Reduce Pain and Relax the Autonomic Nervous System with Mindfulness

Reduce Pain and Relax the Autonomic Nervous System with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we impose a litany of negativity upon our pain, it only becomes worse, and potentially elicits other difficulties including depression and anxiety. When we become more aware of what we are actually experiencing, without the overlay of our judgment, the overall perception of pain is reduced.” – Jennifer Wolkin

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. Mindfulness appears to work by changing how the patient relates to pain rather than actually reducing or eliminating the pain. What is not known is the mechanism by which mindfulness affects chronic pain.

 

In today’s Research News article “The Role of Heart Rate Variability in Mindfulness-Based Pain Relief.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994350/ ) Adler-Neal and colleagues recruited healthy adult non-meditators and randomly assigned them to either a meditation or sham-meditation group. The group met for 4 25-minute sessions over 7 days and practiced focused breath meditation or sham-meditation. In the sham-meditation sessions the participants were told every 2 to 3 minutes to close their eyes and take a deep breath. They were measured before and after training for respiration and heart rate variability. In addition, the participants underwent noxious non-damaging thermal stimulation on the calf of the leg and rated their pain levels.

 

They found that after both meditation and sham-meditation training there was a significant reduction in pain intensity. pain unpleasantness, and respiration rate and increase in heart rate variability, with no group differences. They also found for the meditation group only that the greater the heart rate variability the lower the pain unpleasantness ratings.

 

Heart rate variability refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments and lower stress levels. Higher heart rate variability is an indicator of physiological relaxation. This relaxation may well underlie the reduced pain unpleasantness. Since contemplative practices such as meditation increases heart rate variability it makes sense that these practices would also lower the perception of pain.

 

It is interesting that sham-meditation had similar effects as real meditation on pain and heart rate variability. This suggests that mindfulness reduction in pain may be due to a placebo effect where the participants’ belief that the intervention would reduce pain produced reduced perception of pain. But it could also be that the sham-meditation was actually a mindfulness practice. By focusing the participant’s attention on the breath, it might have increased mindfulness. It remains for future research to investigate this possibility.

 

So, reduce pain and relax the autonomic nervous system with mindfulness.

 

The ancient Buddhist text called the Sullatta Sutta states that mindfulness practitioners have the ability to experience pain but then let go of it.” – Brain Tap

 

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

 

Adler-Neal, A. L., Waugh, C. E., Garland, E. L., Shaltout, H. A., Diz, D. I., & Zeidan, F. (2020). The Role of Heart Rate Variability in Mindfulness-Based Pain Relief. The journal of pain, 21(3-4), 306–323. https://doi.org/10.1016/j.jpain.2019.07.003

 

HIGHLIGHTS

  • Mindfulness and sham mindfulness meditation reduced pain during noxious heat
  • Mindfulness and sham mindfulness meditation increased heart rate variability (HRV)
  • Mindfulness-based pain relief was associated with higher HRV
  • Higher HRV during sham mindfulness meditation was associated with higher pain

Abstract

Mindfulness meditation is a self-regulatory practice premised on sustaining non-reactive awareness of arising sensory events that reliably reduces pain. Yet, the specific analgesic mechanisms supporting mindfulness have not been comprehensively disentangled from the potential non-specific factors supporting this technique. Increased parasympathetic nervous system (PNS) activity is associated with pain relief corresponding to a number of cognitive manipulations. However, the relationship between the PNS and mindfulness-based pain attenuation remains unknown. The primary objective of the present study was to determine the role of high frequency heart rate variability (HF HRV), a marker of PNS activity, during mindfulness-based pain relief as compared to a validated, sham-mindfulness meditation technique that served as a breathing-based control. Sixty-two healthy volunteers (31 females; 31 males) were randomized to a four-session (25 minutes/session) mindfulness or sham-mindfulness training regimen. Before and after each group’s respective training, participants were administered noxious (49°C) and innocuous (35°C) heat to the right calf. HF HRV and respiration rate were recorded during thermal stimulation and pain intensity and unpleasantness ratings were collected after each stimulation series. The primary analysis revealed that during mindfulness meditation, higher HF HRV was more strongly associated with lower pain unpleasantness ratings when compared to sham-mindfulness meditation (B = −0.82, p = 0.04). This finding is in line with the prediction that mindfulness-based meditation engages distinct mechanisms from sham-mindfulness meditation to reduce pain. However, the same prediction was not confirmed for pain intensity ratings (B = −0.41). Secondary analyses determined that mindfulness and sham-mindfulness meditation similarly reduced pain ratings, decreased respiration rate, and increased HF HRV (between group ps < 0.05). More mechanistic work is needed to reliably determine the role of parasympathetic activation in mindfulness-based pain relief as compared to other meditative techniques.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994350/

