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Pongrácz P, Dobos P, Faragó T, Kubinyi E, Lenkei R. Body size awareness matters when dogs decide whether to detour an obstacle or opt for a shortcut. Sci Rep 2023; 13:17899. [PMID: 37857698 PMCID: PMC10587091 DOI: 10.1038/s41598-023-45241-w] [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: 06/04/2023] [Accepted: 10/17/2023] [Indexed: 10/21/2023] Open
Abstract
Body-awareness is one of the fundamental modules of self-representation. We investigated how body-awareness could contribute to dogs' decision making in a novel spatial problem where multiple solutions are possible. Family dogs (N = 68) had to obtain a treat from behind a transparent fence. They had two options: either detour around the fence (7 m), or take a shortcut through a doorway (2 m). We had three conditions: small door open, large door open, and doors closed. Our results indicated that dogs assess the size of the doorway, and if they find it too small, they decide to detour instead, while in the case of the open large door, they rather opted for the shortcut without hesitation. Shorter headed dogs tended to choose open doors more often, while longer headed dogs rather chose detours, probably because of their better peripheral vision. While body size awareness did not manifest differently in dogs with short or long heads, we showed for the first time a connection between head shape and physical cognition in dogs. We showed that dogs rely on their body-awareness in a naturalistic setting where multiple solutions exist simultaneously. Dogs make decisions without lengthy trial-and-error learning and choose between options based on their body-awareness.
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Affiliation(s)
- Péter Pongrácz
- Department of Ethology, Institute of Biology, Eötvös Loránd University, Pázmány Péter Sétány 1/C, 1117, Budapest, Hungary.
| | - Petra Dobos
- Department of Ethology, Institute of Biology, Eötvös Loránd University, Pázmány Péter Sétány 1/C, 1117, Budapest, Hungary
| | - Tamás Faragó
- MTA-ELTE Lendület "Momentum" Companion Animal Research Group, Budapest, Hungary
- Department of Ethology, Neuroethology of Communication Lab, Budapest, Hungary
| | - Enikő Kubinyi
- Department of Ethology, Institute of Biology, Eötvös Loránd University, Pázmány Péter Sétány 1/C, 1117, Budapest, Hungary
- MTA-ELTE Lendület "Momentum" Companion Animal Research Group, Budapest, Hungary
| | - Rita Lenkei
- Department of Ethology, Institute of Biology, Eötvös Loránd University, Pázmány Péter Sétány 1/C, 1117, Budapest, Hungary
- MTA-ELTE Lendület "Momentum" Companion Animal Research Group, Budapest, Hungary
- Doctoral School of Biology, Institute of Biology, ELTE Eötvös Loránd University, Budapest, Hungary
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2
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Dance/Movement Therapy for Individuals with Eating Disorders: A Phenomenological Approach. AMERICAN JOURNAL OF DANCE THERAPY 2023. [DOI: 10.1007/s10465-023-09379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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3
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Baik SM, Kim SH, Lee JH. A scoping review of the different types of exercise programs proposed for the improvement of postural balance in adolescents with idiopathic scoliosis. J Back Musculoskelet Rehabil 2023; 36:1261-1272. [PMID: 37482978 DOI: 10.3233/bmr-220391] [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: 07/25/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS), which is the most common type of scoliosis, is a progressive disease that occurs in children aged 10-16 years. Abnormal curvature in AIS provokes spinal asymmetry of the upper body alignment and might deteriorate postural balancing and control ability. OBJECTIVE To evaluate the effect of exercise interventions on balance and postural stability in patients with adolescent idiopathic scoliosis. METHODS Embase, Scopus, Pubmed (Medline) and Web of Science databases were searched using the terms idiopathic scoliosis, physiotherapy, and balance. The articles selected were published in English in peer-reviewed journals from 2012 to July 2022. RESULTS Ten studies met the inclusion criteria. The PEDro scale values ranged from 2 to 6 (mean, 3.6), indicating a low level of scientific rigor. In the sample studies, spinal stabilization exercises were most often trialed (n= 3), followed by Schroth's exercise (n= 2), stretching and self-elongation exercise (n= 2), the exercise protocol of Blount and Moe, physiotherapeutic scoliosis-specific exercise, and proprioceptive neuromuscular facilitation exercise (all n= 1). CONCLUSIONS Physical therapists will be able to apply hippotherapy, Schroth exercise, physiotherapy scoliosis-specific exercise, trunk stabilization, proprioceptive neuromuscular facilitation exercise, spinal stabilization exercise, core stabilization exercise, and body awareness therapy to manage balance impairments in patients with adolescent idiopathic scoliosis, and further studies are needed to provide stronger evidence.
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Affiliation(s)
- Seung-Min Baik
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Kangwon-do, Korea
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Kangwon-do, Korea
| | - Seok-Hyun Kim
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Kangwon-do, Korea
| | - Ji-Hyun Lee
- Departement of Physical Therapy, Baekseok University, Cheonan-si, Chungcheongnam-do, Korea
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4
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Heywood SE, Connaughton J, Kinsella R, Black S, Bicchi N, Setchell J. Physical Therapy and Mental Health: A Scoping Review. Phys Ther 2022; 102:pzac102. [PMID: 35926073 DOI: 10.1093/ptj/pzac102] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/17/2021] [Accepted: 05/09/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Coexistence of mental and physical health conditions is prevalent. To achieve optimal physical therapy outcomes, neither should be treated in isolation. This review aimed to map intersections between physical therapy and mental health. METHODS This was a scoping review searching MEDLINE, CINAHL, PsycInfo, Cochrane, and PEDro databases. Two independent researchers screened studies of physical therapy practice with adolescents/adults with mental health disorders or research using primary mental health outcomes in physical health conditions or clinicians' perspective. Data were extracted on study type, participants, topics, publication year, and country. RESULTS The search yielded 3633 studies with 135 included. Five studies included adolescents. More than one-half were published since 2015. Studies specific to participants with mental health diagnoses included schizophrenia (n = 12), depressive disorders (n = 8), eating disorders (n = 6), anxiety disorders (n = 4), bipolar disorders (n = 1), somatic disorders (n = 5), and trauma and stressor-related disorders (n = 8) or varied mental health diagnoses (n = 14). Forty-one studies had primary mental health outcomes or clinical practice approaches with a mental health emphasis with participants with physical health conditions (musculoskeletal [n = 13], neurological [n = 7], other [n = 21]). Systematic reviews or randomized controlled trials predominantly involved exercise therapy and/or physical activity. Descriptions of physical therapists as participants (n = 35) included 4 main topics: (1) mental health screening; (2) knowledge, attitudes, and experiences; (3) key practice components; and (4) research priorities. CONCLUSION Physical therapy intersects with people experiencing mental health disorders across a broad spectrum of diagnoses, covering a range of interventions with a small but growing evidence base. IMPACT Exercise and physical activity studies dominated the highest levels of evidence and future focus, although economic evaluations and consumer-driven or patient experience studies are needed. There is a contrast between the confidence and knowledge of specialized physical therapists working within mental health settings and those in general practice settings. Inspiring, integrated education is required to further improve health care outcomes following physical therapy for people with mental health disorders or symptoms.
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Affiliation(s)
- Sophie E Heywood
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Joanne Connaughton
- School of Physiotherapy, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Rita Kinsella
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Susie Black
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nadia Bicchi
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
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5
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Varlı Ü, Naz İ, Yılmaz H. Investigation of Body Awareness and Affecting Factors in Patients with Bariatric Surgery. Obes Surg 2022; 32:829-836. [PMID: 34988896 DOI: 10.1007/s11695-021-05864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Major weight loss after bariatric surgery (BS) makes the body sensitive to the environment. The factors associated with body awareness are unknown in patients with BS. In this study, we aimed to investigate the body awareness and the affecting factors in patients with BS. METHODS Our study included 81 patients who had BS at least 6 months ago and 40 people of the same age and gender who had not. Participants' body awareness was evaluated with the Body Awareness Questionnaire, body compositions with bioelectric impedance device, joint position sensation (JPS) with photography method, physical activity level with International Physical Activity Questionnaire, quality of life with the Short Form-36, depression status with the Beck Depression Inventory, and cognition with the Montreal Cognitive Assessment Scale. Mann-Whitney U and Chi-square tests were used for the comparison of the groups, and Spearman correlation analysis was used for in-group correlation analysis. RESULTS Body awareness was found to be higher in patients with BS compared to the control group (p = 0.002). Body awareness had a positive correlation with cognition (r = 0.277, p = 0.012), quality of life sub-scales (r = 0.245-0.374, p < 0.05), the amount of change in total body weight (r = 0.241, p = 0.027), and body mass index (BMI) (r = 0.269, p = 0.032); negative correlation with depression (r = - 0.409, p = 0.016) and deviation in the JPS (r = - 0.223, p = 0.046). CONCLUSION Body awareness of patients with BS was found to be high after surgery. Body awareness in patients with BS is associated with the amount of weight loss and BMI, depression, cognition, JPS, and health-related quality of life.
