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Garis G, Dettmers C, Hildebrandt A, Duning T, Hildebrandt H. Comparing two relaxation procedures to ease fatigue in multiple sclerosis: a single-blind randomized controlled trial. Neurol Sci 2023; 44:4087-4098. [PMID: 37698785 PMCID: PMC10570225 DOI: 10.1007/s10072-023-07042-x] [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: 03/10/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Various relaxation procedures have been proposed to reduce fatigue in multiple sclerosis (MS). However, it is unknown, which type of relaxation has the largest effect on fatigue reduction and on autonomic nervous system (ANS) activity. OBJECTIVE We aimed to compare two biofeedback-supported relaxation exercises: a deep breathing (DB) exercise and progressive muscle relaxation (PMR), which may ameliorate MS fatigue and alter ANS activity. METHODS We performed a single-blind randomized clinical trial, introducing MS patients (n = 34) to the DB or PMR exercise. We first tested cardiovagal integrity, reflected by changes in heart rate variability (HRV) in response to DB. Participants then performed a fatigue-inducing vigilance task, followed by the DB or PMR. State fatigue was recorded consecutively at baseline, after the vigilance task, and after the relaxation exercise, along with HRV reflecting ANS activity. RESULTS Only patients assigned to the PMR group experienced a significant drop in fatigue, whereas both relaxation exercises changed ANS activity. MS patients showed the expected autonomic response during the cardiovagal reflex test. The vigilance task elevated short-term feelings of fatigue and significantly reduced HRV parameters of parasympathetic activity. Trait fatigue was negatively correlated with HRV during the second half of the vigilance task. CONCLUSION PMR alleviates short-term feelings of fatigue in persons with MS. The vigilance task in combination with HRV measurements may be helpful for evaluating relaxation procedures as a treatment of fatigue. Hereby, future studies should ensure longer and more frequent relaxation exercises and focus on patients with weak to moderate fatigue. TRIAL REGISTRATION Trial Registry: DRKS00024358.
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Affiliation(s)
- Guadalupe Garis
- Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany.
- Department of Neurology, Klinikum Bremen-Ost, 28325, Bremen, Germany.
| | | | - Andrea Hildebrandt
- Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Thomas Duning
- Department of Neurology, Klinikum Bremen-Ost, 28325, Bremen, Germany
| | - Helmut Hildebrandt
- Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany.
- Department of Neurology, Klinikum Bremen-Ost, 28325, Bremen, Germany.
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2
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Kische H, Zenker M, Pieper L, Beesdo-Baum K, Asselmann E. Applied relaxation and cortisol secretion: findings from a randomized controlled indicated prevention trial in adults with stress, anxiety, or depressive symptoms. Stress 2022; 25:122-133. [PMID: 35285766 DOI: 10.1080/10253890.2022.2045939] [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] [Indexed: 10/18/2022] Open
Abstract
Previous research has shown that relaxation interventions can reduce distress, anxiety, and depression. The exact mechanisms that underlie the efficacy of relaxation interventions remain unresolved. This study aimed to investigate whether applied relaxation (AR) leads to changes in cortisol secretion and whether these effects mediate fewer symptoms due to AR. Data come from a randomized controlled preventive interventional trial (N = 277) with elevated tension/distress, anxiety, or depressive symptomatology. Participants were randomized to an intervention group (IG; n = 139, received AR training), or a non-interventional control group (CG, n = 138). Psychopathological symptoms were assessed with DASS-21 and diagnoses of mental disorders via DIA-X-5. Cortisol was measured as short-term index in saliva (six times/d for 2 d at pre-, post-, and follow-up [FU] assessment) and long-term index in hair samples (once at pre-assessment and FU, respectively). Data were analyzed as pre-specified secondary analyses of the randomized controlled trial (RCT) on completer basis (n = 134 CG, n = 102 IG), using multivariable-adjusted linear regression models and mediation analyses (the DASS-21 change in the IG vs. CG with cortisol (area under the curve [AUC]) as mediator). From pre- to post-assessment, total daily salivary cortisol (AUC) decreased more strongly in the IG vs. CG (β-coefficient: -13.83, 95% confidence interval [CI]: -26.85 to -0.81), but was rendered non-significant when adjusting for pre-assessment AUC. This effect was not found for the cortisol awakening response (CAR) or hair cortisol. There was no evidence for a mediation of cortisol (AUC). These findings provide little support for the idea that cortisol reductions explain the beneficial effects of AR on mental health.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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3
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Zampogna E, Spanevello A, Visca D. Pulmonary rehabilitation: promising nonpharmacological approach for treating asthma? Curr Opin Allergy Clin Immunol 2021; 20:80-84. [PMID: 31633568 DOI: 10.1097/aci.0000000000000597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation with a history of respiratory symptoms that vary over time and in intensity, together with variable expiratory airflow limitation. The goal of asthma treatment is to reach symptoms control, reduction in future risk and improvement in quality of life (QoL). Guideline-based pharmacologic therapies and the effect of inhaled steroids and bronchodilators have been widely studied over the past decades. We provide an overview of the available evidence on pulmonary rehabilitation as a nonpharmacologic therapy in asthmatic patients. RECENT FINDINGS Recently, some studies have highlighted the promising role of nonpharmacologic therapies in asthma, such as pulmonary rehabilitation demonstrating that a pulmonary rehabilitation programme consisting of exercise training, breathing retraining, educational and psychological support, improve exercise capacity, asthma control and QoL and reduce dyspnea, anxiety, depression and bronchial inflammation at any step of the disease. SUMMARY Pulmonary rehabilitation shows positive results on exercise tolerance, respiratory symptoms and QoL in asthmatic patients at any steps of the diseases. However, additional information is required to better characterize rehabilitation programmes in order to improve clinical care in asthma.
