1
|
Ponnaiah M, Elumalai R, Muthappan S, Jaisankar S, Bagepally BS, Sivaprakasam S, Parasuraman G. Adverse events in India's Ayush interventions for cervical and lumbar spondylosis: a systematic review. Eur J Med Res 2024; 29:396. [PMID: 39085970 PMCID: PMC11290003 DOI: 10.1186/s40001-024-01985-3] [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: 02/02/2023] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
INTRODUCTION Low back and neck pain are common musculoskeletal disorders with multiple treatment options. India's traditional medical systems, known as Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy) offer range of interventions and are widely used. In view of limited documentation of adverse events following Ayush interventions for lumbar and cervical spondylosis, we synthesized evidence and estimated proportion of studies reporting adverse events. METHODS We systematically searched all published documents from biomedical and multidisciplinary abstract and citation databases and Ayush-specific repositories from their inception to April 2021. We selected studies as per inclusion criteria and extracted information, adhering to PRISMA guidelines. We systematically reviewed the qualitative evidence form the selected studies. RESULTS Majority (94%) of the selected 113 studies were interventional studies and included 77 (68.1%) journal articles and 35 (31%) academic dissertations. Among the Ayush systems, considerable proportion was from Ayurveda (32.7%), followed by Siddha (24.8%), Yoga (22.1%), Unani (15.9%) and Homoeopathy (4.4%). Almost three-fourths of the studies were on lumbar spondylosis (65%; n = 74), followed by cervical spondylosis (31%; n = 35), and the remaining four included both. Thirteen percent of the 113 studies described adverse events [Yoga = 9.7%; Unani = 1.8% and Homoeopathy = 1.8%]. More adverse events were reported among the studies on lumbar (9.7%) than cervical spondylosis (2.7%). The nature of interventions were non-pharmacological (10.6%; n = 12), pharmacological (n = 2; 1.8%) or combined (n = 1; 0.9%). CONCLUSIONS Only one in eight studies reported any adverse event following Ayush interventions for cervical and lumbar spondylosis. There could be certain degree of underreporting of adverse events and requires further exploration. PROSPERO Registration ID CRD42020167433.
Collapse
Affiliation(s)
- Manickam Ponnaiah
- ICMR-National Institute of Epidemiology, R-127, TNHB, Ayapakkam, Chennai, 600077, Tamil Nadu, India.
| | - Rajalakshmi Elumalai
- ICMR-National Institute of Epidemiology, R-127, TNHB, Ayapakkam, Chennai, 600077, Tamil Nadu, India
| | - Sendhilkumar Muthappan
- ICMR-National Institute of Epidemiology, R-127, TNHB, Ayapakkam, Chennai, 600077, Tamil Nadu, India
| | - Saranya Jaisankar
- ICMR-National Institute of Epidemiology, R-127, TNHB, Ayapakkam, Chennai, 600077, Tamil Nadu, India
| | | | - Satish Sivaprakasam
- ICMR-National Institute of Epidemiology, R-127, TNHB, Ayapakkam, Chennai, 600077, Tamil Nadu, India
| | - Ganeshkumar Parasuraman
- ICMR-National Institute of Epidemiology, R-127, TNHB, Ayapakkam, Chennai, 600077, Tamil Nadu, India
| |
Collapse
|
2
|
Baroncini A, Maffulli N, Schäfer L, Manocchio N, Bossa M, Foti C, Klimuch A, Migliorini F. Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis. Sci Rep 2024; 14:11546. [PMID: 38773302 PMCID: PMC11109223 DOI: 10.1038/s41598-024-62276-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement. This analysis is rendered more difficult by the vast number of available therapies and a lack of a widely accepted classification that can effectively highlight the differences in the outcomes of different management options. This study was conducted according to the PRISMA guidelines. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which compared the efficacy of physiotherapy programs in patients with cLBP were accessed. Studies reporting on non-specific or mechanical cLPB were included. Data concerning the Visual Analogic Scale (VAS) or numeric rating scale (NRS), Roland Morris Disability Questionnaire (RMQ) and Oswestry Disability Index (ODI). Data from 12,773 patients were collected. The mean symptom duration was 61.2 ± 51.0 months and the mean follow-up was 4.3 ± 5.9 months. The mean age was 44.5 ± 9.4 years. The mean BMI was 25.8 ± 2.9 kg/m2. The Adapted Physical Exercise group evidenced the lowest pain score, followed by Multidisciplinary and Adapted Training Exercise/Complementary Medicine. The Adapted Physical Exercise group evidenced the lowest RMQ score followed by Therapeutic Exercises and Multidisciplinary. The Multidisciplinary group evidenced the lowest ODI score, followed by Adapted Physical Exercise and Physical Agent modalities. Within the considered physiotherapeutic and non-conventional approaches to manage nonspecific and/or mechanic cLBP, adapted physical exercise, physical agent modalities, and a multidisciplinary approach might represent the most effective strategy to reduce pain and disability.
Collapse
Affiliation(s)
- Alice Baroncini
- GSpine4, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano, Italy
| | - Nicola Maffulli
- Department of Orthopaedics, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke on Trent, ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK
| | - Luise Schäfer
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Nicola Manocchio
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Michela Bossa
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Alexandra Klimuch
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany.
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
| |
Collapse
|
3
|
Herrero P, Val P, Lapuente-Hernández D, Cuenca-Zaldívar JN, Calvo S, Gómez-Trullén EM. Effects of Lifestyle Interventions on the Improvement of Chronic Non-Specific Low Back Pain: A Systematic Review and Network Meta-Analysis. Healthcare (Basel) 2024; 12:505. [PMID: 38470617 PMCID: PMC10931043 DOI: 10.3390/healthcare12050505] [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: 12/27/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic non-specific low back pain (CNSLBP) is a highly prevalent musculoskeletal condition that has a great socioeconomic impact on health systems. Instead of focusing on mechanical causes and direct workload in the development of CNSLBP, genetics, psychosocial environment, lifestyle and quality of life are coming to the forefront in its approach. The main objective was to analyze whether interventions aimed at modifying lifestyle can be effective in improving pain intensity and functional disability in CNSLBP. A search in PubMed, Web of Science, Scopus and SportDiscus databases was performed. Both a univariate and a multivariate network meta-analysis were applied with the difference pre/post-treatment. A total of 20 studies were included for qualitative analysis, of which 16 were randomized clinical trials with a moderate-high methodological quality and were part of the quantitative analysis. The interventions that had the greatest effect in reducing pain intensity were cognitive therapy combined with functional exercise programs, lumbar stabilization exercise and resistance exercise; meanwhile, for functional disability, they were functional exercise programs, aerobic exercise and standard care. In conclusion, a multimodal intervention aimed at changing one's lifestyle that encompasses cognitive, behavioral, and physical aspects seems to be highly effective in improving pain intensity and functional disability caused by CNSLBP; however, it is not yet known if these improvements are maintained in the long term.
Collapse
Affiliation(s)
- Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| | - Paula Val
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
| | - Diego Lapuente-Hernández
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| | - Juan Nicolás Cuenca-Zaldívar
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain;
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute–Segovia de Arana (IDIPHISA), 28222 Madrid, Spain
- Primary Health Center “El Abajón”, 28231 Las Rozas de Madrid, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| | - Eva María Gómez-Trullén
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| |
Collapse
|
4
|
De Giorgio A, Angilletta S, Matteo B, Bonavolontà V, Bragazzi NL, Kuvačić G. Hatha yoga is more effective in improving kinesiophobia and subjective well-being when combined with self-compassion meditation in people with CLBP: a randomized control trial. Front Psychol 2023; 14:1272919. [PMID: 38054176 PMCID: PMC10694472 DOI: 10.3389/fpsyg.2023.1272919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/26/2023] [Indexed: 12/07/2023] Open
Abstract
Objective The present study aims to examine whether combining hatha yoga practice with self-compassion meditation could influence kinesiophobia, emotions, perceived stress, and perceived disability among individuals with chronic low back pain when compared with hatha yoga alone. Methods The randomized controlled study included 70 participants with chronic low back pain (CLBP) who were randomly assigned to a Hatha yoga group (HY; n = 35) or a Hatha yoga group plus self-compassion meditation (HYSCM; n = 35). Participants followed a protocol for 8 weeks, and the assessments were carried out before and after the intervention, with a follow-up evaluation conducted after one month. The participants completed the PANAS, PSS, TSK, and RMQ questionnaires. A Generalized Estimating Equation was used to explore the effect of interventions. Results Both HY and HYSCM groups improved kinesiophobia, perceived disability, and stress at the follow-up. However, the HYSCM group shown a more significant reduction in kinesiophobia compared to the HY group. Moreover, significant improvement in positive affect and a reduction in negative affect over time in the HYSCM group were observed. Conclusion Hatha yoga practice when combined with self-compassion meditation led to extra benefits by exhibiting a prolonged effect, especially on kinesiophobia positive and negative effects.
Collapse
Affiliation(s)
- Andrea De Giorgio
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Klinikos Center for Psychodiagnostics and Psychotherapy, Rome, Italy
| | | | - Barbara Matteo
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Valerio Bonavolontà
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON, Canada
| | - Goran Kuvačić
- Faculty of Kinesiology, University of Split, Split, Croatia
| |
Collapse
|
5
|
Li Y, Yan L, Hou L, Zhang X, Zhao H, Yan C, Li X, Li Y, Chen X, Ding X. Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Front Public Health 2023; 11:1155225. [PMID: 38035307 PMCID: PMC10687566 DOI: 10.3389/fpubh.2023.1155225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/04/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose Chronic low back pain (CLBP) is an aging and public health issue that is a leading cause of disability worldwide and has a significant economic impact on a global scale. Treatments for CLBP are varied, and there is currently no study with high-quality evidence to show which treatment works best. Exercise therapy has the characteristics of minor harm, low cost, and convenient implementation. It has become a mainstream treatment method in clinics for chronic low back pain. However, there is insufficient evidence on which specific exercise regimen is more effective for chronic non-specific low back pain. This network meta-analysis aimed to evaluate the effects of different exercise therapies on chronic low back pain and provide a reference for exercise regimens in CLBP patients. Methods We searched PubMed, EMBASE, Cochrane Library, and Web of Science from inception to 10 May 2022. Inclusion and exclusion criteria were used for selection. We collected information from studies to compare the effects of 20 exercise interventions on patients with chronic low back pain. Results This study included 75 randomized controlled trials (RCTs) with 5,254 participants. Network meta-analysis results showed that tai chi [standardized mean difference (SMD), -2.11; 95% CI, -3.62 to -0.61], yoga (SMD, -1.76; 95% CI -2.72 to -0.81), Pilates exercise (SMD, -1.52; 95% CI, -2.68, to -0.36), and sling exercise (SMD, -1.19; 95% CI, -2.07 to -0.30) showed a better pain improvement than conventional rehabilitation. Tai chi (SMD, -2.42; 95% CI, -3.81 to -1.03) and yoga (SMD, -2.07; 95% CI, -2.80 to -1.34) showed a better pain improvement than no intervention provided. Yoga (SMD, -1.72; 95% CI, -2.91 to -0.53) and core or stabilization exercises (SMD, -1.04; 95% CI, -1.80 to -0.28) showed a better physical function improvement than conventional rehabilitation. Yoga (SMD, -1.81; 95% CI, -2.78 to -0.83) and core or stabilization exercises (SMD, -1.13; 95% CI, -1.66 to -0.59) showed a better physical function improvement than no intervention provided. Conclusion Compared with conventional rehabilitation and no intervention provided, tai chi, toga, Pilates exercise, sling exercise, motor control exercise, and core or stabilization exercises significantly improved CLBP in patients. Compared with conventional rehabilitation and no intervention provided, yoga and core or stabilization exercises were statistically significant in improving physical function in patients with CLBP. Due to the limitations of the quality and quantity of the included studies, it is difficult to make a definitive recommendation before more large-scale and high-quality RCTs are conducted.