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Affiliation(s)
- Ümit Varlı
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, İzmir Katip Çelebi University, 35620, Çiğli İzmir, Turkey. .,Physiotherapy and Rehabilitation Clinic, EMOT Hospital, İzmir, Turkey.
| | - İlknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Katip Çelebi University, İzmir, Turkey
| | - Hüsnü Yılmaz
- Department of Endocrinology and Metabolic Diseases, Private Can Hospital, İzmir, Turkey
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6
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Haeyen S. Effects of Arts and Psychomotor Therapies in Personality Disorders. Developing a Treatment Guideline Based on a Systematic Review Using GRADE. Front Psychiatry 2022; 13:878866. [PMID: 35782411 PMCID: PMC9243752 DOI: 10.3389/fpsyt.2022.878866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
What is the effect of arts and psychomotor therapies, using art, dance, drama, music, movement and body awareness, in personality disorder treatment? This was explored by developing a treatment guideline based on a systematic review using the GRADE system within the context of the Dutch national multidisciplinary guidelines for treatment of personality disorders. Conclusions were formulated by a work group and based on the scientific substantiation and were integrated with other indications in the functioning of arts and psychomotor therapies in personality disorders. The first general search yielded 1,900 records which was brought back to 53 full-texts. Ultimately, 1 RCT and 2 pilot studies were included. Recommendations for treatment are that arts and psychomotor therapies are included in treatment, independent of age, sex or specific diagnostic characteristics. Arts and psychomotor therapies can be considered for purposes of coming into emotional contact with difficult aspects of patients and their experiences, to work on goals such as regulation of emotions, stress, identity/self-image, self-expression, mood/anxiety, relaxation, changing patterns and social functioning. Enlisting arts and psychomotor therapies for patients with a personality disorder is recommended because they value these therapies and perceive these to be effective. It could be considered to ask arts and psychomotor therapies to provide a contribution to the diagnostic process, to the problem analysis via observation and to determining treatment indication and treatment goals. More research is needed.
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Affiliation(s)
- Suzanne Haeyen
- Department 'Scelta', Expert Center for Personality Disorders, GGNet Centre of Mental Health, Apeldoorn, Netherlands.,Special Research Group 'Arts and Psychomotor Therapies in Personality Disorders', HAN University of Applied Sciences, Nijmegen, Netherlands
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7
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Experiences with basic body awareness therapy as an add-on to cognitive behavioural therapy among Danish military veterans with PTSD: An interview study. J Bodyw Mov Ther 2021; 27:550-559. [PMID: 34391286 DOI: 10.1016/j.jbmt.2021.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/05/2021] [Accepted: 03/28/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Danish Veterans Centre offers a body-orientated therapy, Basic Body Awareness Therapy (BBAT), in addition to the psychological trauma-focused therapy to military veterans suffering from symptoms of post-traumatic stress disorder (PTSD). This study explored how the veterans a) experienced BBAT as a physiotherapeutic approach and as an add-on treatment to their usual Cognitive Behavioural Therapy (CBT) and b) whether it makes sense for the individual veteran to incorporate BBAT into their treatment. MATERIALS AND METHODS Individual semi-structured interviews with four veterans who had completed 12 BBAT sessions concurrently with their usual CBT treatment. Interviews were transcribed and analysed using Malterud's version of Giorgi's 4-step systematic text condensation. RESULTS Three main categories emerged: "Effects of treatment", "The setting of the treatment" and "Complementary nature of BBAT and CBT". Within each category were 2-5 underlying subgroups. Participants found it made sense to combine BBAT with their CBT since it benefitted them differently and addressed their bodily symptoms and improved body perception/awareness. CONCLUSION BBAT showed potential as a supplement to CBT and seemed to benefit the veterans through focusing on bodily symptoms and how to calm them. Future studies are needed because of the limited research on the topic.
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Kleinlooh ST, Samaritter RA, van Rijn RM, Kuipers G, Stubbe JH. Dance Movement Therapy for Clients With a Personality Disorder: A Systematic Review and Thematic Synthesis. Front Psychol 2021; 12:581578. [PMID: 33868071 PMCID: PMC8044983 DOI: 10.3389/fpsyg.2021.581578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 02/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners' expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients' experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.
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Affiliation(s)
- S T Kleinlooh
- Department of Arts Therapies, Codarts University of the Arts, Rotterdam, Netherlands
| | - R A Samaritter
- Department of Arts Therapies, Codarts University of the Arts, Rotterdam, Netherlands.,KenVaK Research Centre for the Arts Therapies and Psychomotricity, Heerlen, Netherlands
| | - R M van Rijn
- Professorship Performing Arts Medicine, Codarts University of the Arts, Rotterdam, Netherlands.,PErforming artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - G Kuipers
- AntesPG, Parnassia Group, The Hague, Netherlands
| | - J H Stubbe
- Professorship Performing Arts Medicine, Codarts University of the Arts, Rotterdam, Netherlands.,PErforming artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands.,Department of General Practice, Erasmus MC University Medical Center, Rotterdam, Netherlands
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9
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Bjerg Christensen J, Lassen IS, Helles Carlsen A, Strazek S, Nyboe L. Physical therapy for reducing arousal and mechanical restraint among in-patients with mania. Nord J Psychiatry 2021; 75:49-53. [PMID: 32744113 DOI: 10.1080/08039488.2020.1792981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND From 2003 to 2013 the number of patients exposed to mechanical restraint in Danish psychiatric hospitals was increased. Since, a great effort has been done to reduce mechanical restraint. OBJECTIVES The aim of this study was to assess whether physical therapy could lower the level of arousal and reduce mechanical restraint among patients with mania. METHODS 170 patients admitted with mania at Aarhus University Hospital were offered physical therapy during the study period from 2017 to 2018. Patients reported their experienced level of arousal before and after physical therapy, rating feelings of tension, ability to be at rest, and feelings of irritability/aggression on Visual Analog Scales. Further, the number of manic patients exposed to mechanical restraint in this period was compared with the two previous years and with patients with other diagnoses. RESULTS Patients' level of arousal was significantly reduced after receiving physical therapy. Further, the study showed a significant reduction in mechanical restraint among patients with mania from 2015 to 2017. CONCLUSION The results indicate that physical therapy lowers the level of arousal and it is possible that physical therapy contributed to a reduction in mechanical restraint among manic patients. However, the study-design does not allow for confirming this causality.
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Affiliation(s)
| | - Irene Smith Lassen
- Department of Psychiatry, Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Anders Helles Carlsen
- Department of Psychiatry, Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Sune Strazek
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lene Nyboe
- Department of Psychiatry, Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
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The Effect of Physiotherapy Group Intervention in Reducing Pain Disorders and Mental Health Symptoms among Syrian Refugees: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249468. [PMID: 33348794 PMCID: PMC7767069 DOI: 10.3390/ijerph17249468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/04/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
Chronic pain is common among refugees, and often related to mental health problems. Its management, however, is often challenging. A randomized waitlist-controlled trial was designed to study the effect of group physiotherapy activity and awareness intervention (PAAI) on reducing pain disorders, and secondarily improving mental health, among Syrian refugees. A total of 101 adult Syrian refugees suffering from chronic pain were randomized to either the intervention group or the control group, which thereafter also received PAAI after a waiting period. Pain intensity measured by the Brief Pain Inventory (BPI) was the primary outcome. Scores from the Impact of Events Scale-Revised (IES-R 22) and the General Health Questionnaire (GHQ-12) were secondary outcomes. Intention-to-treat analyses (ITT) showed no effect of the intervention on either pain levels (regression coefficient [B {95% CI} of 0.03 {-0.91, 0.96}], IESR scores [4.8 {-3.7, 13.4}] or GHQ-12 scores [-0.4 {-3.1, 2.3}]). Yet, participants highly appreciated the intervention. Despite the negative findings, our study contributes to the evidence base necessary to plan targeted and effective health care services for refugees suffering from chronic pain and highlights the challenge of evaluating complex interventions adapted to a specific group.
