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

June 12, 2019September 24, 2019 psyjdc Leave a comment

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

May 29, 2019September 24, 2019 psyjdc Leave a comment

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

By John M. de Castro, Ph.D.

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

April 18, 2019September 24, 2019 psyjdc Leave a comment

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

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

March 12, 2019September 24, 2019 psyjdc Leave a comment

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

December 1, 2018September 24, 2019 psyjdc 1 Comment

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/

Improve Quality of Life in Cancer Patients with Mindfulness

November 16, 2018September 24, 2019 psyjdc Leave a comment

Improve Quality of Life in Cancer Patients with Mindfulness

By John M. de Castro, Ph.D.

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. Insomnia is a common occurrence in the aftermath of surviving breast cancer.

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress, sleep disturbance, and anxiety and depression. But, most research is with western populations and there are very few that study the effectiveness of mindfulness training with Asian populations.

In today’s Research News article “Effects of a Mindfulness Meditation Program on Quality of Life in Cancer Outpatients: An Exploratory Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041936/ ), Chang and colleagues recruited Taiwanese outpatient cancer patients and separated them into a usual care group and a mindfulness meditation group. Mindfulness meditation was taught in once a month for 3 months 2.5-hour sessions focusing on sitting insight meditation. The participants were expected to practice at home daily. They were measured before and after training and 3 month later for quality of life, including subscales for physical health, psychological health, social relationships, and environment.

They found that the mindfulness meditation group had significant improvements in their quality of life including all 4 subscales while the usual care group did not. These improvements in quality of life were sustained 3 months later. These results are similar to previously reported improvements in quality of life in cancer patients produced by mindfulness training. But, these findings extend these to include oriental populations. Hence mindfulness training appears to be a safe and effective treatment to improve the well-being and relieve the suffering of patients from all over the world with various forms of cancer.

So, improve quality of life in cancer patients with Mindfulness.

“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – BreastCancer,org

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

Chang, Y.-Y., Wang, L.-Y., Liu, C.-Y., Chien, T.-J., Chen, I.-J., & Hsu, C.-H. (2018). The Effects of a Mindfulness Meditation Program on Quality of Life in Cancer Outpatients: An Exploratory Study. Integrative Cancer Therapies, 17(2), 363–370. http://doi.org/10.1177/1534735417693359

Abstract

Objective. Numerous studies have investigated the efficacy of mindfulness meditation (MM) in managing quality of life (QoL) in cancer populations, yet only a few have studied the Asian population. The aim of this exploratory study is to evaluate the effect of a MM program on the QoL outcomes in Taiwanese cancer outpatients. Methods. Patients with various cancer diagnoses were enrolled and assigned to the MM group and usual care (UC) group. The meditation intervention consisted of 3 sessions held monthly. The outcomes of the whole intervention were measured using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Results. A total of 35 participants in the MM group and 34 in the UC group completed the study. The results showed that the postintervention scores were significantly higher than the preintervention scores in the MM group. In the UC group, there was no significant difference between preintervention and postintervention scores, except for the lower environment domain scores. There was no significant difference between the follow-up scores and postintervention scores in the MM group, indicating that improvement can be maintained for 3 months after completing the MM course. Conclusions. The present study provides preliminary outcomes of the effects on the QoL in Taiwanese cancer patients. The results suggest that MM may serve as an effective mind–body intervention for cancer patients to improve their QoL, and the benefits can persist over a 3-month follow-up period. This occurred in a diverse cancer population with various cancer diagnoses, strengthening the possibility of general use.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041936/

Improve Quality of Life with Migraine Headaches with Mindfulness

September 7, 2018September 24, 2019 psyjdc Leave a comment

Improve Quality of Life with Migraine Headaches with Mindfulness

By John M. de Castro, Ph.D.

“Be mindful of your breathing. If you notice that your respirations are fast and shallow, concentrate on taking slower, deeper and longer breaths. As your breathing slows, your body will begin to relax. Tensions and stress slowly will ebb from your body, allowing you to release the some of the pain and discomfort associated with your headaches.” – National Headache Institute

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

In today’s Research News article “Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/ ), Tavallaei and colleagues recruited women suffering with migraine headaches and randomly assigned them to receive either an on-line mindfulness training based upon the Mindfulness-Based Stress Reduction (MBSR) program or medical treatment as usual. The mindfulness training program was presented over the internet in 8 weekly sessions and included meditation, body scan, and didactic presentation. The participants were measured before and after treatment for mindfulness, migraine disability, pain, and distress including depression, anxiety, and stress.

