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Rubio-Zarapuz A, Apolo-Arenas MD, Fernandes O, Tornero-Aguilera JF, Clemente-Suárez VJ, Parraca JA. Comparative Efficacy of Neuromodulation and Structured Exercise Program on Autonomic Modulation in Fibromyalgia Patients: Pilot Study. J Clin Med 2024; 13:4288. [PMID: 39124555 PMCID: PMC11313562 DOI: 10.3390/jcm13154288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Fibromyalgia is a chronic disorder marked by widespread muscle and joint pain, persistent fatigue, sleep disturbances, and irregularities in the autonomic nervous system (ANS). Methods: This study compared the effectiveness of neuromodulation using the EXOPULSE Mollii suit with a structured exercise program in regulating ANS function in fibromyalgia patients. In this randomized, longitudinal crossover study, 10 female patients were randomly assigned to either the Suit + Exercise group or the Exercise + Suit group. Each group participated in two sessions per week for eight weeks, followed by a two-week washout period before switching to the other intervention. We measured cortical arousal, microcirculation, and heart rate variability (HRV) before and after the 1st, 8th, and 16th sessions. Results: The results showed significant improvements in cortical arousal, HRV, and microcirculation with the neuromodulation treatment whereas the exercise program only produced short-term improvements in cortical arousal. Conclusion: The EXOPULSE Mollii suit exhibited cumulative benefits on ANS modulation over time, suggesting potential long-term advantages for managing fibromyalgia. However, further research is needed to explore the delayed effects of both treatments on ANS modulation.
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Affiliation(s)
- Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.R.-Z.); (J.F.T.-A.); (V.J.C.-S.)
| | - María Dolores Apolo-Arenas
- Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Universidad de Extremadura, 06006 Badajoz, Spain;
- Research Group PhysioH, University of Extremadura, 06006 Badajoz, Spain
| | - Orlando Fernandes
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), University of Évora, 7004-516 Évora, Portugal
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.R.-Z.); (J.F.T.-A.); (V.J.C.-S.)
| | - Vicente J. Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.R.-Z.); (J.F.T.-A.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| | - Jose A. Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), University of Évora, 7004-516 Évora, Portugal
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Wang X, Luo H. Effects of traditional Chinese exercise therapy on pain scores, sleep quality, and anxiety-depression symptoms in fibromyalgia patients: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:99. [PMID: 38281020 PMCID: PMC10821260 DOI: 10.1186/s12891-024-07194-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.
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Affiliation(s)
- Xinzheng Wang
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China
| | - Hongbin Luo
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China.
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3
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Lanario JW, Hudson E, Locher C, Dee A, Elliot K, Davies AF. Body reprogramming for fibromyalgia and central sensitivity syndrome: A preliminary evaluation. SAGE Open Med 2023; 11:20503121231207207. [PMID: 37920842 PMCID: PMC10619357 DOI: 10.1177/20503121231207207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/26/2023] [Indexed: 11/04/2023] Open
Abstract
Objectives Central sensitivity syndrome disorders such as fibromyalgia, provoke continued debate, highlighting diagnostic and therapeutic uncertainty. The Hyland model provides a way of understanding and treating the medically unexplained symptoms of central sensitivity syndromes using complexity theory and principles of adaption in network systems. The body reprogramming is a multi-modal intervention based on the Hyland model designed for patients living with medically unexplained symptoms. This preliminary, naturalistic and single-arm service evaluation set out to evaluate outcome after attending a body reprogramming course in patients living with fibromyalgia or central sensitivity syndrome. Methods Patients diagnosed with fibromyalgia or central sensitivity syndrome were recruited. The body reprogramming courses consisting of eight sessions, each 2.5 h in length, were run at two study sites in England. Data were collected at baseline, post course and 3-months post course using questionnaires assessing symptomatology (FIQR/SIQR), Depression (PHQ9), Anxiety (GAD7) and quality of life (GQoL). Repeated measures t-tests were used, and all comparisons were conducted on an intention to treat basis. Results In total, 198 patients with a mean age of 47.73 years were enrolled on the body reprogramming courses. Statistically and clinically significant improvement were observed in the FIQR from baseline to post course (mean change: 11.28) and baseline to follow-up (mean change: 15.09). PHQ9 scores also improved significantly from baseline to post course (mean reduction 3.72) and baseline to follow-up (mean reduction 5.59). Conclusions Our study provides first evidence that the body reprogramming intervention is an effective approach for patients living with fibromyalgia or central sensitivity syndromes on a variety of clinical measures. Besides these promising results, important limitations of the study are discussed, and larger randomized controlled trials are clearly warranted.
