compared it to a psychoeducation program while 3 compared it to another exercise.

 

They found that the published research reports that in comparison to no-treatment yoga practice significantly improves health related quality of life and reduces fatigue and disturbance of sleep in women recovering from breast cancer. When compared to psychoeducation programs (4 studies), yoga practice had additional significant reductions of anxiety and depression. But, when compared to other exercise programs (3 studies), no significant effects were reported.

 

These results are interesting and suggest that yoga practice is a safe and effective treatment for women recovering from breast cancer, improving their quality of life and physical and mental well-being. The fact that these benefits were not significantly different from other forms of exercise suggests that the it’s the exercise provided by yoga that is the important aspect of the practice producing the benefits. Regardless, it is clear that yoga practice is quite helpful for the well-being of women recovering from breast cancer.

 

So, improve symptoms and quality of life in breast cancer patients with yoga.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” — Linda E. Carlson

 

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

 

Cramer, H., Lauche, R., Klose, P., Lange, S., Langhorst, J., & Dobos, G. J. (2017). Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. The Cochrane database of systematic reviews, 1(1), CD010802. doi:10.1002/14651858.CD010802.pub2

 

Abstract

Background

Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long‐term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer‐related impairments and has been shown to improve physical and mental health in people with different cancer types.

Objectives

To assess effects of yoga on health‐related quality of life, mental health and cancer‐related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment.

Search methods

We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions.

Selection criteria

Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non‐metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient‐reported instruments, including health‐related quality of life, depression, anxiety, fatigue or sleep disturbances.

Data collection and analysis

Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random‐effects model meta‐analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi2 test and the I2 statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention.

Main results

We included 24 studies with a total of 2166 participants, 23 of which provided data for meta‐analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.

Seventeen studies that compared yoga versus no therapy provided moderate‐quality evidence showing that yoga improved health‐related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD ‐0.48, 95% CI ‐0.75 to ‐0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD ‐0.25, 95% CI ‐0.40 to ‐0.09; six studies, 657 participants). The funnel plot for health‐related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD ‐0.13, 95% CI ‐0.31 to 0.05; seven studies, 496 participants; low‐quality evidence) or anxiety (pooled SMD ‐0.53, 95% CI ‐1.10 to 0.04; six studies, 346 participants; very low‐quality evidence) in the short term and had no medium‐term effects on health‐related quality of life (pooled SMD 0.10, 95% CI ‐0.23 to 0.42; two studies, 146 participants; low‐quality evidence) or fatigue (pooled SMD ‐0.04, 95% CI ‐0.36 to 0.29; two studies, 146 participants; low‐quality evidence). Investigators reported no serious adverse events.

Four studies that compared yoga versus psychosocial/educational interventions provided moderate‐quality evidence indicating that yoga can reduce depression (pooled SMD ‐2.29, 95% CI ‐3.97 to ‐0.61; four studies, 226 participants), anxiety (pooled SMD ‐2.21, 95% CI ‐3.90 to ‐0.52; three studies, 195 participants) and fatigue (pooled SMD ‐0.90, 95% CI ‐1.31 to ‐0.50; two studies, 106 participants) in the short term. Very low‐quality evidence showed no short‐term effects on health‐related quality of life (pooled SMD 0.81, 95% CI ‐0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD ‐0.21, 95% CI ‐0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety‐related data.

Three studies that compared yoga versus exercise presented very low‐quality evidence showing no short‐term effects on health‐related quality of life (pooled SMD ‐0.04, 95% CI ‐0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD ‐0.21, 95% CI ‐0.66 to 0.25; three studies, 233 participants); no trial provided safety‐related data.

Authors’ conclusions

Moderate‐quality evidence supports the recommendation of yoga as a supportive intervention for improving health‐related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low‐quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465041/

 

Improve Pain, Mental Health and Quality of Life in Cancer Patients with Mindfulness

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Improve Pain, Mental Health and Quality of Life in Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda E. Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Pain, anxiety, depression, fatigue and insomnia and reduced quality of life are common symptoms in the aftermath of surviving cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. The research is accumulating. So, it is useful to take a step back and look at what has been learned.