They found that in comparison to the baseline and the treatment-as-usual control group that the group who received mindfulness training had significantly lower levels of migraine disability, distress, and pain and significantly higher levels of mindfulness. They found that the reductions in pain were due to changes in the emotional reactions to pain and not the sensory experiences of pain. So, the pain was perceived normally but the women did not react to the sensations emotionally and this resulted in a lower impact of the headache pain.

The results suggest that mindfulness training increases the quality of life and reduces the psychological distress of women with migraine headaches. Similar findings have been reported in other prior research studies. The importance of the present study resides in the presentation of the program over the internet. Presentation over the internet is important as in-person programs are inconvenient and expensive. Presentation over the internet allows for widespread, convenient, and inexpensive distribution of the therapy to affected populations. This makes mindfulness training more readily available to migraine sufferers.

So, improve quality of life with migraine headaches with mindfulness.

“mindfulness has been examined as a treatment for chronic pain and pain-related conditions, finding positive results such as reduction in medication usage, improved physical functioning, and physical-health-related quality of life.” – Monika Tomova

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

Tavallaei, V., Rezapour-Mirsaleh, Y., Rezaiemaram, P., & Saadat, S. H. (2018). Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy. European Journal of Translational Myology, 28(2), 7380. http://doi.org/10.4081/ejtm.2018.7380

Abstract

Our aim was to investigate effectiveness of mindfulness by bibliotherapy on disability, distress, perceived pain and mindfulness in women with tension headaches and migraines. Primary headaches have been of great interest to mental health researchers because of the high prevalence, as well as significant disability and distress in the affected people. Despite the promising results of in-person treatment and some limitations that such interventions may cause, patients may be encountered with problems when using health care services. The present study is a quasi-experimental randomized design with pre-test, post-test, and control group. The study population consisted of 1396 women with migraine headache referring to headache clinic of Baqiyatallah Hospital in Tehran. Of these, 30 patients (including tboh experimental and control group) were selected by objective sampling method and were randomly assigned to the two groups. The experimental group, in addition to medical treatment as usual, was treated for a period of 8 sessions by Mindfulness-based Stress Reduction Internet-based Bibliotherapy, but the control group used only the medical treatment. The sample had no attritions. Data were collected by the four scales of (DASS-21), Migraine Disability Assessment Test (MIDAS), McGill’s Short Form Questionnaire (MPQ-SF), and Mindfulness Inventory (MAAS). We used covariance analysis to analyze the findings in the measured scales. MBSR-IBB treatment had no significant effect on pain sensory dimension (P <0.44), despite improvement of mindfulness (P <0.0001). In contrast, the greatest effect was on the level of disability (P <0.0001). We observed also a significant improvement in distress (P <0.0001). In conclusion, in spite of the presence of headaches, the mindfulness improved the quality of life and reduced the level of mental distress. In addition, using the Internet-based bibliotherapy method, these services can be used with easier access, lower cost, and more flexibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/

Improve the Emotional and Psychosocial Quality of Life of Grammar School Children with Yoga

August 13, 2018September 24, 2019 psyjdc Leave a comment

Improve the Emotional and Psychosocial Quality of Life of Grammar School Children with Yoga

By John M. de Castro, Ph.D.

“Studies show that mindfulness- and yoga-based skills, conscious breath work, and body awareness improve academic performance and emotional regulation. Mindfulness-based practices also reduce anxiety and increase attention. . . . Research also reveals that mindfulness strategies enhance executive function in kids, supporting positive behavioral changes. In addition, a yoga practice promotes confidence and strength along with compassion and self-acceptance.” – Kimberly Jordan Allen

Yoga practice has been shown to have a large number of beneficial effects on the psychological, emotional, and physical health of the individual and is helpful in the treatment of mental and physical illness. The acceptance of yoga practice has spread from the home and yoga studios to its application with children in schools. Studies of these school programs have found that yoga practice produces a wide variety of positive psychosocial and physical benefits.

Teachers also note improvements in their students following yoga practice. These include improved classroom behavior and social–emotional skills, concentration, mood, ability to function under pressure, social skills, and attention and lower levels of hyperactivity. In addition, school records, academic tests have shown that yoga practice produces improvements in student grades and academic performance. This, in turn, improves the classroom experience for the teachers. Hence there are very good reasons to further study the effects of yoga practice in school on grammar school children.

