Balance and Fitness in the Elderly and Tai Chi Training

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Balance and Fitness in the Elderly and Tai Chi Training

 

By John M. de Castro, Ph.D.

 

“Tai chi is an ancient Chinese exercise that can help older adults improve their balance and lower their fall risk. And by reducing their risk of falls, seniors can lower their odds of suffering a debilitating fracture.” – Harvard Health Letter

 

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 fall 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. These studies, however, employ Tai Chi training over long time frames of 6 months to a year. It is not known if shorter term training would also be effective.

 

In today’s Research News article “Effects of 12 Weeks of Tai Chi Chuan Training on Balance and Functional Fitness in Older Japanese Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968980/ ), Takeshima and colleagues recruited older adults averaging 73 years of age and assigned them to either receive 12 weeks of Tai Chi training for 2 days per week for 60 minutes or to a no-treatment control group. They were measured before and after training for static balance, dynamic balance, and functional fitness, including upper and lower body strength, balance and agility, upper and lower body flexibility, and cardiorespiratory fitness.

 

Contrary to longer-term studies, they did not find any significant differences between the Tai Chi training and no-treatment control groups in static balance, dynamic balance, or functional fitness.  This lack of benefit of Tai Chi training may well be due to the relative shortness of the 12-week program relative to previous studies employing 6-month to one year trainings. Indeed, previous research by Holmes and colleagues also employing a 12 week program could not detect any overall improvement in balance, but could detect a subtle improvement in postural-respiratory coupling. This may be a precursor to improvements in overall balance. So, 12-weeks of training may produce subtle changes that, if continued over a longer period of time, will lead to improvements in balance.

 

Tai Chi movement patterns can be fairly complex and the elderly may have difficulty learning them over a few sessions. Indeed, it has been reported that it takes 8 to 16 sessions before the patterns are mastered. So, there may need for longer periods of training to master the technique and benefit from it. Hence, there is a need for further research on the amount of Tai Chi training needed to improve balance and reduce falls in the elderly.

 

“I’ve always been clumsy, so Tai Chi has offered me the opportunity to be able to think more about what I’m doing, pay attention to what I’m doing, and not fall. I’m able to catch myself if I trip over something because of Tai Chi,” – Velma Chapman

 

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

 

Takeshima, N., Islam, M. M., Kato, Y., Koizumi, D., Narita, M., Kitabayashi, Y., … Rogers, M. E. (2017). Effects of 12 Weeks of Tai Chi Chuan Training on Balance and Functional Fitness in Older Japanese Adults. Sports, 5(2), 32. http://doi.org/10.3390/sports5020032

 

Abstract

The purpose of this study was to determine the effects of Tai Chi Chuan on static and dynamic balance, and functional fitness in older adults. Forty-nine volunteers were divided into an exercise group (EX: 9 men and 16 women, average age 72 ± 5 years) and control group (13 men and 11 women, average age 73 ± 6 years). The EX participated in a 12-week supervised exercise program (60 min/day, 2 days/week) that consisted of 10-min warm-up and stretching, 40-min Tai Chi Chuan exercise (long-form Yang style with 108 movements), and 10-min cool-down/relaxation exercises. The control group was asked to not change their physical activity habits. Static (sway velocity standing on firm or foam surfaces with eyes open or closed) and dynamic balance (limits of stability (LOS)), as well as functional fitness measures of body mass; upper- and lower-body strength; and flexibility, mobility, and aerobic fitness were taken before and after the intervention. After the 12-week Tai Chi Chuan exercise program, there were no improvements in any functional fitness or balance variable although components of LOS tended to increase (13.1%, p = 0.052). These results indicate that 12 weeks of Tai Chi Chuan exercise has no significant effect on balance and functional fitness parameters in older Japanese adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968980/

 

Improve Brain Size and Function in Healthy Elderly with Tai Chi

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Improve Brain Size and Function in Healthy Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Epidemiologic studies have shown repeatedly that individuals who engage in more physical exercise or are more socially active have a lower risk of Alzheimer’s disease. The current findings suggest that this may be a result of growth and preservation of critical regions of the brain affected by this illness.” –  James Mortimer

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Using modern neuroimaging techniques, scientists have been able to view the changes that occur in the nervous system with aging. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

 

Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging and to increase brain matter in the elderly. In today’s Research News article “The Effects of Tai Chi Intervention on Healthy Elderly by Means of Neuroimaging and EEG: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915963/ ), Pan and colleagues review, summarize, and perform a meta-analysis of the 11 published research articles that examine the effects of Tai Chi practice on the brain of the elderly.

 

They find that there was 1 published study reporting that long-term Tai Chi practitioners have a thicker cortex in the brain. This is interesting but it cannot be determined if people who practice Tai Chi are simply people who have thicker cortexes. Other studies using functional Magnetic Imaging (fMRI) indicate that Tai Chi results in increased connectivity between brain structures and increased functional activity in the brain, so there is greater activity and signals are better sent from one area to another. Still other studies employing electroencephalographic (EEG) recordings indicate that Tai Chi produces greater electrical activity in the frontal areas of the cortex that are known to be involved in high level cognitive function (executive function)

 

One weakness in the studies is that the comparison groups are most often sedentary, not engaging in any exercise. As a result, it cannot be determined if the changes in the brain are due to Tai Chi per se or whether any form of exercise might have a similar effect. Future research should employ comparisons to groups performing other exercises.

 

Nevertheless, the results are encouraging; suggesting that Tai Chi can alter the brain in ways that may improve memory and cognitive performance. Significantly, Tai Chi practice is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. Also, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice may be ideal for slowing or reversing age-related deterioration of the brain and the related cognitive decline.

 

So, improve brain size and function in healthy elderly with Tai Chi.