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Affiliation(s)
| | - Esther Hudson
- Cornwall Partnership NHS Foundation Trust, Redruth, Cornwall, UK
| | - Cosima Locher
- Faculty of Health, University of Plymouth, Plymouth, UK
- University Hospital Zurich, Zurich, Switzerland
| | - Annily Dee
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Kerry Elliot
- Royal Cornwall Hospital NHS Trust, Truro, Cornwall, UK
| | - Anthony F Davies
- Faculty of Health, University of Plymouth, Plymouth, UK
- University Hospitals Plymouth NHS Trust, Plymouth, UK
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4
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Giorgi V, Farah S, Salaffi F, Butera G, Sarzi-Puttini P. Feldenkrais awareness though movement intervention for fibromyalgia syndrome: A proof-of-concept study. J Bodyw Mov Ther 2023; 36:320-326. [PMID: 37949579 DOI: 10.1016/j.jbmt.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/20/2023] [Accepted: 08/17/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION The Feldenkrais Method® is a form of awareness through movement (ATM) aimed at improving spatial and kinesthetic awareness through verbally guided movements, in order to learn more effective actions. METHOD The present study, a proof-of-concept, observational, non-controlled prospective study, aims at exploring the effectiveness of ATM for fibromyalgia syndrome (FM), measuring the effect by means of multi-dimensional questionnaires, administered at baseline and after 4 months of ATM activity. RESULTS One hundred twenty-eight FM patients (mean age 54 years old, 2% males) participated in the study. A statistically significant improvement was found in FM-specific measures (Polysymptomatic Distress Scale, PDS) (p = 0.003) and the Pain Catastrophization Scale (PCS) (p = 0.020); coherently, the Revised Fibromyalgia Impact Questionnaire (FIQR) showed a trend in improvement after the intervention, although this improvement was not statistically significant. The logistic regression analysis found a correlation between PDS, fatigue and anxiety measures; PCS, years from diagnosis and anxiety. CONCLUSION ATM could improve FM-specific measures and pain-related catastrophizing. Further studies are needed to identify FM subgroups in order to find personalized targets that can be used to guide treatments.
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Affiliation(s)
- Valeria Giorgi
- Rheumatology Unit, IRCCS Istituto Galeazzi - Sant'Ambrogio, Milan, Italy.
| | - Sonia Farah
- Rheumatology Department, Polytechnic University of Marche, Jesi, AN, Italy.
| | - Fausto Salaffi
- Rheumatology Department, Polytechnic University of Marche, Jesi, AN, Italy.
| | - Gabriella Butera
- Rheumatology Unit, IRCCS Istituto Galeazzi - Sant'Ambrogio, Milan, Italy.
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Shi Y, Wu W. Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress. BMC Med 2023; 21:372. [PMID: 37775758 PMCID: PMC10542257 DOI: 10.1186/s12916-023-03076-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Chronic pain conditions impose significant burdens worldwide. Pharmacological treatments like opioids have limitations. Non-invasive non-pharmacological therapies (NINPT) encompass diverse interventions including physical, psychological, complementary and alternative approaches, and other innovative techniques that provide analgesic options for chronic pain without medications. MAIN BODY This review elucidates the mechanisms of major NINPT modalities and synthesizes evidence for their clinical potential across chronic pain populations. NINPT leverages peripheral, spinal, and supraspinal mechanisms to restore normal pain processing and limit central sensitization. However, heterogeneity in treatment protocols and individual responses warrants optimization through precision medicine approaches. CONCLUSION Future adoption of NINPT requires addressing limitations in standardization and accessibility as well as synergistic combination with emerging therapies. Overall, this review highlights the promise of NINPT as a valuable complementary option ready for integration into contemporary pain medicine paradigms to improve patient care and outcomes.
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Affiliation(s)
- Yu Shi
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Wen Wu
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.
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Cuenca-Martínez F, Suso-Martí L, Fernández-Carnero J, Muñoz-Alarcos V, Sempere-Rubio N. Exercise-based interventions on sleep quality in patients with fibromyalgia syndrome: An umbrella and mapping review with meta-analysis. Semin Arthritis Rheum 2023; 61:152216. [PMID: 37229847 DOI: 10.1016/j.semarthrit.2023.152216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023]
Abstract
The main aim of this umbrella review was to assess the impact of exercise-based interventions (EBIs) on sleep quality in patients with fibromyalgia syndrome (FMS). We searched systematically in PubMed, PEDro, EMBASE, CINAHL, SPORTDiscus and Google Scholar. Methodological quality was analyzed using AMSTAR and ROBIS scale, and the strength of evidence was established according to GRADE. Nine systematic reviews were included. Meta-analysis (MA) of primary studies (n = 42) were performed with a random-effects model. The MA revealed a moderate statistically significant effect of EBIs (SMD=-0.46 [-0.69 to -0.23]). Subgroup analyses by type of exercise showed significant effect of body-mind exercises (SMD=-0.55 [-0.86 to -0.23]) and combined exercises (SMD=-1.11 [-2.12 to -0.11]) but not for aerobic (SMD=-0.04 [-0.15 to 0.07]) or strength (SMD=-0.52 [-1.14 to 0.1]) exercises in isolation. The results obtained showed that EBIs were effective in improving sleep quality compared to minimal intervention, no intervention or usual care, with a low certainty of evidence. Subgroup analyses showed that mind-body and combined exercises elicited the strongest effect, while aerobic and strength exercise in isolation did not show significant effects.
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Affiliation(s)
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain.