 

In today’s Research News article “A Systematic Review: Mindfulness Intervention for Cancer-Related Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371675/), Ngamkham and colleagues review and summarize the high quality published research literature on the application of mindfulness training for the treatment of cancer related pain. They found 6 randomized controlled clinical trials (RCTs). These studies used Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Breathing Meditation, or Mindful Awareness Practice (MAP) programs as treatments.

 

They found that the published research reports that mindfulness training produces a significant reduction in cancer related pain that was still present 6-months after the training. The research also found significant reductions in anxiety and depression and significant increases in the patient’s quality of life. Hence, mindfulness training was found to be a safe and effective treatment for patients suffering with cancer related pain.

 

It is not known exactly how mindfulness training produces these benefits. It has been shown, however, that in healthy individuals, mindfulness training also produces reductions in pain, anxiety, and depression. It is thought that one way mindfulness training reduces is by reducing worry and rumination which is thought to amplify pain. Mindfulness training has also been shown to improve emotion regulation and reduce response to stress that may also contribute to pain reduction. Regardless mindfulness training should be recommended for cancer patients to reduce pain and improve their well-being.

 

So, improve pain, mental health and quality of life in cancer patients with mindfulness.

 

“Fear. Uncertainty about the future. Some of the most difficult elements of the cancer experience are well-suited for mindfulness.” – Lu Hanessian

 

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

 

Ngamkham, S., Holden, J. E., & Smith, E. L. (2019). A Systematic Review: Mindfulness Intervention for Cancer-Related Pain. Asia-Pacific journal of oncology nursing, 6(2), 161–169. doi:10.4103/apjon.apjon_67_18

 

Abstract

Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371675/

 

Improve Quality of Life in Breast Cancer Survivors with Exercise or Yoga

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Improve Quality of Life in Breast Cancer Survivors with Exercise or Yoga

 

By John M. de Castro, Ph.D.

 

“In studies of women with breast cancer, yoga has been shown to reduce fatigue and improve quality of sleep, physical vitality, and overall quality of life.” – BreastCancer.org

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients. But yoga practice is both a mindfulness practice and an exercise. It is unclear whether the benefits of yoga practice for cancer patients is due to its mindfulness or exercise components or both. The research has been accumulating. It is thus important to take a step back and summarize what has been learned.

 

In today’s Research News article “Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388460/ ), El-Hashimi and Gorey review, summarize and perform a meta-analysis of the effectiveness of yoga for improving the quality of life in survivors of breast cancer. They found and report on 8 randomized controlled trials that included a comparison to another exercise program.

 

They report that the research demonstrated that exercise practices including yoga produce significant improvements in quality of life for the breast cancer patients that are still present as much as a year later. But yoga practice was not significantly better than other exercise programs in improving the quality of life. It would appear that the fact that yoga practice is an exercise and not its mindfulness aspect is critical for the improvement in the quality of life of breast cancer patients.

 

So, improve quality of life in breast cancer survivors with exercise or yoga.

 

“Yoga, meditation, and breathing practices allow women with breast cancer to explore their emotions, foster mindful empathy, and cope with fatigue and tightness,” – Sierra Campbell

 

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

 

El-Hashimi, D., & Gorey, K. M. (2019). Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory Meta-Analysis of Randomized Controlled Trials. Journal of evidence-based integrative medicine, 24, 2515690X19828325.

 

Abstract

Physical activities during and after cancer treatment have favorable psychosocial effects. Increasingly, yoga has become a popular approach to improving the quality of life (QoL) of women with breast cancer. However, the extant synthetic evidence on yoga has not used other exercise comparison conditions. This meta-analysis aimed to systematically assess yoga-specific effects relative to any other physical exercise intervention (eg, aerobics) for women with breast cancer. QoL was the primary outcome of interest. Eight randomized controlled trials with 545 participants were included. The sample-weighted synthesis at immediate postintervention revealed marginally statistically and modest practically significant differences suggesting yoga’s potentially greater effectiveness: d = 0.14, P = .10. However, at longer term follow-up, no statistically or practically significant between-group difference was observed. This meta-analysis preliminarily demonstrated that yoga is probably as effective as other exercise modalities in improving the QoL of women with breast cancer. Both interventions were associated with clinically significant improvements in QoL. Nearly all of the yoga intervention programs, however, were very poorly resourced. Larger and better controlled trials of well-endowed yoga programs are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388460/

 

Quality of Life of Patients with Cardiovascular Disease is Higher with Spirituality

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Quality of Life of Patients with Cardiovascular Disease is Higher with Spirituality

 

By John M. de Castro, Ph.D.