 

“The ability to reverse this trend with physical exercise and increased mental activity implies that it may be possible to delay the onset of dementia in older persons through interventions that have many physical and mental health benefits.” –  James Mortimer

 

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

 

Pan, Z., Su, X., Fang, Q., Hou, L., Lee, Y., Chen, C. C., … Kim, M.-L. (2018). The Effects of Tai Chi Intervention on Healthy Elderly by Means of Neuroimaging and EEG: A Systematic Review. Frontiers in Aging Neuroscience, 10, 110. http://doi.org/10.3389/fnagi.2018.00110

 

Abstract

Aging is a process associated with a decline in cognitive and motor functions, which can be attributed to neurological changes in the brain. Tai Chi, a multimodal mind-body exercise, can be practiced by people across all ages. Previous research identified effects of Tai Chi practice on delaying cognitive and motor degeneration. Benefits in behavioral performance included improved fine and gross motor skills, postural control, muscle strength, and so forth. Neural plasticity remained in the aging brain implies that Tai Chi-associated benefits may not be limited to the behavioral level. Instead, neurological changes in the human brain play a significant role in corresponding to the behavioral improvement. However, previous studies mainly focused on the effects of behavioral performance, leaving neurological changes largely unknown. This systematic review summarized extant studies that used brain imaging techniques and EEG to examine the effects of Tai Chi on older adults. Eleven articles were eligible for the final review. Three neuroimaging techniques including fMRI (N = 6), EEG (N = 4), and MRI (N = 1), were employed for different study interests. Significant changes were reported on subjects’ cortical thickness, functional connectivity and homogeneity of the brain, and executive network neural function after Tai Chi intervention. The findings suggested that Tai Chi intervention give rise to beneficial neurological changes in the human brain. Future research should develop valid and convincing study design by applying neuroimaging techniques to detect effects of Tai Chi intervention on the central nervous system of older adults. By integrating neuroimaging techniques into randomized controlled trials involved with Tai Chi intervention, researchers can extend the current research focus from behavioral domain to neurological level.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915963/

 

Improve Acceptance with Mindfulness Training or a Psychedelic Drug

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Improve Acceptance with Mindfulness Training or a Psychedelic Drug

 

By John M. de Castro, Ph.D.

 

“If someone gives you 100 micrograms of acid something is going to happen. Two hours later the significance of your existence will have just been borne down on you like an avalanche. And again this can be terrifying or it can be absolutely sublime depending on various causes and conditions. But the one thing it cannot be is boring. And that is you can’t say that about yoga or meditation or just going into solitude or anything else that – any other, you know, non-pharmacological means of inquiry.” – Big Think

 

Psychedelic substances such as peyote, mescaline, LSD, ayahuasca and psilocybin  have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. A substantial number of Brazilian religious groups ingest the natural psychedelic substance ayahuasca on a regular basis for ritual purposes. These groups, like many users of psychedelic substances, employ them to develop spirituality and self-transcendence.

 

Psychedelics produce effects that are similar to those that are reported in spiritual awakenings. They report a loss of the personal self, a decentering. They experience what they used to refer to as the self as just a part of an integrated whole. They report feeling interconnected with everything else in a sense of oneness with all things. They experience a feeling of timelessness where time seems to stop and everything is taking place in a single present moment. They experience ineffability, being unable to express in words what they are experiencing and as a result sometimes producing paradoxical statements. And they experience a positive mood, with renewed energy and enthusiasm.

 

It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny.  In today’s Research News article “Four Weekly Ayahuasca Sessions Lead to Increases in “Acceptance” Capacities: A Comparison Study With a Standard 8-Week Mindfulness Training Program.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869920/ ), Soler and colleagues compare the ability of the psychedelic drug ayahuasca and mindfulness training to change the mindfulness of volunteers.

 

They formed two matched groups from the volunteers, based upon levels of decentering. One group were provided a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program was presented for 2.5 hours, once a week, for 8 weeks with 30-minute daily home practice. It consisted of discussion and meditation, body scan, and yoga practices. The second group of volunteers received 4 weekly 6-8-hour ayahuasca sessions. They were measured before and after treatment for decentering and mindfulness, including the mindfulness facets of observing, describing, non-reacting, non-judging, and acting with awareness.

 

They found that following the MBSR program there were significant increases in decentering and all 5 mindfulness facets. On the other hand, after ayahuasca treatment there was a significant increase only in the non-judging mindfulness facet. Hence, the MBSR program produced the routinely observed improvements in mindfulness and decentering, while ayahuasca treatments only altered “acceptance” (non-judging facet of mindfulness).

 

It is very interesting and perhaps puzzling that ayahuasca treatment did not increase decentering. Decentering changes the nature of experience by having the individual step outside of experiences and observe them from a distanced perspective and be aware of their impermanent nature. This is exactly the type of perspective that is promoted by experiences with psychedelic drugs. The fact that it was not increased with the ayahuasca treatments calls into question the effectiveness of the treatments and dosing used in the current study.

 

Nevertheless the ayahuasca treatments did produce increases in acceptance. This suggests that some of the therapeutic benefits of ayahuasca treatments may be due to changes in mindfulness which, in turn, produce physical and psychological benefits. It will remain for future research to continue to explore the means by which such psychedelic treatments alter the psychological landscape of the individual. It is clear, though, in the current study that Mindfulness-Based Stress Reduction (MBSR) is a potent facilitator of all facets of mindfulness and decentering.

 

So, improve acceptance with mindfulness training or a psychedelic drug.