 

Improve Migraine Headache with Mindfulness

Improve Migraine Headache with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Stress is a migraine trigger for nearly 70% of people living with migraine and disorders that cause severe head pain. Simple mindfulness exercises and relaxation techniques can help alleviate stress, increase calmness and, in some cases, prevent a migraine attack.” – Shirley Kessel

 

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. The research is accumulating. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Mindfulness in migraine: A narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213534/ ) Wells and colleagues review and summarize the published research on the effectiveness of mindfulness-based interventions for the relief of migraine headaches. They identified 8 published studies.

 

They report that the published studies found that mindfulness-based interventions produced significant improvements in patients with migraine headaches in regards to their overall quality of life and disability, self-efficacy and psychological symptoms over headache frequency. They also found that these mindfulness-based interventions work well in combination with pharmacologic treatments.

 

It is not known exactly how mindfulness produces these benefits for the patients with migraine headaches. The authors suggest that mindfulness may work as a result of decreasing pain perception, better coping mechanisms, greater body awareness, lowering reactivity, decreasing inflammation, improving stress coping, and modulating the autonomic nervous system. Regardless it is clear that mindfulness-based interventions do not cure migraines but rather improve the quality of life and reduce the disability of the patients. In combination with pharmacologic treatments mindfulness-based interventions work even better. Migraine headache is a torment. So, the relief produced by mindfulness-based interventions is very important for relieving the suffering of the patients.

 

So, improve migraine headache with mindfulness.

 

Many people with migraine have brains that are more sensitive to change, whether it be changes inside us such as hydration or hormone levels or outside changes such as stress or even weather conditions. Daily mindfulness practice may help to settle these fluctuations and calm the mind which could have a beneficial effect on migraine. It can also be useful during a migraine attack to reduce the impact of the pain.” – David Kernick

 

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

 

Wells, R. E., Seng, E. K., Edwards, R. R., Victorson, D. E., Pierce, C. R., Rosenberg, L., Napadow, V., & Schuman-Olivier, Z. (2020). Mindfulness in migraine: A narrative review. Expert review of neurotherapeutics, 20(3), 207–225. https://doi.org/10.1080/14737175.2020.1715212

 

Abstract

Introduction:

Migraine is the second leading cause of disability worldwide, yet many patients are unable to tolerate, benefit from, or afford pharmacological treatment options. Non-pharmacological migraine therapies exist, especially to reduce opioid use, which represents a significant unmet need. Mindfulness-based interventions (MBI) have potential as a non-pharmacological treatment for migraine, primarily through the development of flexible attentional capacity across sensory, cognitive, and emotional experiences.

Areas Covered:

We review efficacy and potential mechanisms of MBIs for migraine, including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).