 

“Positive beliefs, comfort, and strength gained from religion, meditation, and prayer can contribute to well being. It may even promote healing. Improving your spiritual health may not cure an illness, but it may help you feel better. It also may prevent some health problems and help you cope better with illness, stress, or death.” – FamilyDoctor

 

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). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of heart failure patients decline participation, making these patients at high risk for another attack.

 

Safe and effective alternative treatments for cardiovascular disease are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, weight reduction, and stress reduction. Indeed, yoga practice is both a mindfulness training technique and a physical exercise.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred.” Spirituality has been promulgated as a solution to the challenges of life both in a transcendent sense and in a practical sense. The transcendent claims are untestable with the scientific method. But the practical claims are amenable to scientific analysis. There have been a number of studies of the relationship of spirituality with the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality related to greater personal growth and mental health. So, it would make sense to review what is known regarding the relationship of spirituality and religiosity to the psychological state of patients with cardiovascular disease.

 

In today’s Research News article “Association of religiosity and spirituality with quality of life in patients with cardiovascular disease: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196107/  ), Abu and colleagues review and summarize the published research literature on the relationship of spirituality and religiosity to the quality of life of patients with cardiovascular disease. They found and reviewed 15 published studies that assessed spirituality and/or religiosity and global, mental, physical, or disease-related quality of life. All studies were correlational in nature without any active manipulations. Eleven of the studies included patients with heart failure, 2 with acute myocardial infarction, 1 with congenital heart disease, and 1 with multiple diagnoses.

 

They report that 10 of the 15 reviewed studies reported significant positive associations between spirituality and/or religiosity and quality of life in patients with cardiovascular disease; the greater the levels of spirituality and/or religiosity, the higher the quality of life. These results are correlational and conclusions regarding causality cannot be confidently made. Even reverse causation is possible such that a higher quality of life with heart disease produces greater spirituality and/or religiosity. In addition, only 2/3 of the studies reported significant results suggesting that the relationships are not highly robust.

 

The findings, though, regardless of causality suggest that spirituality and/or religiosity is related to better quality of life in patients with cardiovascular disease. Spirituality and/or religiosity have been shown to be related to resilience and low levels of stress, greater mental health, and better adherence to pharmacologic and non-pharmacologic therapy. These relationships with spirituality and/or religiosity would tend to predict better outcomes and quality of life in the patients. It is also possible that the social relationships and support supplied by spiritual or religious communities are responsible for the relationship. Regardless, it would appear that spirituality and/or religiosity are associated with better quality of life in patients with cardiovascular disease.

 

“There are more than 50 studies in which religious practices were found to be protective against cardiovascular disease, including death due to heart attacks and strokes as well as against numerous risk factors such as high blood pressure and elevated cholesterol and triglyceride levels.” – Michael Murray

 

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

 

Hawa O. Abu, Christine Ulbricht, Eric Ding, Jeroan J. Allison, Elena Salmoirago-Blotcher, Robert J. Goldberg, Catarina I. Kiefe. Association of religiosity and spirituality with quality of life in patients with cardiovascular disease: a systematic review. Qual Life Res. 2018; 27(11): 2777–2797.

 

Abstract

Purpose

This review systematically identified and critically appraised the available literature that has examined the association between religiosity and/or spirituality (R/S) and quality of life (QOL) in patients with cardiovascular disease (CVD).

Methods

We searched several electronic online databases (PubMed, SCOPUS, PsycINFO, and CINAHL) from database inception until October 2017. Included articles were peer-reviewed, published in English, and quantitatively examined the association between R/S and QOL. We assessed the methodological quality of each included study.

Results

The 15 articles included were published between 2002 and 2017. Most studies were conducted in the US and enrolled patients with heart failure. Sixteen dimensions of R/S were assessed with a variety of instruments. QOL domains examined were global, health-related, and disease-specific QOL. Ten studies reported a significant positive association between R/S and QOL, with higher spiritual well-being, intrinsic religiousness, and frequency of church attendance positively related with mental and emotional well-being. Approximately half of the included studies reported negative or null associations.