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain; Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain; La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain; Grupo de investigación en Neurociencia cognitiva, dolor y rehabilitación en ciencias de la salud de la Universidad Rey Juan Carlos, NECODOR, Madrid, Spain
| | - Vicente Muñoz-Alarcos
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
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You T, Leveille SG, Yeh GY, Wayne PM. Is Tai Chi beneficial for multisite pain syndrome in older adults? Aging Clin Exp Res 2023; 35:1443-1448. [PMID: 37256489 PMCID: PMC10428171 DOI: 10.1007/s40520-023-02439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/08/2023] [Indexed: 06/01/2023]
Abstract
Chronic musculoskeletal pain is prevalent and undertreated in older adults. In particular, multisite pain is associated with serious functional consequences and falls and appears to be a novel geriatric syndrome. The causes of multisite pain are often multifactorial, and emerging evidence supports a complex pathway whereby multisite pain leads to cognitive problems, mobility decline, fear of falling, falls, and reduced participation in life roles. A few pharmacologic approaches are safe and effective for older adults with chronic multisite pain and evidence for effectiveness of non-pharmacologic treatments for this common condition is very limited. Compared to light physical exercise, mind-body exercise may prove to be more beneficial for older adults living with chronic pain. Tai Chi, as a movement-based mind-body exercise, can relieve pain symptoms, improve cognition and physical function, and lower risk for falls in older adults. However, little is known about the potential benefits of Tai Chi for older adults with multisite pain syndrome. Future large-scale randomized-controlled trials are needed to investigate the effectiveness of Tai Chi in alleviating pain and lowering fall risk in older adults with multisite pain, and the biological mechanisms that underlie its potential benefits to chronic pain, physical and cognitive functions, and falls in this at-risk population.
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Affiliation(s)
- Tongjian You
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA.
| | - Suzanne G Leveille
- Department of Nursing, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Gloria Y Yeh
- Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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8
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Kocyigit BF, Sagtaganov Z, Yessirkepov M, Akyol A. Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome. Rheumatol Int 2023; 43:617-625. [PMID: 36583800 PMCID: PMC9801164 DOI: 10.1007/s00296-022-05267-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022]
Abstract
A wide variety of musculoskeletal, arthritic, connective tissue, and vasculitic diseases fall under the umbrella of "rheumatic diseases". Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the three members of this disease group with relatively high prevalence. Pharmacological options are at the center of therapeutic algorithms in treating rheumatic diseases, particularly in reducing inflammation. Despite significant advances in pharmacological treatment in recent years, achieving complete treatment success in a group of patients is impossible. Therefore, patients with rheumatic diseases frequently utilize alternative treatment options, such as complementary and alternative medicine. Complementary and alternative medicine is a broad category of health practices not part of the leading health system. Patients with rheumatic diseases turn to complementary and alternative medicine for various reasons, including restricted access to some treatments due to high prices and rigorous regulations, worries about drug side effects, and symptoms that continue despite pharmacological treatment. In addition, because complementary and alternative medicine options are considered natural, they are frequently accepted as well tolerated and have few harmful effects. Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the primary foci of this comprehensive review. First, we attempted to summarize the non-traditional physical medicine and complementary and alternative medicine options that can be utilized to manage these diseases. Second, we addressed the link between exercise and inflammation in rheumatic diseases. We briefly discussed the possible benefits of exercise-based approaches. In addition, we highlighted the benefits of cooperation between rheumatology and physical medicine-rehabilitation clinics.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
| | - Zhaxybek Sagtaganov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Ahmet Akyol
- Physiotherapy and Rehabilitation Application and Research Center, Hasan Kalyoncu University, Gaziantep, Turkey
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Rodríguez-Almagro D, Del Moral-García M, López-Ruiz MDC, Cortés-Pérez I, Obrero-Gaitán E, Lomas-Vega R. Optimal dose and type of exercise to reduce pain, anxiety and increase quality of life in patients with fibromyalgia. A systematic review with meta-analysis. Front Physiol 2023; 14:1170621. [PMID: 37123268 PMCID: PMC10130662 DOI: 10.3389/fphys.2023.1170621] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
The aim of our meta-analysis was to compile the available evidence to evaluate the effect of physical exercise-based therapy (PEBT) on pain, impact of the disease, quality of life (QoL) and anxiety in patients with fibromyalgia syndrome (FMS), to determine the effect of different modes of physical exercise-based therapy, and the most effective dose of physical exercise-based therapy for improving each outcome. A systematic review and meta-analysis was carried out. The PubMed (MEDLINE), SCOPUS, Web of Science, CINAHL Complete and Physiotherapy Evidence Database (PEDro) databases were searched up to November 2022. Randomized controlled trials (RCTs) comparing the effects of physical exercise-based therapy and other treatments on pain, the impact of the disease, QoL and/or anxiety in patients with FMS were included. The standardized mean difference (SMD) and a 95% CI were estimated for all the outcome measures using random effect models. Three reviewers independently extracted data and assessed the risk of bias using the PEDro scale. Sixty-eight RCTs involving 5,474 participants were included. Selection, detection and performance biases were the most identified. In comparison to other therapies, at immediate assessment, physical exercise-based therapy was effective at improving pain [SMD-0.62 (95%CI, -0.78 to -0.46)], the impact of the disease [SMD-0.52 (95%CI, -0.67 to -0.36)], the physical [SMD 0.51 (95%CI, 0.33 to 0.69)] and mental dimensions of QoL [SMD 0.48 (95%CI, 0.29 to 0.67)], and the anxiety [SMD-0.36 (95%CI, -0.49 to -0.25)]. The most effective dose of physical exercise-based therapy for reducing pain was 21-40 sessions [SMD-0.83 (95%CI, 1.1--0.56)], 3 sessions/week [SMD-0.82 (95%CI, -1.2--0.48)] and 61-90 min per session [SMD-1.08 (95%CI, -1.55--0.62)]. The effect of PEBT on pain reduction was maintained up to 12 weeks [SMD-0.74 (95%CI, -1.03--0.45)]. Among patients with FMS, PEBT (including circuit-based exercises or exercise movement techniques) is effective at reducing pain, the impact of the disease and anxiety as well as increasing QoL. Systematic Review Registration: PROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021232013.