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Affiliation(s)
- Elisabetta Zampogna
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Tradate, Tradate, Varese
| | - Antonio Spanevello
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Tradate, Tradate, Varese.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Dina Visca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Tradate, Tradate, Varese.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
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4
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Elnaggar RK, Moawd SA, Ali SE, Yousef AM, Azab AR. Potential impacts of Acu-TENS in the treatment of adolescents with moderate to severe bronchial asthma: A randomized clinical study. Complement Ther Med 2021; 57:102673. [PMID: 33508442 DOI: 10.1016/j.ctim.2021.102673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/20/2020] [Accepted: 01/19/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the efficacy of transcutaneous electrical nerve stimulation over the acupuncture points (Acu-TENS) on total serum immunoglobulin E (IgEtotal), pulmonary function, and quality of life in adolescents with asthma. METHODS In a double-blind randomized clinical trial, 32 adolescents (age; 12-16 years) with asthma participated and were assigned randomly to receive either the breathing retraining program (control group) or the breathing retraining program plus Acu-TENS application (Acu-TENS group). Acu-TENS was applied for 40 min' day-after-day session for two successive months, with no side-effects reported. Serum IgEtotal, pulmonary function [forced vital capacity (FVC), forced expiratory volume at one second (FEV1), and FEV1/FVC], and quality of life were evaluated pre- and post-treatment. RESULTS Serum IgEtotal (P = 0.028, ηp2 = 0.15), Pulmonary function [FVC (P = 0.043, ηp2 = 0.13), FEV1 (P = .046, ηp2 = 0.12)], and quality of life (P < .001, ηp2 = 0.17) increased significantly in the Acu-TENS group when compared to the control group. CONCLUSION This study demonstrates that the Acu-TENS is an impending asthma treatment that may be used to reinforce the immune system response, ameliorate lung function, and increase the quality of life in adolescents with asthma.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
| | - Samah A Moawd
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Shaimaa E Ali
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Abeer M Yousef
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Alshimaa R Azab
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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5
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Zampogna E, Zappa M, Spanevello A, Visca D. Pulmonary Rehabilitation and Asthma. Front Pharmacol 2020; 11:542. [PMID: 32435190 PMCID: PMC7219266 DOI: 10.3389/fphar.2020.00542] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/09/2020] [Indexed: 12/29/2022] Open
Abstract
Asthma is a chronic inflammatory disease characterized by airflow limitation and variable respiratory symptoms. It is characterized by variable symptoms such as cough, wheeze, chest tightness, and shortness of breath which vary in intensity and time. In order to reach a comprehensive approach of disease management, the importance of non-pharmacological treatment in addition to pharmacological therapy has been recently highlighted. Studies have documented that pulmonary rehabilitation has beneficial effects in patients with asthma, at any stage of the disease, improving exercise capacity, asthma control, and quality of life and reducing wheezing, anxiety, depression, and bronchial inflammation. Although several evidences suggest a role of pulmonary rehabilitation in patients with asthma, additional information is required to identify a specific program in order to improve clinical care based on specific patient’s needs.
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Affiliation(s)
- Elisabetta Zampogna
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Tradate (VA), Tradate, Italy
| | - Martina Zappa
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Antonio Spanevello
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Tradate (VA), Tradate, Italy.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Dina Visca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Tradate (VA), Tradate, Italy.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
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6
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Lu SM, Lin MF, Chang HJ. Progressive muscle relaxation for patients with chronic schizophrenia: A randomized controlled study. Perspect Psychiatr Care 2020; 56:86-94. [PMID: 31012119 DOI: 10.1111/ppc.12384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/08/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To evaluate progressive muscle relaxation (PMR) as an intervention for anxiety, psychotic symptoms, and quality of life (QOL) in patients with chronic schizophrenia. DESIGN AND METHODS Eighty patients were recruited from a Taiwanese psychiatry ward. The intervention group received group PMR; control group received treatment-as-usual. RESULTS The results indicated that PMR might have a short-term effect on reducing anxiety, improving psychotic syndromes, and QOL among patients with chronic schizophrenia; however, the effectiveness at the 3-month follow-up was not evident. PRACTICE IMPLICATIONS Both the psychiatric patients and the health institutions may be able to list PMR as a clinical routine care, and then become a mental health practice strategy for mental patients to improve the quality of mental care. IMPLICATIONS FOR NURSING PRACTICE Our studies suggest that prevention of severe mental illness among patients with schizophrenia requires PMR interventions. PMR had an immediate effect, and it is possible that a shorter intervention period using this approach would also be successful.
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Affiliation(s)
- Shu-Min Lu
- School of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Ju Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Harorani M, Noruzi Zamenjani M, Golitaleb M, Davodabady F, Zahedi S, Jadidi A, Rezaei M. Effects of relaxation on self-esteem of patients with cancer: a randomized clinical trial. Support Care Cancer 2019; 28:405-411. [PMID: 31418073 DOI: 10.1007/s00520-019-05025-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/01/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Cancer is usually associated with decreased self-esteem. Relaxation is one of the most effective methods to promote self-esteem of patients with chronic diseases. Hence, the present study aimed to investigate the effects of relaxation on self-esteem of patients with cancer. METHODS This randomized clinical trial was conducted on 80 patients with cancer. The samples were selected by convenience sampling method and were randomly divided into experimental and control groups. In the experimental group, the patients implemented relaxation techniques once a day for 30 min during 60 consecutive days in addition to receiving routine care, while patients in the control group received only routine care. Before and after the intervention, the Persian version of the Coopersmith Self-Esteem Inventory (CSEI) was completed. RESULTS After the interventions, significant differences were observed between groups in favor of the relaxation group in total score of CSEI and all its subscales (P = 0.0001). In the experimental group, a significant increase in total score and all subscales of CSEI was observed after the intervention (P = 0.001), whereas in the control group, a significant decrease was found in all dimensions (P = 0.001). CONCLUSION The relaxation seems to be potentially effective in promoting self-esteem of patients with cancer. Further studies, particularly randomized clinical trials with higher sample size and more power, are needed to confirm the obtained findings.