Expert Opinion:

While most mindfulness research studies for migraine to date have been pilot trials, which are small and/or lacked rigor, initial evidence suggests there, may be improvements in overall headache-related disability and psychological well-being. Many research questions remain to help target the treatment to patients most likely to benefit, including the ideal dosage, duration, delivery method, responder characteristics, and potential mechanisms and biomarkers. A realistic understanding of these factors is important for patients, providers, and the media. Mindfulness will not “cure” migraine; however, mindfulness may be an important tool as part of a comprehensive treatment approach to help patients “mindfully” engage in valued life activities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213534/

 

Tai Chi Practice Improves the Symptoms of Multiple Diseases

Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

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

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

 

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

 

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

 

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

 

What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

 

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

 

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

 

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723

 

jenny.rickardsson@ki.se

 

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation is related to improved mental health across a variety of disorders, including different anxiety disorders, depression, eating disorders, substance abuse, and chronic pain symptom reduction.” – Jennifer Wolkin

 

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

 

Over the last few decades, a vast amount of research has been published on the benefits of mindfulness practices on the mental and physical health of the practitioners. Many reviews, summarizations, and meta-analyses have been performed of these studies. So, it makes sense to step back and summarize what these meta-analyses have found.

 

In today’s Research News article “The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials.” (See summary below or view the full text of the study at: https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf ) Goldberg and colleagues review, summarize, and perform a meta-analysis of previous meta-analyses of published randomized controlled studies on benefits of sustained meditation practices on mental and physical well-being. They identified 44 published meta-analyses, representing 336 randomized controlled trials, which included a total of 30,483 participants.

 

They report that the meta-analyses of published randomized controlled trials found that sustained mindfulness meditation practices in comparison to passive, no treatment, controls had a very wide range of beneficial effects across a wide range of participants from children to the elderly, over a variety of programs from Mindfulness-Based Stress Reduction (MBSR) to mobile health, over a variety of psychological issues from anxiety to psychoses, and over a wide range of diseases from chronic pain to cancer. These effects were present immediately post treatment and at later follow-ups (an average of 7 months after treatment).

 

Comparison of these mindfulness meditation practices to active control conditions such as attentional controls to evidence-based treatments, resulted in reduced effect sizes and many were non-significant. Mindfulness meditation practices had significantly superior effects than active controls for adults, children, employees, and health care professionals/trainees but not for students. They were superior for psychiatric disorders, substance use, smoking, and depression but not for physical health conditions, pain, weight/eating-related conditions, cancer, or anxiety. They were superior for stress, and psychiatric symptoms but not for sleep, physical health symptoms, objective measures, or physiological measures.

 

These findings are essentially summaries of summaries and are based upon a wide variety of different researchers, methodologies, cultures, and time frames. Yet, the results are fairly consistent. In comparison to doing nothing, passive controls, mindfulness meditation practices are very beneficial for a wide range of physical and psychological issues over a wide range of ages. But these practices when compared to other types of treatments, are less effective and at times not superior. Nevertheless, this meta-analysis of meta-analyses paints a clear picture of the wide-ranging efficacy of mindfulness meditation practices for the relief of physical and psychological issues. These results verify the unprecedented depth and breadth of benefits of mindfulness meditation practices.

 

So, improve physical and mental well-being with mindfulness meditation-based interventions.

 

Practicing mindfulness exercises can have many possible benefits, including: reduced stress, anxiety and depression, less negative thinking and distraction, and improved mood,” -Mayo Clinic

 

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

 

Goldberg, S. B., Riordan, K., Sun, S., & Davidson, R. J. (2021). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials. Perspectives on Psychological Science 1–23, DOI: 10.1177/1745691620968771

 

Abstract

In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on ≥4 trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k=336 RCTs, N=30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds=0.10-0.89). Effects were typically smaller and less often statistically significant when compared to active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. As MBIs show promise across some PICOS, future RCTs and meta-analyses should build upon identified strengths and limitations of this literature.

https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf

 

Decrease Defensiveness and Increase Psychological Health with Meditation

Decrease Defensiveness and Increase Psychological Health with Meditation

 

By John M. de Castro, Ph.D.