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Affiliation(s)
| | | | | | | | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaén, Jaén, Spain
- *Correspondence: Esteban Obrero-Gaitán,
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Yang GY, Hunter J, Bu FL, Hao WL, Zhang H, Wayne PM, Liu JP. Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials. Syst Rev 2022; 11:260. [PMID: 36463306 PMCID: PMC9719113 DOI: 10.1186/s13643-022-02100-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. METHODS Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method. RESULTS Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol. CONCLUSIONS The findings suggest Tai Chi has multidimensional effects, including physical, psychological and quality of life benefits for a wide range of conditions, as well as multimorbidity. Clinically important benefits were most consistently reported for Parkinson's disease, falls risk, knee osteoarthritis, low back pain, cerebrovascular, and cardiovascular diseases including hypertension. For most conditions, higher-quality SRs with rigorous primary studies are required. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021225708.
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Affiliation(s)
- Guo-Yan Yang
- grid.1029.a0000 0000 9939 5719NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | | | - Fan-Long Bu
- grid.411609.b0000 0004 1758 4735National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045 China
| | - Wen-Li Hao
- grid.410612.00000 0004 0604 6392Public Health School, Inner Mongolia Medical University, Hohht, 010000 Inner Mongolia China
| | - Han Zhang
- grid.24695.3c0000 0001 1431 9176School of Acupuncture and Massage, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Peter M. Wayne
- grid.38142.3c000000041936754XOsher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215 USA
| | - Jian-Ping Liu
- grid.24695.3c0000 0001 1431 9176Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029 China
- grid.10919.300000000122595234The Faculty of Health Science, Department of Community Medicine, UiT The Arctic University of Norway, The National Research Center in Complementary and Alternative Medicine – NAFKAM, Hansine Hansens veg 19, 9037 Tromsø, Norway
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Qi F, Soh KG, Mohd Nasirudddin NJ, Mai Y. Effects of taichi on physical and psychological health of college students: A systematic review. Front Physiol 2022; 13:1008604. [PMID: 36246109 PMCID: PMC9562146 DOI: 10.3389/fphys.2022.1008604] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/09/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Increasing studies have documented taichi’s usefulness in physical and psychological health in various participants, especially patients or the elderly. However, there is a need for a systematic review to evaluate its effects and health benefits among college students. Objective:The present study aims to evaluate the current literature surrounding the effects of taichi on physical and psychological health among college students and identify the experimental areas for future research to establish guidelines for learning and teaching taichi in university. Methods: The literature search involved several databases (PubMed, EBSCOhost, Web of Science, Scopus, and China National Knowledge Infrastructure). Subsequent research utilised the Preferred Reporting Items for Systematic Reviews and PRISMA checklist. In addition, the “QualSyst” tool assessed the quality of full-text articles. Results: A total of 22 articles were analysed, out of which eight were strong, and 14 were of moderate quality. It is challenging to conduct a meta-analysis since the research contents were distributed differently. The general finding demonstrated that Taichi interventions have beneficial effects on college students. For example, the physical and psychological health benefits compared to other control groups include balance, leg strength, flexibility, cardiopulmonary functions, reducing stress, anxiety, and depression, and improving attention. However, there are some uncertain parameters in a state of poor or no evidence, such as upper strength, mood, and psychoticism. Conclusion: Overall, this study shows that Taichi exercise is beneficial for college students compared to the control group. Evidence of health benefits for females is more than males. In addition, the current evidence showed that the effectiveness of taichi does not match some other sports such as Pilates, Yoga, Mindfulness courses, and even bodybuilding exercise. This research analyzed the mind-body mechanism of included studies. It revealed that it is difficult for college students, as a beginner of Taichi, to regulate an even breathing and quiet mind while maintaining low posture movements. Therefore, this study assumes that relaxation theories and approaches of Taichi that are easier to understand and closer to Chinese traditional Taichi theory are more appropriate in the research trials compared with coordination theory. Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021278032.
