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Vitali D, Olugbade T, Eccleston C, Keogh E, Bianchi-Berthouze N, de C Williams AC. Sensing behavior change in chronic pain: a scoping review of sensor technology for use in daily life. Pain 2024; 165:1348-1360. [PMID: 38258888 DOI: 10.1097/j.pain.0000000000003134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/26/2023] [Indexed: 01/24/2024]
Abstract
ABSTRACT Technology offers possibilities for quantification of behaviors and physiological changes of relevance to chronic pain, using wearable sensors and devices suitable for data collection in daily life contexts. We conducted a scoping review of wearable and passive sensor technologies that sample data of psychological interest in chronic pain, including in social situations. Sixty articles met our criteria from the 2783 citations retrieved from searching. Three-quarters of recruited people were with chronic pain, mostly musculoskeletal, and the remainder with acute or episodic pain; those with chronic pain had a mean age of 43 (few studies sampled adolescents or children) and 60% were women. Thirty-seven studies were performed in laboratory or clinical settings and the remainder in daily life settings. Most used only 1 type of technology, with 76 sensor types overall. The commonest was accelerometry (mainly used in daily life contexts), followed by motion capture (mainly in laboratory settings), with a smaller number collecting autonomic activity, vocal signals, or brain activity. Subjective self-report provided "ground truth" for pain, mood, and other variables, but often at a different timescale from the automatically collected data, and many studies reported weak relationships between technological data and relevant psychological constructs, for instance, between fear of movement and muscle activity. There was relatively little discussion of practical issues: frequency of sampling, missing data for human or technological reasons, and the users' experience, particularly when users did not receive data in any form. We conclude the review with some suggestions for content and process of future studies in this field.
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Affiliation(s)
- Diego Vitali
- Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
| | - Temitayo Olugbade
- School of Engineering and Informatics, University of Sussex, Brighton, United Kingdom
- Interaction Centre, University College London, London, United Kingdom
| | - Christoper Eccleston
- Centre for Pain Research, The University of Bath, Bath, United Kingdom
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Psychology, The University of Helsinki, Helsinki, Finland
| | - Edmund Keogh
- Centre for Pain Research, The University of Bath, Bath, United Kingdom
| | | | - Amanda C de C Williams
- Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
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Moreira MF, Gamboa OL, Oliveira MAP. Mindfulness-Based Intervention Effect on the Psychophysiological Marker of Self-Regulation in Women With Endometriosis-Related Chronic Pain. THE JOURNAL OF PAIN 2024; 25:118-131. [PMID: 37524218 DOI: 10.1016/j.jpain.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023]
Abstract
Endometriosis is a gynecological disease that involves a broad biopsychosocial compromise with the potential to create a negative vicious cycle. Despite the complexity of factors influencing women's improvement, most interventions investigated target just the peripheral nociceptive sources of endometriosis-related pain. An alternative is intervening in self-regulation, which can potentially influence multiple domains of the illness experience. The present study examines the effect of a brief Mindfulness-Based Intervention (bMBI) on attention and autonomic nervous system regulation in women with endometriosis-related pain. Also, explore the interaction between these self-regulation domains and the affective pain dimension. An exploratory analysis of the secondary outcomes of a pilot randomized controlled trial was performed. The vagally-mediated Heart Rate Variability (vmHRV) at rest, cognitive stress, and recovery was employed to measure autonomic regulation. The Flanker and Stroop tasks were used to estimate the attention domains. Results showed that bMBI (n = 26) significantly improved Flanker accuracy and Flanker and Stroop reaction time compared to the control group (n = 28). bMBI significantly increased vmHRV at rest and recovery after cognitive stress. Attention mediated the bMBI effect on affective pain improvement. Results suggest that bMBI improves self-regulation domains with the potential to develop a broad biopsychosocial benefit in the endometriosis context. PERSPECTIVE: This article demonstrates the positive impact of a brief Mindfulness-Based Intervention on attention and parasympathetic regulation in women suffering from endometriosis-related pain. This mindfulness-induced self-regulation improvement can benefit affective pain and potentially multiple psychophysiological processes relevant to endometriosis.