 

“Meditating can be hard, lonely work, but if recent research is to be believed there may be a quick-and-dirty shortcut to enlightenment: psychedelic drugs. According to an exploratory study, drinking the hallucinogenic brew ayahuasca can bring about improvements in mindfulness that would take years of dedicated meditation to achieve. The research found that ayahuasca raised mindfulness abilities to levels equal to or even greater than those of people who have been practising meditation for around seven years.” – Plastic Brain

 

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

 

Soler, J., Elices, M., Dominguez-Clavé, E., Pascual, J. C., Feilding, A., Navarro-Gil, M., … Riba, J. (2018). Four Weekly Ayahuasca Sessions Lead to Increases in “Acceptance” Capacities: A Comparison Study With a Standard 8-Week Mindfulness Training Program. Frontiers in Pharmacology, 9, 224. http://doi.org/10.3389/fphar.2018.00224

 

Abstract

Background: The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic N,N-dimethyltryptamine (DMT) and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a) participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b) participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR), with the specific goal of improving these skills.

Methods: Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). The MINDSENS Composite Index was also calculated, including those EQ and FFMQ items that have proven to be the most sensitive to meditation practice. Group A (n = 10) was assessed before and after the last of four closely spaced consecutive ayahuasca sessions. Group B (n = 10) was assessed before and after completion of a standard 8-week MBSR course.

Results: MBSR training led to greater increases in overall mindfulness scores after the 8-week period. MBSR but not ayahuasca led to increases in the MINDSENS Composite Index. However, the ayahuasca sessions induced comparable increases in the Non-Judging subscale of the FFMQ, specifically measuring “acceptance.” Improving this capacity allows for a more detached and less judgmental stance toward potentially distressing thoughts and emotions.

Results: The present findings suggest that a small number of ayahuasca sessions can be as effective at improving acceptance as more lengthy and costly interventions. Future studies should address the benefits of combining ayahuasca administration with mindfulness-based interventions. This will allow us to investigate if ayahuasca will improve the outcome of psychotherapeutic interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869920/

 

Improve Caregivers Emotion Regulation with Mindfulness

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Improve Caregivers Emotion Regulation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Caregivers have a habit of neglecting their own wellbeing for their patients’ sakes. Some caregivers even believe taking a few minutes out of the day to practice mindfulness is “selfish.” Nothing could be further from the truth. In fact, taking a few minutes to practice mindfulness everyday will improve the quality of care you can give to your patient. It should be mandatory that all caregivers practice some form of mindfulness today” – Caregiver Space

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Mindfulness training has been shown to be beneficial for both the caregiver and the patients. But, this is reactive, working with already stressed caregivers. It is important to be able to be proactive and better prepare caregivers to withstand the difficulties and stress of caregiving and provide better care for patients. In today’s Research News article “Developing professional caregivers’ empathy and emotional competencies through mindfulness-based stress reduction (MBSR): results of two proof-of-concept studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781061/ ), Lamothe and colleagues investigate the effects of mindfulness training on the emotion regulation ability of psychology students and professional caregivers.

 

They recruited psychology students in a university and professional caregivers in a pediatric hematology-oncology unit of a hospital. They were provided a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program was presented for 2 hours, once a week, for 8 weeks with 30-minute daily home practice. It consisted of discussion and meditation, body scan, and yoga practices. They were measured before and after the program and 3 months later for mindfulness, empathy, emotional competencies, recognition of emotions in others, emotional acceptance, and emotion regulation.

 

They found that in both groups there were large increases in mindfulness that were maintained 3 month later. In addition, they found that there were significant improvements after training in empathy, emotional competencies, recognition of emotions in others, identification of emotions in others, emotional acceptance, and emotion regulation, with the exception that the caregivers change in recognition of emotions in others was not statistically significant. At the 3-month follow-up they found that there were still significant improvements in identifying emotions and emotional acceptance.

 

These results are preliminary as there wasn’t a comparison, control, condition. As such, they are interpreted as a proof of concept. To reach firm conclusions a randomized controlled clinical trial with an active control condition is necessary. The results are interesting and powerful enough that such an extensive study is warranted. Nevertheless, the results provide preliminary evidence that mindfulness training improves the emotional competences of both students and professional caregivers. This suggests that mindfulness training can be used both for practicing caregivers and those in training. Hence, mindfulness training may be helpful both reactively and proactively to promote the emotional health of the caregivers and, in turn, provide better care.

 

So, improve caregivers emotion regulation with mindfulness.

 

“mindfulness practices can help both caregivers and their loved ones maintain their emotional well-being. This is important for two reasons. First, strong emotional well-being is a good defense against such stress-related problems as depression and anxiety. Second, emotional well-being supports the resiliency that makes a person’s life not just tolerable, but enjoyable and meaningful: restful sleep, invigorating exercise, healthful food and some form of spiritual or emotional nourishment.” – Adam Perlman

 

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

 

Lamothe, M., McDuff, P., Pastore, Y. D., Duval, M., & Sultan, S. (2018). Developing professional caregivers’ empathy and emotional competencies through mindfulness-based stress reduction (MBSR): results of two proof-of-concept studies. BMJ Open, 8(1), e018421. http://doi.org/10.1136/bmjopen-2017-018421

 

Abstract

Objectives

To assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies.

Design

Two pre–post proof-of-concept studies.

Setting

Participants were recruited at the University of Montreal’s Psychology Department (Study 1) and the CHU Sainte-Justine Department of Hematology-Oncology (Study 2).

Participants

Study 1: 12 students completed the 8-week programme (mean age 24, range 18–34). Study 2: 25 professionals completed the 8-week programme (mean age 48, range 27–63).

Intervention

Standard MBSR programme including 8-week mindfulness programme consisting of 8 consecutive weekly 2-hour sessions and a full-day silent retreat.