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Affiliation(s)
- Fengmeng Qi
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Henan Polytechnic University, Jiaozuo, China
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- *Correspondence: Kim Geok Soh,
| | | | - Yiqiang Mai
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
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Li Y, Wu K, Hu X, Xu T, Li Z, Zhang Y, Li K. Altered Effective Connectivity of Resting-State Networks by Tai Chi Chuan in Chronic Fatigue Syndrome Patients: A Multivariate Granger Causality Study. Front Neurol 2022; 13:858833. [PMID: 35720086 PMCID: PMC9203735 DOI: 10.3389/fneur.2022.858833] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/05/2022] [Indexed: 12/05/2022] Open
Abstract
Numerous evidence has shown that patients with chronic fatigue syndrome (CFS) have changes in resting brain functional connectivity, but there is no study on the brain network effect of Tai Chi Chuan intervention in CFS. To explore the influence of Tai Chi Chuan exercise on the causal relationship between brain functional networks in patients with CFS, 21 patients with CFS and 19 healthy controls were recruited for resting-state functional magnetic resonance imaging (rs-fMRI) scanning and 36-item Short-Form Health Survey (SF-36) scale assessment before and after 1month-long training in Tai Chi Chuan. We extracted the resting brain networks using the independent component analysis (ICA) method, analyzed the changes of FC in these networks, conducted Granger causality analysis (GCA) on it, and analyzed the correlation between the difference causality value and the SF-36 scale. Compared to the healthy control group, the SF-36 scale scores of patients with CFS were lower at baseline. Meanwhile, the causal relationship between sensorimotor network (SMN) and default mode network (DMN) was weakened. The above abnormalities could be improved by Tai Chi Chuan training for 1 month. In addition, the correlation analyses showed that the causal relationship between SMN and DMN was positively correlated with the scores of Role Physical (RP) and Bodily Pain (BP) in CFS patients, and the change of causal relationship between SMN and DMN before and after training was positively correlated with the change of BP score. The findings suggest that Tai Chi Chuan is helpful to improve the quality of life for patients with CFS. The change of Granger causality between SMN and DMN may be a readout parameter of CFS. Tai Chi Chuan may promote the functional plasticity of brain networks in patients with CFS by regulating the information transmission between them.
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Affiliation(s)
- Yuanyuan Li
- Department of Neurology and Stroke Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Kang Wu
- Department of Neurology and Stroke Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaojie Hu
- Department of Rehabilitation, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianjiao Xu
- Department of Neurology and Stroke Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yong Zhang
- Department of Rehabilitation, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Yong Zhang
| | - Kuangshi Li
- Department of Rehabilitation, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Kuangshi Li
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13
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Fogaça LZ, Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Front Public Health 2022; 9:659075. [PMID: 34988045 PMCID: PMC8722380 DOI: 10.3389/fpubh.2021.659075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
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Affiliation(s)
| | | | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health (CABSIn), São Paulo, Brazil
| | - Carmen Verônica Mendes Abdala
- BIREME (Latin American and Caribbean Center on Health Sciences Information) - Pan American Health Organization/World Health Organization (PAHO/WHO), São Paulo, Brazil
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Cortés-Pérez I, Zagalaz-Anula N, Ibancos-Losada MDR, Nieto-Escámez FA, Obrero-Gaitán E, Osuna-Pérez MC. Virtual Reality-Based Therapy Reduces the Disabling Impact of Fibromyalgia Syndrome in Women: Systematic Review with Meta-Analysis of Randomized Controlled Trials. J Pers Med 2021; 11:1167. [PMID: 34834518 PMCID: PMC8621064 DOI: 10.3390/jpm11111167] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Virtual reality-based therapy (VRBT) is a novel therapeutic approach to be used in women with fibromyalgia syndrome (FMS). The aim of our study is to assess the effect of VRBT to reduce the impact of FMS in outcomes such as pain, dynamic balance, aerobic capacity, fatigue, quality of life (QoL), anxiety and depression. METHODS Systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science and CINAHL until April 2021 in accordance with PRISMA guidelines. We included randomized controlled trials (RCTs) that compare VRBT versus others to assess the mentioned outcomes in women with FMS. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). RESULTS Eleven RCTs involving 535 women with FMS were included. Using the PEDro scale, the mean methodological quality of the included studies was moderate (6.63 ± 0.51). Our findings showed an effect of VRBT on the impact of FMS (SMD -0.62, 95% CI -0.93 to -0.31); pain (SMD -0.45, 95% CI -0.69 to -0.21); dynamic balance (SMD -0.76, 95% CI -1.12 to -0.39); aerobic capacity (SMD 0.32, 95% CI 0.004 to 0.63); fatigue (SMD -0.58, 95% CI -1.02 to -0.14); QoL (SMD 0.55, 95% CI 0.3 to 0.81); anxiety (SMD -0.47, 95% CI -0.91 to -0.03) and depression (SMD -0.46, 95% CI -0.76 to -0.16). CONCLUSIONS VRBT is an effective therapy that reduces the impact of FMS, pain, fatigue, anxiety and depression and increases dynamic balance, aerobic capacity and quality of life in women with FMS. In addition, VRBT in combination with CTBTE showed a large effect in reducing the impact of FMS and fatigue and increasing QoL in these women.