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Lefranc B, Martin-Krumm C, Aufauvre-Poupon C, Berthail B, Trousselard M. Mindfulness, Interoception, and Olfaction: A Network Approach. Brain Sci 2020; 10:brainsci10120921. [PMID: 33260427 PMCID: PMC7760383 DOI: 10.3390/brainsci10120921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/02/2022] Open
Abstract
The fine-tuned interplay between the brain and the body underlies the adaptive ability to respond appropriately in the changing environment. Mindfulness Disposition (MD) has been associated with efficient emotional functioning because of a better ability to feel engaged by information from the body and to notice subtle changes. This interoceptive ability is considered to shape the ability to respond to external stimuli, especially olfaction. However, few studies have evaluated the relationships between interoception and exteroception according to MD. We conducted an exploratory study among 76 healthy subjects for first investigating whether MD is associated with better exteroception and second for describing the causal interactions network between mindfulness, interoception, emotion, and subjective and objective olfaction assessments. Results found that a high level of MD defined by clustering exhibited best scores in positive emotions, interoception, and extra sensors’ acuity. The causal network approach showed that the interactions between the interoception subscales differed according to the MD profiles. Moreover, interoception awareness is strongly connected with both the MD and the hedonic value of odors. Then, differences according to MD might provide arguments for a more mindful attention style toward interoceptive cues in relation to available exteroceptive information. This interaction might underlie positive health.
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Affiliation(s)
- Barbara Lefranc
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France; (C.M.-K.); (M.T.)
- French Armed Forces Biomedical Research Institute, BP73, CEDEX, 91223 Brétigny-sur-Orge, France
- Correspondence:
| | - Charles Martin-Krumm
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France; (C.M.-K.); (M.T.)
- French Armed Forces Biomedical Research Institute, BP73, CEDEX, 91223 Brétigny-sur-Orge, France
- Ecole de Psychologues Praticiens, Institut Catholique de Paris (Catholic Institute of Paris), VCR/ICP EA 7403-23, rue du Montparnasse, 75006 Paris, France
| | | | - Benoit Berthail
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France;
| | - Marion Trousselard
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France; (C.M.-K.); (M.T.)
- French Armed Forces Biomedical Research Institute, BP73, CEDEX, 91223 Brétigny-sur-Orge, France
- Ecole de Psychologues Praticiens, Institut Catholique de Paris (Catholic Institute of Paris), VCR/ICP EA 7403-23, rue du Montparnasse, 75006 Paris, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France;
- Réseau ABC des Psychotraumas, 34000 Montpellier, France
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Ahlmark NG, Dahl A, Andersen HS, Tjørnhøj-Thomsen T, Andersen S. Body therapy versus treatment as usual among Danish veterans with PTSD: Study protocol for a randomised controlled trial combined with a qualitative study. Contemp Clin Trials Commun 2020; 19:100596. [PMID: 32617435 PMCID: PMC7322676 DOI: 10.1016/j.conctc.2020.100596] [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: 12/23/2019] [Revised: 06/05/2020] [Accepted: 06/14/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many veterans suffer from Post-Traumatic Stress Disorder (PTSD) after returning from military missions. This implies complex physical and psychosocial problems for veterans and their families. Treatment options today are primarily medically and psychologically founded but treatment response is incomplete. Body therapy for PTSD is scarcely researched though subject of increased attention. In 2015, a Danish pilot study was conducted exploring body therapy for PTSD. The study showed positive results and formed basis for a randomised controlled trial. This paper outlines the protocol for this trial. METHODS The intervention will be evaluated in a two-arm randomised controlled trial (1:1). The trial will include 42 veterans with PTSD recruited by the Danish Military Psychiatric Centre. The intervention group receives treatment as usual and weekly body therapy treatment as add-on. The control group receives treatment as usual (TAU). Participants will complete four questionnaires assessing PTSD, depression, quality of life, function level and body awareness: at baseline, and at 3 months, 6 months and 12 months post baseline. Linear regression models and mixed effects models will be used to assess intervention effects. Furthermore, an ethnographic study will examine how the participants experience the treatment and changes in their everyday life. The ethnographic study is based on in-depth interviews, participant observations and focus groups. A mixed method, convergent parallel design will be applied. DISCUSSION This study examines the efficacy of body therapy for veterans with PTSD and how the treatment is experienced and affects daily life. The study will contribute with important knowledge on an alternative treatment for PTSD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03777800.
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Affiliation(s)
- Nanna Gram Ahlmark
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Anders Dahl
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Henrik Steen Andersen
- Danish Military Psychiatric Center, Capital Region of Denmark, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
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Ganslev CA, Storebø OJ, Callesen HE, Ruddy R, Søgaard U. Psychosocial interventions for conversion and dissociative disorders in adults. Cochrane Database Syst Rev 2020; 7:CD005331. [PMID: 32681745 PMCID: PMC7388313 DOI: 10.1002/14651858.cd005331.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Conversion and dissociative disorders are conditions where people experience unusual neurological symptoms or changes in awareness or identity. However, symptoms and clinical signs cannot be explained by a neurological disease or other medical condition. Instead, a psychological stressor or trauma is often present. The symptoms are real and can cause significant distress or problems with functioning in everyday life for the people experiencing them. OBJECTIVES To assess the beneficial and harmful effects of psychosocial interventions of conversion and dissociative disorders in adults. SEARCH METHODS We conducted database searches between 16 July and 16 August 2019. We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and eight other databases, together with reference checking, citation searching and contact with study authors to identify additional studies. SELECTION CRITERIA: We included all randomised controlled trials that compared psychosocial interventions for conversion and dissociative disorders with standard care, wait list or other interventions (pharmaceutical, somatic or psychosocial). DATA COLLECTION AND ANALYSIS: We selected, quality assessed and extracted data from the identified studies. Two review authors independently performed all tasks. We used standard Cochrane methodology. For continuous data, we calculated mean differences (MD) and standardised mean differences (SMD) with 95% confidence interval (CI). For dichotomous outcomes, we calculated risk ratio (RR) with 95% CI. We assessed and downgraded the evidence according to the GRADE system for risk of bias, imprecision, indirectness, inconsistency and publication bias. MAIN RESULTS We included 17 studies (16 with parallel-group designs and one with a cross-over design), with 894 participants aged 18 to 80 years (female:male ratio 3:1). The data were separated into 12 comparisons based on the different interventions and comparators. Studies were pooled into the same comparison when identical interventions and comparisons were evaluated. The certainty of the evidence was downgraded as a consequence of potential risk of bias, as many of the studies had unclear or inadequate allocation concealment. Further downgrading was performed due to imprecision, few participants and inconsistency. There were 12 comparisons for the primary outcome of reduction in physical signs. Inpatient paradoxical intention therapy compared with outpatient diazepam: inpatient paradoxical intention therapy did not reduce conversive symptoms compared with outpatient diazepam at the end of treatment (RR 1.44, 95% CI 0.91 to 2.28; 1 study, 30 participants; P = 0.12; very low-quality evidence). Inpatient treatment programme plus hypnosis compared with inpatient treatment programme: inpatient treatment programme plus hypnosis did not reduce severity of impairment compared with inpatient treatment programme at the end of treatment (MD -0.49 (negative value better), 95% CI -1.28 to 0.30; 1 study, 45 participants; P = 0.23; very low-quality evidence). Outpatient hypnosis compared with wait list: outpatient hypnosis might reduce severity of impairment compared with wait list at the end of treatment (MD 2.10 (higher value better), 95% CI 1.34 to 2.86; 1 study, 49 participants; P < 0.00001; low-quality evidence). Behavioural therapy plus routine clinical care compared with routine clinical care: behavioural therapy plus routine clinical care might reduce the number of weekly seizures compared with routine clinical care alone at the end of treatment (MD -21.40 (negative value better), 95% CI -27.88 to -14.92; 1 study, 18 participants; P < 0.00001; very low-quality evidence). Cognitive behavioural therapy (CBT) compared with standard medical care: CBT did not reduce monthly seizure frequency compared to standard medical care at end of treatment (RR 1.56, 95% CI 0.39 to 6.19; 1 study, 16 participants; P = 0.53; very low-quality evidence). CBT did not reduce physical signs compared to standard medical care at the end of treatment (MD -4.75 (negative value better), 95% CI -18.73 to 9.23; 1 study, 61 participants; P = 0.51; low-quality evidence). CBT did not reduce seizure freedom compared to standard medical care at end of treatment (RR 2.33, 95% CI 0.30 to 17.88; 1 trial, 16 participants; P = 0.41; very low-quality evidence). Psychoeducational follow-up programmes compared with treatment as usual (TAU): no study measured reduction in physical signs at end of treatment. Specialised CBT-based physiotherapy inpatient programme compared with wait list: no study measured reduction in physical signs at end of treatment. Specialised CBT-based physiotherapy outpatient intervention compared with TAU: no study measured reduction in physical signs at end of treatment. Brief psychotherapeutic intervention (psychodynamic interpersonal treatment approach) compared with standard care: brief psychotherapeutic interventions did not reduce conversion symptoms compared to standard care at end of treatment (RR 0.12, 95% CI 0.01 to 2.00; 1 study, 19 participants; P = 0.14; very low-quality evidence). CBT plus adjunctive physical activity (APA) compared with CBT alone: CBT plus APA did not reduce overall physical impacts compared to CBT alone at end of treatment (MD 5.60 (negative value better), 95% CI -15.48 to 26.68; 1 study, 21 participants; P = 0.60; very low-quality evidence). Hypnosis compared to diazepam: hypnosis did not reduce symptoms compared to diazepam at end of treatment (RR 0.69, 95% CI 0.39 to 1.24; 1 study, 40 participants; P = 0.22; very low-quality evidence). Outpatient motivational interviewing (MI) and mindfulness-based psychotherapy compared with psychotherapy alone: psychotherapy preceded by MI might decrease seizure frequency compared with psychotherapy alone at end of treatment (MD 41.40 (negative value better), 95% CI 4.92 to 77.88; 1 study, 54 participants; P = 0.03; very low-quality evidence). The effect on the secondary outcomes was reported in 16/17 studies. None of the studies reported results on adverse effects. In the studies reporting on level of functioning and quality of life at end of treatment the effects ranged from small to no effect. AUTHORS' CONCLUSIONS The results of the meta-analysis and reporting of single studies suggest there is lack of evidence regarding the effects of any psychosocial intervention on conversion and dissociative disorders in adults. It is not possible to draw any conclusions about potential benefits or harms from the included studies.