Collapse
Affiliation(s)
- Ying Li
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Lei Yan
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Lingyu Hou
- Department of Nursing, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiaoya Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hanping Zhao
- College of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Chengkun Yan
- School of Nursing, Nanchang University, Nanchang, Jiangxi, China
| | - Xianhuang Li
- Digestive Endoscopy Center, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yuanhe Li
- College of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Xiaoan Chen
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Xiaorong Ding
- Department of Nursing, Peking University Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
6
|
Dewan M, Nijhawan M, Chhabra HS, Shandilya S, Kumar P, Phadke V. Electromyographic analysis of trunk and hip muscles during Yoga poses prescribed for treating chronic low back pain. J Bodyw Mov Ther 2023; 36:117-124. [PMID: 37949547 DOI: 10.1016/j.jbmt.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
Yoga is effective for the management of chronic low back pain as it improves muscle strength and endurance. The objective of the current study was to assess trunk and hip muscle activation during Yoga poses usually prescribed for patients with chronic LBP. The study included 22 healthy Yoga trained subjects (mean age: 24.4 ± 2.6 years; 16 females, 6 males). The testing involved collecting surface electromyography data from Rectus Abdominis (RA) and Transverse Abdominis (TA), Gluteus Medius (GM), and Erector Spinae (ES) as subjects attained and held 16 different Yoga poses in standing, kneeling, supine, or prone positions in random order. The signal of each muscle was processed and normalized to its maximum voluntary isometric contraction (MVC). Statistical comparisons were made across selected poses and phases (attaining and holding) for each muscle using repeated-measures ANOVA. The data was also descriptively analyzed for sorting muscle activity. The activation of trunk flexors was significantly higher during boat pose (>50% MVC) followed by plank pose (∼30% MVC), activation of ES was significantly higher during reverse boat (41.7% ± 3.3 MVC) as compared to bow, snake, backward-sway, and warrior poses. The GM activation was significantly less in standing poses than during side-lying and Tiger poses (32-42% MVC). The cat-camel, kneeling camel, downward dog, backward-sway, swaying-palm tree, and warrior poses activated all tested muscles fairly (<20% MVC). The study helps the grading of Yoga positions according to the challenge imposed. The challenging poses may be used to develop graded rehabilitation programs to improve muscle strength/endurance.
Collapse
Affiliation(s)
- Mansi Dewan
- ITS Institute of Health and Allied Sciences, Ghaziabad, India.
| | - Megha Nijhawan
- Indian Spinal Injuries Centre-Institute of Rehabilitation Sciences, Sector C, Vasant Kunj, New Delhi, India.
| | - Harvinder Singh Chhabra
- Chief of Spine and Rehabilitation Centre, Sri Balaji Action Medical Institute, Paschim Vihar, New Delhi, Delhi, 110063, India.
| | - Sakshi Shandilya
- Research Department, Indian Spinal Injuries Centre, Sector C, Vasant Kunj, New Delhi, India.
| | - Parmod Kumar
- Research Department, Indian Spinal Injuries Centre, Sector C, Vasant Kunj, New Delhi, India.
| | - Vandana Phadke
- Research Department, Indian Spinal Injuries Centre, Sector C, Vasant Kunj, New Delhi, India.
| |
Collapse
|
7
|
Yamuna U, Madle K, Majumdar V, Saoji AA. Designing and validation of Yoga module for workers with prolonged standing. J Ayurveda Integr Med 2023; 14:100788. [PMID: 37713945 PMCID: PMC10511782 DOI: 10.1016/j.jaim.2023.100788] [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: 03/13/2022] [Revised: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Prolonged standing is a part of several professions, which can have physical and psychosocial implications. Yoga as a mind-body therapy may be useful to prevent and manage such health issues. However, there is a lack of a standardized yoga module addressing the health issues of workers with prolonged standing. OBJECTIVES Thus, the present study was undertaken to design and validate a specific yoga module for the target population. METHODS A yoga module was prepared by reviewing yoga texts for the specific needs of the target population. This was validated for content validity for the experts on a Likert scale. 71 yoga experts validated the module. The content validity ratio (CVR) above 0.70 was considered to be valid. RESULTS The validated yoga module consists of joint loosening and strengthening exercises, asana, pranayama and relaxation techniques. The average CVR for the module was found to be 0.80. CONCLUSION The designed yoga module is found to be valid by the experts. The module needs to be assessed for feasibility and efficacy in the target population.
Collapse
Affiliation(s)
- U Yamuna
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India
| | - Kshamashree Madle
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India
| | - Vijaya Majumdar
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India
| | - Apar Avinash Saoji
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India.
| |
Collapse
|
8
|
Metri KG, Raghuram N, Narayan M, Sravan K, Sekar S, Bhargav H, Babu N, Mohanty S, Revankar R. Impact of workplace yoga on pain measures, mental health, sleep quality, and quality of life in female teachers with chronic musculoskeletal pain: A randomized controlled study. Work 2023; 76:521-531. [PMID: 36847050 DOI: 10.3233/wor-210269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Chronic pain conditions such as low back pain, knee pain and cervical pain are highly prevalent among female teachers. Chronic pain significantly affects the mental health, sleep and quality of life among teachers. OBJECTIVE This study is intended to investigate the impact of a workplace yoga intervention on musculoskeletal pain, anxiety, depression, sleep, and quality of life (QoL) among female teachers who had chronic musculoskeletal pain. METHOD Fifty female teachers aged between 25-55 years with chronic musculoskeletal pain were randomized to either the yoga group (n = 25) or the control group (n = 25). The yoga group received a 60-minute structured Integrated Yoga intervention (IY) four days a week for six consecutive weeks at school. The control group received no intervention. OUTCOME MEASURES Pain intensity, anxiety, depression, stress, fatigue, self-compassion, sleep quality, and quality of life were assessed at the baseline and six weeks. RESULTS A significant (p < 0.05) reduction in pain intensity and pain disability in the yoga group was observed after 6-week compared to baseline. Anxiety, depression, stress, sleep scores and fatigues also improved in the yoga group after six weeks. The control group showed no change. Post score comparison showed a significant difference between the groups for all the measures. CONCLUSION Workplace yoga intervention is found to be effective in improving pain, pain disability, mental health, sleep quality among female teachers with chronic musculoskeletal pain. This study strongly recommends yoga for the prevention of work-related health issues and for the promotion of wellbeing among teachers.
Collapse
Affiliation(s)
| | - Nagaratna Raghuram
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bangalore, India
| | - Meera Narayan
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bangalore, India
| | - Karthik Sravan
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bangalore, India
| | - Sanjana Sekar
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bangalore, India
| | - Hemant Bhargav
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Natesh Babu
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bangalore, India
| | - Sriloy Mohanty
- Department of Integrative Medicine and Research, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | |
Collapse
|
9
|
Hong JY, Song KS, Cho JH, Lee JH, Kim NH. An Updated Overview of Low Back Pain Management. Asian Spine J 2022; 16:968-982. [PMID: 34963043 PMCID: PMC9827206 DOI: 10.31616/asj.2021.0371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/12/2021] [Indexed: 01/11/2023] Open
Abstract
We aimed to determine the recommendation level for the treatment of acute and chronic low back pain (LBP). A systematic review (SR) of the literature was performed and all English-language articles that discuss acute and chronic LBP, including MEDLINE and the Cochrane Database of Systematic Reviews, were searched. Of the 873 searched literature reports, 259 articles, including 131 clinical trials, 115 SRs, nine meta-analyses, and four clinical guidelines were analyzed. In these articles, high-quality randomized controlled trials, SRs, and used well-written clinical guidelines were reviewed. The results indicated multiple acute and chronic LBP treatment methods in the literature, and these reports when reviewed included general behavior, pharmacological therapy, psychological therapy, specific exercise, active rehabilitation and educational interventions, manual therapy, physical modalities, and invasive procedures. The Trial conclusions and SRs were classified into four categories of A, B, C, and D. If there were not enough high-quality articles, it was designated as "I" (insufficient). This review and summary of guidelines may be beneficial for physicians to better understand and make recommendations in primary care.
Collapse
Affiliation(s)
- Jae-Young Hong
- Department of Orthopedics, Korea University Ansan Hospital, Ansan,
Korea
| | - Kwang-Sup Song
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Jae Hwan Cho
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jae Hyup Lee
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul,
Korea
| | - Nack Hwan Kim
- Department of Physical Medicine and Rehabilitation, Korea University Ansan Hospital, Ansan,
Korea
| |
Collapse
|
10
|
Wieland LS, Skoetz N, Pilkington K, Harbin S, Vempati R, Berman BM. Yoga for chronic non-specific low back pain. Cochrane Database Syst Rev 2022; 11:CD010671. [PMID: 36398843 PMCID: PMC9673466 DOI: 10.1002/14651858.cd010671.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines recommend exercise therapy. Yoga is a mind-body exercise sometimes used for non-specific low back pain. OBJECTIVES To evaluate the benefits and harms of yoga for treating chronic non-specific low back pain in adults compared to sham yoga, no specific treatment, a minimal intervention (e.g. education), or another active treatment, focusing on pain, function, quality of life, and adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 31 August 2021 without language or publication status restrictions. SELECTION CRITERIA We included randomized controlled trials of yoga compared to sham yoga, no intervention, any other intervention and yoga added to other therapies. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. Our major outcomes were 1. back-specific function, 2. pain, 3. clinical improvement, 4. mental and physical quality of life, 5. depression, and 6. ADVERSE EVENTS Our minor outcome was 1. work disability. We used GRADE to assess certainty of evidence for the major outcomes. MAIN RESULTS We included 21 trials (2223 participants) from the USA, India, the UK, Croatia, Germany, Sweden, and Turkey. Participants were recruited from both clinical and community settings. Most were women in their 40s or 50s. Most trials used iyengar, hatha, or viniyoga yoga. Trials compared yoga to a non-exercise control including waiting list, usual care, or education (10 trials); back-focused exercise such as physical therapy (five trials); both exercise and non-exercise controls (four trials); both non-exercise and another mind-body exercise (qigong) (one trial); and yoga plus exercise to exercise alone (one trial). One trial comparing yoga to exercise was an intensive residential one-week program, and we analyzed this trial separately. All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment, and outcomes were self-assessed. We found no trials comparing yoga to sham yoga. Low-certainty evidence from 11 trials showed that there may be a small clinically unimportant improvement in back-specific function with yoga (mean difference [MD] -1.69, 95% confidence interval [CI] -2.73 to -0.65 on the 0- to 24-point Roland-Morris Disability Questionnaire [RMDQ], lower = better, minimal clinically important difference [MCID] 5 points; 1155 participants) and moderate-certainty evidence from nine trials showed a clinically unimportant improvement in pain (MD -4.53, 95% CI -6.61 to -2.46 on a 0 to 100 scale, 0 no pain, MCID 15 points; 946 participants) compared to no exercise at three months. Low-certainty evidence from four trials showed that there may be a clinical improvement with yoga (risk ratio [RR] 2.33, 95% CI 1.46 to 3.71; assessed as participant rating that back pain was improved or resolved; 353 participants). Moderate-certainty evidence from six trials showed that there is probably a small improvement in physical and mental quality of life (physical: MD 1.80, 95% CI 0.27 to 3.33 on the 36-item Short Form [SF-36] physical health scale, higher = better; mental: MD 2.38, 95% CI 0.60 to 4.17 on the SF-36 mental health scale, higher = better; both 686 participants). Low-certainty evidence from three trials showed little to no improvement in depression (MD -1.25, 95% CI -2.90 to 0.46 on the Beck Depression Inventory, lower = better; 241 participants). There was low-certainty evidence from eight trials that yoga increased the risk of adverse events, primarily increased back pain, at six to 12 months (RR 4.76, 95% CI 2.08 to 10.89; 43/1000 with yoga and 9/1000 with no exercise; 1037 participants). For yoga compared to back-focused exercise controls (8 trials, 912 participants) at three months, we found moderate-certainty evidence from four trials for little or no difference in back-specific function (MD -0.38, 95% CI -1.33 to 0.62 on the RMDQ, lower = better; 575 participants) and very low-certainty evidence from two trials for little or no difference in pain (MD 2.68, 95% CI -2.01 to 7.36 on a 0 to 100 scale, lower = better; 326 participants). We found very low-certainty evidence from three trials for no difference in clinical improvement assessed as participant rating that back pain was improved or resolved (RR 0.97, 95% CI 0.72 to 1.31; 433 participants) and very low-certainty evidence from one trial for little or no difference in physical and mental quality of life (physical: MD 1.30, 95% CI -0.95 to 3.55 on the SF-36 physical health scale, higher = better; mental: MD 1.90, 95% CI -1.17 to 4.97 on the SF-36 mental health scale, higher = better; both 237 participants). No studies reported depression. Low-certainty evidence from five trials showed that there was little or no difference between yoga and exercise in the risk of adverse events at six to 12 months (RR 0.93, 95% CI 0.56 to 1.53; 84/1000 with yoga and 91/1000 with non-yoga exercise; 640 participants). AUTHORS' CONCLUSIONS There is low- to moderate-certainty evidence that yoga compared to no exercise results in small and clinically unimportant improvements in back-related function and pain. There is probably little or no difference between yoga and other back-related exercise for back-related function at three months, although it remains uncertain whether there is any difference between yoga and other exercise for pain and quality of life. Yoga is associated with more adverse events than no exercise, but may have the same risk of adverse events as other exercise. In light of these results, decisions to use yoga instead of no exercise or another exercise may depend on availability, cost, and participant or provider preference. Since all studies were unblinded and at high risk of performance and detection bias, it is unlikely that blinded comparisons would find a clinically important benefit.