In today’s Research News article “Effect of mindfulness and yoga on quality of life for elementary school students and teachers: results of a randomized controlled school-based study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903833/ ), Bazzano and colleagues recruited third grade students who screened positive for symptoms of anxiety and randomly assigned them to receive either an 8-week yoga/mindfulness training or to a no-treatment control condition. The yoga program occurred in 10 in-class 40-minute sessions and included postures, breathing exercises, and relaxation. The students were measured at the beginning, middle, and end of the 8-week intervention period for life satisfaction and childhood quality of life including physical, emotional, social, and school domains. In addition, teachers were measured for health-related quality of life.

They found that in the middle and after the yoga/mindfulness intervention the students had significant improvements in psychosocial and emotional quality of life. The teachers reported that after the program they were significantly more likely to include yoga practice in their classrooms. Hence, the brief yoga/mindfulness program was successful in improving the social and emotional life conditions for the children and these improvements were sufficiently noticeable that the teachers decided to continue employing yoga practice in the classroom after the program was completed.

These results are encouraging and suggest that even at a relatively young age and early in children’s school life practicing yoga in school improves their and their teachers’ lives. It should be noted that the comparison condition did not include any treatment. In future research an active control condition such as aerobic exercise should be included to determine if the effects are specific for yoga practice or might occur with any exercise program. Regardless, the program helped to improve the lives of anxious young students.

So, improve the emotional and psychosocial quality of life of grammar school children with Yoga.

“Yoga in my classroom creates a sense of community. They are more of a unified group. Something about yoga brings the students together, almost like team building.” – YogaCalm

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

Bazzano, A. N., Anderson, C. E., Hylton, C., & Gustat, J. (2018). Effect of mindfulness and yoga on quality of life for elementary school students and teachers: results of a randomized controlled school-based study. Psychology Research and Behavior Management, 11, 81–89. http://doi.org/10.2147/PRBM.S157503

Abstract

Objective

To assess the impact of a yoga curriculum in an elementary school on student quality of life, and to assess teacher and staff perception of potential barriers to, and benefits of, introducing yoga and mindfulness into the classroom.

Methods

A randomized controlled trial was utilized to assess the impact of a brief intervention on third-grade students who screened positive for symptoms of anxiety. Students were randomized to an intervention group of 20 students receiving small-group yoga/mindfulness activities for 8 weeks between October 2016 and February 2017, and a control group of 32 students receiving care as usual. The Brief Multidimensional Students’ Life Satisfaction Scale-Peabody Treatment Progress Battery and the Pediatric Quality of Life Inventory (PedsQL) served as outcomes. Teachers were invited to participate in two professional development sessions about introducing yoga and mindfulness into the classroom, and completed a survey following each of the sessions.

Results

In generalized estimating equation models adjusted for time, the yoga-based intervention was associated with a 14.17 unit increase in student emotional PedsQL (p-value 0.001) and a 7.43 unit increase in psychosocial PedsQL (p-value 0.01). Results were not attenuated by adjustment. Teachers and staff reported using yoga more frequently in the classroom following the second of two professional development sessions (p-value <0.05). Perceived barriers to introducing yoga to the classroom were similar at two data collection time points, while perceived benefits remained high.

Conclusion

The intervention was associated with a significant improvement in emotional and psychosocial quality of life in the intervention group when compared to the control group, suggesting that yoga/mindfulness interventions may improve symptoms of anxiety among students. Yoga/mindfulness activities may facilitate stress management among elementary school students and may be added as a complement to social and emotional learning activities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903833/

Improve Cancer Survivor Quality of Life with Exercise or Mindfulness

February 5, 2018September 24, 2019 psyjdc Leave a comment

Improve Cancer Survivor Quality of Life with Exercise or Mindfulness

By John M. de Castro, Ph.D.

“One of the main reasons people with cancer use meditation is to help them to feel better. Meditation can reduce anxiety and stress. It might also help control problems such as: pain, difficulty sleeping, tiredness, feeling sick, high blood pressure.” – Cancer Research UK

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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

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. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress, sleep disturbance, and anxiety and depression. In today’s Research News article “Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719270/ ), Duncan and colleagues summarize the published scientific reviews of randomized controlled trials on the effects of non-drug interventions on the quality of life of adult cancer survivors. The interventions included fell into a number of categories including physical (e.g. aerobic exercise, yoga), psychological education, peer support, and mind-body therapies (Mindfulness-Based Stress Reduction (MBSR), cognitive behavioral therapy (CBT), psychotherapy, relaxation training).

They discovered 21 published reviews of 362 randomized controlled trials. They found that the literature supported the efficacy of aerobic exercise, yoga, cognitive behavioral therapy (CBT), and Mindfulness-Based Stress Reduction (MBSR) in improving the quality of life in cancer survivors. Hence, published scientific randomized controlled trials of non-drug treatment approaches demonstrate that the quality of life of cancer survivors can be improved with exercise, CBT, and mindfulness practices such as MBSR and yoga.