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Affiliation(s)
- Christina A Ganslev
- Clinic of Liaison Psychiatry, Region Zealand, Denmark
- Psychiatric Research Unit, Psychiatry of Region Zealand, Slagelse, Denmark
| | - Ole Jakob Storebø
- Psychiatric Research Unit, Psychiatry of Region Zealand, Slagelse, Denmark
- Child and Adolescent Psychiatric Department, Region Zealand, Roskilde, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | | | - Ulf Søgaard
- Clinic of Liaison Psychiatry, Region Zealand, Denmark
- Psychiatric Research Unit, Psychiatry of Region Zealand, Slagelse, Denmark
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Bratberg G, Leira K, Granan LP, Jonsbu E, Fadnes BL, Thuland SF, Myklebust TÅ. Learning oriented physiotherapy (LOP) in anxiety and depression: an 18 months multicentre randomised controlled trial (RCT). EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1739747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Grete Bratberg
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Research, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kirsti Leira
- Department of Psychiatry, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Lars-Petter Granan
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Egil Jonsbu
- Department of Psychiatry, Møre and Romsdal Hospital Trust, Molde, Norway
- Department of Mental Health, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Britt Lenes Fadnes
- Department of Psychiatry, Møre and Romsdal Hospital Trust, Molde, Norway
| | | | - Tor Åge Myklebust
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
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Köpsén S, Sjöström R. Patients' Experiences of a Stress-Management Programme in Primary Care. J Multidiscip Healthc 2020; 13:207-216. [PMID: 32110035 PMCID: PMC7041602 DOI: 10.2147/jmdh.s235930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Stress and stress-related ill health have a multifactorial impact; both on physical and mental health. To better meet this category of patients a primary care unit started a stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Purpose To describe participant´s experiences of a primary care stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Methods In a qualitative study, a semi-structured interview guide was used in individual interviews with 9 people, all women aged 41–57, working or on sick leave, who had enrolled in the stress-management programme. The material was analysed through qualitative content analysis. Results The analysis resulted in the theme “Process of change for a sustainable everyday living”. The participants described having gained awareness of the symptoms of their stress, knowledge and tools to manage their stress, ways to relax, awareness of their body, and the means to develop better habits and to change their behaviour. Fundamental in the material was the importance of participants’ identification with the others in the group. Conclusion The participants started a process of change with new knowledge and growth, but they encountered difficulties and obstacles. Behavioural change is a time-consuming process.
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Affiliation(s)
- Sofia Köpsén
- Krokom Health Care Center, Region Jämtland Härjedalen, Krokom, Sweden.,Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Rita Sjöström
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.,Unit of Research, Education and Development, Region Jämtland Härjedalen, Östersund, Sweden
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Gyllensten AL, Ovesson MN, Hedlund L, Ambrus L, Tornberg Å. To increase physical activity in sedentary patients with affective - or schizophrenia spectrum disorders - a clinical study of adjuvant physical therapy in mental health. Nord J Psychiatry 2020; 74:73-82. [PMID: 31560246 DOI: 10.1080/08039488.2019.1669706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose: To understand if physical therapy in addition to individualized psychiatric specialist treatment could aid sedentary patients with schizophrenia spectrum disorders or affective spectrum disorders to become more physically active and also to identify assessments suitable for measuring physical activity, physical function and movement motivation.Materials and methods: In a longitudinal, clinical study 18 sedentary patients that filled inclusion criteria were consecutively included. The patients were diagnosed with affective disorders (n = 10) or schizophrenia spectrum disorders (n = 8).Results: Fifteen patients fulfilled the 6-month treatment. The affective group significantly improved physical activity, walking capacity, physical function, exercise habits and attitudes. The schizophrenia spectrum group significantly improved the attitudes to the body and movements but did not increase their physical activity. Instruments to study physical activity, physical function and movement motivation were identified.Conclusion: The study revealed that physical therapy in addition to individualized psychiatric specialist treatment might be an aid for the patients to become more physically active. Patients with affective disorders reached recommended levels of moderate physical activity according to World Health Organization guidelines. Sedentary patients with schizophrenia spectrum disorders revealed positive attitude-changes, but no behavioral change.
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Affiliation(s)
| | - Maria N Ovesson
- Department of Psychiatry, Lund University Hospital, Lund, Sweden
| | - Lena Hedlund
- Department of Psychiatry, Malmö University, Malmö, Sweden
| | - Livia Ambrus
- Department of Clinical Sciences, Section of Psychiatry, Clinical Psychiatric Research Center, Lund University, Region Skåne, Sweden
| | - Åsa Tornberg
- Department of Health Sciences, Lund University, Lund, Sweden
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17
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Lundwall A, Ryman A, Bjarnegård Sellius A, Mannerkorpi K. Pain requires processing - How the experience of pain is influenced by Basic Body Awareness Therapy in patients with long-term pain. J Bodyw Mov Ther 2019; 23:701-707. [PMID: 31733750 DOI: 10.1016/j.jbmt.2019.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE Long-term pain is common and entails large costs to society. One physiotherapy treatment with documented positive effects for patients with long-term pain is Basic Body Awareness therapy (BBAT). However, studies are lacking about patients' experience of BBAT's influence on their pain. Therefore, the aim of this study was to investigate how patients experience BBAT's influence on their long-term pain. METHODS For this qualitative interview study, participants were selected from two supervised BBAT groups. To qualify for the study, participants had to meet two inclusion criteria: having pain for at least 6 months, and attending BBAT for at least 6 months. Six females between the ages of 25 and 61 years were included. Pain duration ranged from 9 to 20 years, and duration of practicing BBAT ranged from 8 to 120 months. Semi-structured interviews were conducted and qualitative content analysis was performed. RESULTS The analysis revealed four main categories of BBAT experience: increases motivation, requires processing, increases control over pain and changes attitude to oneself, body and pain. DISCUSSION Patients with long-term pain experienced BBAT as being helpful in processing their pain because they were forced to face the pain instead of trying to ignore it. Participants experienced a decrease in pain through development of an increased sense of control as well as a changed attitude to themselves, their bodies and their pain. It is important for physiotherapists to understand that pain can increase during BBAT and to support the patients in this process during the therapy.