 

“Meditation is the habitual process of training your mind to focus and redirect your thoughts. . . People also use the practice to develop other beneficial habits and feelings, such as a positive mood and outlook, self-discipline, healthy sleep patterns, and even increased pain tolerance.” – Matthew Thorpe

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented.

 

Meditation practice has been shown to improve physical and psychological health and longevity. But people use defense mechanisms to cope with demanding emotional situations, including stress. It is not known if this defensiveness may interfere with the ability of meditation practice to improve the psychological health of the practitioners.

 

In today’s Research News article “Defensive Functioning Moderates the Effects of Nondirective Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876444/ )  Hersoug and colleagues recruited adult working professionals and had them attend a 2-hour seminar on stress management. Afterward they were assigned to either a no-treatment control condition or to receive 5 2-hour sessions over 8 weeks of open monitoring meditation training. They were measured before and after training and 1 and 4 months later for defense mechanisms, neuroticism, general health, insomnia, and musculoskeletal pain.

 

They found that in comparison to baseline and the control group, the group that received open monitoring meditation training had significant improvements in sleep, muscle pain, neuroticism, and general health. These improvements were maintained during the follow-up period. They also found that the levels of defense mechanisms moderated these improvements such that the greater the level of defensiveness, the smaller the impact of meditation training on the physical and psychological health of the participants.

 

The findings suggest that open monitoring meditation training is beneficial for the psychological and physical health of working professionals. This replicates previous findings that mindfulness training improves sleep, personality, health, and pain. The current study adds that these effects are negatively impacted by the level of defense mechanisms of the participants. In other words, using defense mechanisms when confronted by stress rather than seeing it for what it is interferes with the ability of open monitoring meditation to improve psychological functioning and health. This makes sense as open monitoring meditation practice is designed to improve the individual’s ability to see things as they are. Using defense mechanisms interferes with seeing things as they are.

 

So, decrease defensiveness and increase psychological health with meditation.

 

mindfulness meditation . . .  practices focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calmness, clarity and concentration.” – Daphne Davis

 

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

 

Hersoug, A. G., Wærsted, M., & Lau, B. (2021). Defensive Functioning Moderates the Effects of Nondirective Meditation. Frontiers in psychology, 12, 629784. https://doi.org/10.3389/fpsyg.2021.629784

 

Abstract

We have recently found that nondirective meditation facilitates stress reduction. This supplementary study investigated whether defensive functioning would moderate these beneficial effects. We explored the occurrence of defense mechanisms and the impact of defensive functioning on the outcome of companies’ stress management programs regarding worries nervousness, mental distress, sleep problems, and muscle pain. The sample was a population of active, working professionals recruited from Norwegian companies (n = 105). The intervention group obtained significant benefits on all outcome measures, but there were no effects in the control group. We analyzed defensive functioning with the self-report questionnaire, Life Style Index, at four time points. The healthy adults who participated had a low level of defense scores at the outset. There was a significant reduction in the level of defenses in both groups over the study period, 6 months. Defensive functioning significantly moderated the change of the outcome measures from baseline to follow-up in the intervention group, but not in the control group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876444/

 

Increase Quality of Life and Decrease Weight of Patients with Diabetes with Tai Chi

Increase Quality of Life and Decrease Weight of Patients with Diabetes with Tai Chi

 

By John M. de Castro, Ph.D.

 

“a regular tai chi exercise program may help lower blood glucose levels, allowing people with diabetes to better control their disease.” – Lindsey Getz

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetesTai Chi is mindfulness practice and a gentle exercise that has been found to improve the symptoms of Type 2 Diabetes. The research is accumulating. So, it is reasonable to examine what has been learned.

 

In today’s Research News article “Effect of Tai Chi on Quality of Life, Body Mass Index, and Waist-Hip Ratio in Patients With Type 2 Diabetes Mellitus: 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/PMC7851054/ ) Qin and colleagues review, summarize, and perform a meta-analysis of the published research studies of the effectiveness of Tai Chi practice in the treatment of Type 2 Diabetes. They found 18 published research studies, 15 of which were randomized controlled studies.