It was not reported how these practices might improve quality of life in cancer survivors. But, it can be speculated that because cancer treatments are physically demanding and of themselves produce physical debilitation, that exercise is a useful countermeasure to help overcome the physical losses occurring in treatment. It can also be speculated that mindfulness training may be helpful by improving the survivor’s ability to regulate the emotions produced by a cancer diagnosis and its treatment. These include anxiety, depression, fear, catastrophizing etc. By improving the ability to feel these emotions but react to them adaptively and thereby not amplifying them, the survivors may help to improve their emotional well-being and as a result their quality of life.

So, improve cancer survivor quality of life with exercise or mindfulness.

“We already know that psychosocial interventions like mindfulness meditation will help you feel better mentally, but now for the first time we have evidence that they can also influence key aspects of your biology,” – Linda 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

Duncan, M., Moschopoulou, E., Herrington, E., Deane, J., Roylance, R., Jones, L., … Bhui, K. (2017). Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors. BMJ Open, 7(11), e015860. http://doi.org/10.1136/bmjopen-2017-015860

Strengths and limitations of this study

This is a systematic review of reviews and evidence synthesis of non-pharmacological interventions in cancer survivors.
Longer term studies are needed and studies of greater methodological quality that adopt similar reporting standards.
Definitions of survivor varied and more studies are needed for different types of cancer, and specifically for patients who have poor quality of life.
More studies are needed that investigate educational, online and multidisciplinary team-based interventions.
This review has some limitations in the methodology. Studies not in English and grey literature were not included. This was a review of reviews: we did not review individual studies focused on specific cancers or stage, and we did not reassess the quality of the primary studies included in each review.

Abstract

Objectives

Over two million people in the UK are living with and beyond cancer. A third report diminished quality of life.

Design

A review of published systematic reviews to identify effective non-pharmacological interventions to improve the quality of life of cancer survivors.

Data sources

Databases searched until May 2017 included PubMed, Cochrane Central, EMBASE, MEDLINE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.

Study selection

Published systematic reviews of randomised trials of non-pharmacological interventions for people living with and beyond cancer were included; included reviews targeted patients aged over 18. All participants had already received a cancer diagnosis. Interventions located in any healthcare setting, home or online were included. Reviews of alternative therapies or those non-English reports were excluded. Two researchers independently assessed titles, abstracts and the full text of papers, and independently extracted the data.

Outcomes

The primary outcome of interest was any measure of global (overall) quality of life.

Analytical methods

Quality assessment assessing methdological quality of systematic reviews (AMSTAR) and narrative synthesis, evaluating effectiveness of non-pharmacological interventions and their components.

Results

Of 14 430 unique titles, 21 were included in the review of reviews. There was little overlap in the primary papers across these reviews. Thirteen reviews covered mixed tumour groups, seven focused on breast cancer and one focused on prostate cancer. Face-to-face interventions were often combined with online, telephone and paper-based reading materials. Interventions included physical, psychological or behavioural, multidimensional rehabilitation and online approaches. Yoga specifically, physical exercise more generally, cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) programmes showed benefit in terms of quality of life.

Conclusions

Exercise-based interventions were effective in the short (less than 3–8 months) and long term. CBT and MBSR also showed benefits, especially in the short term. The evidence for multidisciplinary, online and educational interventions was equivocal.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719270/

Improve Activity and Quality of Life in High Risk Cardiac Patients with Tai Chi

January 24, 2018September 24, 2019 psyjdc Leave a comment

Improve Activity and Quality of Life in High Risk Cardiac Patients with Tai Chi

By John M. de Castro, Ph.D.

“We thought that Tai Chi might be a good option for these people because you can start very slowly and simply and, as their confidence increases, the pace and movements can be modified to increase intensity.” – Elena Salmoirago-Blotcher

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. Cardiac rehabilitation programs for patients recovering from a heart attack, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of cardiac patients decline participation, making these patients at high risk for another attack.

Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation, weight reduction and stress reduction. Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are 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, they 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. Since Tai Chi is both a mindfulness practice and an exercise, it may be an acceptable and effective treatment for the 60% of cardiac patients who refuse participation in more traditional cardiac rehabilitation programs.