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Affiliation(s)
- Adam Lundwall
- University of Gothenburg, Sahlgrenska Academy, Inst of Neuroscience and Physiology, Section of Health and Rehabilitation, Unit of Physiotherapy, Sweden.
| | - Anton Ryman
- University of Gothenburg, Sahlgrenska Academy, Inst of Neuroscience and Physiology, Section of Health and Rehabilitation, Unit of Physiotherapy, Sweden
| | - Anna Bjarnegård Sellius
- University of Gothenburg, Sahlgrenska Academy, Inst of Neuroscience and Physiology, Section of Health and Rehabilitation, Unit of Physiotherapy, Sweden
| | - Kaisa Mannerkorpi
- University of Gothenburg, Sahlgrenska Academy, Inst of Neuroscience and Physiology, Section of Health and Rehabilitation, Unit of Physiotherapy, Sweden
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18
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Ölund H, Danielsson L, Rosberg S. Anxiety management: Participants' experiences of a physiotherapeutic group treatment in Swedish psychiatric outpatient care. Physiother Theory Pract 2018; 36:276-290. [PMID: 29913081 DOI: 10.1080/09593985.2018.1485192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Anxiety disorders are among the most persistent mental health syndromes. There is extensive research showing effectiveness of pharmacotherapy and psychotherapy interventions targeting anxiety, while knowledge is still sparse for other treatment options. The aim of this study was to explore how participants with anxiety disorders experience a physiotherapeutic group treatment in psychiatric outpatient care, and their perceived ability to manage anxiety within two months after participating in the treatment. Semi-structured interviews with participants were conducted to explore experiences of the treatment. Data were analyzed using qualitative content analysis, which resulted in one main theme: Reconnecting to the body in the supportive atmosphere of a group. Six categories reflect the main theme: (1) sharing with others supported by the group, (2) grounding oneself in the body, (3) getting to know the body and learning to manage its reactions, (4) learning to tolerate bodily sensations of anxiety, (5) gaining a more compassionate attitude toward oneself, and (6) challenging old patterns to become more active in life. The participants reported that their ability to reconnect to their bodies increased so that anxious sensations became more endurable and acceptable after treatment. The supportive group context was described as valuable, enabling the participants to feel safe enough to start exploring new ways to manage anxiety. In conclusion, this study suggests that a physiotherapeutic group treatment can be a useful add-on treatment to the standard treatment models of anxiety disorders, including psychotherapy and pharmacotherapy, since it targets the embodied, nonverbal domain of anxiety.
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Affiliation(s)
- Helena Ölund
- The Sahlgrenska Academy, Institute of Neuroscience and Physiology Section for Physiotherapy, Göteborg University, Göteborg, Sweden
| | - Louise Danielsson
- The Sahlgrenska Academy, Institute of Neuroscience and Physiology Section for Physiotherapy, Göteborg University, Göteborg, Sweden
| | - Susanne Rosberg
- The Sahlgrenska Academy, Institute of Neuroscience and Physiology Section for Physiotherapy, Göteborg University, Göteborg, Sweden
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19
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Skjaerven LH, Mattsson M, Catalan-Matamoros D, Parker A, Gard G, Gyllensten AL. Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy. Physiother Theory Pract 2018; 35:80-93. [DOI: 10.1080/09593985.2018.1434578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- LH. Skjaerven
- Department of Occupational Therapy, Physiotherapy and Radiography, Western Norway University of Applied Sciences, Campus Kronstad, Bergen, Norway
| | - M. Mattsson
- Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden
| | - D. Catalan-Matamoros
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Faculty of Humanities, Communication and Documentation, University Carlos III of Madrid, Madrid, Spain
| | - A. Parker
- Physiotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK
| | - G. Gard
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Yagci G, Yakut Y, Simsek E. The effects of exercise on perception of verticality in adolescent idiopathic scoliosis. Physiother Theory Pract 2018; 34:579-588. [PMID: 29308950 DOI: 10.1080/09593985.2017.1423429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Visual and proprioceptive cues are important for body orientation to maintain correct posture. This study investigated the effects of exercise training on subjective visual, postural, and haptic perception of verticality in patients with scoliosis. SUBJECTS AND METHODS Thirty-two female adolescents with moderate idiopathic scoliosis were randomly allocated to "Core Stabilization Exercise (CSE)," "Body Awareness," or "Traditional Exercise (TE)" groups. Each group completed a 1-hour supervised program, two days per week for 10 weeks while continuing to wear spinal braces. Perceptual visual, postural, and haptic estimates were assessed before and after treatment. RESULTS Subjective visual vertical perception only improved in the awareness group. Subjective visual horizontal perception, postural vertical perception, total postural perception scores, total haptic perception scores, and haptic perception 45° to the right were significantly improved in the stabilization and awareness groups. For the 60° right and 60° left postural perception parameters, as well as the 45° left haptic perception parameters, perception improved only in the stabilization group. No improvement was observed in the traditional group. CONCLUSION Improvements in visual, postural, and haptic verticality perception within the stabilization exercise training and Basic Body Awareness group treatment suggest the addition of these exercise methods for the treatment of idiopathic scoliosis to improve internal body orientation.
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Affiliation(s)
- Gozde Yagci
- a Hacettepe University, Faculty of Health Sciences , School of Physical Therapy and Rehabilitation Sciences, Samanpazari , Ankara , Turkey
| | - Yavuz Yakut
- b Physiotherapy and Rehabilitation Department, Hasan Kalyoncu University, Faculty of Health Sciences , Altindag Turkey , Turkey
| | - Engin Simsek
- c Dokuz Eylul University, School of Physical Therapy and Rehabilitation Sciences , İzmir , Turkey
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21
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Sertel M, Şimşek TT, Yümin ET. The effect of body awareness therapy on pain and body image in patients with migraine and tension type headache. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2017. [DOI: 10.1080/17432979.2017.1371642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Sertel
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - T. T. Şimşek
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
| | - E. T. Yümin
- School of Physical Therapy and Rehabilitation, Abant İzzet Baysal University, Bolu, Turkey
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22
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Nyboe L, Bentholm A, Gyllensten AL. Bodily symptoms in patients with post traumatic stress disorder: A comparative study of traumatized refugees, Danish war veterans, and healthy controls. J Bodyw Mov Ther 2017; 21:523-527. [DOI: 10.1016/j.jbmt.2016.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/12/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
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Bang DH, Cho HS. Effect of body awareness training on balance and walking ability in chronic stroke patients: a randomized controlled trial. J Phys Ther Sci 2016; 28:198-201. [PMID: 26957757 PMCID: PMC4756003 DOI: 10.1589/jpts.2016.198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/14/2015] [Indexed: 01/13/2023] Open
Abstract
[Purpose] To investigate the effects of body awareness training on balance and walking
ability in chronic stroke patients. [Subjects] The subjects were randomly assigned to a
body awareness training group (n=6) and a control group (n=6). [Methods] Patients in the
body awareness training group received body awareness training for 20 minutes, followed by
walking training for 30 minutes a day, 5 days a week for 4 weeks. The control group
received walking training for 30 minutes a day, 5 days a week for 4 weeks. [Results] After
the intervention, both groups showed significant improvements in the Berg Balance Scale,
Timed Up and Go Test, and 10 m walk test compared with baseline results. The body
awareness training group showed more significant improvements in the Berg Balance Scale
and Timed Up and Go Test than the control group. There was no significant difference in
the 10 m walk test between the groups. [Conclusion] The results of this study suggest that
body awareness training has a positive effect on balance in patients with chronic
stroke.
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Affiliation(s)
- Dae-Hyouk Bang
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Hyuk-Shin Cho
- Department of Physical Therapy, Wonkwang Health Science University, Republic of Korea
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Kang R, Wu Y, Li Z, Jiang J, Gao Q, Yu Y, Gao K, Yan Y, He Y. Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study. Psychopathology 2016; 49:345-355. [PMID: 27584836 DOI: 10.1159/000448195] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 06/25/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. METHODS In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. RESULTS Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p < 0.001) and negative symptoms (F = 44.909, p < 0.001), a lower risk for aggressive behavior (F = 12.382, p < 0.001), and a greater improvement in adherence to medication (F = 12.391, p < 0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p < 0.001; negative symptoms: t = 8.250, p < 0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p < 0.001), negative score (B = 0.709, p < 0.001), and social domain of quality of life (B = -0.673, p = 0.044). CONCLUSIONS This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.