Outcomes measures

Mindfulness as measured by the Mindful Attention Awareness Scale; empathy as measured by the Interpersonal Reactivity Index (IRI)’s Perspective Taking and Empathic Concern subscales; identification of one’s own emotions and those of others as measured by the Profile of Emotional Competence (PEC)’s Identify my Emotions and Identify Others’ Emotions subscales; emotional acceptance as measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the Emotion Regulation Scale (ERQ)’s Expressive Suppression subscale; and recognition of emotions in others as measured by the Geneva Emotion Recognition Test (GERT).

Results

In both studies, retention rates (80%–81%) were acceptable. Participants who completed the programme improved on all measures except the PEC’s Identify Others’ Emotions and the IRI’s Empathic Concern (Cohen’s d median=0.92, range 45–1.72). In Study 2, favourable effects associated with the programme were maintained over 3 months on the PEC’s Identify my Emotions, the AAQ-II, the ERQ’s Expressive Suppression and the GERT.

Conclusions

The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one’s own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes.

The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one’s own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes.

 

Strengths and limitations of this study

Two feasibility studies of a mindfulness-based stress reduction (MBSR)-based intervention in students and professionals had high attendance rates and acceptability levels.

Results suggested a significant clinical signal on most measured outcomes in the domains of emotion regulation and empathy, with effects lasting at follow-up for identification of one’s own emotions and emotional acceptance.

The same pattern of results was obtained in two independent small-scale studies.

A limitation to theses studies is that samples were not randomly selected, had limited size, and no control groups were used.

Another limitation is that most outcomes were self-reported and could be subject to desirability bias.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781061/

 

Improve Psychological Health in the Elderly with Mindfulness

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Improve Psychological Health in the Elderly with Mindfulness

 

By John M. de Castro, Ph.D.

 

“In nursing homes and other long-term care facilities, loneliness, depression, and anxiety are considerable risk factors for residents. Mindfulness may help elders to find peace within themselves with daily practice.” – GoldenCares

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development but regret their decline during aging. As we age, there are systematic progressive declines in every system in the body, the brain included. This includes our mental abilities and results in impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Aging also results in changes in mental health. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. All of these are legitimate sources of worry. In addition, many elderly experience withdrawal and isolation from social interactions. But, no matter how reasonable, the increased loneliness, worry and anxiety add extra stress that can impact on the elderly’s already deteriorating physical and psychological health.

 

Mindfulness appears to be effective for an array of physical and psychological issues that occur with aging. It appears to strengthen the immune system and reduce inflammation. It has also been shown to be beneficial in slowing or delaying physical and mental decline with aging. and improve cognitive processes. It has also been shown to reduce anxiety, worry, and depression and improve overall mental health. Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate safe and effective methods to improve mental health in the elderly. In addition, more and more elderly individuals are residing in continuing care retirement communities. Hence it is important to find treatment methods amenable to implementation in these facilities.

 

In today’s Research News article “An Adapted Mindfulness-Based Stress Reduction Program for Elders in a Continuing Care Retirement Community: Quantitative & Qualitative Results from a Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973835/ ), Moss and colleagues recruited elderly residents, predominantly female (82%), of a continuing care retirement community. They were 62 to 92 years of age. They were randomly assigned to either receive an adapted Mindfulness-Based Stress Reduction (MBSR) program or to a wait-list control condition. The MBSR program was presented for 2 hours, once a week, for 8 weeks with 30-minute daily home practice. It consisted of the standard meditation, body scan, and yoga practices. But, yoga practice was changed to chair yoga to be better practiced by the elderly. The participants were measured before and after the treatment for acceptability of the program including attendance and rate of home practice, health, psychological flexibility, mindfulness, self-compassion, anxiety, depression, and somatization.

 

They found a high degree of acceptability of the program with only 20% dropping out and the participants averaged 5 days a week of home practice. In comparison to the baseline and wait-list control group, the participants who received the Mindfulness-Based Stress Reduction (MBSR) had significantly improved psychological flexibility and reduced physical limitations. In comparison to baseline the MBSR participants had significantly greater observing mindfulness, mental health, and vitality, and significantly less emotional limitations. The participants reflected that after the training they were better able to attend to the present moment, had greater well-being, self-compassion and kindness, and reduced self-judgement and stress.

 

These are wonderful results that demonstrate that Mindfulness-Based Stress Reduction (MBSR) is an acceptable, safe, and effective program to enhance the psychological health of elderly residents of a continuing care retirement community. The adaptations to the program to recognize the physical limitations of the elderly did not appear to blunt its’ effectiveness and perhaps made it more acceptable. Future research should employ an active control condition, such as aerobic exercise to better control for confounding variables. Regardless, the MBSR program would appear to have great benefits for the aging population.

 

So, improve psychological health in the elderly with mindfulness.

 

“Often elderly people can live uncomfortable, lonely, quiet lives. Teaching them to pay attention moment by moment, on purpose but without judgement, to each of their experiences, can improve of the quality of their lives, based on the demonstrated effectiveness of mindfulness techniques in many forms of therapy. Mindfulness practice has a definite positive impact on issues such as recurrent depression, stress, anxiety, chronic physical pain and loneliness. For the elderly, chronic health conditions, the loss of self-determination in their daily lives, isolation, and a lack of interaction with the outside world can understandably take much of the joy out of life.” – MyHomecare

 

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

 

Moss, A. S., Reibel, D. K., Greeson, J. M., Thapar, A., Bubb, R., Salmon, J., & Newberg, A. B. (2015). An Adapted Mindfulness-Based Stress Reduction Program for Elders in a Continuing Care Retirement Community: Quantitative & Qualitative Results from a Pilot Randomized Controlled Trial. Journal of Applied Gerontology : The Official Journal of the Southern Gerontological Society, 34(4), 518–538. http://doi.org/10.1177/0733464814559411

 