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Affiliation(s)
- Mehdi Harorani
- Faculty of Nursing and Midwifery, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Masoomeh Noruzi Zamenjani
- Faculty of Nursing and Midwifery, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Mohamad Golitaleb
- Faculty of Nursing and Midwifery, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Fahimeh Davodabady
- Faculty of Nursing and Midwifery, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Sima Zahedi
- Faculty of Nursing and Midwifery, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Ali Jadidi
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Rezaei
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
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8
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Zampogna E, Centis R, Negri S, Fiore E, Cherubino F, Pignatti P, Heffler E, Canonica GW, Sotgiu G, Saderi L, Migliori GB, Spanevello A, Visca D. Effectiveness of pulmonary rehabilitation in severe asthma: a retrospective data analysis. J Asthma 2019; 57:1365-1371. [PMID: 31317799 DOI: 10.1080/02770903.2019.1646271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Pulmonary Rehabilitation (PR) is a multimodal treatment that is still poorly investigated in severe asthma where respiratory symptoms remain "uncontrolled" despite intensive pharmacological therapy. Bronchiectasis and obstructive sleep apnea (OSAS) are common comorbidities which may worsen asthma control.Aim: Aim of the present study is to investigate the effectiveness of PR on functional exercise, dyspnea, and muscle fatigue in patients with severe asthma.Methods: A total of 317 patients affected from severe asthma according to GINA guidelines who underwent a multidisciplinary 3 weeks rehabilitation program with an adherence of >80% to PR and able to complete a Six Minute Walking Test (6MWT) were retrospectively included in the analysis. Pulmonary rehabilitation included endurance training, educational meetings, chest physiotherapy, breathing exercises, and psychological support. Six-minute walking distance and Borg scale for dyspnea and muscle fatigue were recorded before and after the rehabilitation.Results: A total of 371 patients were analyzed, 39 had bronchiectasis (10.5%), 163 (43.9%) OSAS and 17 had both (4.6%). PR significantly improved 6MWT distance, Borg dyspnea and muscle fatigue (p value < 0.0001 for all outcomes) and mean SpO2 recorded during 6MWT (p value < 0.0001). Median (IQR) delta 6 minute walking distance was 33 (14-60) m. 6MWT distance (p < 0.0001) and the oxygen saturation (p < 0.01) significantly improved in severe asthma with bronchiectasis and/or OSAS.Conclusions: Our study provides evidence for the first time on a large sample of patients with severe asthma that a multidisciplinary PR program is effective in terms of exercise capacity and symptoms. In addition, exercise capacity improved in the presence of bronchiectasis and/or OSAS.
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Affiliation(s)
- Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - Rosella Centis
- Clinical Epidemiology of Respiratory Diseases Service, Clinical Scientific Institutes Maugeri, IRCCS, Tradate, Italy
| | - Stefano Negri
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Italy
| | - Elisabetta Fiore
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Italy
| | - Francesca Cherubino
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - Patrizia Pignatti
- Allergy and Immunology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy - Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Giorgio Walter Canonica
- Personalized Medicine, Asthma and Allergy - Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Battista Migliori
- Clinical Epidemiology of Respiratory Diseases Service, Clinical Scientific Institutes Maugeri, IRCCS, Tradate, Italy
| | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Italy
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9
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The effect of stress management incorporating progressive muscle relaxation and biofeedback-assisted relaxation breathing on patients with asthma: a randomised controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2019. [DOI: 10.1016/j.aimed.2018.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Noruzi Zamenjani M, Masmouei B, Harorani M, Ghafarzadegan R, Davodabady F, Zahedi S, Davodabady Z. The effect of progressive muscle relaxation on cancer patients' self-efficacy. Complement Ther Clin Pract 2018; 34:70-75. [PMID: 30712748 DOI: 10.1016/j.ctcp.2018.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/18/2018] [Accepted: 10/25/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Self-efficacy is considered as one of the influential parameters affecting the health of patients. This study aimed to investigate the effect of relaxation techniques on self-efficacy of patients suffering from cancer. MATERIALS AND METHODS This study was a clinical trial in which 80 patients suffering from cancer were randomly assigned to two groups of experimental and control. Data collection instruments consisted of demographic information and Strategies Used by People to Promote Health questionnaires. In the experimental group, the patients performed relaxation techniques once a day for 30 min over two months. In the control group, the patients received the routine care. RESULTS A statistically significant difference was observed between the mean self-efficacy indices in the experimental group (p = 0.001). There was no significant difference in the control group (p = 0.3). CONCLUSION Muscle relaxation can enhance self-efficacy of cancer patients. Therefore, it can be used as an alternative method for patients who are willing to use this technique.