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Affiliation(s)
- Ruiying Kang
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
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Nordbrandt MS, Carlsson J, Lindberg LG, Sandahl H, Mortensen EL. Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomised controlled trial. Trials 2015; 16:477. [PMID: 26492879 PMCID: PMC4619210 DOI: 10.1186/s13063-015-0974-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 09/23/2015] [Indexed: 11/23/2022] Open
Abstract
Background Treatment of traumatised refugees is one of the fields within psychiatry, which has received little scientific attention. Evidence based treatment and knowledge on the efficiency of the treatment for this complex patient group is therefore scarce. This leads to uncertainty as to which treatment should be offered and potentially lowers the quality of life for the patients. Chronic pain is very common among traumatised refugees and it is believed to maintain the mental symptoms of trauma. Hence, treating chronic pain is believed to be of high clinical value for this patient group. In clinical studies, physical activity has shown a positive effect on psychiatric illnesses such as depression and anxiety and for patients with chronic pain. However, scientific knowledge about physical activity as part of the treatment for traumatised refugees is very limited and no guidelines exist on this topic. Methods/design This study will include approximately 310 patients, randomised into three groups. All three groups receive psychiatric treatment as usual for the duration of 6–7 months, consisting of consultations with a medical doctor including pharmacological treatment and manual-based Cognitive Behavioural Therapy. The first group only receives treatment as usual while the second and the third groups receive either Basic-Body Awareness Therapy or mixed physical activity as add-on treatments. Each physical activity is provided for an individual 1-hour consultation per week, for the duration of 20 weeks. The study is being conducted at the Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup in the Capital Region of Denmark. The primary endpoint of the study is symptoms of Post Traumatic Stress Disorder; the secondary endpoints are depression and anxiety as well as quality of life, functional capacity, coping with pain, body awareness and physical fitness. Discussion This study will examine the effect of physical activity for traumatised refugees. This has not yet been done in a randomised controlled setting on such a large scale before. Hereby the study will contribute to important knowledge that is expected to be used in future clinical guidelines and reference programs. Trial registration ClinicalTrials.gov NCT01955538. Date of registration: 18 September 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0974-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maja Sticker Nordbrandt
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Laura Glahder Lindberg
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Hinuga Sandahl
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Erik Lykke Mortensen
- Section of Occupational and Environmental Health, Øster Farimagsgade 5, building 5, 1., 1353, København K, Denmark.
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Danielsson L, Rosberg S. Opening toward life: experiences of basic body awareness therapy in persons with major depression. Int J Qual Stud Health Well-being 2015; 10:27069. [PMID: 25956354 PMCID: PMC4425812 DOI: 10.3402/qhw.v10.27069] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 11/25/2022] Open
Abstract
Although there is a vast amount of research on different strategies to alleviate depression, knowledge of movement-based treatments focusing on body awareness is sparse. This study explores the experiences of basic body awareness therapy (BBAT) in 15 persons diagnosed with major depression who participated in the treatment in a randomized clinical trial. Hermeneutic phenomenological methodology inspired the approach to interviews and data analysis. The participants’ experiences were essentially grasped as a process of enhanced existential openness, opening toward life, exceeding the tangible corporeal dimension to also involve emotional, temporal, and relational aspects of life. Five constituents of this meaning were described: vitality springing forth, grounding oneself, recognizing patterns in one's body, being acknowledged and allowed to be oneself, and grasping the vagueness. The process of enhanced perceptual openness challenges the numbness experienced in depression, which can provide hope for change, but it is connected to hard work and can be emotionally difficult to bear. Inspired by a phenomenological framework, the results of this study illuminate novel clinical and theoretical insight into the meaning of BBAT as an adjunctive approach in the treatment of depression.
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Affiliation(s)
- Louise Danielsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.,Närhälsan Gibraltar Rehabilitation Centre, Gothenburg, Sweden;
| | - Susanne Rosberg
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden
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Bang DH, Noh HJ, Cho HS. Effects of body awareness training on mild visuospatial neglect in patients with acute stroke: a pilot randomized controlled trial. J Phys Ther Sci 2015; 27:1191-3. [PMID: 25995586 PMCID: PMC4434007 DOI: 10.1589/jpts.27.1191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/11/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to investigate the effects of body awareness training (BAT) on
mild visuospatial neglect in patients following acute stroke. [Subjects] The subjects were
12 stroke patients randomly assigned to either the experimental group (n1=6) or
control group (n2=6). [Methods] The experimental group underwent BAT for 15
minutes and then task-oriented training for 30 minutes a day, five times a week for three
weeks. The control group underwent task-oriented training for 30 minutes a day, five times
a week for three weeks. Assessments were made using the Motor-free Visual Perception Test
(MVPT), Line Bisection Test (LBT), and modified Barthel index (MBI). [Results] Following
the interventions, the experimental group showed a significant change in MVPT, LBT, and
MBI scores. [Conclusion] The results of this study suggest the feasibility and suitability
of BAT with task-oriented training for mild visuospatial neglect in patients with acute
stroke.
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Affiliation(s)
- Dae-Hyouk Bang
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Hyun-Jeong Noh
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Hyuk-Shin Cho
- Department of Physical Therapy, Wonkwang Health Science University, Republic of Korea
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Sundén A, Ekdahl C, Horstman V, Gyllensten AL. Analyzing Movements Development and Evaluation of the Body Awareness Scale Movement Quality (BAS MQ). PHYSIOTHERAPY RESEARCH INTERNATIONAL 2014; 21:70-6. [PMID: 25452007 DOI: 10.1002/pri.1618] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 06/11/2014] [Accepted: 10/02/2014] [Indexed: 11/08/2022]
Affiliation(s)
- A. Sundén
- Department of Health Sciences, Faculty of Medicine; Lund University; Lund Sweden
| | - C. Ekdahl
- Department of Health Sciences, Faculty of Medicine; Lund University; Lund Sweden
| | - V. Horstman
- Department of Health Sciences, Faculty of Medicine; Lund University; Lund Sweden
| | - A. L. Gyllensten
- Department of Health Sciences, Faculty of Medicine; Lund University; Lund Sweden
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van Dessel N, den Boeft M, van der Wouden JC, Kleinstäuber M, Leone SS, Terluin B, Numans ME, van der Horst HE, van Marwijk H. Non-pharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults. Cochrane Database Syst Rev 2014; 2014:CD011142. [PMID: 25362239 PMCID: PMC10984143 DOI: 10.1002/14651858.cd011142.pub2] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Medically unexplained physical symptoms (MUPS) are physical symptoms for which no adequate medical explanation can be found after proper examination. The presence of MUPS is the key feature of conditions known as 'somatoform disorders'. Various psychological and physical therapies have been developed to treat somatoform disorders and MUPS. Although there are several reviews on non-pharmacological interventions for somatoform disorders and MUPS, a complete overview of the whole spectrum is missing. OBJECTIVES To assess the effects of non-pharmacological interventions for somatoform disorders (specifically somatisation disorder, undifferentiated somatoform disorder, somatoform disorders unspecified, somatoform autonomic dysfunction, pain disorder, and alternative somatoform diagnoses proposed in the literature) and MUPS in adults, in comparison with treatment as usual, waiting list controls, attention placebo, psychological placebo, enhanced or structured care, and other psychological or physical therapies. SEARCH METHODS We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to November 2013. This register includes relevant randomised controlled trials (RCTs) from The Cochrane Library, EMBASE, MEDLINE, and PsycINFO. We ran an additional search on the Cochrane Central Register of Controlled Trials and a cited reference search on the Web of Science. We also searched grey literature, conference proceedings, international trial registers, and relevant systematic reviews. SELECTION CRITERIA We included RCTs and cluster randomised controlled trials which involved adults primarily diagnosed with a somatoform disorder or an alternative diagnostic concept of MUPS, who were assigned to a non-pharmacological intervention compared with usual care, waiting list controls, attention or psychological placebo, enhanced care, or another psychological or physical therapy intervention, alone or in combination. DATA COLLECTION AND ANALYSIS Four review authors, working in pairs, conducted data extraction and assessment of risk of bias. We resolved disagreements through discussion or consultation with another review author. We pooled data from studies addressing the same comparison using standardised mean