Abstract

The purpose of this study was to test the feasibility and effectiveness of an adapted 8-week mindfulness-based stress reduction (MBSR) program for elders in a continuing care community. This mixed-methods study used both quantitative and qualitative measures. A randomized wait-list control design was used for the quantitative aspect of the study. Thirty-nine elderly were randomized to MBSR (n=20) or a wait-list control group (n=19); mean age 82 years. Both groups completed pre-post measures of health related quality of life, acceptance and psychological flexibility, facets of mindfulness, self-compassion, and psychological distress. A subset of MBSR participants completed qualitative interviews. MBSR participants showed significantly greater improvement in acceptance and psychological flexibility and in role limitations due to physical health. In the qualitative interviews, MBSR participants reported increased awareness, less judgment and greater self-compassion. Study results demonstrate the feasibility and potential effectiveness of an adapted MBSR program in promoting mind-body health for elders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973835/

 

Improve Cardiorespiratory Fitness in Coronary Disease Rehabilitation with Tai Chi

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Improve Cardiorespiratory Fitness in Coronary Disease Rehabilitation with Tai Chi

 

By John M. de Castro, Ph.D.

 

“practicing tai chi may help to modestly lower blood pressure. It’s also proved helpful for people with heart failure, who tend to be tired and weak as a result of the heart’s diminished pumping ability. The slow movements involve both the upper and lower body, which safely strengthens the heart and major muscle groups without undue strain.” – Harvard Heart Letter

 

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 failure, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of heart failure 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. Since Tai Chi is both a mindfulness practice and a gentle exercise, it may be an acceptable and effective treatment for coronary disease patients.

 

In today’s Research News article “The Effect of Tai Chi on Cardiorespiratory Fitness for Coronary Disease Rehabilitation: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758591/ ), Yang and colleagues review, summarize and perform a meta-analysis of 5 published research articles on the use of Tai Chi for the treatment of patients with coronary disease.

 

They found that in comparison to other gentle aerobic exercise practice Tai Chi produced significantly greater improvement in cardiorespiratory fitness, or aerobic capacity, which is reflected by VO2max, measured with a stress test. But, the effect was not as great as that produced by vigorous aerobic exercise. No adverse events were reported. Hence, Tai Chi practice was found to be safe and effective in improving cardiorespiratory fitness in patients with coronary disease.

 

Tai Chi practice was not as effective as vigorous aerobic exercise. But it is difficult to get patients with coronary disease to engage in and sustain vigorous exercise. It scares them and produces considerable discomfort. Tai Chi practice, on the other hand, is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice may be an ideal treatment for patients with coronary disease, not only one that is effective but also one that they will engage in and sustain.

 

So, improve cardiorespiratory fitness in coronary disease rehabilitation with Tai Chi.

 

“Both fear of exercise and the perception of cardiac rehabilitation as dangerous were the most commonly reported reasons for declining participation in cardiac rehabilitation. Tai chi can clearly overcome these barriers because it is a different form of exercise. During training, participants are constantly reminded they do not need to strive or struggle to achieve predetermined goals in terms of heart rate or exercise intensity. Instead, they are invited to focus their attention on the breath and/or on the movements of the body. As a result, participants do not see tai chi exercise as threatening, and this may result in improvements in exercise self-efficacy,” – Elena Salmoirago-Blotcher

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Yang, Y., Wang, Y., Wang, S., Shi, P., & Wang, C. (2017). The Effect of Tai Chi on Cardiorespiratory Fitness for Coronary Disease Rehabilitation: A Systematic Review and Meta-Analysis. Frontiers in Physiology, 8, 1091. http://doi.org/10.3389/fphys.2017.01091

 

Abstract

Background: Tai Chi that originated in China as a martial art is an aerobic exercise with low-to-moderate intensity and may play a role in cardiac rehabilitation.

Aim: To systematically review the effect of Tai Chi on cardiorespiratory fitness for coronary disease rehabilitation.

Methods: We performed a search for Chinese and English studies in the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database. The search strategy included terms relating to or describing Tai Chi and coronary disease, and there were no exclusion criteria for other types of diseases or disorders. Further, bibliographies of the related published systematic reviews were also reviewed. The searches, data extraction, and risk of bias (ROB) assessments were conducted by two independent investigators. Differences were resolved by consensus. RevMan 5.3.0 was used to analyze the study results. We used quantitative synthesis if the included studies were sufficiently homogeneous and performed subgroup analyses for studies with different control groups. To minimize bias in our findings, we used GRADEpro to grade the available evidence.

Results: Five studies were enrolled—two randomized controlled trials (RCTs) and three nonrandomized controlled trials (N-RCTs)—that included 291 patients. All patients had coronary disease. ROB assessments showed a relatively high selection and detection bias. Meta-analyses showed that compared to other types of low- or moderate-intensity exercise, Tai Chi could significantly improve VO2max [MD = 4.71, 95% CI (3.58, 5.84), P < 0.00001], but it seemed less effective at improving VO2max as compared to high-intensity exercise. This difference, however, was not statistically significant [MD = −1.10, 95% CI (−2.46, 0.26), P = 0.11]. The GRADEpro showed a low level of the available evidence.