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Affiliation(s)
| | - Behnam Masmouei
- Department of Nursing, Abadeh Branch, Islamic Azad University, Abadeh, Iran
| | - Mehdi Harorani
- Department of Nursing and Midwifery, Arak University of Medical Sciences: Basij Square, Arak, IR, Iran.
| | - Rezvan Ghafarzadegan
- Instructor, Department of Nursing, Faculty of Nursing & Midwifery, Khomein University of Medical Sciences, Khomein, Iran
| | - Fahimeh Davodabady
- Department of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Sima Zahedi
- Department of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Zakie Davodabady
- Master of Nursing, Valiasr Hospital Arak, Arak University of Medical Sciences, Arak, Iran
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Haut SR, Lipton RB, Cornes S, Dwivedi AK, Wasson R, Cotton S, Strawn JR, Privitera M. Behavioral interventions as a treatment for epilepsy: A multicenter randomized controlled trial. Neurology 2018; 90:e963-e970. [PMID: 29444968 DOI: 10.1212/wnl.0000000000005109] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/11/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy. METHODS Adults with medication-resistant focal epilepsy (n = 66) were recruited from 3 centers and randomized to 1 of 2 interventions: (1) progressive muscle relaxation (PMR) with diaphragmatic breathing, or (2) control focused-attention activity with extremity movements. Following an 8-week baseline period, participants began 12 weeks of double-blind treatment. Daily self-reported mood and stress ratings plus seizure counts were completed by participants using an electronic diary, and no medication adjustments were permitted. The primary outcome was percent reduction in seizure frequency per 28 days comparing baseline and treatment; secondary outcomes included stress reduction and stress-seizure interaction. RESULTS In the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, p < 0.05; focused attention: 25%, p < 0.05). PMR and focused attention did not differ in seizure reduction (p = 0.38), although PMR was associated with stress reduction relative to focused attention (p < 0.05). Daily stress was not a predictor of seizures. CONCLUSIONS Both PMR and the focused-attention groups showed reduced seizure frequency compared to baseline in participants with medication-resistant focal seizures, although the 2 treatments did not differ. PMR was more effective than focused attention in reducing self-reported stress. CLINICALTRIALSGOV IDENTIFIER NCT01444183.
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Affiliation(s)
- Sheryl R Haut
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH.
| | - Richard B Lipton
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Susannah Cornes
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Alok K Dwivedi
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Rachel Wasson
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Sian Cotton
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Jeffrey R Strawn
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
| | - Michael Privitera
- From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH
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Sharifah Maimunah SMP, Hashim HA. Differential Effects of 7 and 16 Groups of Muscle Relaxation Training Following Repeated Submaximal Intensity Exercise in Young Football Players. Percept Mot Skills 2016; 122:227-37. [PMID: 27420318 DOI: 10.1177/0031512515625383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study compares two versions of progressive muscle relaxation (PMR) training (7 and 16 muscle groups) on oxygen consumption (VO2), heart rates, rating of perceived exertion and choice reaction time. Football (soccer) players (N = 26; M age = 13.4 yr., SD = 0.5) were randomly assigned to either 7 muscle groups PMR, 16 muscle groups PMR, or a control group. PMR training requires the participants to tense a muscle, hold the muscle contraction, and then relax it. Measurement was conducted prior to and after the completion of 12 sessions of PMR. The dependent variables were measured following four bouts of intermittent exercise consisting of 12 min. of running at 60% VO2max for 10 min. followed by running at 90% VO2max for 2 min. with a 3-min. rest for each bout. Lower VO2, heart rate, perceived exertion, and quicker reaction time were expected in both relaxation groups compared to the control group. The results revealed a significant reduction in heart rates and choice reaction time for both relaxation groups, but the longer version produced significantly quicker choice reaction time.
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Affiliation(s)
- S M P Sharifah Maimunah
- Sports Science Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - H A Hashim
- Sports Science Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Kim KJ, Na YK, Hong HS. Effects of Progressive Muscle Relaxation Therapy in Colorectal Cancer Patients. West J Nurs Res 2016; 38:959-73. [PMID: 26945016 DOI: 10.1177/0193945916635573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to examine the effect of progressive muscle relaxation therapy (PMRT) on cortisol level, the Stress Arousal Checklist (SACL) score, blood pressure, and heart rate in colorectal cancer patients undergoing laparoscopic surgery. Forty-six patients were divided into control and experimental groups. Cortisol levels, blood pressure, and heart rate were measured before surgery and between 8:00 and 11:00 a.m. on the first, third, and fifth days after surgery. SACL score was measured before surgery and on the fifth day after surgery at the same time points. PMRT was performed twice a day for 5 days. Analyses of covariance with advanced covariate levels and t tests showed that PMRT helps colorectal cancer patients achieve a lower stress response and provides an important basis for stress control.
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Affiliation(s)
- Kyeng Jin Kim
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Yeon Kyung Na
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Hae Sook Hong
- College of Nursing, Kyungpook National University, Daegu, Korea
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Masoudi R, Sharifi Faradonbeh A, Mobasheri M, Moghadasi J. Evaluating the Effectiveness of Using a Progressive Muscle Relaxation Technique in Reducing the Pain of Multiple Sclerosis Patients. ACTA ACUST UNITED AC 2013. [DOI: 10.3109/10582452.2013.852150] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Isa MR, Moy FM, Abdul Razack AH, Zainuddin ZM, Zainal NZ. Impact of applied progressive deep muscle relaxation training on the level of depression, anxiety and stress among prostate cancer patients: a quasi-experimental study. Asian Pac J Cancer Prev 2013; 14:2237-42. [PMID: 23725119 DOI: 10.7314/apjcp.2013.14.4.2237] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the impact of applied progressive muscle relaxation training on the levels of depression, anxiety and stress among prostate cancer patients. MATERIALS AND METHODS A quasi-experimental study was conducted at the University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over six months. Prostate cancer patients from UMMC received the intervention and patients from UKMMC were taken as controls. The level of depression, anxiety and stress were measured using Depression, Anxiety Stress Scales - 21 (DASS-21). RESULTS A total of 77 patients from the UMMC and 78 patients from the UKMMC participated. At the end of the study, 90.9% and 87.2% of patients from the UMMC and UKMMC groups completed the study respectively. There were significant improvements in anxiety (p<0.001, partial ?2=0.198) and stress (p<0.001, partial ?2=0.103) at the end of the study in those receiving muscle training. However, there was no improvement in depression (p=0.956). CONCLUSIONS The improvement in anxiety and stress showed the potential of APMRT in the management of prostate cancer patients. Future studies should be carried out over a longer duration to provide stronger evidence for the introduction of relaxation therapy among prostate cancer patients as a coping strategy to improve their anxiety and stress.
