Protocol: The Effect of 12 Weeks of Tai Chi Practice on Anxiety in Healthy but Stressed People Compared to Exercise and Wait-list Comparison Groups: A Randomized Controlled Trial

Effects of Acupressure on Preoperative Acute Anxiety in Cesarean Section Under Spinal Anesthesia: A Double-Blind Randomized Controlled Study

Anxiety during the preoperative period is a common problem experienced by women who will deliver by cesarean section. The use of nonpharmacological methods to control anxiety in pregnant women has been shown to be more appropriate. This double-blind randomized controlled experimental study was conducted to assess the effect of acupressure on acute anxiety developing before cesarean section under spinal anesthesia. In the present study, 82 pregnant women scheduled for surgery were randomly assigned to the acupressure and control groups including 40 and 42 persons, respectively. Acupressure was applied to HE-7 acupuncture points in the participants in the acupressure (intervention) group for 10 minutes before the surgery. The participants in the control group were subjected to the hospital protocol. Anxiety levels of the participating women were assessed twice preoperatively using the State-Trait Anxiety Inventory. Anxiety scores of the participants in the acupressure group before the procedure (49.13 ± 6.22) were higher than were those of the participants in the control group (41.71 ± 3.26); however, after the procedure, the anxiety scores decreased statistically significantly in the acupressure group (38.30 ± 4.45) compared with the control group (52.48 ± 7.30) (P < .001). Acupressure reduced the preoperative acute anxiety suffered by the participating pregnant women.

Investigating the Effect of Acupressure on the Patients' Anxiety Before Open-Heart Surgery: A Randomized Clinical Trial

BACKGROUND

Anxiety is a common complaint of patients before diagnostic or therapeutic invasive procedures, especially before open-heart surgery. The most well-known method to reduce anxiety is the use of sedatives, which have pronounced side effects.

OBJECTIVES

The purpose of this study was to determine the effect of acupressure on anxiety in patients undergoing open-heart surgery.

METHOD

This is a randomized clinical trial study conducted on 90 patients who were candidates for open-heart surgery. The patients were randomly assigned into either intervention or control groups. Acupressure intervention was applied at three real acupoints over two consecutive days in the intervention group. The control group received acupressure on sham points. We used Spielberger State-Trait Anxiety Inventory to assess anxiety in our study.

RESULTS

The results showed that before acupressure, there was no statistically significant difference between state anxiety scores and intergroup traits, and this difference was only significant in state anxiety after the second intervention. State and trait anxiety were significant before and after the intervention in the test group, respectively include (p < 0.001) (p = 0.01), but these changes in the control group did not show a statistically significant difference. After completing the second phase of the intervention at the actual sites, systolic blood pressure (p = 0.007) and heart rate (p = 0.001) decreased significantly. However, acupressure did not have a significant effect on diastolic blood pressure in any of the groups.

CONCLUSION

Based on the results of this study, the application of acupressure in patients who are candidates for open-heart surgery can reduce their state anxiety. Further larger-scale and rigorous studies are warranted.

A randomized controlled trial of mindfulness-based Tai Chi Chuan for subthreshold depression adolescents

PURPOSE

The incidence of subthreshold depression (StD) in adolescents is growing rapidly, which in turn is known to impair functioning and increase the risk of major depression. It is therefore important to provide effective intervention to prevent the transition from StD to major depression. As a traditional Chinese mind-body exercise, Tai Chi Chuan (TCC) may be an available selection. Researchers have shown the effectiveness of mindfulness-based therapy on depression; however, for the StD youth, there have been no studies to investigate whether mindfulness-based Tai Chi Chuan (MTCC) can be recommended as an effective exercise for improving their psychological state. The aim of present study was to evaluate the effect of MTCC on psychological outcomes of StD adolescents including the depression levels and mindfulness state in a randomized controlled trial (RCT).

PATIENTS AND METHODS

An RCT was carried out. A sample of 64 participants who meet the inclusion criteria agreed to be arranged randomly to either the MTCC group (n=32) or the control group (n=32). Participants of the MTCC group received an 8-week, 2 days per week, 90-minute MTCC intervention for each session. Usual physical curriculum was administered to the participants in the control group. The effectiveness of MTCC training was measured by blinded evaluators through validated scales, which included depressive symptoms, stress, and mindfulness level before and after the intervention.

RESULTS

Significant improvements in psychological health were observed from MTCC groups. After 8-week intervention, superior outcomes were also observed for MTCC when compared with control group for decrease in depression (F=59.482, P<0.001) and stress level (F=59.482, P<0.001) and increase in mindfulness (F=59.482, P<0.001).

CONCLUSION

The findings of this preliminary study indicated the effects of the MTCC intervention on depression level among StD youngsters. This study provides preliminary evidence that MTCC is suitable for Chinese adolescents and is effective in decreasing depression level.

Development of a Novel Questionnaire for the Traditional Chinese Medicine Pattern Diagnosis of Stress

Currently, there is no definitive diagnosis or list of signs and symptoms for "stress" in either modern biomedicine or Chinese medicine (CM). While modern theories on stress relate to the neurological interaction of a stressor or stimuli on the autonomic nervous system, it is generally regarded as subjective in nature and as such each individual will likely present varying somatic or cognitive signs and symptoms. A questionnaire was therefore developed, based on textual research, that incorporated both general as well as gender specific signs and symptom responses to determine the most common CM patterns associated with individuals who report as feeling stressed. For the 45 females who completed the questionnaire, the mean percentage of symptoms per CM pattern showed that the pattern with the highest average percentage was heart qi deficiency (61.88%) followed by liver blood deficiency (60.23%) and then heart blood deficiency (60.12%). For males (n = 16), heart qi deficiency was also the highest scoring CM pattern with a scoring percentage of 54.81%. In males, however, heart blood deficiency was second with 53.29% followed by liver blood deficiency with 51.10%. Of the general non gender-specific symptoms collected (n = 65 symptoms), the symptom most commonly reported by both men and women was "anxious or racing thoughts", followed by "constant worrying" and "inability to concentrate". The CM diagnostic pattern results may prove useful for clinicians as the change in diagnostic understanding will also modify the treatment principle and subsequent treatment with acupuncture or herbal medicine. Future CM research studies should consider including the questionnaire either as a diagnostic aid or as an outcome measure for acupuncture or herbal medicine studies related to stress.

Tai chi as an alternative and complimentary therapy for anxiety: a systematic review

Anxiety has become a global public health problem. Tai chi offers one possible way of reducing anxiety. The purpose of this study was to examine studies from 1989 to March 2014 to assess whether tai chi can be an efficacious approach for managing anxiety. A systematic search of Medline, CINAHL, and Alt HealthWatch databases was conducted for quantitative articles involving applications of tai chi for anxiety. A total of 17 articles met the inclusion criteria. Of these, 8 were from the United States, 2 from Australia, 2 from Japan, 2 from Taiwan, and 1 each from Canada, Spain, and China. Statistically significant results of anxiety reduction were reported in 12 of the studies reviewed. Despite the limitations of not all studies using randomized controlled designs, having smaller sample sizes, having different outcomes, having nonstandardized tai chi interventions, and having varying lengths, tai chi appears to be a promising modality for anxiety management.