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Affiliation(s)
- Irene Cortés-Pérez
- Granada Northeast Health District, Andalusian Health Service, Street San Miguel 2, 18500 Guadix, Spain;
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (N.Z.-A.); (M.d.R.I.-L.); (M.C.O.-P.)
| | - Noelia Zagalaz-Anula
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (N.Z.-A.); (M.d.R.I.-L.); (M.C.O.-P.)
| | - María del Rocío Ibancos-Losada
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (N.Z.-A.); (M.d.R.I.-L.); (M.C.O.-P.)
| | - Francisco Antonio Nieto-Escámez
- Department of Psychology, University of Almería, Ctra. Sacramento s/n, 04120 Almería, Spain;
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), Ctra. Sacramento s/n, 04120 Almeria, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (N.Z.-A.); (M.d.R.I.-L.); (M.C.O.-P.)
| | - María Catalina Osuna-Pérez
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (N.Z.-A.); (M.d.R.I.-L.); (M.C.O.-P.)
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Lopez G, Narayanan S, Christie A, Powers-James C, Liu W, Garcia MK, Gomez T, Wu J, Chunduru A, Williams JL, Li Y, Bruera E, Cohen L. Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers. Integr Cancer Ther 2021; 19:1534735420941605. [PMID: 32686504 PMCID: PMC7374530 DOI: 10.1177/1534735420941605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: There is increasing interest in complementary approaches
such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the
effects of TC/QG delivered in group classes at a comprehensive cancer center.
Methods: Patients and caregivers who participated in TC or QG
completed assessments before and after an in-person group class. Assessments
included questions about expectancy/satisfaction and common cancer symptoms
(Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed
included global (GDS), physical (PHS), and psychosocial (PSS).
Results: Three hundred four participants (184 patients, 120
caregivers) were included in the analysis. At baseline, caregivers had a greater
expectancy for change in energy level as a result of class participation
compared with patients (22.9% vs 9.9%). No significant difference was observed
between baseline patient and caregiver PSS. Clinically significant improvement
in well-being was observed among patients in TC classes (1.0) and caregivers in
QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating
in QG experienced clinically significant improvement. Both TC and QG classes
were associated with clinically significant improvements (ESAS GDS decrease ≥3)
in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and
caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of
participants responded that their expectations were met.
Conclusions: Patients and caregivers participating in TC or QG
group classes were satisfied overall and experienced significant improvement in
global distress. Additional research is warranted to explore the integration of
TC and QG in the delivery of supportive cancer care.
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Affiliation(s)
- Gabriel Lopez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Aimee Christie
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Wenli Liu
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Kay Garcia
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Telma Gomez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jimin Wu
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aditi Chunduru
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Janet L Williams
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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16
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Consideration of Fibromyalgia in the Assessment and Treatment of SLE. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2021. [DOI: 10.1007/s40674-021-00181-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Patients suffering from fibromyalgia have many vexing symptoms; in contrast, physicians do not have a logical physiopathological framework to explain the multiple complaints. The objective of this writing is to discuss a patient-centered holistic fibromyalgia therapy based on a coherent physiopathological model.The rationale proposing fibromyalgia as stress-related sympathetically maintained neuropathic pain syndrome has solid research foundations. Autoimmunity is evident in a subset of fibromyalgia cases. Dorsal root ganglia are likely the crucial sympathetic-nociceptive short circuit sites. Skin biopsy and corneal confocal microscopy have demonstrated small nerve fiber pathology in fibromyalgia cases.Patient empowerment through information and symptom validation is the first step for a successful fibromyalgia therapy. POINTS TO HIGHLIGHT Fibromyalgia is a genuine painful neuropathic pain syndrome. In fibromyalgia stress becomes pain. Autonomic (sympathetic) dysfunction explains the multiplicity of fibromyalgia symptoms.The well-informed patient (and her/his family) must take on the leading role in her/his own rehabilitation. Fibromyalgia treatment often requires important lifestyle changes. Physicians and allied health care personnel facilitate this adjustment. Specific fibromyalgia drivers are discussed. Common modern bad habits alter autonomic nervous system balance and worsen fibromyalgia symptoms. Currently used drugs for fibromyalgia are rudimentary and with low retention rates. Autoimmune fibromyalgia requires focused therapeutic approach. CONCLUSION A patient-centered holistic therapy aimed to regain autonomic nervous system resilience remains the most effective fibromyalgia therapy. FUTURE DIRECTIONS Corneal confocal microscopy will likely become an objective fibromyalgia diagnostic and follow-up procedure. More specific analgesic antineuropathic medications for fibromyalgia are on the horizon.