In today’s Research News article “Tai Chi Is a Promising Exercise Option for Patients with Coronary Heart Disease Declining Cardiac Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721863/ ), Salmoirago‐Blotcher and colleagues recruited cardiac patients who were physically inactive and offered them participation in group Tai Chi practices for 30 minutes per session. The participants were randomly assigned to one of two levels of practice, Lite and Plus. In the Lite condition practice occurred 2 times per week for 12 weeks. In the Plus condition practice occurred 3 times per week for 12 weeks followed by 4 weeks of twice a week practices and 8 weeks of once a week practice. Patients were measured before treatment and at 3, 6, and 9 months later. They were measured for acceptability and participation rates in the clinic and at home. They were also measured for physical activity and aerobic fitness with stress test, body size, anxiety, and depression.

Retention rates in the program were excellent with 90% of the Lite group and 84% of the Plus group still participating at the 9-month follow-up. There were no cardiac related adverse events during the study and most participants indicated that the program was acceptable and enjoyable. The Plus condition resulted in significant increases in the patients’ levels of physical activity and self-reported quality of life and decreases in body weight, but not improvement in aerobic fitness. Hence, the 6-month Plus Tai Chi program was safe and acceptable and produced measurable improvements in the patients activity levels and quality of life.

The high acceptability and retention rates are particularly important as these patients had declined participation in more traditional cardiac rehabilitation programs. They stated that they feared that the traditional programs would be too stressful and potentially harmful. But, Tai Ch practice was perceived as acceptable and not dangerous. Hence, the program was successful in getting these reluctant patients more physically active. The hope is that this would overcome their reluctance to engage in more strenuous programs and eventually lead to participation and improvement in aerobic fitness levels. This would be a breakthrough in the treatment of these very high-risk patients.

So, improve activity and quality of life in high risk cardiac patients with Tai Chi.

“Tai chi may be a useful form of exercise for cardiac rehab programs, as it’s safe for high-risk patients. Findings also suggest that tai chi alone may be beneficial for patients who are unwilling to participate in a rehab program.” – CardioSmart

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

Elena Salmoirago‐Blotcher, Peter M. Wayne, Shira Dunsiger, Julie Krol, Christopher Breault, Beth C. Bock, Wen‐Chih Wu, Gloria Y. Yeh, Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation. J Am Heart Assoc. 2017 Oct; 6(10): e006603. Published online 2017 Oct 11. doi: 10.1161/JAHA.117.006603

Clinical Perspective

What Is New?

Compared with a shorter intervention, a 6‐month tai chi exercise intervention was safe, feasible, and enjoyable and increased moderate‐to‐vigorous physical activity among deconditioned patients with coronary heart disease who had declined enrollment in cardiac rehabilitation.

Other benefits included weight loss and improvements in quality of life.

This is the first study showing that tai chi may improve exercise behaviors in this high‐risk population.

What Are the Clinical Implications?

Tai chi is a promising and safe exercise alternative for patients with coronary heart disease who are unable or unwilling to attend traditional cardiac rehabilitation.

If proved effective in larger studies, tai chi could be offered as an alternative exercise option within existing cardiac rehabilitation programs or within the context of community‐based rehabilitation programs.

Abstract

Background

More than 60% of patients decline participation in cardiac rehabilitation after a myocardial infarction. Options to improve physical activity (PA) and other risk factors in these high‐risk individuals are limited. We conducted a phase 2 randomized controlled trial to determine feasibility, safety, acceptability, and estimates of effect of tai chi on PA, fitness, weight, and quality of life.

Methods and Results

Patients with coronary heart disease declining cardiac rehabilitation enrollment were randomized to a “LITE” (2 sessions/week for 12 weeks) or to a “PLUS” (3 sessions/week for 12 weeks, then maintenance classes for 12 additional weeks) condition. PA (accelerometry), weight, and quality of life (Health Survey Short Form) were measured at baseline and 3, 6, and 9 months after baseline; aerobic fitness (stress test) was measured at 3 months. Twenty‐nine participants (13 PLUS and 16 LITE) were enrolled. Retention at 9 months was 90% (LITE) and 88% (PLUS). No serious tai chi–related adverse events occurred. Significant mean between group differences in favor of the PLUS group were observed at 3 and 6 months for moderate‐to‐vigorous PA (100.33 min/week [95% confidence interval, 15.70–184.95 min/week] and 111.62 min/week; [95% confidence interval, 26.17–197.07 min/week], respectively, with a trend toward significance at 9 months), percentage change in weight, and quality of life. No changes in aerobic fitness were observed within and between groups.

Conclusions

In this community sample of patients with coronary heart disease declining enrollment in cardiac rehabilitation, a 6‐month tai chi program was safe and improved PA, weight, and quality of life compared with a 3‐month intervention. Tai chi could be an effective option to improve PA in this high‐risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721863/