differences (SMD) or risk ratios (RR) and a random-effects model. Primary outcomes were severity of somatic symptoms and acceptability of treatment. MAIN RESULTS We included 21 studies with 2658 randomised participants. All studies assessed the effectiveness of some form of psychological therapy. We found no studies that included physical therapy.Fourteen studies evaluated forms of cognitive behavioural therapy (CBT); the remainder evaluated behaviour therapies, third-wave CBT (mindfulness), psychodynamic therapies, and integrative therapy. Fifteen included studies compared the studied psychological therapy with usual care or a waiting list. Five studies compared the intervention to enhanced or structured care. Only one study compared cognitive behavioural therapy with behaviour therapy.Across the 21 studies, the mean number of sessions ranged from one to 13, over a period of one day to nine months. Duration of follow-up varied between two weeks and 24 months. Participants were recruited from various healthcare settings and the open population. Duration of symptoms, reported by nine studies, was at least several years, suggesting most participants had chronic symptoms at baseline.Due to the nature of the intervention, lack of blinding of participants, therapists, and outcome assessors resulted in a high risk of bias on these items for most studies. Eleven studies (52% of studies) reported a loss to follow-up of more than 20%. For other items, most studies were at low risk of bias. Adverse events were seldom reported.For all studies comparing some form of psychological therapy with usual care or a waiting list that could be included in the meta-analysis, the psychological therapy resulted in less severe symptoms at end of treatment (SMD -0.34; 95% confidence interval (CI) -0.53 to -0.16; 10 studies, 1081 analysed participants). This effect was considered small to medium; heterogeneity was moderate and overall quality of the evidence was low. Compared with usual care, psychological therapies resulted in a 7% higher proportion of drop-outs during treatment (RR acceptability 0.93; 95% CI 0.88 to 0.99; 14 studies, 1644 participants; moderate-quality evidence). Removing one outlier study reduced the difference to 5%. Results for the subgroup of studies comparing CBT with usual care were similar to those in the whole group.Five studies (624 analysed participants) assessed symptom severity comparing some psychological therapy with enhanced care, and found no clear evidence of a difference at end of treatment (pooled SMD -0.19; 95% CI -0.43 to 0.04; considerable heterogeneity; low-quality evidence). Five studies (679 participants) showed that psychological therapies were somewhat less acceptable in terms of drop-outs than enhanced care (RR 0.93; 95% CI 0.87 to 1.00; moderate-quality evidence). AUTHORS' CONCLUSIONS When all psychological therapies included this review were combined they were superior to usual care or waiting list in terms of reduction of symptom severity, but effect sizes were small. As a single treatment, only CBT has been adequately studied to allow tentative conclusions for practice to be drawn. Compared with usual care or waiting list conditions, CBT reduced somatic symptoms, with a small effect and substantial differences in effects between CBT studies. The effects were durable within and after one year of follow-up. Compared with enhanced or structured care, psychological therapies generally were not more effective for most of the outcomes. Compared with enhanced care, CBT was not more effective. The overall quality of evidence contributing to this review was rated low to moderate.The intervention groups reported no major harms. However, as most studies did not describe adverse events as an explicit outcome measure, this result has to be interpreted with caution.An important issue was that all studies in this review included participants who were willing to receive psychological treatment. In daily practice, there is also a substantial proportion of participants not willing to accept psychological treatments for somatoform disorders or MUPS. It is unclear how large this group is and how this influences the relevance of CBT in clinical practice.The number of studies investigating various treatment modalities (other than CBT) needs to be increased; this is especially relevant for studies concerning physical therapies. Future studies should include participants from a variety of age groups; they should also make efforts to blind outcome assessors and to conduct follow-up assessments until at least one year after the end of treatment.
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Affiliation(s)
- Nikki van Dessel
- EMGO Institute for Health and Care Research, VU University Medical CenterDepartment of General Practice and Elderly Care MedicineVan der Boechorststraat 7, room D‐550AmsterdamNetherlands1081 BT
| | - Madelon den Boeft
- EMGO Institute for Health and Care Research, VU University Medical CenterDepartment of General Practice and Elderly Care MedicineVan der Boechorststraat 7, room D‐550AmsterdamNetherlands1081 BT
| | - Johannes C van der Wouden
- VU University Medical CenterDepartment of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Maria Kleinstäuber
- Philipps‐University MarburgDepartment of Clinical Psychology and PsychotherapyGutenbergstr. 18MarburgHessenGermanyD‐35032
| | - Stephanie S Leone
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute)Department of Public Mental HealthDa Costakade 45UtrechtNetherlands3521 VS
| | - Berend Terluin
- EMGO Institute for Health and Care Research, VU University Medical CenterDepartment of General Practice and Elderly Care MedicineVan der Boechorststraat 7, room D‐550AmsterdamNetherlands1081 BT
| | - Mattijs E Numans
- LUMCDepartment of Public Health and Primary CarePO Box 9600LeidenNetherlands2300 RC
| | - Henriëtte E van der Horst
- EMGO Institute for Health and Care Research, VU University Medical CenterDepartment of General Practice and Elderly Care MedicineVan der Boechorststraat 7, room D‐550AmsterdamNetherlands1081 BT
| | - Harm van Marwijk
- VU University Medical CenterDepartment of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
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Danielsson L, Papoulias I, Petersson EL, Carlsson J, Waern M. Exercise or basic body awareness therapy as add-on treatment for major depression: a controlled study. J Affect Disord 2014; 168:98-106. [PMID: 25043321 DOI: 10.1016/j.jad.2014.06.049] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 06/27/2014] [Accepted: 06/28/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. METHODS Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. RESULTS Improvements in MADRS score (mean change=-10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4ml oxygen/kg/min, 95% CI (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. LIMITATIONS The small sample size and the challenge of missing data. Participants׳ positive expectations regarding the exercise intervention need to be considered. CONCLUSIONS Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
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Affiliation(s)
- Louise Danielsson
- Institute of Neuroscience and Physiology, Department of Clinical Neurosciences and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sweden.
| | | | - Eva-Lisa Petersson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Jane Carlsson
- Institute of Neuroscience and Physiology, Department of Clinical Neurosciences and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sweden
| | - Margda Waern
- Institute of Neuroscience and Physiology, Department of Clinical Neurosciences and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Gothenburg, Sweden; Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden
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Ho RTH, Wan AHY, Au-Yeung FSW, Lo PHY, Siu PJCY, Wong CPK, Ng WYH, Cheung IKM, Ng SM, Chan CLW, Chen EYH. The psychophysiological effects of Tai-chi and exercise in residential schizophrenic patients: a 3-arm randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:364. [PMID: 25262346 PMCID: PMC4189583 DOI: 10.1186/1472-6882-14-364] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Patients with schizophrenia are characterized by high prevalence rates and chronicity that often leads to long-term institutionalization. Under the traditional medical model, treatment usually emphasizes the management of psychotic symptoms through medication, even though anti-psychotic drugs are associated with severe side effects, which can diminish patients' physical and psychological well-being. Tai-chi, a mind-body exercise rooted in Eastern health philosophy, emphasizes the motor coordination and relaxation. With these potential benefits, a randomized controlled trial (RCT) is planned to investigate the effects of Tai-chi intervention on the cognitive and motor deficits characteristic of patients with schizophrenia. METHODS/DESIGN A 3-arm RCT with waitlist control design will be used in this study. One hundred and fifty three participants will be randomized into (i) Tai-chi, (ii) exercise or (iii) waitlist control groups. Participants in both the Tai-chi and exercise groups will receive 12-weeks of specific intervention, in addition to the standard medication and care received by the waitlist control group. The exercise group will serve as a comparison, to delineate any unique benefits of Tai-chi that are independent of moderate aerobic exercise. All three groups will undergo three assessment phases: (i) at baseline, (ii) at 12 weeks (post-intervention), and (iii) at 24 weeks (maintenance). All participants will be assessed in terms of symptom management, motor coordination, memory, daily living function, and stress levels based on self-perceived responses and a physiological marker. DISCUSSION Based on a promising pilot study conducted prior to this RCT, subjects in the Tai-chi intervention group are expected to be protected against deterioration of motor coordination and interpersonal functioning. They are also expected to have better symptoms management and lower stress level than the other treatment groups. TRIAL REGISTRATION The trail has been registered in the Clinical Trials Center of the University of Hong Kong (HKCTR-1453).