 

They report that the published research found that patients with Type 2 Diabetes who practiced Tai Chi had significant improvements in their quality of life including physical function, pain, overall health, vitality, social function, emotional function, and mental health dimensions. The research also found that Tai Chi practice produced significant reductions in body size as reflected in the waist-hip ration and the body mass index (BMI), but the improvements were equivalent to that produced by other aerobic exercises.

 

These are important findings as Type 2 Diabetes is so impactful on the health and longevity of large numbers of patients. The results suggest that Tai Chi practice reduces body size which is very important in improving metabolic and glucose control. As a consequence, it greatly improves the quality of life of the patients. It appears from the research that the exercise component of Tai Chi practice is important for the improvements as other aerobic exercises produce similar effects.

 

Some advantages of Tai Chi practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the physical and psychological symptoms experienced by patients with Type 2 Diabetes.

 

So, increase quality of life and decrease weight of patients with diabetes with Tai Chi.

 

Tai Chi exercises can improve blood glucose levels and improve the control of type 2 diabetes and immune system response.” – Anna Sophia McKenney

 

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

 

Qin, J., Chen, Y., Guo, S., You, Y., Xu, Y., Wu, J., Liu, Z., Huang, J., Chen, L., & Tao, J. (2021). Effect of Tai Chi on Quality of Life, Body Mass Index, and Waist-Hip Ratio in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Frontiers in endocrinology, 11, 543627. https://doi.org/10.3389/fendo.2020.543627

 

Abstract

Background

Type 2 diabetes mellitus (T2DM) is a worldwide public health concern with high morbidity and various progressive diabetes complications that result in serious economic expenditure and social burden. This systematic review aims to evaluate the effect of Tai Chi on improving quality of life (QoL), body mass index (BMI) and waist-hip ratio (WHR) in patients with T2DM.

Method

A systematic review and meta-analysis was performed following PRISMA recommendation. Four English databases and three Chinese databases were searched. The PEDro scale was used to assess the methodological quality of including studies. Study inclusion criteria: randomized controlled trials (RCTs) and quasi-experimental studies were included, patients with T2DM that adopted Tai Chi as intervention and QoL, BMI and/or WHR as outcome measurements.

Results

Eighteen trials were included. The aggregated results of seven trials showed that Tai Chi statistically significantly improved QoL measured by the SF-36 on every domains (physical function: MD = 7.73, 95% confidence interval (CI) = 1.76 to 13.71, p = 0.01; role-physical function: MD = 9.76, 95% CI = 6.05 to 13.47, p < 0.001; body pain: MD = 8.49, 95% CI = 1.18 to 15.8, p = 0.02; general health: MD = 9.80, 95% CI = 5.77 to 13.82, p < 0.001; vitality: MD = 6.70, 95% CI = 0.45 to 12.94, p = 0.04; social function: MD = 9.1, 95% CI = 4.75 to 13.45, p < 0.001; role-emotional function: MD = 7.88, 95% CI = 4.03 to 11.72, p < 0.001; mental health: MD = 5.62, 95% CI = 1.57 to 9.67, p = 0.006) and BMI (MD = −1.53, 95% CI = −2.71 to −0.36, p < 0.001) compared with control group (wait list; no intervention; usual care; sham exercise).

Conclusion

Tai Chi could improve QoL and decrease BMI for patients with T2DM, more studies are needed to be conducted in accordance with suggestions mentioned in this review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851054/

 

Improve Brain Function and Mental Health in Chronic Pain Patients with Mindfulness

Improve Brain Function and Mental Health in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“With the ACT approach, learning to let go of behaviors, memories, thoughts, and emotions creates space to explore new experiences, including acceptance of chronic pain sensations.” – Rosemary Black

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

Hence, it is important to find an effective method to treat Chronic pain. There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alter the brain’s processing of pain. So, it makes sense to study the how Acceptance and Commitment Therapy (ACT) may affect the brain to improve the mental health of chronic pain patients.