Collapse
Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Nicole Skoetz
- Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karen Pilkington
- School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
| | | | | | - Brian M Berman
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
11
|
Pravalika B, Yamuna U, Saoji AA. Effect of Yoga on musculoskeletal pain and discomfort, perceived stress, and quality of sleep in industrial workers: Study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
INDA MDM, MARGARIT C, VARA A, CUTILLAS E, MATEU M, MARTÍNEZ E, COVES M, RODRÍGUEZ J, BALLESTER P, BARRACHINA J, MORALES D, PEIRÓ AM. Non-pharmacological therapy in chronic musculoskeletal pain. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.22.04702-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
A feasibility study on yoga's mechanism of action for chronic low back pain: psychological and neurophysiological changes, including global gene expression and DNA methylation, following a yoga intervention for chronic low back pain. Pilot Feasibility Stud 2022; 8:142. [PMID: 35794661 PMCID: PMC9260994 DOI: 10.1186/s40814-022-01103-2] [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: 12/13/2020] [Accepted: 06/23/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Yoga has been shown to reduce pain and improve function in populations with chronic low back pain (cLBP), yet the underlying molecular mechanisms remain elusive. This study examined the feasibility and acceptability of a yoga research protocol, including recruitment, retention, and data collection, and investigated the preliminary effects of yoga on psychological and neurophysiological functions, including gene expression and DNA methylation profiles, in participants with cLBP. METHODS A one-arm trial was conducted with 11 participants with cLBP who enrolled in a 12-week yoga intervention. Data on subjective pain characteristics, quantitative sensory testing, and blood for analysis of differentially expressed genes and CpG methylation was collected prior to the start of the intervention and at study completion. RESULTS Based on pre-determined feasibility and acceptability criteria, the yoga intervention was found to be feasible and highly acceptable to participants. There was a reduction in pain severity, interference, and mechanical pain sensitivity post-yoga and an increase in emotion regulation and self-efficacy. No adverse reactions were reported. Differential expression analysis demonstrated that the yoga intervention induced increased expression of antisense genes, some of which serve as antisense to known pain genes. In addition, there were 33 differentially hypomethylated positions after yoga (log2 fold change ≥ 1), with enrichment of genes involved in NIK/NF-kB signaling, a major pathway that modulates immune function and inflammation. DISCUSSION/CONCLUSIONS The study supports the feasibility and acceptability of the proposed protocol to test a specific mechanism of action for yoga in individuals with cLBP. These results also support the notion that yoga may operate through our identified psychological and neurophysiologic pathways to influence reduced pain severity and interference.
Collapse
|
14
|
Biswas I, Lewis S, Chattopadhyay K. Content, Structure and Delivery Characteristics of Yoga Interventions for the Management of Osteoarthritis: A Systematic Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5806. [PMID: 35627341 PMCID: PMC9140376 DOI: 10.3390/ijerph19105806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023]
Abstract
The global burden of osteoarthritis among adults is rising. Yoga might be a potential solution for the management of osteoarthritis. This systematic review aims to synthesise the content, structure and delivery characteristics of effective yoga interventions for the management of osteoarthritis. The JBI methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed. Randomised controlled trials (RCTs) assessing the effectiveness of yoga interventions for the management of osteoarthritis in adults will be included in this review. We aim to search the following databases to find published and unpublished studies: MEDLINE, EMBASE, CINAHL, PsycInfo, SPORTDiscus, AMED, Web of Science, CENTRAL, TRIP, AYUSH Research Portal, ABIM, CAM-QUEST, PeDro, OpenGrey, EthOS, ProQuest Dissertations and Theses and DART-Europe-e-theses portal. No date or language restrictions will be applied. A narrative synthesis will be conducted with the help of tables. A meta-regression will be conducted to explore the statistical evidence for which the components (content, structure and delivery characteristics) of yoga interventions are effective.
Collapse
Affiliation(s)
- Isha Biswas
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK; (S.L.); (K.C.)
| | - Sarah Lewis
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK; (S.L.); (K.C.)
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK; (S.L.); (K.C.)
- The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham NG5 1PB, UK
| |
Collapse
|
15
|
Ho EKY, Chen L, Simic M, Ashton-James CE, Comachio J, Wang DXM, Hayden JA, Ferreira ML, Ferreira PH. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ 2022; 376:e067718. [PMID: 35354560 PMCID: PMC8965745 DOI: 10.1136/bmj-2021-067718] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine the comparative effectiveness and safety of psychological interventions for chronic low back pain. DESIGN Systematic review with network meta-analysis. DATA SOURCES Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, and CINAHL from database inception to 31 January 2021. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomised controlled trials comparing psychological interventions with any comparison intervention in adults with chronic, non-specific low back pain. Two reviewers independently screened studies, extracted data, and assessed risk of bias and confidence in the evidence. Primary outcomes were physical function and pain intensity. A random effects network meta-analysis using a frequentist approach was performed at post-intervention (from the end of treatment to <2 months post-intervention); and at short term (≥2 to <6 months post-intervention), mid-term (≥6 to <12 months post-intervention), and long term follow-up (≥12 months post-intervention). Physiotherapy care was the reference comparison intervention. The design-by-treatment interaction model was used to assess global inconsistency and the Bucher method was used to assess local inconsistency. RESULTS 97 randomised controlled trials involving 13 136 participants and 17 treatment nodes were included. Inconsistency was detected at short term and mid-term follow-up for physical function, and short term follow-up for pain intensity, and were resolved through sensitivity analyses. For physical function, cognitive behavioural therapy (standardised mean difference 1.01, 95% confidence interval 0.58 to 1.44), and pain education (0.62, 0.08 to 1.17), delivered with physiotherapy care, resulted in clinically important improvements at post-intervention (moderate quality evidence). The most sustainable effects of treatment for improving physical function were reported with pain education delivered with physiotherapy care, at least until mid-term follow-up (0.63, 0.25 to 1.00; low quality evidence). No studies investigated the long term effectiveness of pain education delivered with physiotherapy care. For pain intensity, behavioural therapy (1.08, 0.22 to 1.94), cognitive behavioural therapy (0.92, 0.43 to 1.42), and pain education (0.91, 0.37 to 1.45), delivered with physiotherapy care, resulted in clinically important effects at post-intervention (low to moderate quality evidence). Only behavioural therapy delivered with physiotherapy care maintained clinically important effects on reducing pain intensity until mid-term follow-up (1.01, 0.41 to 1.60; high quality evidence). CONCLUSIONS For people with chronic, non-specific low back pain, psychological interventions are most effective when delivered in conjunction with physiotherapy care (mainly structured exercise). Pain education programmes (low to moderate quality evidence) and behavioural therapy (low to high quality evidence) result in the most sustainable effects of treatment; however, uncertainty remains as to their long term effectiveness. Although inconsistency was detected, potential sources were identified and resolved. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019138074.
Collapse
Affiliation(s)
- Emma Kwan-Yee Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Lingxiao Chen
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Milena Simic
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Claire Elizabeth Ashton-James
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Pain Management Research Institute, Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - Josielli Comachio
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Daniel Xin Mo Wang
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jill Alison Hayden
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Manuela Loureiro Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Paulo Henrique Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
16
|
Kurland DB, Mureb MC, Liu AH, Seidenstein AH, Stern E, Anderer EG. Yoga as an adjunctive treatment for nonoperative low-back pain. J Neurosurg Spine 2022; 36:517-521. [PMID: 34653967 DOI: 10.3171/2021.6.spine2198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David B Kurland
- 1Department of Neurosurgery, New York University Langone Health, New York, New York
| | - Monica C Mureb
- 2Department of Neurosurgery, New York Medical College, Valhalla, New York
| | - Albert H Liu
- 1Department of Neurosurgery, New York University Langone Health, New York, New York
| | | | | | - Erich G Anderer
- 1Department of Neurosurgery, New York University Langone Health, New York, New York
| |
Collapse
|
17
|
Kim DY, Hong SH, Jang SH, Park SH, Noh JH, Seok JM, Jo HJ, Son CG, Lee EJ. Systematic Review for the Medical Applications of Meditation in Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031244. [PMID: 35162267 PMCID: PMC8834867 DOI: 10.3390/ijerph19031244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 11/23/2022]
Abstract
Background: Meditation has been increasingly adapted for healthy populations and participants with diseases. Its beneficial effects are still challenging to determine due to the heterogeneity and methodological obstacles regarding medical applications. This study aimed to integrate the features of therapeutic meditation in randomized controlled trials (RCTs). Methods: We conducted a systematic review of RCTs with meditation for populations with diseases using the PubMed database through June 2021. We analyzed the characteristics of the diseases/disorders, participants, measurements, and their overall benefits. Results: Among a total of 4855 references, 104 RCTs were determined and mainly applied mindfulness-based (51 RCTs), yoga-based (32 RCTs), and transcendental meditation (14 RCTs) to 10,139 patient-participants. These RCTs were conducted for participants with a total of 45 kinds of disorders; the most frequent being cancer, followed by musculoskeletal and connective tissue diseases and affective mood disorder. Seven symptoms or signs were frequently assessed: depressive mood, feeling anxious, quality of life, stress, sleep, pain, and fatigue. The RCTs showed a higher ratio of positive outcomes for sleep (73.9%) and fatigue (68.4%). Conclusions: This systematic review produced the comprehensive features of RCTs for therapeutic meditation. These results will help physicians and researchers further study clinical adaptations in the future as reference data.
Collapse
Affiliation(s)
- Do-Young Kim
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Soo-Hwa Hong
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Seung-Hyeon Jang
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - So-Hyeon Park
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Jung-Hee Noh
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Jung-Mi Seok
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Hyun-Jeong Jo
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Chang-Gue Son
- Department of Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
- Correspondence: (C.-G.S.); (E.-J.L.)
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, Daejeon Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
- Correspondence: (C.-G.S.); (E.-J.L.)
| |
Collapse
|
18
|
Singh J, Metri K, Tekur P, Mohanty S, Jha M, Singh A, Raghuram N. Designing, validation, and feasibility of a yoga module for patients with ankylosing spondylitis. J Ayurveda Integr Med 2022; 13:100479. [PMID: 34953604 PMCID: PMC8724870 DOI: 10.1016/j.jaim.2021.06.019] [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: 11/25/2020] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes significant disability and reduced quality of life. Scientific studies on yoga have revealed its various health benefits in chronic conditions, including autoimmune diseases. However, whether yoga is feasible for AS patients or not is not studied. Further, no validated yoga module is available for AS patients. OBJECTIVE(S) This study intended to develop a yoga module for AS patients and investigated its feasibility of use. MATERIALS AND METHODS The study was completed in three stages. In Stage I, six yoga experts prepared a list of 64 yoga practices based on the classical and contemporary yogic literature review. Of these practices, 41 were included in the designed yoga module. In Stage II, 41 experts with a minimum of five years of experience in yoga therapy were invited for yoga module validation. The usefulness of the practices was rated by experts on a 3-point scale (1: not at all useful, 2: moderately useful, and 3: very much useful). The Lawshe content validity ratio (CVR) method was used for the content validity of the yoga module. Practices with a CVR score of > 0.3 were retained in the final yoga module. In Stage III, a certified yoga instructor administered the validated yoga module to 19 AS patients (average age: 35.5 ± 10.7 years) thrice weekly for a month. Feasibility was assessed on the basis of the attrition rate, retention rate, attendance of the participants, and the subjective response on practical sessions using a structured checklist. RESULTS Of the 41 practices in the module, 31 had a CVR score of > 0.3 and were included in the final yoga module. Of the 25 participants, 19 (76%) completed the study while six dropped out (24%). Nineteen patients reported greater improvement in pain and flexibility. They found yoga relaxing and easy to practice. Most participants (65%) were able to practice a minimum of 30 min/day. CONCLUSION The present study offers a validated yoga module consisting of 31 practices for AS patients. The results of the pilot suggested that the module is feasible, acceptable, and easy to practice for AS patients. We recommend that AS patients should practice this yoga module for a minimum of 30 min every day under the supervision of a yoga expert.