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Affiliation(s)
- Mohamad Rodi Isa
- Population Health and Preventive Medicine Unit, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Sungai Buloh, Malaysia.
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16
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Ritz T, Meuret AE, Trueba AF, Fritzsche A, von Leupoldt A. Psychosocial factors and behavioral medicine interventions in asthma. J Consult Clin Psychol 2013; 81:231-50. [PMID: 23025250 PMCID: PMC6019133 DOI: 10.1037/a0030187] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This review examines the evidence for psychosocial influences in asthma and behavioral medicine approaches to its treatment. METHOD We conducted a systematic review of the literature on psychosocial influences and the evidence for behavioral interventions in asthma with a focus on research in the past 10 years and clinical trials. Additional attention was directed at promising new developments in the field. RESULTS Psychosocial factors can influence the pathogenesis and pathophysiology of asthma, either directly through autonomic, endocrine, immunological, and central nervous system mechanisms or indirectly through lifestyle factors, health behaviors, illness cognitions, and disease management, including medication adherence and trigger avoidance. The recent decade has witnessed surging interest in behavioral interventions that target the various pathways of influence. Among these, self-management training, breathing training, and exercise or physical activation programs have proved particularly useful, whereas other essential or promising interventions, such as smoking cessation, dietary programs, perception and biofeedback training, and suggestive or expressive psychotherapy, require further, more rigorous evaluation. Given the high comorbidity with anxiety and mood disorders, further evaluation of illness-specific cognitive behavior therapy is of particular importance. Progress has also been made in devising community-based and culturally tailored intervention programs. CONCLUSION In concert with an essential medication treatment, behavioral medicine treatment of asthma is moving closer toward an integrated biopsychosocial approach to disease management.
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Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX 75275, USA.
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Fujino H. Subjective experience of Dohsa-hourelaxation: a qualitative study. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2013. [DOI: 10.1080/21507686.2013.775170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Polak EL, Privitera MD, Lipton RB, Haut SR. Behavioral intervention as an add-on therapy in epilepsy: designing a clinical trial. Epilepsy Behav 2012; 25:505-10. [PMID: 23153715 DOI: 10.1016/j.yebeh.2012.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 09/07/2012] [Accepted: 09/08/2012] [Indexed: 10/27/2022]
Abstract
Many patients with epilepsy continue to experience seizures despite taking medication, and stress is a commonly reported trigger for seizures in these individuals. Therefore, a behavioral therapy proven to be effective in epilepsy could be a valuable adjunct to current pharmacotherapy. The challenges in testing such a behavioral intervention for epilepsy are numerous, including lack of consensus about sham designs, maintaining the blind, and powering the study absent known effect sizes. Herein, we present the design of a randomized, controlled, double-blind trial of progressive muscle relaxation as an add-on therapy for refractory epilepsy. Progressive muscle relaxation, which involves the tensing and releasing of muscle groups one at a time, is a well-established technique that relaxes the body and mind, reduces stress, and may improve seizure control. Study design issues discussed may provide insights that will inform future behavioral research in epilepsy.
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Affiliation(s)
- Emily L Polak
- Montefiore-Einstein Epilepsy Center, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA
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Mammen J, Rhee H. Adolescent Asthma Self-Management: A Concept Analysis and Operational Definition. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2012; 25:180-189. [PMID: 23285426 DOI: 10.1089/ped.2012.0150] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 08/15/2012] [Indexed: 11/12/2022]
Abstract
BACKGROUND: Adolescents with asthma have a higher risk of morbidity and mortality than other age groups. Asthma self-management has been shown to improve outcomes; however, the concept of asthma self-management is not explicitly defined. METHODS: We use the Norris method of concept clarification to delineate what constitutes the concept of asthma self-management in adolescents. Five databases were searched to identify components of the concept of adolescent asthma self-management, and lists of relevant subconcepts were compiled and categorized. RESULTS: Analysis revealed 4 specific domains of self-management behaviors: (1) symptom prevention; (2) symptom monitoring; (3) acute symptom management; and (4) communication with important others. These domains of self-management were mediated by intrapersonal/cognitive and interpersonal/contextual factors. CONCLUSIONS: Based on the analysis, we offer a research-based operational definition for adolescent asthma self-management and a preliminary model that can serve as a conceptual base for further research.