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Müller M, Wüthrich F, Federspiel A, Wiest R, Egloff N, Reichenbach S, Exadaktylos A, Jüni P, Curatolo M, Walther S. Altered central pain processing in fibromyalgia-A multimodal neuroimaging case-control study using arterial spin labelling. PLoS One 2021; 16:e0235879. [PMID: 33529254 PMCID: PMC7853499 DOI: 10.1371/journal.pone.0235879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 01/19/2021] [Indexed: 01/12/2023] Open
Abstract
Fibromyalgia is characterized by chronic pain and a striking discrepancy between objective signs of tissue damage and severity of pain. Function and structural alterations in brain areas involved in pain processing may explain this feature. Previous case-control studies in fibromyalgia focused on acute pain processing using experimentally-evoked pain paradigms. Yet, these studies do not allow conclusions about chronic, stimulus-independent pain. Resting-state cerebral blood flow (rsCBF) acquired by arterial spin labelling (ASL) may be a more accurate marker for chronic pain. The objective was to integrate four different functional and structural neuroimaging markers to evaluate the neural correlate of chronic, stimulus-independent pain using a resting-state paradigm. In line with the pathophysiological concept of enhanced central pain processing we hypothesized that rsCBF is increased in fibromyalgia in areas involved in processing of acute pain. We performed an age matched case-control study of 32 female fibromyalgia patients and 32 pain-free controls and calculated group differences in rsCBF, resting state functional connectivity, grey matter volume and cortical thickness using whole-brain and region of interest analyses. We adjusted all analyses for depression and anxiety. As centrally acting drugs are likely to interfere with neuroimaging markers, we performed a subgroup analysis limited to patients not taking such drugs. We found no differences between cases and controls in rsCBF of the thalamus, the basal ganglia, the insula, the somatosensory cortex, the prefrontal cortex, the anterior cingulum and supplementary motor area as brain areas previously identified to be involved in acute processing in fibromyalgia. The results remained robust across all neuroimaging markers and when limiting the study population to patients not taking centrally acting drugs and matched controls. In conclusion, we found no evidence for functional or structural alterations in brain areas involved in acute pain processing in fibromyalgia that could reflect neural correlates of chronic stimulus-independent pain.
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Affiliation(s)
- Monika Müller
- University Clinic of Anesthesiology and Pain Medicine, Inselspital, Bern, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Roland Wiest
- Department of Neuroradiology, University Clinic of Radiology, Inselspital, Bern, Switzerland
| | - Niklaus Egloff
- Department of Psychosomatic Medicine, University Clinic of Internal Medicine, Inselspital, Bern, Switzerland
| | - Stephan Reichenbach
- University Clinic of Rheumatology, Clinical Immunology and Allergology, Inselspital, Bern, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Peter Jüni
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Michele Curatolo
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, United States of America
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
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Oh B, Van Der Saag D, Morgia M, Carroll S, Boyle F, Back M, Lamoury G. An Innovative Tai Chi and Qigong Telehealth Service in Supportive Cancer Care During the COVID-19 Pandemic and Beyond. Am J Lifestyle Med 2020; 15:475-477. [PMID: 34366746 DOI: 10.1177/1559827620983762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Supportive cancer care services, including acupuncture and Tai Chi and Qigong (TQ), are offered to cancer patients to manage cancer symptoms and/or treatment-related adverse effects and improve quality of life during and after standard care. Normal face-to-face acupuncture and TQ group services were suspended during the coronavirus (COVID-19) pandemic to reduce the risk of transmission of infection and meet social distancing restriction guidelines. This led to a sudden shift from face-to-face sessions to telehealth sessions in the health care system. We report patients' experiences of TQ telehealth services as a new initiative developed for cancer care. We found that delivery of TQ telehealth is feasible and resulted in increased overall patient satisfaction with cancer care services during the lockdown. The delivery of TQ telehealth experiences and challenges are discussed.
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Affiliation(s)
- Byeongsang Oh
- GenesisCare, Mater Hospital, North Sydney, New South Wales, Australia
| | | | - Morita Morgia
- GenesisCare, Mater Hospital, North Sydney, New South Wales, Australia
| | - Susan Carroll
- GenesisCare, Mater Hospital, North Sydney, New South Wales, Australia
| | - Frances Boyle
- Patricia Ritchie Centre for Cancer Care, Mater Hospital, North Sydney, New South Wales, Australia
| | - Michael Back
- GenesisCare, Mater Hospital, North Sydney, New South Wales, Australia
| | - Gillian Lamoury
- GenesisCare, Mater Hospital, North Sydney, New South Wales, Australia
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20
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Wood RC. Tai Chi as a method of improving pain management in patients with fibromyalgia. LIFESTYLE MEDICINE 2020. [DOI: 10.1002/lim2.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Rebecca Carole Wood
- Knowledge Spa Royal Cornwall Hospital Trust (RCHT) University of Exeter Medical School Truro UK
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Abstract
Tai chi is an ancient Chinese internal martial art that has increased in popularity across the United States over the past 2 decades. Tai chi combines gentle physical movement, mental imagery, and natural, relaxed breathing. There is increasing scientific evidence showing the impact of tai chi exercise on multifaceted areas of health and well-being, including positive effects on cognition, depression, anxiety, sleep, cardiovascular health, and fall prevention. A review of the health benefits of tai chi exercise is presented, as well as recommendations for nurses seeking to answer patient questions about tai chi.