Collapse
Affiliation(s)
- Jyoti Singh
- Division of Yoga & Life Sciences Swami Vivekananda Yoga Anusandhan Samsthan, #19 Eknath Bhavan, Gavipuram Circle, K G Nagar, Bengaluru, 560019, India
| | | | - Padmini Tekur
- Division of Yoga & Life Sciences Swami Vivekananda Yoga Anusandhan Samsthan, #19 Eknath Bhavan, Gavipuram Circle, K G Nagar, Bengaluru, 560019, India
| | - Sriloy Mohanty
- Center for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Monika Jha
- Center for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Singh
- Division of Yoga & Life Sciences Swami Vivekananda Yoga Anusandhan Samsthan, #19 Eknath Bhavan, Gavipuram Circle, K G Nagar, Bengaluru, 560019, India
| | - Nagaratna Raghuram
- Division of Yoga & Life Sciences Swami Vivekananda Yoga Anusandhan Samsthan, #19 Eknath Bhavan, Gavipuram Circle, K G Nagar, Bengaluru, 560019, India
| |
Collapse
|
19
|
Singh J, Jha M, Metri K, Mohanty S, Singh A, Tekur P. "A study protocol for a randomised controlled trial on the efficacy of yoga as an adjuvant therapy for patients with Ankylosing spondylitis amidst COVID-19 pandemic". ADVANCES IN INTEGRATIVE MEDICINE 2021; 9:75-79. [PMID: 34840945 PMCID: PMC8606184 DOI: 10.1016/j.aimed.2021.11.001] [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: 08/04/2021] [Revised: 10/21/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022]
Abstract
Background Amidst the adversities of the COVID-19 pandemic, the health care system has seen a new paradigm shift towards e-health or telehealth services. In the advent of catering to the geometrically increasing health care needs of the patients suffering from various chronic health conditions when in social isolation, the need for such shifts is paramount. Patients with Ankylosing spondylitis using immunosuppressants with variable degrees of disabilities are at higher risk from this isolated status. This study aims to assess the efficacy of e-Yoga as a treatment option for these patients. Methods The proposed study is a single-center, parallel-group prospective randomized, open-blinded end-point trial. Patients aged between 30 and 50 years will be recruited from the members of Antardhwani: A society of ankylosing spondylitis based in Ahmedabad, Gujarat. Yoga experts will administer a scientifically developed and validated Yoga module via e-Yoga modalities. A total of 135 patients will be recruited and randomly allocated to Yoga and control groups. Data will be recorded at baseline and three months on disease activity, degree of functional limitations in patients, quality of life, inflammatory biomarkers, depression, and anxiety using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), AS Quality of Life index (ASQOL), C reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Physical health questionnaire-4 (PHQ-4), respectively. Discussion The study will report the efficacy of e-Yoga in catering to the physical and mental insufficiencies of inpatients with Ankylosing spondylitis amidst COVID-19 pandemic. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2020/08/027215)
Collapse
Affiliation(s)
- Jyoti Singh
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Yoga University), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bengaluru - 560019 Karnataka, India
| | - Monika Jha
- Center for Integrative Medicine and Research, 7 Floor, Convergence Block, AIIMS, New Delhi, India
| | - Kashinath Metri
- Department of Yoga, Central University of Rajasthan, Kishangarh, Rajasthan, India
| | - Sriloy Mohanty
- Research Associate, Center for Integrative Medicine and Research, 7 Floor, Convergence Block, AIIMS, New Delhi, India
| | - Amit Singh
- Swami Vivekananda Yoga Anusandhana Samsansthana, Bangalore, Karnataka, India
| | - Padmini Tekur
- Swami Vivekananda Yoga Anusandhana Samsansthana, Bangalore, Karnataka, India
| |
Collapse
|
20
|
Jain D, Norman K, Werner Z, Makovoz B, Baker T, Huber S. Using Postmarket Surveillance to Assess Safety-Related Events in a Digital Rehabilitation App (Kaia App): Observational Study. JMIR Hum Factors 2021; 8:e25453. [PMID: 34751664 PMCID: PMC8663617 DOI: 10.2196/25453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/11/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022] Open
Abstract
Background Low back pain (LBP) affects nearly 4 out of 5 individuals during their lifetime and is the leading cause of disability globally. Digital therapeutics are emerging as effective treatment options for individuals experiencing LBP. Despite the growth of evidence demonstrating the benefits of these therapeutics in reducing LBP and improving functional outcomes, little data has been systematically collected on their safety profiles. Objective This study aims to evaluate the safety profile of a multidisciplinary digital therapeutic for LBP, the Kaia App, by performing a comprehensive assessment of reported adverse events (AEs) by users as captured by a standardized process for postmarket surveillance. Methods All users of a multidisciplinary digital app that includes physiotherapy, mindfulness techniques, and education for LBP (Kaia App) from 2018 to 2019 were included. Relevant messages sent by users via the app were collected according to a standard operating procedure regulating postmarket surveillance of the device. These messages were then analyzed to determine if they described an adverse event (AE). Messages describing an AE were then categorized based on the type of AE, its seriousness, and its relatedness to the app, and they were described by numerical counts. User demographics, including age and gender, and data on app use were collected and evaluated to determine if they were risk factors for increased AE reporting. Results Of the 138,337 active users of the Kaia App, 125 (0.09%) reported at least one AE. Users reported 0.00014 AEs per active day on the app. The most common nonserious AE reported was increased pain. Other nonserious AEs reported included muscle issues, unpleasant sensations, headache, dizziness, and sleep disturbances. One serious AE, a surgery, was reported. Details of the event and its connection to the intervention were not obtainable, as the user did not provide more information when asked to do so; therefore, it was considered to be possibly related to the intervention. There was no relationship between gender and AE reporting (P>.99). Users aged 25 to 34 years had reduced odds (odds ratio [OR] 0.31, 95% CI 0.08-0.95; P=.03) of reporting AEs, while users aged 55 to 65 years (OR 2.53, 95% CI 1.36-4.84, P=.002) and ≥75 years (OR 4.36, 95% CI 1.07-13.26; P=.02) had increased odds. AEs were most frequently reported by users who had 0 to 99 active days on the app, and less frequently reported by users with more active days on the app. Conclusions This study on the Kaia App provides the first comprehensive assessment of reported AEs associated with real-world use of digital therapeutics for lower back pain. The overall rate of reported AEs was very low, but significant reporting bias is likely to be present. The AEs reported were generally consistent with those described for in-person therapies for LBP.
Collapse
Affiliation(s)
- Deeptee Jain
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, United States
| | - Kevin Norman
- Neoteric Consulting, New York, NY, United States
| | | | - Bar Makovoz
- Neoteric Consulting, New York, NY, United States
| | - Turner Baker
- Neoteric Consulting, New York, NY, United States
| | | |
Collapse
|
21
|
Abstract
BACKGROUND Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. OBJECTIVES The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic non-specific low back pain compared to no treatment, usual care, placebo and other conservative treatments. SEARCH METHODS We searched CENTRAL (which includes the Cochrane Back and Neck trials register), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, SPORTDiscus, and trials registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform), and conducted citation searching of relevant systematic reviews to identify additional studies. The review includes data for trials identified in searches up to 27 April 2018. All eligible trials have been identified through searches to 7 December 2020, but have not yet been extracted; these trials will be integrated in the next update. SELECTION CRITERIA We included randomised controlled trials that assessed exercise treatment compared to no treatment, usual care, placebo or other conservative treatment on the outcomes of pain or functional limitations for a population of adult participants with chronic non-specific low back pain of more than 12 weeks' duration. DATA COLLECTION AND ANALYSIS Two authors screened and assessed studies independently, with consensus. We extracted outcome data using electronic databases; pain and functional limitations outcomes were re-scaled to 0 to 100 points for meta-analyses where 0 is no pain or functional limitations. We assessed risk of bias using the Cochrane risk of bias (RoB) tool and used GRADE to evaluate the overall certainty of the evidence. When required, we contacted study authors to obtain missing data. To interpret meta-analysis results, we considered a 15-point difference in pain and a 10-point difference in functional limitations outcomes to be clinically important for the primary comparison of exercise versus no treatment, usual care or placebo. MAIN RESULTS We included 249 trials of exercise treatment, including studies conducted in Europe (122 studies), Asia (38 studies), North America (33 studies), and the Middle East (24 studies). Sixty-one per cent of studies (151 trials) examined the effectiveness of two or more different types of exercise treatment, and 57% (142 trials) compared exercise treatment to a non-exercise comparison treatment. Study participants had a mean age of 43.7 years and, on average, 59% of study populations were female. Most of the trials were judged to be at risk of bias, including 79% at risk of performance bias due to difficulty blinding exercise treatments. We found moderate-certainty evidence that exercise treatment is more effective for treatment of chronic low back pain compared to no treatment, usual care or placebo comparisons for pain outcomes at earliest follow-up (MD -15.2, 95% CI -18.3 to -12.2), a clinically important difference. Certainty of evidence was downgraded mainly due to heterogeneity. For the same comparison, there was moderate-certainty evidence for functional limitations outcomes (MD -6.8 (95% CI -8.3 to -5.3); this finding did not meet our prespecified threshold for minimal clinically important difference. Certainty of evidence was downgraded mainly due to some evidence of publication bias. Compared to all other investigated conservative treatments, exercise treatment was found to have improved pain (MD -9.1, 95% CI -12.6 to -5.6) and functional limitations outcomes (MD -4.1, 95% CI -6.0 to -2.2). These effects did not meet our prespecified threshold for clinically important difference. Subgroup analysis of pain outcomes suggested that exercise treatment is probably more effective than education alone (MD -12.2, 95% CI -19.4 to -5.0) or non-exercise physical therapy (MD -10.4, 95% CI -15.2 to -5.6), but with no differences observed for manual therapy (MD 1.0, 95% CI -3.1 to 5.1). In studies that reported adverse effects (86 studies), one or more adverse effects were reported in 37 of 112 exercise groups (33%) and 12 of 42 comparison groups (29%). Twelve included studies reported measuring adverse effects in a systematic way, with a median of 0.14 (IQR 0.01 to 0.57) per participant in the exercise groups (mostly minor harms, e.g. muscle soreness), and 0.12 (IQR 0.02 to 0.32) in comparison groups. AUTHORS' CONCLUSIONS We found moderate-certainty evidence that exercise is probably effective for treatment of chronic low back pain compared to no treatment, usual care or placebo for pain. The observed treatment effect for the exercise compared to no treatment, usual care or placebo comparisons is small for functional limitations, not meeting our threshold for minimal clinically important difference. We also found exercise to have improved pain (low-certainty evidence) and functional limitations outcomes (moderate-certainty evidence) compared to other conservative treatments; however, these effects were small and not clinically important when considering all comparisons together. Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments.
Collapse
Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jenna Ellis
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Antti Malmivaara
- Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
22
|
Vambheim SM, Kyllo TM, Hegland S, Bystad M. Relaxation techniques as an intervention for chronic pain: A systematic review of randomized controlled trials. Heliyon 2021; 7:e07837. [PMID: 34485731 PMCID: PMC8405991 DOI: 10.1016/j.heliyon.2021.e07837] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/09/2020] [Accepted: 08/17/2021] [Indexed: 12/14/2022] Open
Abstract
Chronic pain increases the risk of sleep disturbances, depression and disability. Even though medical treatments have limited value, the use of prescription-based analgesics have increased over the recent years. It is therefore important to evaluate the effect of non-pharmacological treatments. A systematic search for studies evaluating the effect of relaxation techniques on chronic pain was conducted. Randomized controlled trials were included. Significant effects on pain, or on pain and one or more secondary outcome measure, were found in 21 studies. Four studies found significant effects on secondary outcome measures only. Four studies showed no significant effects on any outcome measure. Thus, most of the studies reported that relaxation techniques reduced pain and/or secondary outcome measures. However, the included studies have evaluated effects across a wide variety of chronic pain conditions and relaxation techniques. Hence, there is a large degree of heterogeneity among the included studies. This complicates the effect evaluation and makes it difficult to draw a clear and unambiguous conclusion. Relaxation techniques are probably most effective when used through regular and continued practice. Future studies should therefore investigate long-term effects of relaxation technique interventions, evaluate the dose-response relationship and examine efficacy differences across pain conditions and interventions.