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Affiliation(s)
- Jennifer Mammen
- School of Nursing, University of Rochester , Rochester, New York
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20
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Silva KCLD, Andrade TCQD, Pessoa MF, Andrade ADD. Posicionamento corporal alterando a força muscular respiratória e o grau de obstrução em crianças asmáticas. FISIOTERAPIA EM MOVIMENTO 2012. [DOI: 10.1590/s0103-51502012000300009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: A asma é uma desordem inflamatória crônica que, em casos graves, altera o fluxo aéreo, mesmo no período intercrise. OBJETIVO: Verificar, em crianças asmáticas, a influência das posturas sentada ereta e sentada inclinada para frente sobre o efeito da nebulização medicamentosa, avaliando as forças inspiratória e expiratória máximas (PI máx e PE máx) e o pico de fluxo expiratório (PFE). MÉTODO: 57 crianças, na faixa etária de 6 a 12 anos, foram distribuídas em três grupos: Grupo I, com crianças na postura sentada ereta e sentada inclinada para frente; Grupo II, com crianças na postura sentada ereta antes e após a nebulização; e Grupo III, com crianças na postura sentada inclinada para frente antes e após a nebulização. As crianças foram avaliadas três vezes nas medidas analisadas. Para comparação, foi utilizado o teste t de student (pareado) RESULTADOS: A PI máx, a PE máx e o PFE foram maiores na posição sentada inclinada para frente, com p = 0,003, p = 0,006 e p = 0,000, respectivamente. Após a nebulização, o Grupo II apresentou aumentos de 44,16% na PI máx, 36,02% no PEF e 34,88% na PE máx. Após a nebulização, o Grupo III apresentou elevação de 69,46% na PI máx, 60,87% na PE máx e 52,05% no PFE. Comparados os grupos II e III, os ganhos são maiores no Grupo III, com (p < 0,05) para as medidas do PFE e da PE máx. CONCLUSÃO: A postura sentada inclinada para frente oferece maior vantagem mecânica para a musculatura expiratória, favorecendo a redução da obstrução, por evidenciar aumentos na PE máx e no PFE.
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Pradhan B, Nagendra HR. Effect of yoga relaxation techniques on performance of digit-letter substitution task by teenagers. Int J Yoga 2011; 2:30-4. [PMID: 21234213 PMCID: PMC3017965 DOI: 10.4103/0973-6131.43293] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background/Aims Memory and selective attention are important skills for academic and professional performance. Techniques to improve these skills are not taught either in education or company training courses. Any system which can systematically improve these skills will be of value in schools, universities, and workplaces. Aims:To investigate possible improvements in memory and selective attention, as measured by the Digit–Letter Substitution Task (DLST), due to practice of Cyclic Meditation (CM), a yoga relaxation technique, as compared to Supine Rest (SR). Materials and Methods Subjects consisted of 253 school students, 156 boys, 97 girls, in the age range 13–16 years, who were attending a 10-day yoga training course during summer vacation. The selected subjects had English as their medium of instruction in school and they acted as their own controls. They were allocated to two groups, and tested on the DLST, immediately before and after 22.5 minutes practice of CM on one day, and immediately before and after an equal period of SR on the other day. The first group performed CM on day 9 and SR on day 10. For the second group, the order was reversed. Results Within each group pre-post test differences were significant for both the relaxation techniques. The magnitude of net score improvement was greater after SR (7.85%) compared to CM (3.95%). Significance levels were P < 0.4 × 10-9for SR and P < 0.1 × 10-3 for CM. The number of wrong attempts also increased significantly on both interventions, even after removing two outlier data points on day 1 in the SR group. Conclusions: Both CM and SR lead to improvement in performance on the DLST. However, these relaxation techniques lead to more wrong cancellation errors.
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Affiliation(s)
- Balaram Pradhan
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, India
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Singh VP, Rao V, V. P, RC S, K. KP. Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD—A randomized controlled pilot study. Chron Respir Dis 2009; 6:209-16. [DOI: 10.1177/1479972309346754] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute effects of music and relaxation have not been evaluated in hospitalized subjects with chronic obstructive pulmonary disease (COPD). This study aims to evaluate the acute effects of music and progressive muscle relaxation (PMR) in hospitalized COPD subjects after a recent episode of exacerbation. A Randomized controlled study was performed of pre-test post-test design after recruiting 82 COPD subjects from K.M.C hospitals. All patients were admitted for acute exacerbation and were medically stabilized. After being screened for the inclusion and exclusion criteria, 72 subjects were selected for the study. Demographic and baseline data was taken on the day subjects were screened. Music group listened to a self selected music of 60-80 beats per minute for 30 minutes. PMR group practiced relaxation through a pre-recorded audio of instructions of 16 muscle groups. Outcome variables were Spielberger’s state anxiety inventory (SSAI), Spielberger’s trait anxiety inventory (STAI), dyspnea, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR) and respiratory rate (RR). There was statistically significant main effect across the sessions for state anxiety (F = 62.621, p = 0.000), trait anxiety (F = 19.528, p = 0.000), dyspnea ( F = 122.227, p = 0.000), SBP ( F = 63.885, p = 0.000), PR ( F = 115.780, p = 0.000) and RR ( F = 202.977, p = 0.000). There was statistically significant interaction effect between the two groups for state anxiety ( F = 6.024, p = 0.003), trait anxiety ( F = 8.222, p = 0.000), dyspnea ( F = 10.659, p = 0.000), SBP ( F = 12.889, p = 0.000), PR ( F = 4.746, p = 0.008) and RR ( F = 12.078, p = 0.000). There were greater changes observed after the second session in both groups however, change in DBP was not significant in either group. Music and PMR are effective in reducing anxiety and dyspnoea along with physiologic measures such as SBP, PR and RR in two sessions in COPD patients hospitalized with exacerbation. However, reductions in the music group were greater compared to the PMR group.