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22
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Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol 2020; 16:645-660. [DOI: 10.1038/s41584-020-00506-w] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/20/2022]
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23
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Pfalzgraf AR, Lobo CP, Giannetti V, Jones KD. Use of Complementary and Alternative Medicine in Fibromyalgia: Results of an Online Survey. Pain Manag Nurs 2020; 21:516-522. [PMID: 32893131 DOI: 10.1016/j.pmn.2020.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 06/25/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fibromyalgia is a chronic condition which may negatively impact various aspects of patients' lives. Many people with fibromyalgia look to complementary and alternative medicine treatments for symptom relief. AIMS The three main objectives of this study were to examine self-reported complementary and alternative medicine use in patients with fibromyalgia, to determine associations between the use of complementary and alternative medicine treatments and patients' self-reported quality of live and self-reported pain levels. DESIGN Cross-sectional survey. SETTING Web-based. PARTICIPANTS/SUBJECTS Adults over the age of 18 years who had been diagnosed with fibromyalgia. METHODS Patients with fibromyalgia responded to an online questionnaire regarding the following: treatments (complementary and alternative medicine, prescription and over-the-counter medications), quality of life (Quality of Life Scale-16), assessment of current pain (visual analog scale), and demographic information. RESULTS Approximately 66% of the respondents used complementary and alternative treatments. Vitamins, massage therapy, and meditation were the most commonly used complementary and alternative therapies. Results indicated respondents using a combination of complementary and alternative medicine and pharmacologic treatments (prescription or over-the-counter) had significantly higher quality of life versus those using pharmacologic treatments alone, p = .011. Similarly, respondents using only complementary and alternative medicine treatment reported significantly lower pain levels versus those using pharmacologic treatment alone, p = .046. CONCLUSIONS The study suggests that a large proportion of fibromyalgia patients use complementary and alternative medicine, and these treatments may offer beneficial effects to these patients. Integration of complementary and alternative medicine into conventional treatment regimens may provide opportunities for a holistic treatment approach and greater symptom relief for fibromyalgia patients. This approach is timely, as controlled substances are increasingly difficult for patients with fibromyalgia to access.
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Affiliation(s)
- Andrea R Pfalzgraf
- National University of Natural Medicine & Oregon Health and Science University, Portland, Oregon.
| | - Carroline P Lobo
- School of Pharmacy, Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, Pennsylvania
| | - Vincent Giannetti
- School of Pharmacy, Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, Pennsylvania
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Oh B, Bae K, Lamoury G, Eade T, Boyle F, Corless B, Clarke S, Yeung A, Rosenthal D, Schapira L, Back M. The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. MEDICINES (BASEL, SWITZERLAND) 2020; 7:E39. [PMID: 32629903 PMCID: PMC7400467 DOI: 10.3390/medicines7070039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 12/13/2022]
Abstract
Background: Effective preventative health interventions are essential to maintain well-being among healthcare professionals and the public, especially during times of health crises. Several studies have suggested that Tai Chi and Qigong (TQ) have positive impacts on the immune system and its response to inflammation. The aim of this review is to evaluate the current evidence of the effects of TQ on these parameters. Methods: Electronic searches were conducted on databases (Medline, PubMed, Embase and ScienceDirect). Searches were performed using the following keywords: "Tai Chi or Qigong" and "immune system, immune function, immunity, Immun*, inflammation and cytokines". Studies published as full-text randomized controlled trials (RCTs) in English were included. Estimates of change in the levels of immune cells and inflammatory biomarkers were pooled using a random-effects meta-analysis where randomised comparisons were available for TQ versus active controls and TQ versus non-active controls. Results: Nineteen RCTs were selected for review with a total of 1686 participants and a range of 32 to 252 participants within the studies. Overall, a random-effects meta-analysis found that, compared with control conditions, TQ has a significant small effect of increasing the levels of immune cells (SMD, 0.28; 95% CI, 0.13 to 0.43, p = 0.00), I2 = 45%, but not a significant effect on reducing the levels of inflammation (SMD, -0.15; 95% CI, -0.39 to 0.09, p = 0.21), I2 = 85%, as measured by the systemic inflammation biomarker C-reactive protein (CRP) and cell mediated biomarker cytokines. This difference in results is due to the bidirectional regulation of cytokines. An overall risk of bias assessment found three RCTs with a low risk of bias, six RCTs with some concerns of bias, and ten RCTs with a high risk of bias. Conclusions: Current evidence indicates that practising TQ has a physiologic impact on immune system functioning and inflammatory responses. Rigorous studies are needed to guide clinical guidelines and harness the power of TQ to promote health and wellbeing.
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Affiliation(s)
- Byeongsang Oh
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Kyeore Bae
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- Center for Immunity and Pain, Kwanghye Hospital, Seoul 06174, Korea
| | - Gillian Lamoury
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Thomas Eade
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Frances Boyle
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Brian Corless
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
| | - Stephen Clarke
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Albert Yeung
- Harvard Medical School, Boston, MA 02115, USA; (A.Y.); (D.R.)
| | - David Rosenthal
- Harvard Medical School, Boston, MA 02115, USA; (A.Y.); (D.R.)
| | - Lidia Schapira
- Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Michael Back
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
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