Collapse
Affiliation(s)
- Sara Magelssen Vambheim
- Department of Psychology, UiT The Arctic University of Norway, Norway
- Department of Pain Management and Research, Emergency Clinic, Oslo University, Norway
| | | | - Sanne Hegland
- Department of Psychology, UiT The Arctic University of Norway, Norway
| | - Martin Bystad
- Department of Pain Management and Research, Emergency Clinic, Oslo University, Norway
- Department of Geropsychiatry, UNN University Hospital of North Norway, Norway
| |
Collapse
|
23
|
Yoga for treating low back pain: a systematic review and meta-analysis. Pain 2021; 163:e504-e517. [PMID: 34326296 DOI: 10.1097/j.pain.0000000000002416] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
ABSTRACT Yoga is frequently used for back pain relief. However, evidence was judged to be of only low- or moderate. To assess the efficacy and safety of yoga in patients with low back pain a meta-analysis was performed. Therefore Medline/PubMed, Scopus, and the Cochrane Library was searched to May 26 2020. Only randomized controlled trials (RCTs) comparing Yoga with passive control (usual care or waitlist), or an active comparator, for patients with low back pain, that assessed pain intensity or pain-related disability as a primary outcome were considered to be eligible. Two reviewers independently extracted data on study characteristics, outcome measures, and results at short-term and long-term follow-up. Risk of bias was assessed using the Cochrane Risk of Bias Tool. 30 articles on 27 individual studies (2702 participants in total) proved eligible for review. Compared to passive control, yoga was associated with short-term improvements in pain intensity (15 RCTs; Mean Difference (MD)=-0.74 points on a numeric rating scale; 95%CI=-1.04,-0.44; Standardized Mean Difference (SMD)=-0.37 95%CI=-0.52,-0.22), pain-related disability (15 RCTs; MD=-2.28; 95%CI=-3.30,-1.26; SMD=-0.38 95%CI=-0.55,-0.21), mental health (7 RCTs; MD=1.70; 95%CI=0.20,3.20; SMD=0.17 95%CI=0.02,0.32) and physical functioning (9 RCTs; MD=2.80; 95%CI=1.00,4.70; SMD=0.28 95%CI=0.10,0.47). Except for mental health all effects sustained long-term. Compared to an active comparator, yoga was not associated with any significant differences in short- or long-term outcomes.In conclusion, yoga revealed robust short- and long-term effects for pain, disability, physical function and mental health, when compared to non-exercise controls. However these effects were mainly not clinically significant.
Collapse
|
24
|
A qualitative investigation of a prenatal yoga intervention to prevent excessive gestational weight gain: A thematic analysis of interviews. Complement Ther Clin Pract 2021; 44:101414. [PMID: 33989862 DOI: 10.1016/j.ctcp.2021.101414] [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: 10/27/2020] [Revised: 03/21/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To describe pregnant women's experiences and perceived facilitators/barriers of a prenatal yoga intervention to prevent excessive gestational weight gain (EGWG). METHODS Pregnant women (N = 13) were interviewed after participation in a 12-week prenatal yoga intervention to prevent EGWG. Interviews were summarized using thematic analysis. RESULTS Twelve themes were identified and organized into four categories: 1) experiences of prenatal yoga (positive experience/enjoyment, pain relief, connecting to body), 2) prenatal yoga and weight (increased mindfulness/self-awareness, increased physical activity, weight management), 3) barriers to prenatal yoga (physical body, commute/traffic, schedule), and 4) facilitators of prenatal yoga (healthy pregnancy, support from other pregnant women, the feeling from prenatal yoga). CONCLUSION Prenatal yoga may relieve pain and help women be more connected to their bodies. Prenatal yoga may also help women become more aware of their health behaviors and increases their physical activity which may have important implications for reducing EGWG.
Collapse
|
25
|
Singh J, Tekur P, Metri KG, Mohanty S, Singh A, Nagaratna R. Potential Role of Yoga in the Management of Ankylosing Spondylitis: A Retrospective Study. Ann Neurosci 2021; 28:74-78. [PMID: 34733057 PMCID: PMC8558989 DOI: 10.1177/09727531211035335] [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: 04/14/2021] [Accepted: 06/25/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a chronic autoimmune inflammatory spondyloarthropathy with unclear pathogenesis. The inflammatory pain in AS leads to restricted spinal mobility and significant disability. Yoga is a nonpharmacological intervention that has positive effects on various musculoskeletal-related problems. However, its role in AS is unknown. OBJECTIVE The present retrospective study assessed the efficacy of a two-week residential yoga intervention on spinal flexibility among AS patients. METHODS The records for 24 male AS patients within the age range 30 to 50 years (average age 38.3 ± 10.5 years) who underwent a two-week residential yoga retreat between 2015 and 2020 were obtained from a yoga center located in South India. Yoga intervention consisted of yoga postures, breathing practices, meditation, a healthy diet, and devotional sessions. Pre and Post data of the sit-and-reach test, blood pressure, heart rate, and symptom score were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS Compared to the baseline, the post scores of the sit-and-reach test, systolic blood pressure and heart rate were found to be significantly (P < .05) lower. The symptom score and analgesic medication score also showed significant improvement after two-weeks compared to the baseline. CONCLUSION This retrospective study indicates the positive impact of on and analgesic use among AS patients. However, additional studies using robust research designs are warranted.
Collapse
Affiliation(s)
- Jyoti Singh
- Division of Yoga and Life Sciences, Swami
Vivekananda Yoga Anusandhan Samsthan (SVYASA University), Bengaluru, India
| | - Padmini Tekur
- Department of Yoga, Central University of
Rajasthan, Ajmer, Rajasthan, India
| | - Kashinath G. Metri
- Department of Yoga, Central University of
Rajasthan, Ajmer, Rajasthan, India
| | - Sriloy Mohanty
- Center for Integrative Medicine and Research
(CIMR), AlIMS, New Delhi, India
| | - Amit Singh
- Division of Yoga and Life Sciences, Swami
Vivekananda Yoga Anusandhan Samsthan (SVYASA University), Bengaluru, India
| | - Raghuram Nagaratna
- Division of Yoga and Life Sciences, Swami
Vivekananda Yoga Anusandhan Samsthan (SVYASA University), Bengaluru, India
| |
Collapse
|
26
|
Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2020; 15:e0238544. [PMID: 32870936 PMCID: PMC7462307 DOI: 10.1371/journal.pone.0238544] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/18/2020] [Indexed: 01/08/2023] Open
Abstract
Background Chronic low back pain (CLBP) is a common and often disabling musculoskeletal condition. Yoga has been proven to be an effective therapy for chronic low back pain. However, there are still controversies about the effects of yoga at different follow-up periods and compared with other physical therapy exercises. Objective To critically compare the effects of yoga for patients with chronic low back pain on pain, disability, quality of life with non-exercise (e.g. usual care, education), physical therapy exercise. Methods This study was registered in PROSPERO, and the registration number was CRD42020159865. Randomized controlled trials (RCTs) of online databases included PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase which evaluated effects of yoga for patients with chronic low back pain on pain, disability, and quality of life were searched from inception time to November 1, 2019. Studies were eligible if they assessed at least one important outcome, namely pain, back-specific disability, quality of life. The Cochrane risk of bias tool was used to assess the methodological quality of included randomized controlled trials. The continuous outcomes were analyzed by calculating the mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) according to whether combining outcomes measured on different scales or not. Results A total of 18 randomized controlled trials were included in this meta-analysis. Yoga could significantly reduce pain at 4 to 8 weeks (MD = -0.83, 95% CI = -1.19 to -0.48, p<0.00001, I2 = 0%), 3 months (MD = -0.43, 95% CI = -0.64 to -0.23, p<0.0001, I2 = 0%), 6 to 7 months (MD = -0.56, 95% CI = -1.02 to -0.11, p = 0.02, I2 = 50%), and was not significant in 12 months (MD = -0.52, 95% CI = -1.64 to 0.59, p = 0.36, I2 = 87%) compared with non-exercise. Yoga was better than non-exercise on disability at 4 to 8 weeks (SMD = -0.30, 95% CI = -0.51 to -0.10, p = 0.003, I2 = 0%), 3 months (SMD = -0.31, 95% CI = -0.45 to -0.18, p<0.00001, I2 = 30%), 6 months (SMD = -0.38, 95% CI = -0.53 to -0.23, p<0.00001, I2 = 0%), 12 months (SMD = -0.33, 95% CI = -0.54 to -0.12, p = 0.002, I2 = 9%). There was no significant difference on pain, disability compared with physical therapy exercise group. Furthermore, it suggested that there was a non-significant difference on physical and mental quality of life between yoga and any other interventions. Conclusion This meta-analysis provided evidence from very low to moderate investigating the effectiveness of yoga for chronic low back pain patients at different time points. Yoga might decrease pain from short term to intermediate term and improve functional disability status from short term to long term compared with non-exercise (e.g. usual care, education). Yoga had the same effect on pain and disability as any other exercise or physical therapy. Yoga might not improve the physical and mental quality of life based on the result of a merging.
Collapse
|
27
|
Nduwimana I, Nindorera F, Thonnard JL, Kossi O. Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials. Medicine (Baltimore) 2020; 99:e21969. [PMID: 32871946 PMCID: PMC7458239 DOI: 10.1097/md.0000000000021969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Walking and mind-body therapies (MBTs) are commonly recommended to relieve pain and improve function in patients with chronic low back pain (CLBP). The purpose of this study was to compare the effectiveness of walking and MBTs in CLBP. METHODS We included randomized controlled trials (RCTs) comparing walking or MBTs to any other intervention or control in adults with CLBP. Studies were identified through PubMed, Cochrane Library, PsycINFO, Scopus, and ScienceDirect databases. The research was limited to studies published in English and French between January 2008 and December 2018. Two reviewers independently selected the studies, extracted data, and assessed studies quality using the Physiotherapy Evidence Database (PEDro) scale. Statistical analyses were performed under a random-effects model. We analyzed pain and activity limitation, with the calculation of standardized mean differences and 95% confidence intervals for the different treatment effects. RESULTS Thirty one randomized controlled trials involving 3193 participants were analyzed. Walking was as effective as control interventions in the short-term and slightly superior in the intermediate term with respect to pain (Standardized mean differences (SMD) = -0.34; 95% CI, -0.65 to -0.03; P = .03) and activity limitation (SMD = -0.30; 95% CI, -0.50 to -0.10; P = .003). In contrast, yoga was more effective than control interventions in the short term in terms of pain (SMD = -1.47; 95% CI, -2.26 to -0.68; P = .0003) and activity limitation (SMD = -1.17; 95% CI, -1.80 to -0.55; P = .0002). Yoga was no longer superior to the control interventions for pain at the 6-month follow-up. CONCLUSION MBTs, especially yoga, seem to be more effective in the short term, and walking seems to be more effective in the intermediate term, for the relief of pain and activity limitation in patients with CLBP. A combination of walking and MBTs fits the biopsychosocial model and might be valuable therapy for CLBP throughout follow-up due to combined effects.
Collapse
Affiliation(s)
- Ildephonse Nduwimana
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- National Center for Physical Therapy and Rehabilitation (CNRKR), Bujumbura, Burundi
| | - Félix Nindorera
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- National Center for Physical Therapy and Rehabilitation (CNRKR), Bujumbura, Burundi
| | - Jean Louis Thonnard
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- National Center for Physical Therapy and Rehabilitation (CNRKR), Bujumbura, Burundi
| | - Oyene Kossi
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Rehabilitation, University Hospital of Parakou
- National School of Public Health and Epidemiology, University of Parakou, Parakou, Bénin
| |
Collapse
|
28
|
Tobe M, Saito S. Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy. J Anesth 2020; 34:944-949. [PMID: 32803435 PMCID: PMC7429199 DOI: 10.1007/s00540-020-02840-5] [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: 07/02/2018] [Accepted: 08/09/2020] [Indexed: 11/25/2022]
Abstract
Anesthesiologists and intensivists are modern-day professionals who provide appropriate respiratory care, vital for patient survival. Recently, anesthesiologists have increasingly focused their attention on the type of spontaneous breathing made by non-intubated patients with pulmonary disease cared for in an intensive care unit, and also patients with chronic pain receiving cognitive behavioral therapy. Prior to our modern understanding of respiratory physiology, Zen meditators recognized that breathing has a significant impact on a person’s mental state and general physical well-being. Examples of this knowledge regarding respiration include the beneficial effects of deep inhalation and slow exhalation on anxiety and general wellness. The classical literature has noted many suggestions for breathing and its psycho-physical effects. In the present review, we examine the effect of classical breathing methods and find an analogy between typical Yoga/Zen breathing and modern clinical respiratory therapy. Evidence is increasing about historical breathing and related meditation techniques that may be effective in modern clinical practice, especially in the field of anesthesiology, such as in improving respiratory function and reducing chronic pain. Clarification of the detailed mechanisms involved is anticipated.
Collapse
Affiliation(s)
- Masaru Tobe
- Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Shigeru Saito
- Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| |
Collapse
|
29
|
Evidence Supports PA Prescription for Parkinson's Disease: Motor Symptoms and Non-Motor Features: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082894. [PMID: 32331349 PMCID: PMC7215784 DOI: 10.3390/ijerph17082894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 01/15/2023]
Abstract
Parkinson’s disease (PD) is a prevalent neurodegenerative disorder, which relates to not only motor symptoms, but also cognitive, autonomic, and mood impairments. The literature suggests that pharmacological or surgical treatment has a limited effect on providing relief of the symptoms and also restricting its progression. Recently, research on non-pharmacological interventions for people living with PD (pwPD) that alleviate their motor and non-motor features has shown a new aspect in treating this complex disease. Numerous studies are supporting exercise intervention as being effective in both motor and non-motor facets of PD, such as physical functioning, strength, balance, gait speed, and cognitive impairment. Via the lens of the physical profession, this paper strives to provide another perspective for PD treatment by presenting exercise modes categorized by motor and non-motor PD symptoms, along with its effects and mechanisms. Acknowledging that there is no “one size fits all” exercise prescription for such a variable and progressive disease, this review is to outline tailored physical activities as a credible approach in treating pwPD, conceivably enhancing overall physical capacity, ameliorating the symptoms, reducing the risk of falls and injuries, and, eventually, elevating the quality of life. It also provides references and practical prescription applications for the clinician.