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Affiliation(s)
- VP Singh
- Srinivas College of Physiotherapy, Pandeshwar, Mangalore, India,
| | - V. Rao
- Department of Physiotherapy, Kasturba Medical College, Mangalore, India
| | - Prem V.
- Department of Physiotherapy, Kasturba Medical College, Mangalore, India
| | - Sahoo RC
- Department of Pulmonary Disease, Kasturba Medical College, Mangalore, India
| | - Keshav Pai K.
- Department of Psychiatry, Kasturba Medical College, Mangalore, India
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Ghafari S, Ahmadi F, Nabavi M, Anoshirvan K, Memarian R, Rafatbakhsh M. Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. J Clin Nurs 2009; 18:2171-9. [PMID: 19583649 DOI: 10.1111/j.1365-2702.2009.02787.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS AND OBJECTIVES To identify the effects of applying Progressive Muscle Relaxation Technique on Quality of Life of patients with multiple Sclerosis. BACKGROUND In view of the growing caring options in Multiple Sclerosis, improvement of quality of life has become increasingly relevant as a caring intervention. Complementary therapies are widely used by multiple sclerosis patients and Progressive Muscle Relaxation Technique is a form of complementary therapies. DESIGN Quasi-experimental study. METHOD Multiple Sclerosis patients (n = 66) were selected with no probability sampling then assigned to experimental and control groups (33 patients in each group). Means of data collection included: Individual Information Questionnaire, SF-8 Health Survey, Self-reported checklist. PMRT performed for 63 sessions by experimental group during two months but no intervention was done for control group. Statistical analysis was done by SPSS software. RESULTS Student t-test showed that there was no significant difference between two groups in mean scores of health-related quality of life before the study but this test showed a significant difference between two groups, one and two months after intervention (p < 0.05). anova test with repeated measurements showed that there is a significant difference in mean score of whole and dimensions of health-related quality of life between two groups in three times (p < 0.05). CONCLUSIONS Although this study provides modest support for the effectiveness of Progressive Muscle Relaxation Technique on quality of life of multiple sclerosis patients, further research is required to determine better methods to promote quality of life of patients suffer multiple sclerosis and other chronic disease. RELEVANCE TO CLINICAL PRACTICE Progressive Muscle Relaxation Technique is practically feasible and is associated with increase of life quality of multiple sclerosis patients; so that health professionals need to update their knowledge about complementary therapies.
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Affiliation(s)
- Somayeh Ghafari
- Department of Nursing, Fasa University of Medical Science, Fasa, Iran.
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Hinton DE, Hofmann SG, Pollack MH, Otto MW. Mechanisms of efficacy of CBT for Cambodian refugees with PTSD: improvement in emotion regulation and orthostatic blood pressure response. CNS Neurosci Ther 2009; 15:255-63. [PMID: 19691545 PMCID: PMC6494047 DOI: 10.1111/j.1755-5949.2009.00100.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Based on the results of a randomized controlled trial, we examined a model of the mechanisms of efficacy of culturally adapted cognitive-behavior therapy (CBT) for Cambodian refugees with pharmacology-resistant posttraumatic stress disorder (PTSD) and comordid orthostatic panic attacks (PAs). Twelve patients were in the initial treatment condition, 12 in the delayed treatment condition. The patients randomized to CBT had much greater improvement than patients in the waitlist condition on all psychometric measures and on one physiological measure-the systolic blood pressure response to orthostasis (d = 1.31)-as evaluated by repeated-measures MANOVA and planned contrasts. After receiving CBT, the Delayed Treatment Group improved on all measures, including the systolic blood pressure response to orthostasis. The CBT treatment's reduction of PTSD severity was significantly mediated by improvement in orthostatic panic and emotion regulation ability. The current study supports our model of the generation of PTSD in the Cambodian population, and suggests a key role of decreased vagal tone in the generation of orthostatic panic and PTSD in this population. It also suggests that vagal tone is involved in emotion regulation, and that both vagal tone and emotion regulation improve across treatment.
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Affiliation(s)
- Devon E Hinton
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, WACC 812, Boston, MA, USA.
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Dickinson HO, Campbell F, Beyer FR, Nicolson DJ, Cook JV, Ford GA, Mason JM. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev 2008:CD004935. [PMID: 18254065 DOI: 10.1002/14651858.cd004935.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Lifestyle interventions are often recommended as initial treatment for mild hypertension, but the efficacy of relaxation therapies is unclear. OBJECTIVES To evaluate the effects of relaxation therapies on cardiovascular outcomes and blood pressure in people with elevated blood pressure. SEARCH STRATEGY We searched the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, ISI Proceedings, ClinicalTrials.gov, Current Controlled Trials and reference lists of systematic reviews, meta-analyses and randomised controlled trials (RCTs) included in the review. INCLUSION CRITERIA RCTs of a parallel design comparing relaxation therapies with no active treatment, or sham therapy; follow-up >/=8 weeks; participants over 18 years, with raised systolic blood pressure (SBP) >/=140 mmHg or diastolic blood pressure (DBP) >/=85 mmHg); SBP and DBP reported at end of follow-up. EXCLUSION CRITERIA participants were pregnant; participants received antihypertensive medication which changed during the trial. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Random effects meta-analyses and sensitivity analyses were conducted. MAIN RESULTS 29 RCTs, with eight weeks to five years follow-up, met our inclusion criteria; four were excluded from the primary meta-analysis because of inadequate outcome data. The remaining 25 trials assessed 1,198 participants, but adequate randomisation was confirmed in only seven trials and concealment of allocation in only one. Only one trial reported deaths, heart attacks and strokes (one of each). Meta-analysis indicated that relaxation resulted in small, statistically significant reductions in SBP (mean difference: -5.5 mmHg, 95% CI: -8.2 to -2.8, I2 =72%) and DBP (mean difference: -3.5 mmHg, 95% CI: -5.3 to -1.6, I2 =75%) compared to control. The substantial heterogeneity between trials was not explained by duration of follow-up, type of control, type of relaxation therapy or baseline blood pressure. The nine trials that reported blinding of outcome assessors found a non-significant net reduction in blood pressure (SBP mean difference: -3.2 mmHg, 95% CI: -7.7 to 1.4, I(2) =69%) associated with relaxation. The 15 trials comparing relaxation with sham therapy likewise found a non-significant reduction in blood pressure (SBP mean difference: -3.5 mmHg, 95% CI: -7.1 to 0.2, I(2) =63%). AUTHORS' CONCLUSIONS In view of the poor quality of included trials and unexplained variation between trials, the evidence in favour of causal association between relaxation and blood pressure reduction is weak. Some of the apparent benefit of relaxation was probably due to aspects of treatment unrelated to relaxation.