 

In today’s Research News article “Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/ ) Aytur and colleagues recruited with musculoskeletal pain who did not abuse opioids. They completed 2 sessions per week for 4 weeks of Acceptance and Commitment Therapy (ACT). Before and after therapy they were measured for acceptance, chronic pain acceptance, quality of life, pain interference, and depression. Brain systems were measured before and after therapy with functional Magnetic Resonance Imaging (fMRI).

 

They found that in comparison to baseline after Acceptance and Commitment Therapy (ACT) the participants had significant increases in acceptance, chronic pain acceptance, quality of life and significant decreases in pain interference, and depression. In the fMRIs they also observed significant decreases in activation and connectivity in the Default Mode Network (DMN), Salience Network (SN), and Frontal-Parietal Network (FPN) networks of the brain. In addition, they observed that changes in the connectivity between these networks were correlated with decreases in depression and pain interference, and increases in quality of life.

 

These are interesting results that need to be interpreted with caution as there wasn’t a control, comparison condition present opening the findings up to alternative confounded interpretations. But the results replicate previous findings with controlled designs that Acceptance and Commitment Therapy (ACT) produces improvements in depression, pain, and quality of life. So, the improvements observed in the present study are likely due to causal effects of ACT.

 

These results also show that the psychological improvements produced by Acceptance and Commitment Therapy (ACT) are related to changes in the activity and connectivity within and between significant brain networks. This suggests that these neural alterations may underly the improvements in mental health of chronic pain patients produced by ACT. It remains for future studies to unravel the cause effect relationships.

 

So, improve brain function and mental health in chronic pain patients with mindfulness.

 

ACT can help us to break out of that box that we have created for ourselves. To understand that the key to living with our condition is not to limit our lives and miss out on experiences, but instead to face things head on and be dedicated to working with our pain and doing things that bring us joy. ACT’s goal is not necessarily to reduce the pain but to help you to live your life with it, to feel more confident in engaging in activities that you might have otherwise swayed away from.” – Ann-Marie D’arcy-Sharpe

 

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

 

Aytur, S. A., Ray, K. L., Meier, S. K., Campbell, J., Gendron, B., Waller, N., & Robin, D. A. (2021). Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach. Frontiers in human neuroscience, 15, 587018. https://doi.org/10.3389/fnhum.2021.587018

 

Abstract

Over 100 million Americans suffer from chronic pain (CP), which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year (Institute of Medicine, 2011). Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy (CBT) can be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy (ACT) has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions (Gutierrez et al., 2004). However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women (n = 9) with chronic musculoskeletal pain. Functional magnetic resonance imaging (fMRI) data were collected pre- and post-ACT, and changes in functional connectivity (FC) were measured using Network-Based Statistics (NBS). Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire (AAQ-II), the Chronic Pain Acceptance Questionnaire (CPAQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the NIH Toolbox Neuro-QoLTM (Quality of Life in Neurological Disorders) scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection (default mode, DMN), emotion (salience, SN), and cognitive control (frontal parietal, FPN). These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/

 

Self-centeredness Moderates the Effect of Mindfulness on Psychological Health

 

Improve Physical Function in Chronic Pain Patients with Mind-Body Practice

 

By John M. de Castro, Ph.D.

 

“mind-body practices like tai chi, yoga, mindfulness and cognitive-behavioral therapy can all relieve lower back pain effectively.” – Wayne Jonas

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating painYoga practice has been shown to have a myriad of health benefits. These include relief of chronic painYoga practice has also been shown to be effective for the relief of chronic pain.  Other mind-body  practices such as Tai Chi  improves spinal health and reduces pain. Since mind body practices involve exercise, it would seem reasonable to look at the effectiveness of mind-body practices in improving physical function and relieving pain in chronic pain patients.