Collapse
|
30
|
Colgrove YM, Gravino-Dunn NS, Dinyer SC, Sis EA, Heier AC, Sharma NK. Physical and Physiological Effects of Yoga for an Underserved Population with Chronic Low Back Pain. Int J Yoga 2019; 12:252-264. [PMID: 31543635 PMCID: PMC6746048 DOI: 10.4103/ijoy.ijoy_78_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Yoga has been shown useful in reducing chronic low back pain (CLBP) through largely unknown mechanisms. The aim of this pilot study is to investigate the feasibility of providing yoga intervention to a predominantly underserved population and explore the potential mechanisms underlying yoga intervention in improving CLBP pain. Methods The quasi-experimental within-subject wait-listed crossover design targeted the recruitment of low-income participants who received twice-weekly group yoga for 12 weeks, following 6-12 weeks of no intervention. Outcome measures were taken at baseline, preintervention (6-12 weeks following baseline), and then postintervention. Outcome measures included pain, disability, core strength, flexibility, and plasma tumor necrosis factor (TNF)-α protein levels. Outcomes measures were analyzed by one-way ANOVA and paired one-tailed t-tests. Results Eight patients completed the intervention. Significant improvements in pain scores measured over time were supported by the significant improvement in pre- and post-yoga session pain scores. Significant improvements were also seen in the Oswestry Disability Questionnaire scores, spinal and hip flexor flexibility, and strength of core muscles following yoga. Six participants saw a 28.6%-100% reduction of TNF-α plasma protein levels after yoga, while one showed an 82.4% increase. Two participants had no detectable levels to begin with. Brain imaging analysis shows interesting increases in N-acetylaspartate in the dorsolateral prefrontal cortex and thalamus. Conclusion Yoga appears effective in reducing pain and disability in a low-income CLBP population and in part works by increasing flexibility and core strength. Changes in TNF-α protein levels should be further investigated for its influence on pain pathways.
Collapse
Affiliation(s)
- Yvonne M Colgrove
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Nicole S Gravino-Dunn
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Sarah C Dinyer
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Emily A Sis
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Alexa C Heier
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Neena K Sharma
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| |
Collapse
|
31
|
Neyaz O, Sumila L, Nanda S, Wadhwa S. Effectiveness of Hatha Yoga Versus Conventional Therapeutic Exercises for Chronic Nonspecific Low-Back Pain. J Altern Complement Med 2019; 25:938-945. [DOI: 10.1089/acm.2019.0140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Osama Neyaz
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Lukram Sumila
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Srishti Nanda
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Wadhwa
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
32
|
Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2019; 8:jcm8050628. [PMID: 31072005 PMCID: PMC6571780 DOI: 10.3390/jcm8050628] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Chronic low back pain (CLBP) is a common health issue worldwide. Tai Chi, Qigong, and Yoga, as the most widely practiced mindful exercises, have promising effects for CLBP-specific symptoms. Objective: We therefore conducted a comprehensive review investigating the effects of mindful exercises versus active and/or non-active controls while evaluating the safety and pain-related effects of mindful exercises in adults with CLBP. Methods: We searched five databases (MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Library) from inception to February 2019. Two investigators independently selected 17 eligible randomized controlled trials (RCT) against inclusion and exclusion criteria, followed by data extraction and study quality assessment. Standardized mean difference (SMD) was used to determine the magnitude of mindful exercises versus controls on pain- and disease-specific outcome measures. Results: As compared to control groups, we observed significantly favorable effects of mindful exercises on reducing pain intensity (SMD = −0.37, 95% CI −0.5 to −0.23, p < 0.001, I2 = 45.9 %) and disability (SMD = −0.39, 95% CI −0.49 to −0.28, p < 0.001, I2 = 0 %). When compared with active control alone, mindful exercises showed significantly reduced pain intensity (SMD = −0.40, p < 0.001). Furthermore, of the three mindful exercises, Tai Chi has a significantly superior effect on pain management (SMD= −0.75, 95% CI −1.05 to −0.46, p < 0.001), whereas Yoga-related adverse events were reported in five studies. Conclusion: Findings of our systematic review suggest that mindful exercises (Tai Chi and Qigong) may be beneficial for CLBP symptomatic management. In particular, Tai Chi appears to have a superior effect in reducing pain intensity irrespective of non-control comparison or active control comparison (conventional exercises, core training, and physical therapy programs). Importantly, training in these mindful exercises should be implemented with certified instructors to ensure quality of movement and injury prevention.
Collapse
|
33
|
Stabilization exercise versus yoga exercise in non-specific low back pain: Pain, disability, quality of life, performance: a randomized controlled trial. Complement Ther Clin Pract 2019; 35:102-108. [DOI: 10.1016/j.ctcp.2019.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/01/2019] [Accepted: 02/03/2019] [Indexed: 11/20/2022]
|
34
|
McClintock AS, McCarrick SM, Garland EL, Zeidan F, Zgierska AE. Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review. J Altern Complement Med 2019; 25:265-278. [PMID: 30523705 PMCID: PMC6437625 DOI: 10.1089/acm.2018.0351] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Nonpharmacologic approaches have been characterized as the preferred means to treat chronic noncancer pain by the Centers for Disease Control and Prevention. There is evidence that mindfulness-based interventions (MBIs) are effective for pain management, yet the typical MBI may not be feasible across many clinical settings due to resource and time constraints. Brief MBIs (BMBIs) could prove to be more feasible and pragmatic for safe treatment of pain. The aim of the present article is to systematically review evidence of BMBI's effects on acute and chronic pain outcomes in humans. METHODS A literature search was conducted using PubMed, PsycINFO, and Google Scholar and by examining the references of retrieved articles. Articles written in English, published up to August 16, 2017, and reporting on the effects of a BMBI (i.e., total contact time <1.5 h, with mindfulness as the primary therapeutic technique) on a pain-related outcome (i.e., pain outcome, pain affect, pain-related function/quality of life, or medication-related outcome) were eligible for inclusion. Two authors independently extracted the data and assessed risk of bias. RESULTS Twenty studies meeting eligibility criteria were identified. Studies used qualitative (n = 1), within-group (n = 3), or randomized controlled trial (n = 16) designs and were conducted with clinical (n = 6) or nonclinical (i.e., experimentally-induced pain; n = 14) samples. Of the 25 BMBIs tested across the 20 studies, 13 were delivered with audio/video recording only, and 12 were delivered by a provider (participant-provider contact ranged from 3 to 80 min). Existing evidence was limited and inconclusive overall. Nevertheless, BMBIs delivered in a particular format-by a provider and lasting more than 5 min-showed some promise in the management of acute pain. CONCLUSIONS More rigorous large scale studies conducted with pain populations are needed before unequivocally recommending BMBI as a first-line treatment for acute or chronic pain.
Collapse
Affiliation(s)
- Andrew S. McClintock
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Athens, Ohio
| | - Fadel Zeidan
- Department of Neurobiology and Anatomy, Center of Integrative Medicine, Wake Forrest School of Medicine, Winston-Salem, North Carolina
| | - Aleksandra E. Zgierska
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, Wisconsin
| |
Collapse
|
35
|
Complementary and Alternative Medicine. Pain 2019. [DOI: 10.1007/978-3-319-99124-5_232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Wang Y, Lu S, Wang R, Jiang P, Rao F, Wang B, Zhu Y, Hu Y, Zhu J. Integrative effect of yoga practice in patients with knee arthritis: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018; 97:e11742. [PMID: 30075589 PMCID: PMC6081169 DOI: 10.1097/md.0000000000011742] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Benefits of yoga practice in patients with knee osteoarthritis and rheumatoid arthritis remains controversial. This study performs a meta-analysis to quantify the efficiency of yoga exercise for patients pain reduction, functional recovery, and general wellbeing. METHODS A computerized search of PubMed and Embase was performed to identify relevant studies. The outcome measures were pain, stiffness, and physical function. Two investigators identified eligible studies and extracted data independently. The quality of citations was measured using Jadad score. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for pain, musculoskeletal impairment, quality of life, general wellbeing, and mental wellbeing. RESULTS A total of 13 clinical trials involving 1557 patients with knee osteoarthritis and rheumatoid arthritis were included in final meta-analysis with the average Jadad score 2.8. The SMD was -0.98 (95% CI -1.18, -0.78, P < .05) for pain, -1.83 (95% CI -2.09, -1.57, P < .05) for functional disability, was 0.80 (95% CI 0.59, 1.01, P < .05) for Short Form 36 Health Survey (SF-36) general health, 0.49 (95% CI 0.14, 0.82, P < .05) for SF-36 mental health, and HAQ was -0.55 (95% CI -0.83, -0.26, P < .05) for health associated questionnaire (HAQ). All the results favor yoga training group. CONCLUSIONS Regular yoga training is helpful in reducing knee arthritic symptoms, promoting physical function, and general wellbeing in arthritic patients.
Collapse
Affiliation(s)
- Yiguo Wang
- School of Medicine, Nankai University, Tianjin
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
| | - Shibi Lu
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
| | - Ruomei Wang
- Department of Endocrinology, The Fourth Affiliated Hospital of Anhui Medical University. Hefei
| | - Peng Jiang
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
| | - Feng Rao
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Bo Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Yong Zhu
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Yihe Hu
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Jianxi Zhu
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| |
Collapse
|
37
|
Mocanu E, Mohr C, Pouyan N, Thuillard S, Dan-Glauser ES. Reasons, Years and Frequency of Yoga Practice: Effect on Emotion Response Reactivity. Front Hum Neurosci 2018; 12:264. [PMID: 30022932 PMCID: PMC6039555 DOI: 10.3389/fnhum.2018.00264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/08/2018] [Indexed: 01/23/2023] Open
Abstract
Yoga practice, even in the short term, is supposed to enhance wellbeing and counteract psychopathology through modification of emotion reactivity. Yoga teaches that emotional responses may be less pronounced with longer and more frequent practice, and potentially when people perform yoga for mental rather than physical reasons. We tested 36 yoga practitioners of varying experience (between 6 months and 11 years of practice). We assessed participants’ self-reported emotional experience and peripheral physiological reactions (heart rate, skin conductance, respiration) when seeing positive and negative pictures. Results were analyzed as a function of the years of, frequency of, and reasons for yoga practice. We found a heart rate increase with the degree participants performed yoga for mental reasons. In addition, years of yoga practice were significantly associated with reduced abdominal respiratory rate when facing negative pictures, speaking in favor of reduced arousal with yoga experience. Finally, regarding frequency of practice, a higher frequency in the last month was linked to less negative and positive experiences as well as a reduced abdominal respiratory amplitude when viewing positive pictures. Altogether, these results demonstrate that intense short-term yoga practice might relate to a (i) decrease in the intensity of self-reported emotional experiences and (ii) deepened respiration. Short-term effects might be shaped by what participants expect as practice benefits. However, several years of practice might be needed to decrease respiratory arousal in the face of negative situations, which likely is a manifestation of an evolution in the emotion regulation process.
Collapse
Affiliation(s)
- Elisabeth Mocanu
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Christine Mohr
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Niloufar Pouyan
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Simon Thuillard
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | |
Collapse
|
38
|
Kuvačić G, Fratini P, Padulo J, Antonio DI, De Giorgio A. Effectiveness of yoga and educational intervention on disability, anxiety, depression, and pain in people with CLBP: A randomized controlled trial. Complement Ther Clin Pract 2018; 31:262-267. [DOI: 10.1016/j.ctcp.2018.03.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 12/13/2022]
|
39
|
Abstract
Whole body protein utilization (WBPU), which includes flux (Q), protein synthesis (PS), protein breakdown (PB), and whole body protein balance (WBPB), provides insight regarding muscle mass, a criterion for sarcopenia. To characterize yoga's impact on WBPU, body composition and functional measures in healthy (50-65 years) women. WBPU and functional measures were compared between women who routinely practiced yoga (YOGA; n = 7) and nonactive counterparts (CON; n = 8). Q (0.61 ± 0.06 vs. 0.78 ± 0.07, p = .04), PS (3.07 ± 0.37 vs. 4.17 ± 0.40, p = .03), PB (2.59 ± 0.48 vs. 3.80 ± 0.48, p = .05) were lower, and lean body mass higher (64 ± 1 vs. 58 ± 2%, p ≤ .01) for YOGA vs. CON, respectively. WBPB and functional measures were similar. Routine yoga practice influenced WBPU in healthy older women. Study findings are novel and provide a basis for future investigations evaluating long-term benefits of yoga as an alternative mode of exercise for maintaining muscle mass in support of active aging.