Conclusion: Compared to no exercise or other types of exercise with low-to-moderate intensity, Tai Chi seems a good choice for coronary disease rehabilitation in improving cardiorespiratory fitness. However, owing to the poor methodology quality, more clinical trials with large sample size, strict randomization, and clear description about detection and reporting processes are needed to further verify the evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758591/

 

Improve the Social, Emotional, and Behavioral Functioning of Autistic Children and Their Parents with Mindfulness

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Improve the Social, Emotional, and Behavioral Functioning of Autistic Children and Their Parents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A weekly mindfulness session for children with autism and a separate program for their parents showed promising results. After nine weekly sessions of mindfulness training, 21 adolescents with autism reported better quality of life and less time spent wandering in thought about topics like sadness, pain, and why they react to things the way they do. Parents reported that their children were more socially responsive. Parents also reported reduced stress and less frequent use of “dysfunctional parenting styles,” such as shouting.” – Sarah Hansen

 

Autism spectrum disorder (ASD) is a developmental disability that tends to appear during early childhood and affect the individual throughout their lifetime. It affects a person’s ability to communicate, and interact with others, delays learning of language, makes eye contact or holding a conversation difficult, impairs reasoning and planning, narrows and intensifies interests, produces poor motor skills and sensory sensitivities, and is frequently associated with sleep and gastrointestinal problems. ASD is a serious disorder that impairs the individual’s ability to lead independent lives including complete an education, enter into relationships or find and hold employment. It is also difficult and stressful for the caregivers.

 

The diagnosis of autism spectrum disorder (ASD) has been increasing markedly over the last couple of decades. It is currently estimated that over 1% of the world population has autism spectrum disorder (ASD). Its causes are unknown and there are no known cures. Treatment is generally directed at symptoms and can include behavioral therapies and drug treatments. Clearly, there is a need for effective alternative treatment options.

 

Mindfulness training has been shown to be helpful in treating ASD.  In today’s Research News article “Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968048/ ), Ridderinkhof and colleagues examined the effectiveness of mindfulness training to improve the social and psychological health of children and their families.

 

They recruited children with autism spectrum disorder (ASD) and their parents and provided the child and one or both parents separately with a 9-week mindfulness training program. The sessions occurred once a week for 1.5 hours. For the children the sessions included breathing meditation, body scan, a 3-min breathing space, and yoga practices. For the parents the sessions also focused on mindful parenting. Home practice was encouraged. Before and after training and 2 months and one year later, the children were measured through self- and parental report for social communications, emotional and behavioral functioning, and mindfulness. Parents were assessed for their social communications, emotional and behavioral functioning, mindfulness, and parental stress.

 

They found that after treatment and 2 months and one year later the parents reported that the children showed significant improvement in social communications and attention and significant decreases in externalizing and internalizing symptoms, and rumination. The parents showed significant improvements in their social communications, attention mindfulness, and self-compassion and significant decreases in externalizing and internalizing symptoms, perceived stress, stress concerning parenting, and over-reactivity,. Hence, the mindfulness training appeared to produce significant improvements in both the children with autism spectrum disorder and their parents.

 

The results, however, have to be interpreted very cautiously. This study ran for over a year and there was no comparison condition. During that time the children mature, learn in school, and have additional experiences and the parents continue to learn how to cope with their child’s ASD. So, the observed improvements may have occurred anyway, even without the mindfulness training. The results, though are encouraging and suggest that a randomized controlled trial is justified. ASD is such a difficult issue for the child and the parents that the investment in further study is needed.

 

So, improve the social, emotional, and behavioral functioning of autistic children and their parents with mindfulness.

 

“mindfulness practices may be a viable technique in not only improving behavioral and cognitive responses in those with ASD, but also the overall well-being of their caregivers.” – Krupa Patel

 

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

 

Ridderinkhof, A., de Bruin, E. I., Blom, R., & Bögels, S. M. (2018). Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements. Mindfulness, 9(3), 773–791. http://doi.org/10.1007/s12671-017-0815-x

 

A combined mindfulness-based program for children and their parents (MYmind) was beneficial for adolescents with autism spectrum disorder (ASD). In this study, we investigated whether this program is also beneficial for younger children with ASD, whether effects last on the long-term, and whether it reduces common comorbid problems. Forty-five children referred with ASD aged 8 until 19 years old, and their parents participated. Repeated measures of children’s and parents’ social communication problems, emotional and behavioral functioning, mindful awareness, and of parenting were conducted pre-intervention, post intervention, 2-month follow-up, and 1-year follow-up. While children did not report significant changes in mindful awareness, their social communication problems decreased, and their emotional and behavioral functioning improved. Results were not consistent at each occasion; improvements reported by children were most substantial at a 2-month follow-up and only partly remained at a 1-year follow-up, while all children’s improvements as reported by parents were present on all occasions. Parents themselves reported improved emotional and behavioral functioning, improved parenting, and increased mindful awareness on all occasions. Parents’ social communication problems reduced only directly after the intervention. Most improvements were supported by the qualitative investigation of children’s and parents’ experienced change as reported on open-ended questions. This study suggests that children, including adolescents, with ASD and their parents can benefit from a mindfulness-based program with parallel sessions for children and parents.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968048/

 

Reduce Perfectionism with Mindfulness

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Reduce Perfectionism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The goal of mindfulness practices is to help you practice “awareness of the present moment without judgment.” The tricky part for us perfectionists is the “without judgment.” As perfectionists, we are conditioned to judge—ourselves and others, anything and everything. Letting go of the judgment is the biggest opportunity you have to release your perfectionist hat, and meditation is a great place to begin making peace with perfectionism.” – Melissa Eisler

 

It can be useful to constructively criticize yourself as long as you realize that you’re human and are not, and will not ever be, perfect. You can then use the self-criticism to try to improve, not become perfect, but a little better. But, when self-criticism becomes extreme it can lead to perfectionistic thinking where you are never happy with yourself. This can lead to great unhappiness and psychological distress.

Mindfulness has been thought to help prevent perfectionism from producing distress. In support of this mindfulness has been found to reduce self-criticism and to improve self-esteem and a healthy self-esteem is counter to perfectionism. It’s difficult to be happy with oneself and critical of yourself as less than ideal at the same time. So, mindfulness training should be an antidote to perfectionism.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy Versus Pure Cognitive Behavioural Self-Help for Perfectionism: a Pilot Randomised Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968046/ ), James and Rimes recruited college students who were perfectionistic and this perfectionism caused significant distress and impairment of everyday function. They were randomly assigned to an 8-week Cognitive Behavioral self-help for perfectionism program or an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program.