 

In today’s Research News article “Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872894/ )  Greenberg and colleagues recruited patients with chronic musculoskeletal pain and randomly assigned them to 10-week mind-body physical activity programs either with or without a Fitbit activity monitor. The programs consisted of 10 weekly 90-minute sessions teaching mindfulness, deep breathing, pain-specific cognitive behavioral skills, physical restoration skills, and education on the disability spiral. They were measured before and after training for physical function, disability, walking distance, and accelerometer-based steps, kinesiophobia (fear of movement due to pain), pain resilience, mindfulness, and pain catastrophizing.

 

Using multilevel linear modelling, they found that compared to baseline, after treatment, there were significant increases in walking distance, step count, pain resilience and mindfulness, and a significant decrease in kinesiophobia and disability. Mediation analysis revealed that the improvement in disability was due to increases in pain resilience and mindfulness and decreases in kinesiophobia. For the walk test, only decreases in kinesiophobia mediated the improvement.

 

It should be noted that there wasn’t a control condition as both groups received the mind-body physical activity program. So, it is possible that confounds such as placebo effects and time-based healing may be operative. So, conclusions must be reached with caution. That being said, the results suggest that mind-body physical activity program improves physical function in chronic pain patients. The improvements are associated with increases in mindfulness, and pain resilience and decreases in kinesiophobia. But these variables only appear to mediate the effects of the training with regard to disability.

 

Mindfulness has been well documented to improve the disability of chronic pain patients. It is not surprising that the ability to be resilient in the face of pain and the lowering the fear of moving with pain are also helpful. Chronic pain makes life miserable for the patients and the effectiveness of the mind-body physical activity program in improving physical ability is helpful to some extent in decreasing the disability resulting from the pain and reducing the patient’s suffering.

 

So, improve physical function in chronic pain patients with mind-body practice.

 

The mind, emotions and attention play an important role in the experience of pain. In patients with chronic pain, stress, fear and depression can amplify the perception of pain. Mind-body approaches act to change a person’s mental or emotional state or utilise physical movement to train attention or produce mental relaxation.” – Craig Hassed

 

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

 

Greenberg, J., Mace, R. A., Bannon, S. M., Kulich, R. J., & Vranceanu, A. M. (2021). Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function. Journal of pain research, 14, 359–368. https://doi.org/10.2147/JPR.S298212

 

Abstract

Background

Improving physical function among patients with chronic pain is critical for reducing disability and healthcare costs. However, mechanisms underlying improvement in patient-reported, performance-based, and ambulatory physical function in chronic pain remain poorly understood.

Purpose

To explore psychosocial mediators of improvement in patient-reported, performance-based, and objective/accelerometer-measured physical function among participants in a mind-body activity program.

Methods

Individuals with chronic pain were randomized to one of two identical 10-week mind-body activity interventions aimed at improving physical function with (GetActive-Fitbit; N=41) or without (GetActive; N=41) a Fitbit device. They completed self-reported (WHODAS 2.0), performance-based (6-minute walk test), and objective (accelerometer-measured step-count) measures of physical function, as well as measures of kinesiophobia (Tampa Kinesiophobia Scale), mindfulness (CAMS-R), and pain resilience (Pain Resilience Scale) before and after the intervention. We conducted secondary data analyses to test mediation via mixed-effects modeline.

Results

Improvements in patient-reported physical function were fully and uniquely mediated by kinesiophobia (Completely Standardized Indirect Effect (CSIE)=.18; CI=0.08, 0.30; medium-large effect size), mindfulness (CSIE=−.14; CI=−25, −.05; medium effect size) and pain resilience (CSIE=−.07; CI=−.16, −.005; small-medium effect size). Improvements in performance-based physical function were mediated only by kinesiophobia (CSIE=−.11; CI=−23, −.008; medium effect size). No measures mediated improvements in objective (accelerometer measured) physical function.