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Affiliation(s)
- Rainbow Tin Hung Ho
- />Centre on Behavioral Health, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam Hong Kong, China
- />Department of Social Work and Social Administration, The University of Hong Kong, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Hong Kong, China
| | - Adrian Ho Yin Wan
- />Centre on Behavioral Health, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam Hong Kong, China
- />Department of Social Work and Social Administration, The University of Hong Kong, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Hong Kong, China
| | - Friendly So Wah Au-Yeung
- />The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, No. 82, Tsun Wen Road, Tuen Mun, New Territories Hong Kong
| | - Phyllis Hau Yan Lo
- />Centre on Behavioral Health, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam Hong Kong, China
| | - Pantha Joey Chung Yue Siu
- />Department of Social Work and Social Administration, The University of Hong Kong, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Hong Kong, China
| | - Cathy Pui Ki Wong
- />The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, No. 82, Tsun Wen Road, Tuen Mun, New Territories Hong Kong
| | - Winnie Yuen Han Ng
- />The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, No. 82, Tsun Wen Road, Tuen Mun, New Territories Hong Kong
| | - Irene Kit Man Cheung
- />Centre on Behavioral Health, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam Hong Kong, China
| | - Siu Man Ng
- />Department of Social Work and Social Administration, The University of Hong Kong, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Hong Kong, China
| | - Cecilia Lai Wan Chan
- />Department of Social Work and Social Administration, The University of Hong Kong, The University of Hong Kong, Room 534, Jockey Club Tower, The Centennial Campus, Hong Kong, China
| | - Eric Yu Hai Chen
- />Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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Lindvall MA, Forsberg A. Body awareness therapy in persons with stroke: a pilot randomized controlled trial. Clin Rehabil 2014; 28:1180-8. [PMID: 24668360 DOI: 10.1177/0269215514527994] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke. DESIGN A pilot randomized controlled study with follow-up at one and 4-6 weeks after the intervention period. SETTING Four primary healthcare centres in Örebro County Council. SUBJECTS Persons more than six months post stroke, with walking ability of 100 metres. INTERVENTION The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities. MAIN MEASURES Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire. RESULTS A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test. CONCLUSION In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.
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Affiliation(s)
- Mialinn A Lindvall
- Family Medicine Research Centre, Örebro County Council, Örebro, Sweden School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Anette Forsberg
- Family Medicine Research Centre, Örebro County Council, Örebro, Sweden School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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Hedin Larsson Y, Speck R, Schmitz KH, Johansson K, Gyllensten AL. The Body Image and Relationship Scale: A Swedish translation, cultural adaptation, and reliability and validity testing. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2014. [DOI: 10.3109/21679169.2014.881913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hedlund L, Gyllensten AL. The physiotherapists' experience of Basic Body Awareness Therapy in patients with schizophrenia and schizophrenia spectrum disorders. J Bodyw Mov Ther 2013; 17:169-76. [DOI: 10.1016/j.jbmt.2012.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 09/18/2012] [Accepted: 10/01/2012] [Indexed: 11/24/2022]
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Danielsson L, Hansson Scherman M, Rosberg S. To sense and make sense of anxiety: Physiotherapists' perceptions of their treatment for patients with generalized anxiety. Physiother Theory Pract 2013; 29:604-15. [DOI: 10.3109/09593985.2013.778382] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Kolnes LJ. Embodying the body in anorexia nervosa--a physiotherapeutic approach. J Bodyw Mov Ther 2012; 16:281-288. [PMID: 22703737 DOI: 10.1016/j.jbmt.2011.12.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/13/2011] [Accepted: 12/20/2011] [Indexed: 11/17/2022]
Abstract
Body dissatisfaction and disturbances in bodily sensations are prevailing qualities among patients with anorexia nervosa (AN). However, therapies addressing the body are typically marginalized within treatment programs for anorexia nervosa. The purpose of this article is to 1) describe common bodily symptoms and experiences of anorexia nervosa patients and discuss the accompanying physical and emotional impact, and 2) present physiotherapeutic approaches to help patients with anorexia nervosa. Recommendations are based on the author's clinical observations and patient testimonials, in addition to the theory and methodology outlined by Norwegian Psychomotor Physiotherapy (NPMP), body awareness therapies, and current knowledge on bodily stability. It is the author's experience that anorexia nervosa patients tend to have significant impairments in their body awareness, a restricted breathing pattern, significant muscular tension, poor postural stability, and they are frequently engaged in compulsive physical activity. A body awareness approach for these patients may contribute to novel ways of sensing and interpreting bodily signals, improving emotional awareness, experiencing the body and integrating the body as one's own, i.e., becoming an embodied person. Embodying the body in patients with anorexia nervosa by utilizing approaches from NPMP and body awareness therapies, in addition to stability training principles, may help stabilize the body and the mind, and thus, constitute a beneficial addition to overall treatment for anorexia nervosa.
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Affiliation(s)
- Liv-Jorunn Kolnes
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ulleval, P.O. Box 4956 Nydalen, 0424 Oslo, Norway.
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Gyllensten AL, Skär L, Miller M, Gard G. Embodied identity--a deeper understanding of body awareness. Physiother Theory Pract 2011; 26:439-46. [PMID: 20649495 DOI: 10.3109/09593980903422956] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The aims of this study were to explore and generate an understanding of the meaning of body awareness through explanations of the experience of body awareness given by professionals and patients in psychiatric rehabilitation. A total of 20 strategically selected healthy informants were interviewed individually and in groups. Thirteen previous interviews with physiotherapists and 11 previous interviews with patients in psychiatric rehabilitation, describing their experiences of body awareness therapy and its effects were reanalyzed and included in the data for this study; in all 44 informants were included. Grounded theory methods guided the data construction and analysis. A theoretical understanding was conceptualised from which a core category of body awareness emerged: the embodied identity. This core category was related to two categories: living in the body and living in relation to others and in society. The subcategory "living in the body" was conceived as an important aspect to become more aware of the body and to experience oneself fromwithin in order to recognize one's needs. A key point was the fact that bodily experiences always exists in the present moment. The experience of the body, the balance, and stability of the physical self were basic experiences that were connected to the conception of well-being and control. To understand one's emotions and needs through the awareness of the body were understood as the base for self-confidence, trust in one-self, and the ability to take care of oneself and one's needs physically and mentally. The subcategory "living in relation to others and in society" was conceived as an important aspect for the embodied self to interact with others and for societal participation. Working with the body in physiotherapy practice should include an understanding that body awareness is inseparable from the identity and may have an impact on the health of the individual. This implies that interventions to address problems in body awareness should be integrated into physiotherapy practice.
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Johnsen RW, Råheim M. Feeling more in balance and grounded in one's own body and life. Focus group interviews on experiences with Basic Body Awareness Therapy in psychiatric healthcare. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/14038196.2010.501383] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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The experiences of basic body awareness therapy in patients with schizophrenia. J Bodyw Mov Ther 2010; 14:245-54. [DOI: 10.1016/j.jbmt.2009.03.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 03/03/2009] [Accepted: 03/31/2009] [Indexed: 11/18/2022]
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Abstract
INTRODUCTION Sexual pain disorders refer to conditions of genital pain that interfere with intercourse. They often have a musculoskeletal component related to the pelvic floor and are included in the DSM-IV as sexual dysfunctions. Musculoskeletal pain (MP) that is not essentially genitally based often interferes with sex as well yet is not considered a distinct sexual dysfunction. MP is generally addressed by physiatrists, orthopedists, and rheumatologists who are not traditionally trained in sexual medicine, and therefore, the sexual concerns of women with MP often go unaddressed. AIM The purposes of this review article were to describe how MP is perceived in the literature as affecting sexual function, illustrate how specific MP conditions prevalent in women may affect sexual function, and offer recommendations for clinical practice. METHODS PubMed and Medline searches were performed using the keywords "musculoskeletal pain and sex,""lower back pain and sex,""arthritis and sex," and "fibromyalgia and sex". Main Outcome Measure. Review of the peer-reviewed literature. RESULTS Most studies cite fatigue, medication, and relationship adjustment as affecting sexuality much as chronic illness does. While musculoskeletal contributors to genital sexual response and pain are considered relevant to sexual function, little is understood about how MP syndromes specifically affect sexual activity. CONCLUSION Lack of mobility and MP can restrict intercourse and limit sexual activity, and gender differences are noted in response to pain. Sexual and relationship counseling should be offered as a component of rehabilitative treatment. Physical therapists are uniquely qualified to provide treatment to address functional activities of daily living, including sexual intercourse, and offer advice for modifications in positioning.
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Gard G, Lundvik Gyllensten A. Are emotions important for good interaction in treatment situations? Physiother Theory Pract 2009. [DOI: 10.1080/09593980490452995] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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