 

MBCT consisted of 2-hour sessions once a week for 8 weeks and included home practice. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. They were measured before and after training and 10 weeks later for perfectionism, impairment caused by perfectionism, self-reported depression, anxiety and stress, self-compassion, rumination, unhelpful beliefs about emotions, mindfulness and decentering.

 

They found that in comparison to baseline and the Cognitive Behavioural self-help for perfectionism program the students who underwent the Mindfulness-Based Cognitive Therapy (MBCT) program had significantly greater decreases in perfectionism, unhelpful beliefs about emotions and rumination, and significantly higher levels of mindfulness, self-compassion and decentering. These differences were present both immediately after training and 10 weeks later. Mediation analysis revealed that the MBCT program produced greater self-compassion which, in turn, was associated with lower perfectionism.

 

These are interesting results and suggest that the mindfulness training component of MBCT is critical as MBCT had significantly greater effects than simply presenting the Cognitive Behavior components by themselves. They further suggest that the effectiveness of MBCT for perfectionism results from changes in self-compassion. This makes sense as understanding and accepting one’s own faults is incompatible with criticizing oneself for those faults. Finally, the results suggest that MBCT is a safe and effective treatment for students suffering from high levels of perfectionism that produce distress and impairment of everyday function.

 

So, reduce perfectionism with mindfulness.

 

“Mindfulness practice reveals how pervasive this pressure to be perfect is, and how I impose perfectionistic rules on myself. I’m happier when I give myself permission to be imperfect.” – Arnie Kozak

 

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

 

James, K., & Rimes, K. A. (2018). Mindfulness-Based Cognitive Therapy Versus Pure Cognitive Behavioural Self-Help for Perfectionism: a Pilot Randomised Study. Mindfulness, 9(3), 801–814. http://doi.org/10.1007/s12671-017-0817-8

 

Abstract

This pilot study compared mindfulness-based cognitive therapy (MBCT) with a self-help guide based on cognitive behaviour therapy (CBT) for university students experiencing difficulties due to perfectionism. Participants were randomised to an MBCT intervention specifically tailored for perfectionism or pure CBT self-help. Questionnaires were completed at baseline, 8 weeks later (corresponding to the end of MBCT) and at 10-week follow-up. Post-intervention intention-to-treat (ITT) analyses identified that MBCT participants (n = 28) had significantly lower levels of perfectionism and stress than self-help participants (n = 32). There was significant MBCT superiority for changes in unhelpful beliefs about emotions, rumination, mindfulness, self-compassion and decentering. At 10-week follow-up, effects were maintained in the MBCT group, and analyses showed superior MBCT outcomes for perfectionism and daily impairment caused by perfectionism. Pre-post changes in self-compassion significantly mediated the group differences in pre-post changes in clinical perfectionism. Greater frequency of mindfulness practice was associated with larger improvements in self-compassion. MBCT is a promising intervention for perfectionist students, which may result in larger improvements than pure CBT self-help. The findings require replication with a larger sample.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968046/

 

Rumination and Worry Interfere with the Development of Mindfulness

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Rumination and Worry Interfere with the Development of Mindfulness

 

By John M. de Castro, Ph.D.

 

“Worry and rumination are forms of persistent negative thinking. They involve a predominance of verbal thoughts, and can be likened to a negative inner-speech. Worry is concerned with the possibility of threats in the future and ways to effectively avoid or deal with them whilst rumination is concerned more with things that happened in the past.” – MCT Institute

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses. Techniques such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness. One way they may do this is by disrupting the development of mindfulness. In today’s Research News article “Barriers to Mindfulness: a Path Analytic Model Exploring the Role of Rumination and Worry in Predicting Psychological and Physical Engagement in an Online Mindfulness-Based Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968050/ ), Banerjee and colleagues had adult volunteers participate in a 2-week, once a day, online Mindfulness-based self-help program. They were measured before and after the program for mindfulness, including the observe, describe, acting with awareness, non-judging, and non-reacting facets, rumination, worry, beliefs about rumination, beliefs about worry, physical engagement, and psychological engagement. The measures were intercorrelated and their relationships were assessed with a path analysis.

 

They found that the higher the levels of both rumination and worry, the lower the levels of physical and psychological engagement in the mindfulness program. The path models revealed that rumination and worry were associated with reduced physical and psychological engagement in the program and these were, in turn, associated with reductions in four of the mindfulness facets of describe, acting with awareness, non-judging, and non-reacting.

 

These results are interesting and suggest that the individual’s levels of worry and rumination before engaging in mindfulness training tend to interfere with the development of mindfulness. They appear to do so by interfering with the individual’s engagement in the program, that is by promoting disengagement. It should be kept in mind that these findings are correlational, so no conclusions about causation are warranted. But, the results suggest that training in mindfulness should take into consideration the psychological state of the participant at the beginning of the program. Perhaps, programs can be tailored for the participants state taking into consideration their levels of worry and rumination. They may, thereby, be more effective in promoting mindfulness and all of its benefits.