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Affiliation(s)
- Heather O Dickinson
- University of Newcastle, Institute of Health and Society, 21 Claremont Place, Newcastle upon Tyne, Tyne & Wear, UK, NE2 4AA.
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Grepmair L, Mitterlehner F, Rother W, Nickel M. Promotion of mindfulness in psychotherapists in training and treatment results of their patients. J Psychosom Res 2006; 60:649-50. [PMID: 16731244 DOI: 10.1016/j.jpsychores.2006.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2006] [Revised: 03/31/2006] [Accepted: 04/04/2006] [Indexed: 11/21/2022]
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Abstract
BACKGROUND Many people have asthma, and for some their symptoms may be triggered by psychological factors. In addition compliance with medical therapy may have a psychological dimension. Therefore, psychological interventions aim to reduce the burden of symptoms and improve management of the disease. OBJECTIVES To assess the effectiveness of psychological interventions for adults with asthma. SEARCH STRATEGY The Cochrane Airways Group Specialised Register and PsycINFO were searched with pre-defined terms up until August 2005. SELECTION CRITERIA Randomised controlled trials published in any language assessing the effects of a psychological intervention compared with a form of control in adult participants were included in the review. DATA COLLECTION AND ANALYSIS Two reviewers assessed the relevance of abstracts identified by electronic searching and retrieved agreed studies for further scrutiny. The studies that met the inclusion criteria were assembled and data extracted. MAIN RESULTS Fourteen studies, involving 617 particpants, were included in the review, however study quality was poor and sample sizes were frequently small. However, some pooled effects were analysed. The use of 'as needed' medications was reduced in two studies, (47 patients), by relaxation therapy (OR 4.47, CI 1.22 to 16.44). There was no significant difference in FEV1 for relaxation therapy in four studies of 150 patients, (SMD -0.01, CI -0.41 to 0.40). Quality of life, measured using the Asthma Quality of Life Questionnaire in two studies, (48 patients), showed a positive effect following CBT (WMD 0.71, CI 0.23 to 1.19). Peak Expiratory Flow outcome data in two studies, (51 patients), indicated a significant difference in favour of bio-feedback therapy (SMD 0.66, CI 0.09 to 1.23). The remainder of the findings between studies were conflicting. This may have been due to the different types of interventions used and the deficiencies in trial design. AUTHORS' CONCLUSIONS This review was unable to draw firm conclusions for the role of psychological interventions in asthma due to the absence of an adequate evidence base. Larger, well-conducted and reported randomised trials are required in this area, in order to determine the effects of these techniques in the treatment of asthma in adults.
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Affiliation(s)
- J Yorke
- Royal Brompton Hospital, Sydney Street, London, UK.
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Abstract
BACKGROUND Asthma is a chronic disease of inflammation and smooth muscle dysfunction, including bronchoconstriction. These symptoms are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment. Psychological factors may influence the symptoms and management of asthma in children in many ways, for example, evidence suggests that emotional stress can either precipitate or exacerbate both acute and chronic asthma. OBJECTIVES To assess the efficacy of psychological interventions in improving health and behavioural outcomes for children with asthma. SEARCH STRATEGY The Cochrane Airways Group Specialised Register and PsycINFO were searched with pre-defined terms up until March 2005. SELECTION CRITERIA Randomised controlled trials published in any language assessing the effects of a psychological intervention compared with a control intervention in children and adolescents with asthma were included in the review. Cross-over trials were considered inappropriate for studies using psychological interventions and were therefore excluded from this systematic review. DATA COLLECTION AND ANALYSIS Two reviewers assessed the relevance of abstracts identified by electronic searching and retrieved agreed studies for further scrutiny. The studies that met the inclusion criteria were assembled and data extracted. MAIN RESULTS Twelve studies (588 children) were included in the review. Study quality was poor and sample sizes were frequently small. A meta-analysis was possible on two studies only examining the effects of relaxation therapy on PEFR which favoured the treatment group (32 L/min, 95% CI 13 to 50 L/min). No other meta-analysis could be performed due to the diversity of interventions and the outcomes assessed. In addition, many studies reported insufficient data. AUTHORS' CONCLUSIONS This review was unable to draw firm conclusions for the role of psychological interventions for children with asthma. This review demonstrates the absence of an adequate evidence base and highlights the need for well-conducted and reported randomised trials in this area.
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Affiliation(s)
- J Yorke
- Royal Brompton Hospital, Sydney Street, London, UK.
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