Conclusions

Our findings suggest that higher levels of R/S may be related to better QOL among patients with CVD, with varying associations depending on the R/S dimension and QOL domain assessed. Future longitudinal studies in large patient samples with different CVDs and designs are needed to better understand how R/S may influence QOL. More uniformity in assessing R/S would enhance the comparability of results across studies. Understanding the influence of R/S on QOL would promote a holistic approach in managing patients with CVD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196107/

 

Improve Quality of Life with Low Back Pain with Yoga

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Improve Quality of Life with Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is great for working on flexibility and core stability, correcting posture, and breathing—all of which are necessary for a healthy back.” – Sasha Cyrelson

 

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. 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 and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

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 and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain.

 

In today’s Research News article “A Randomized Trial Comparing Effect of Yoga and Exercises on Quality of Life in among nursing population with Chronic Low Back Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134737/ ), Patil and colleagues recruited nurses who worked in a tertiary care hospital and who also were diagnosed with chronic low back pain. They were randomly assigned to either participate in yoga or physical exercise. In the yoga condition, the participants practiced a 1-hour Integrated Approach to Yoga Therapy module 5 times per week for 6 weeks. The physical exercise group practiced on the same schedule and performed stretching and gym exercises such as leg lifts, curls, and pull ups. Participants were measured before and after training with the “World Health Organization Quality of Life-brief questionnaire. . . The scale provides a measure of an individual’s perception of QOL on four domains: (1) physical health (seven items), (2) psychological health (six items), (3) social relationships (three items), and (4) environmental health” (Patil et al., 2018).

 

They found that both groups of nurses showed significant improvements after training in physical and psychological health and social relationships. But, the yoga group had significantly greater improvements in all three quality of life dimensions.

 

The fact that yoga was compared to a comparable exercise is a strength of this research project. The results are potentially important and suggest that yoga practice is superior to other exercise in improving the quality of life of nursing professionals with chronic low back pain. This may be of great importance in allowing the nurses to better perform their duties and also to prevent turnover and burnout that are prevalent with nurses.

 

So, improve quality of life with low back pain with yoga.

 

“Achy back? Give yoga a go. Numerous studies have shown the power of the ancient practice, which emphasizes stretching, strength, and flexibility, to relieve back soreness and improve function. . . yoga may even help reduce the need for pain medication.” – Annie Hauser

 

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

 

Patil, N. J., Nagaratna, R., Tekur, P., Manohar, P., Bhargav, H., & Patil, D. (2018). A Randomized Trial Comparing Effect of Yoga and Exercises on Quality of Life in among nursing population with Chronic Low Back Pain. International Journal of Yoga, 11(3), 208–214. http://doi.org/10.4103/ijoy.IJOY_2_18

 

Abstract

Background:

Chronic low back pain (CLBP) adversely affects quality of life (QOL) in nursing professionals. Integrated yoga has a positive impact on CLBP. Studies assessing the effects of yoga on CLBP in nursing population are lacking. Aim: This study was conducted to evaluate the effects of integrated yoga and physical exercises on QOL in nurses with CLBP.

Methods:

A total of 88 women nurses from a tertiary care hospital of South India were randomized into yoga group (n = 44; age – 31.45 ± 3.47 years) and physical exercise group (n = 44; age – 32.75 ± 3.71 years). Yoga group was intervened with integrated yoga therapy module practices, 1 h/day and 5 days a week for 6 weeks. Physical exercise group practiced a set of physical exercises for the same duration. All participants were assessed at baseline and after 6 weeks with the World Health Organization Quality of Life-brief (WHOQOL-BREF) questionnaire.

Results:

Data were analyzed by Paired-samples t-test and Independent-samples t-test for within- and between-group comparisons, respectively, using the Statistical Package for the Social Sciences (SPSS). Within-group analysis for QOL revealed a significant improvement in physical, psychological, and social domains (except environmental domain) in both groups. Between-group analysis showed a higher percentage of improvement in yoga as compared to exercise group except environmental domain.

Conclusions:

Integrated yoga was showed improvements in physical, psychological, and social health domains of QOL better than physical exercises among nursing professionals with CLBP. There is a need to incorporate yoga as lifestyle intervention for nursing professionals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134737/