 

“repeated practice in noticing, observing with curiosity and compassion, and shifting perspective helps participants to realise that their thoughts, emotions and sensations are just thoughts, emotions and sensations, rather than ‘truth’ or ‘me’. They learn to see more clearly the patterns of the mind, and to recognise when mood is beginning to dip without adding to the problem by falling into analysis and rumination – to stand on the edge of the whirlpool and watch it go round, rather than disappearing into it.” – B. J. Bidushi

 

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

 

Banerjee, M., Cavanagh, K., & Strauss, C. (2018). Barriers to Mindfulness: a Path Analytic Model Exploring the Role of Rumination and Worry in Predicting Psychological and Physical Engagement in an Online Mindfulness-Based Intervention. Mindfulness, 9(3), 980–992. http://doi.org/10.1007/s12671-017-0837-4

 

Abstract

Little is known about the factors associated with engagement in mindfulness-based interventions (MBIs). Moreover, engagement in MBIs is usually defined in terms of class attendance (‘physical engagement’) only. However, in the psychotherapy literature, there is increasing emphasis on measuring participants’ involvement with interventions (‘psychological engagement’). This study tests a model that rumination and worry act as barriers to physical and psychological engagement in MBIs and that this in turn impedes learning mindfulness. One hundred and twenty-four participants were given access to a 2-week online mindfulness-based self-help (MBSH) intervention. Self-report measures of mindfulness, rumination, worry, positive beliefs about rumination, positive beliefs about worry and physical and psychological engagement were administered. A path analysis was used to test the linear relationships between the variables. Physical and psychological engagement were identified as two distinct constructs. Findings were that rumination and worry both predicted psychological disengagement in MBSH. Psychological engagement predicted change in the describe, act with awareness, non-judge and non-react facets of mindfulness while physical engagement only predicted changes in the non-react facet of mindfulness. Thus, rumination and worry may increase risk of psychological disengagement from MBSH which may in turn hinder cultivating mindfulness. Future suggestions for practice are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968050/

 

Improve Knee Osteoarthritis with Yoga

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Improve Knee Osteoarthritis with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga is proven to help people with arthritis improve many physical and psychological symptoms. . . .  regular yoga practice can help reduce joint pain, improve joint flexibility and function and lower stress and tension to promote better sleep.” – Susan Bernstein

 

Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. It is the leading cause of disability in the U.S., with about 43% of arthritis sufferers limited in mobility and about a third having limitations that affect their ability to perform their work. Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. It is painful and disabling. Its causes are varied including, hereditary, injury including sports injuries, repetitive stress injuries, infection, or from being overweight.

 

There are no cures for knee osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary practices that involve gentle knee movements may be useful for treatment.

 

Mindfulness practices such as Tai Chi and Qigong  and yoga have been shown to reduce the physical symptoms of knee osteoarthritis. Yoga, has been shown to be a safe and effective treatment for a wide variety of physical and psychological conditions, including arthritis. So, it would seem reasonable to look further into the effectiveness of yoga practice in treating knee osteoarthritis.

 

In today’s Research News article “Effect of Yoga Based Lifestyle Intervention on Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Frontiers in Psychiatry.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952125/ ), Deepeshwar and colleagues recruited adults with knee osteoarthritis and randomly assigned then to receive twice daily sessions for one week of Integrated Approach to Yoga Therapy (IAYT) or to a no-yoga control condition. IAYT consists of yoga postures, yoga breathing, relaxation, meditation and lectures on yogic lifestyle, devotional sessions, and stress management. They were measured before and after training for standing, walking, and sitting, knee flexibility and range of motion, handgrip strength, and fear of falling.

 

They found that the group who received the Integrated Approach to Yoga Therapy (IAYT) treatment significantly improved in comparison to baseline and the control group in their speed of standing, walking, and sitting, their knee flexibility and range of motion, and their handgrip strength. Hence, they found that IAYT produced significant improvement in the symptoms of knee osteoarthritis.

 

It would have been better if they included an active control group in the study (e.g. a different exercise) to control for participant expectancy effects and experimenter biases. Nevertheless, the results replicate the previous findings that yoga practice is effective in treating knee osteoarthritis, strengthening the conclusions. IAYT is a complex of practices and future research should be targeted at identifying which components are effective and which are not. Regardless, gentle yoga practice appears to be a safe and effective alternative treatment for the improvement in movement in patients suffering from knee osteoarthritis.

 

So, improve knee osteoarthritis with yoga.

 

“The culprit is osteoarthritis, the “wear-and-tear” arthritis, of the knees. Good weight-bearing alignment, learned and practiced in yoga class, can help keep the knees happy and healthy. On the other hand, bad alignment in poses—heaven forbid—can actually contribute to the breakdown of the joint surfaces, and the subsequent painful inflammation, caused by osteoarthritis.” – Julie Gudmustad

 

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

 

Deepeshwar, S., Tanwar, M., Kavuri, V., & Budhi, R. B. (2018). Effect of Yoga Based Lifestyle Intervention on Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Frontiers in Psychiatry, 9, 180. http://doi.org/10.3389/fpsyt.2018.00180

 

Abstract

Objective: To investigate the effect of integrated approach of yoga therapy (IAYT) intervention in individual with knee Osteoarthritis.

Design: Randomized controlled clincial trail.

Participants: Sixty-six individual prediagnosed with knee osteoarthritis aged between 30 and 75 years were randomized into two groups, i.e., Yoga (n = 31) and Control (n = 35). Yoga group received IAYT intervention for 1 week at yoga center of S-VYASA whereas Control group maintained their normal lifestyle.

Outcome measures: The Falls Efficacy Scale (FES), Handgrip Strength test (left hand LHGS and right hand RHGS), Timed Up and Go Test (TUG), Sit-to-Stand (STS), and right & left extension and flexion were measured on day 1 and day 7.

Results: There were a significant reduction in TUG (p < 0.001), Right (p < 0.001), and Left Flexion (p < 0.001) whereas significant improvements in LHGS (p < 0.01), and right extension (p < 0.05) & left extension (p < 0.001) from baseline in Yoga group.

Conclusion: IAYT practice showed an improvement in TUG, STS, HGS, and Goniometer test, which suggest improved muscular strength, flexibility, and functional mobility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952125/