Collapse
|
40
|
Patil NJ, Nagaratna R, Tekur P, Manohar PV, Bhargav H, Patil D. A Randomized Trial Comparing Effect of Yoga and Exercises on Quality of Life in among nursing population with Chronic Low Back Pain. Int J Yoga 2018; 11:208-214. [PMID: 30233114 PMCID: PMC6134737 DOI: 10.4103/ijoy.ijoy_2_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Chronic low back pain (CLBP) adversely affects quality of life (QOL) in nursing professionals. Integrated yoga has a positive impact on CLBP. Studies assessing the effects of yoga on CLBP in nursing population are lacking. Aim: This study was conducted to evaluate the effects of integrated yoga and physical exercises on QOL in nurses with CLBP. Methods: A total of 88 women nurses from a tertiary care hospital of South India were randomized into yoga group (n = 44; age – 31.45 ± 3.47 years) and physical exercise group (n = 44; age – 32.75 ± 3.71 years). Yoga group was intervened with integrated yoga therapy module practices, 1 h/day and 5 days a week for 6 weeks. Physical exercise group practiced a set of physical exercises for the same duration. All participants were assessed at baseline and after 6 weeks with the World Health Organization Quality of Life-brief (WHOQOL-BREF) questionnaire. Results: Data were analyzed by Paired-samples t-test and Independent-samples t-test for within- and between-group comparisons, respectively, using the Statistical Package for the Social Sciences (SPSS). Within-group analysis for QOL revealed a significant improvement in physical, psychological, and social domains (except environmental domain) in both groups. Between-group analysis showed a higher percentage of improvement in yoga as compared to exercise group except environmental domain. Conclusions: Integrated yoga was showed improvements in physical, psychological, and social health domains of QOL better than physical exercises among nursing professionals with CLBP. There is a need to incorporate yoga as lifestyle intervention for nursing professionals.
Collapse
Affiliation(s)
- Nitin J Patil
- Department of Integrative Medicine, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
| | - R Nagaratna
- Medical Director, Arogyadhama, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - Padmini Tekur
- Division of Yoga and Life Sciences, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - P V Manohar
- Department of Orthopedics, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
| | - Hemant Bhargav
- Integrated Centre for Yoga (NICY), NIMHANS, Bengaluru, Karnataka, India
| | - Dhanashri Patil
- Department of Integrative Medicine, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
| |
Collapse
|
41
|
Sheeran L, Hemming R, van Deursen R, Sparkes V, Jin Z. Can different seating aids influence a sitting posture in healthy individuals and does gender matter? COGENT ENGINEERING 2018; 5:1442109. [PMID: 30023408 PMCID: PMC6034358 DOI: 10.1080/23311916.2018.1442109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/13/2018] [Indexed: 05/03/2023]
Abstract
This study determined differences in spinal-pelvic kinematics sitting on (i) mat (ii) block and (iii) novel 10º forward inclined wedge (ButtaflyTM) in a same-subject repeated measures cross-over design in 60 healthy individuals (34 females). Repeated measures ANOVA revealed statistically significant differences between sitting conditions and lumbar and pelvic sagittal angles. Both, the inclined wedge and the block seating aids reduced overall flexion, but the inclined wedge had a greater influence in the lumbar region whilst the block induced the greatest change in the pelvis. This may be relevant for seating aid design personalised to posture type. Statistically significant gender differences were identified in all 3 seating conditions with males adopting more flexed lumbar spine and posteriorly tilted pelvis. Females flexed less in thoracic spine when sitting on an inclined wedge and a block. These statistically significant differences between males and females may provide first explorative direction for bespoke seating aids design.
Collapse
Affiliation(s)
- Liba Sheeran
- School of Healthcare Sciences, Cardiff University, 13th Floor Eastgate House, 35–43 Newport Road, Cardiff, CF24 0AB, Wales, UK
- Research Centre for Clinical Kinaesiology, Cardiff University, Cardiff, CF14 4XN, UK
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, Cardiff, Wales, UK
- Corresponding author: Liba Sheeran, School of Healthcare Sciences, Cardiff University, 13th Floor Eastgate House, 35–43 Newport Road, Cardiff, CF24 0AB, Wales, UK; Research Centre for Clinical Kinaesiology, Cardiff University, Cardiff, CF14 4XN, UK; Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, Cardiff, Wales, UK. E-mail:
| | - Rebecca Hemming
- School of Healthcare Sciences, Cardiff University, 13th Floor Eastgate House, 35–43 Newport Road, Cardiff, CF24 0AB, Wales, UK
| | - Robert van Deursen
- School of Healthcare Sciences, Cardiff University, 13th Floor Eastgate House, 35–43 Newport Road, Cardiff, CF24 0AB, Wales, UK
- Research Centre for Clinical Kinaesiology, Cardiff University, Cardiff, CF14 4XN, UK
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, Cardiff, Wales, UK
| | - Valerie Sparkes
- School of Healthcare Sciences, Cardiff University, 13th Floor Eastgate House, 35–43 Newport Road, Cardiff, CF24 0AB, Wales, UK
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, Cardiff, Wales, UK
| | - Zhongmin Jin
- Xian Jiao Tong University, China
- Leeds University, UK
| |
Collapse
|
42
|
Metri KG, Pradhan B, Singh A, Nagendra HR. Effect of 1-Week Yoga-Based Residential Program on Cardiovascular Variables of Hypertensive Patients: A Comparative Study. Int J Yoga 2018; 11:170-174. [PMID: 29755228 PMCID: PMC5934954 DOI: 10.4103/ijoy.ijoy_77_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Hypertension (HTN) is an important public health concern and a leading cause of morbidity and mortality worldwide. Yoga is a form of mind–body medicine shown to be effective in controlling blood pressure (BP) and reduces cardiac risk factors in HTN. Integrated approach of Yoga therapy (IAYT) is a residential yoga-based lifestyle intervention proven to be beneficial in several health conditions. Aim: To study the efficacy of 1 week of residential IAYT intervention on cardiovascular parameters in hypertensive patients. Methodology: Twenty hypertensive individuals (7 females) within age range between 30 and 60 years (average; 46.62 ± 9.9 years), who underwent 1 week of IAYT treatment for HTN, were compared with age- gender-matched non-IAYT group (5 females; average age; 47.08 ± 9.69 years) in terms of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), baroreflex sensitivity (BRS), and total peripheral vascular resistance (TPVR), IAYT program consisted of sessions of asanas, breathing practices, meditation and relaxation techniques, low salt, low-calorie diet, devotional session, and counseling. Individuals in non-IAYT group followed their normal routine. All the variables were assessed before and after one week. Data were analyzed using SPSS version 16. RM-ANOVA was applied to assess within group and between group changes after intervention. Results: There was a significant improvement in SBP (P = 0.004), DBP (P = 0.008), MAP (0.03), BRS (P < 0.001), and TPVR (P = 0.007) in IAYT, group whereas in control group, we did not find significant difference in any of the variables. Between-group comparison showed a significant improvement in SBP (P = 0.038), BRS (P = 0.034), and TPVR (P = 0.015) in IAYT group as compared to non-IAYT group. Conclusion: One-week IAYT intervention showed an improvement in baroreflex sensitivity, systolic BP, and total peripheral vascular resistance in hypertensive patients. However, further randomized control trials need to be performed to confirm the present findings.
Collapse
Affiliation(s)
- Kashinath G Metri
- Division of Yoga and Life sciences, School of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Yoga University, Bengaluru, Karnataka, India
| | - Balaram Pradhan
- Division of Yoga and Life sciences, School of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Yoga University, Bengaluru, Karnataka, India
| | - Amit Singh
- Division of Yoga and Life sciences, School of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Yoga University, Bengaluru, Karnataka, India
| | - H R Nagendra
- Division of Yoga and Life sciences, School of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Yoga University, Bengaluru, Karnataka, India
| |
Collapse
|
43
|
Sherman SA, Rogers RJ, Jakicic JM. Yoga for Health: Considerations beyond Energy Cost and Isolated Asanas (Poses). Med Sci Sports Exerc 2017; 49:859. [PMID: 28306644 DOI: 10.1249/mss.0000000000001156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Sally A Sherman
- Department of Health and Physical Activity Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh, PA
| | | | | |
Collapse
|
44
|
Wieland LS, Skoetz N, Pilkington K, Vempati R, D'Adamo CR, Berman BM. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev 2017; 1:CD010671. [PMID: 28076926 PMCID: PMC5294833 DOI: 10.1002/14651858.cd010671.pub2] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain. OBJECTIVES To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e.g. education), or another active treatment, with a focus on pain, function, and adverse events. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, five other databases and four trials registers to 11 March 2016 without restriction of language or publication status. We screened reference lists and contacted experts in the field to identify additional studies. SELECTION CRITERIA We included randomized controlled trials of yoga treatment in people with chronic non-specific low back pain. We included studies comparing yoga to any other intervention or to no intervention. We also included studies comparing yoga as an adjunct to other therapies, versus those other therapies alone. DATA COLLECTION AND ANALYSIS Two authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We contacted study authors to obtain missing or unclear information. We evaluated the overall certainty of evidence using the GRADE approach. MAIN RESULTS We included 12 trials (1080 participants) carried out in the USA (seven trials), India (three trials), and the UK (two trials). Studies were unfunded (one trial), funded by a yoga institution (one trial), funded by non-profit or government sources (seven trials), or did not report on funding (three trials). Most trials used Iyengar, Hatha, or Viniyoga forms of yoga. The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention (three trials), or both exercise and non-exercise interventions (two trials). All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment assignment, and outcomes were self-assessed. Therefore, we downgraded all outcomes to 'moderate' certainty evidence because of risk of bias, and when there was additional serious risk of bias, unexplained heterogeneity between studies, or the analyses were imprecise, we downgraded the certainty of the evidence further.For yoga compared to non-exercise controls (9 trials; 810 participants), there was low-certainty evidence that yoga produced small to moderate improvements in back-related function at three to four months (standardized mean difference (SMD) -0.40, 95% confidence interval (CI) -0.66 to -0.14; corresponding to a change in the Roland-Morris Disability Questionnaire of mean difference (MD) -2.18, 95% -3.60 to -0.76), moderate-certainty evidence for small to moderate improvements at six months (SMD -0.44, 95% CI -0.66 to -0.22; corresponding to a change in the Roland-Morris Disability Questionnaire of MD -2.15, 95% -3.23 to -1.08), and low-certainty evidence for small improvements at 12 months (SMD -0.26, 95% CI -0.46 to -0.05; corresponding to a change in the Roland-Morris Disability Questionnaire of MD -1.36, 95% -2.41 to -0.26). On a 0-100 scale there was very low- to moderate-certainty evidence that yoga was slightly better for pain at three to four months (MD -4.55, 95% CI -7.04 to -2.06), six months (MD -7.81, 95% CI -13.37 to -2.25), and 12 months (MD -5.40, 95% CI -14.50 to -3.70), however we pre-defined clinically significant changes in pain as 15 points or greater and this threshold was not met. Based on information from six trials, there was moderate-certainty evidence that the risk of adverse events, primarily increased back pain, was higher in yoga than in non-exercise controls (risk difference (RD) 5%, 95% CI 2% to 8%).For yoga compared to non-yoga exercise controls (4 trials; 394 participants), there was very-low-certainty evidence for little or no difference in back-related function at three months (SMD -0.22, 95% CI -0.65 to 0.20; corresponding to a change in the Roland-Morris Disability Questionnaire of MD -0.99, 95% -2.87 to 0.90) and six months (SMD -0.20, 95% CI -0.59 to 0.19; corresponding to a change in the Roland-Morris Disability Questionnaire of MD -0.90, 95% -2.61 to 0.81), and no information on back-related function after six months. There was very low-certainty evidence for lower pain on a 0-100 scale at seven months (MD -20.40, 95% CI -25.48 to -15.32), and no information on pain at three months or after seven months. Based on information from three trials, there was low-certainty evidence for no difference in the risk of adverse events between yoga and non-yoga exercise controls (RD 1%, 95% CI -4% to 6%).For yoga added to exercise compared to exercise alone (1 trial; 24 participants), there was very-low-certainty evidence for little or no difference at 10 weeks in back-related function (SMD -0.60, 95% CI -1.42 to 0.22; corresponding to a change in the Oswestry Disability Index of MD -17.05, 95% -22.96 to 11.14) or pain on a 0-100 scale (MD -3.20, 95% CI -13.76 to 7.36). There was no information on outcomes at other time points. There was no information on adverse events.Studies provided limited evidence on risk of clinical improvement, measures of quality of life, and depression. There was no evidence on work-related disability. AUTHORS' CONCLUSIONS There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance. It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone. Yoga is associated with more adverse events than non-exercise controls, but may have the same risk of adverse events as other back-focused exercise. Yoga is not associated with serious adverse events. There is a need for additional high-quality research to improve confidence in estimates of effect, to evaluate long-term outcomes, and to provide additional information on comparisons between yoga and other exercise for chronic non-specific low back pain.