Conclusion

Interventions aiming to improve patient-reported physical function in patients with chronic pain may benefit from skills that target kinesiophobia, mindfulness, and pain resilience, while those focused on improving performance-based physical function should target primarily kinesiophobia. More research is needed to understand mechanisms of improvement in objective, accelerometer-measured physical function.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872894/

 

Reduce Migraine Symptoms with Yoga or Physical Therapy

Reduce Migraine Symptoms with Yoga or Physical Therapy

 

By John M. de Castro, Ph.D.

 

“Overall, yoga improved the cardiac autonomic balance. Disturbances in the autonomic nervous system and in the regulation of the circulatory system are associated with migraines. If balance is restored, the likelihood of a migraine is reduced.” – Debra Sullivan

 

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, exercise, 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. Yoga is both a mindfulness practice and an exercise. It has also been shown to help reduce pain. Hence, it may be effective in treating migraines.

 

In today’s Research News article “Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846311/ ) Mehta and colleagues recruited adult patients diagnosed with migraine headaches and randomly assigned them to either standard care or to receive standard care plus either yoga training or physical therapy. They were trained and then practiced at home daily for 3 months. Before training, at 1 and 2-months during training, and after training they were measured for headache pain and headache frequency and headache impact.

 

They found that all three groups had significant reductions in migraine frequency, severity (pain), and impact on life. Both yoga and physical therapy reduced frequency and impact on life to a significantly greater extent than standard care.

 

These findings suggest that either yoga or physical therapy when added to standard care for migraine headache produces significant additional improvements in the symptoms of migraine headaches. The fact that yoga and physical therapy did not differ in effectiveness suggests that the physical exercise provided by yoga is the reason for yoga’s effectiveness. These findings suggest that yoga practice or physical therapy should be added to the standard care for patients with Migraine headaches.

 

So, reduce migraine symptoms with yoga or physical therapy.

 

Yoga’s postures, deep breathing and meditation . . . could be very helpful in both treating migraine and fighting the disability associated with migraine.” – American Migraine Foundation

 

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

 

Mehta, J. N., Parikh, S., Desai, S. D., Solanki, R. C., & G. Pathak, A. (2021). Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine. Journal of Neurosciences in Rural Practice, 12(1), 60–66. https://doi.org/10.1055/s-0040-1718842

 

Abstract

Objective  We aimed to evaluate and compare the effectiveness of physical and yoga therapies as an adjuvant therapy along with standard pharmacologic treatment in patients with migraine.

Materials and Methods  A total of 61 consenting patients diagnosed to have migraine were randomized into three groups to receive either standard treatment alone, physical therapy along with standard treatment, or yoga therapy along with standard treatment. The respective adjuvant intervention was taught to the respective group of patients and they were advised to perform it daily for 3 months with weekly telephonic reminders and review of their activity logs. Outcome measures assessed were headache frequency, Short-Form McGill Pain Questionnaire (SF-MPQ), and Headache Impact Test-6 (HIT-6) at recruitment and once every month for 3 months.

Statistical Analysis  Statistical analysis of the study was done by using Stata 14.1 software. All the descriptive statistics, paired t -test was used to compare the difference between pre and postintervention values of headache frequency, SF-MPQ, and HIT-6 score within all the three groups. Analysis of variance test and post hoc test were used to compare the differences between all groups for outcome measures ( p < 0.05).

Results  Headache frequency and the visual analog scale before intervention compared during each month intervals for 3 months in all the three groups were significantly decreased in all the three groups ( p < 0.005). Yoga or physical therapy as an adjuvant to standard treatment leads to a higher reduction in headache frequency and severity. Sensory and affective pain ratings of SF-MPQ and HIT-6 also showed a significant improvement at 1 to 3 months of treatment compared with baseline in all the three groups.

Conclusion  Either physical or yoga therapy as an adjuvant to standard pharmacologic treatment may further improve the quality of life and reduce headache frequency in patients with migraine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846311/