Collapse
Affiliation(s)
- L. Susan Wieland
- University of Maryland School of MedicineCenter for Integrative Medicine520 W. Lombard StreetBaltimoreMarylandUSA21201
| | - Nicole Skoetz
- University Hospital of CologneCochrane Haematological Malignancies Group, Department I of Internal MedicineKerpener Str. 62CologneGermany50937
| | - Karen Pilkington
- University of PortsmouthSchool of Health Sciences and Social Work (SHSSW)PortsmouthUK
| | | | - Christopher R D'Adamo
- University of Maryland School of MedicineCenter for Integrative Medicine520 W. Lombard StreetBaltimoreMarylandUSA21201
| | - Brian M Berman
- University of Maryland School of MedicineCenter for Integrative Medicine520 W. Lombard StreetBaltimoreMarylandUSA21201
| | | |
Collapse
|
45
|
Vadiraja HS, Rao RM, Nagarathna R, Nagendra HR, Patil S, Diwakar RB, Shashidhara HP, Gopinath KS, Ajaikumar BS. Effects of Yoga in Managing Fatigue in Breast Cancer Patients: A Randomized Controlled Trial. Indian J Palliat Care 2017; 23:247-252. [PMID: 28827926 PMCID: PMC5545948 DOI: 10.4103/ijpc.ijpc_95_17] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Cancer-related fatigue is widely prevalent in cancer patients and affects quality of life in advanced cancer patients. Fatigue is caused due to both psychologic distress and physiological sequel following cancer progression and its treatment. In this study, we evaluate the effects of yogic intervention in managing fatigue in metastatic breast cancer patients. Methods: Ninety-one patients with metastatic breast cancer were randomized to receive integrated yoga program (n = 46) or supportive therapy and education (n = 45) over a 3-month period. Assessments such as perceived stress, fatigue symptom inventory, diurnal salivary cortisol, and natural killer cell counts were carried out before and after intervention. Analysis was done using an intention-to-treat approach. Postmeasures for the above outcomes were assessed using ANCOVA with respective baseline measure as a covariate. Results: The results suggest that yoga reduces perceived stress (P = 0.001), fatigue frequency (P < 0.001), fatigue severity (P < 0.001), interference (P < 0.001), and diurnal variation (P < 0.001) when compared to supportive therapy. There was a positive correlation of change in fatigue severity with 9 a.m. salivary cortisol levels. Conclusion: The results suggest that yoga reduces fatigue in advanced breast cancer patients.
Collapse
Affiliation(s)
- H S Vadiraja
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Raghavendra Mohan Rao
- Department of Complementary Alternative Medicine, Health Care Global Enterprises Ltd., Bengaluru, Karnataka, India
| | - R Nagarathna
- Department of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - H R Nagendra
- Department of Research and Development, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Shekhar Patil
- Department of Medical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - Ravi B Diwakar
- Department of Medical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - H P Shashidhara
- Department of Medical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - K S Gopinath
- Department of Surgical Oncology, HCG Bangalore Institute of Oncology, Bengaluru, Karnataka, India
| | - B S Ajaikumar
- Department of Radiation Oncology, HCG Bangalore Institute of Oncology, Bengaluru, Karnataka, India
| |
Collapse
|
46
|
Harkess KN, Delfabbro P, Mortimer J, Hannaford Z, Cohen-Woods S. Brief Report on the Psychophysiological Effects of a Yoga Intervention for Chronic Stress. J PSYCHOPHYSIOL 2017. [DOI: 10.1027/0269-8803/a000169] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract. This paper evaluates the results of a longitudinal investigation of the potential benefits of yoga in a nonclinical sample of chronically stressed women (N = 116). Women undertook a twice weekly, hour-long yoga class for a period of 2 months, measuring psychological and physical indicators of health periodically. Changes in both areas were compared against a wait-list control group. The reported energy expenditure between groups was estimated to be similar, which suggests that the control group engaged in physical activities other than yoga. Of the six psychological outcomes measured, we found improvements in three. Specifically, those in the practicing yoga group experienced increases in positive affect, decreases in levels of distress and stress, as well as a decrease in waist circumference and increased flexibility. No between-group differences were found in mindfulness, well-being, and negative affect. These findings are generally consistent with an emerging literature, suggesting that yoga may provide both psychological and physiological effects that extend beyond its more obvious physical benefits, and are discussed in terms of the body’s allostatic load. These results should be considered in light of this study’s limitations, which include its small sample size, lack of an “active” control group, and female-only participants.
Collapse
Affiliation(s)
| | | | - Jane Mortimer
- School of Psychology, University of Adelaide, Australia
| | | | - Sarah Cohen-Woods
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
| |
Collapse
|
47
|
Manik RK, Mahapatra AK, Gartia R, Bansal S, Patnaik A. Effect of Selected Yogic Practices on Pain and Disability in Patients with Lumbar Spondylitis. Int J Yoga 2017; 10:81-87. [PMID: 28546678 PMCID: PMC5433117 DOI: 10.4103/0973-6131.205516] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: The study was designed to find the effect of selected yogic practices on lumbar spondylitis. Materials and Methods: This was a prospective, randomized study without a control trial. A total of 172 participants with lumbar spondylitis (age 21–79 years) from the outpatient department (OPD) of neurosurgery, AIIMS, Bhubaneswar, were randomly assigned to receive yoga therapy. The module of selected yogic practices consisted of pawanamuktasana series 1 (loosening and strengthening), asana, pranayama, and relaxation techniques Yoga Nidra. Statistics Analysis: Within groups, comparison was done by paired t-test, and between groups, ANOVA test was carried out to determine the significant difference among the various groups under study. Correlation regression analysis was done to measure the degree of linear relationship between pre- and post-study for various groups. Results: Significant differences were observed with yoga therapy in instant relieve practice group, in short-term practice group, and in long-term practice group (LTPG) with better results in LTPG. Conclusion: Selected yoga therapy has got the better result in management of pain in lumbar spondylitis.
Collapse
Affiliation(s)
- Rajesh Kumar Manik
- Department of Aayush, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ashok Kumar Mahapatra
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rajendra Gartia
- Department of Statistics, Sambalpur University, Sambalpur, Odisha, India
| | - Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ashis Patnaik
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| |
Collapse
|
48
|
Chauhan A, Semwal DK, Mishra SP, Semwal RB. Yoga Practice Improves the Body Mass Index and Blood Pressure: A Randomized Controlled Trial. Int J Yoga 2017; 10:103-106. [PMID: 28546682 PMCID: PMC5433109 DOI: 10.4103/ijoy.ijoy_46_16] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Yoga, an ancient Indian system of exercise and therapy is an art of good living or an integrated system for the benefit of the body, mind, and inner spirit. Regular practice of yoga can help to increase blood flow to the brain, reduce stress, have a calming effect on the nervous system, and greatly help in reducing hypertension. AIM Aim of the present study is to evaluate the effect of 1-month yoga practice on body mass index (BMI), and blood pressure (BP). MATERIALS AND METHODS The present study was conducted to determine the effect of yoga practice on 64 participants (age 53.6 ± 13.1 years) (experimental group) whereas the results were compared with 26 healthy volunteers (control group). We examined the effects of yoga on physiological parameters in a 1-month pilot study. Most of the participants were learner and practiced yoga for 1 h daily in the morning for 1 month. BMI and BP (systolic and diastolic) were studied before and after 1 month of yoga practice. RESULTS Yoga practice causes decreased BMI (26.4 ± 2.5-25.22 ± 2.4), systolic BP (136.9 ± 22.18 mmHg to 133 ± 21.38 mmHg), and diastolic BP (84.7 ± 6.5 mmHg to 82.34 ± 7.6 mmHg). On the other hand, no significant changes were observed in BMI and BP of control group. CONCLUSION This study concludes that yoga practice has potential to control BMI and BP without taking any medication.
Collapse
Affiliation(s)
- Ashutosh Chauhan
- Department of Biotechnology, Faculty of Biomedical Sciences, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India
| | - Deepak Kumar Semwal
- Department of Phytochemistry, Faculty of Biomedical Sciences, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India
| | | | - Ruchi Badoni Semwal
- Department of Pharmaceutical Sciences, Tshwane University of Technology, Pretoria 0001, South Africa
| |
Collapse
|
49
|
Maddalozzo GF, Kuo B, Maddalozzo WA, Maddalozzo CD, Galver JW. Comparison of 2 Multimodal Interventions With and Without Whole Body Vibration Therapy Plus Traction on Pain and Disability in Patients With Nonspecific Chronic Low Back Pain. J Chiropr Med 2016; 15:243-251. [PMID: 27857632 PMCID: PMC5106425 DOI: 10.1016/j.jcm.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The purpose of this secondary data analysis was to compare the effect of 2 multimodal exercise-based physical therapy interventions (one with and one without whole-body vibration [WBV] therapy plus traction) on pain and disability in patients with nonspecific chronic low back pain (NSCLBP). METHODS We conducted a secondary analysis of data from 2 distinct samples. One sample was from the Focus on Therapeutic Outcomes Inc. (FOTO) group (n = 55, age 55.1 ± 19.0 years), and the other was the Illinois Back Institute (IBI) (n = 70, age 47.5 ± 13.4 years). Both groups of patients had NSCLBP for more than 3 months and a pain numeric rating scale (NRS) score of ≥7. Both groups received treatment consisting of flexibility or stretching exercises, core stability training, functional training, and postural exercises and strengthening exercises. However, the IBI group also received WBV plus traction. NSCLBP was measured before and after therapeutic trials using the NRS for pain and Oswestry Disability Index (ODI). RESULTS The NRS scores were significantly improved in both groups, decreasing by 2 points in the FOTO group and by 5 points in the IBI group. The ODI scores were significantly improved in both groups; the FOTO group score improved by 9 points and the IBI group improved by 22 points. CONCLUSIONS The results of this preliminary study suggest that NPS and ODI scores statistically improved for both NSCLBP groups receiving multimodal care. However, the group that included WBV therapy plus traction in combination with multimodal care had greater clinical results. This study had several limitations making it difficult to generalize the results from this study sample to the entire population.
Collapse
Affiliation(s)
| | - Brian Kuo
- School of Biological and Population Health Sciences, Corvallis, OR
| | | | | | | |
Collapse
|
50
|
Hasanpour-Dehkordi A, Jivad N, Solati K. Effects of Yoga on Physiological Indices, Anxiety and Social Functioning in Multiple Sclerosis Patients: A Randomized Trial. J Clin Diagn Res 2016; 10:VC01-VC05. [PMID: 27504387 DOI: 10.7860/jcdr/2016/18204.7916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 01/12/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) as a chronic disease could affect patients' various domains of life. AIM This study was conducted to study the effect of yoga on the physiological indices, anxiety and social functioning of patients with MS in southwest, Iran. MATERIALS AND METHODS In this clinical trial study, 60 MS patients were enrolled according to inclusion criteria and randomly assigned to two groups of 30 each. Prior to and after intervention, the patients' vital signs were measured. For case group yoga exercises were performed three sessions a week for 12 weeks while control group performed no exercise. The data were gathered by questionnaire and analysed by descriptive and analytical statistics in SPSS. RESULTS Prior to intervention, there was no significant difference in fatigue severity and pain between the two groups but the mean fatigue severity and pain in case group decreased compared to the control group after the intervention. Prior to intervention, there was no significant difference in mean physiological indices between the two groups but the mean physiological indices in case group decreased significantly after the intervention (p<0.05). CONCLUSION Yoga is likely to increase self-efficacy of MS patients through enhancing physical activity, increasing the strength of lower limbs and balance, and decreasing fatigue and pain, and finally to promote social functioning and to relieve stress and anxiety in these patients.
Collapse
Affiliation(s)
- Ali Hasanpour-Dehkordi
- Assistant Professor, Nursing and Midwifery Holistic Research Center & Department of Medical Surgical, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Nahid Jivad
- Assistant Professor, Department of Neurology, Shahrekord University of Medical Sciences , Shahrekord, IR Iran
| | - Kamal Solati
- Associate Professor, Department of Psychiatry, Shahrekord University of Medical Sciences , Shahrekord, Iran
| |
Collapse
|