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Affiliation(s)
- Marcelo F Moreira
- State University of Rio de Janeiro, Faculty of Medical Sciences, Rio de Janeiro, RJ, Brazil
| | - Olga L Gamboa
- EQness, Sydney, Australia; School of Psychology, A19-Griffith Taylor Building, University of Sydney, Camperdown, NSW, Australia
| | - Marco A P Oliveira
- Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Churchill R, Swartz B, Johnston-Dumerauf A, Halaris A. The Impact of Mindfulness-Based Interventions on Objective Physiological Measures of Autonomic Function for Individuals With Medical Conditions: A Review of the Evidence. Psychosom Med 2024; 86:2-10. [PMID: 37982538 DOI: 10.1097/psy.0000000000001260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Autonomic dysregulation is common in many medical conditions and can have a widespread, negative impact on multiple bodily systems, leading to poorer health outcomes. Thus, addressing autonomic dysregulation as part of a comprehensive treatment plan is important. The goal of this study was to gain a better understanding of the physiological benefits of a mindfulness-based intervention (MBI) for a population with medical conditions, using validated, objective measures of autonomic functioning. METHODS We conducted a review of the literature and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. Studies were included if a) participants were diagnosed with a medical condition, b) an MBI was used, and c) objective pre/post measurements of autonomic nervous system function were collected. Medical conditions were included as a category for this review when a minimum of three articles met the criteria for inclusion. RESULTS Ten articles met the criteria and included oncology, cardiac, and chronic pain conditions. Clinical recommendations were made based on the Clinical Practice Guideline Process Manual, 2017 Edition by the American Academy of Neurology. CONCLUSIONS Based on level of evidence, only oncology met the criteria for "possibly effective." However, there was some evidence of the benefit of MBIs for all three medical conditions, based on individual study findings.
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Affiliation(s)
- Rachel Churchill
- From the Psychology Department (Churchill), Rosalind Franklin University of Medicine and Science, North Chicago; and Psychiatry and Behavioral Neuroscience Department (Swartz, Johnston-Dumerauf, Halaris), Loyola University Chicago: Stritch School of Medicine, Maywood, Illinois
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Barrett B, Walters S, Checovich MM, Grabow ML, Middlecamp C, Wortzel B, Tetrault K, Riordan KM, Goldberg S. Mindful Eco-Wellness: Steps Toward Personal and Planetary Health. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241235922. [PMID: 38410151 PMCID: PMC10896055 DOI: 10.1177/27536130241235922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
Rising greenhouse gas levels heat the earth's surface and alter climate patterns, posing unprecedented threats to planetary ecology and human health. At the same time, obesity, diabetes, and cardiovascular disease have reached epidemic proportions across the globe, caused in part by decreases in physical activity and by over-consumption of carbon-intensive foods. Thus, interventions that support active transportation (walking or cycling rather than driving) and healthier food choices (eating plant-based rather than meat-based diets) would yield health and sustainability "co-benefits." Emerging research suggests that mindfulness-based practices might be effective means toward these ends. At the University of Wisconsin-Madison, we have developed a mindfulness-based group program, Mindful Eco-Wellness: Steps Toward Healthier Living. Loosely based on the Mindfulness-Based Stress Reduction course, our curriculum teaches mindfulness practices in tandem with sustainability principles, following weekly themes of Air, Water, Food, Energy, Transportation, Consumption, Nature Experience, and Ethics. For example, the "Air" class offers participants practice in guided breath meditations while they learn about the benefits of clean air. The theme of "Food" is presented through mindful eating, accompanied by educational videos highlighting the consequences of food production and consumption. "Transportation" includes walking/movement meditations and highlights the health benefits of physical activity and detriments of fossil-fueled transportation. Pedagogical lessons on energy, ecological sustainability, and the ethics of planetary health are intertwined with mindful nature experience and metta (loving-kindness) meditation. Curricular materials, including teaching videos, are freely available online. Pilot testing in community settings (n = 30) and in group medical visits (n = 34) has demonstrated feasibility; pilot data suggests potential effectiveness. Rigorous evaluation and testing are needed.
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Affiliation(s)
- Bruce Barrett
- Department of Family Medicine and Community Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Sarah Walters
- Department of Family Medicine and Community Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Mary M. Checovich
- Department of Family Medicine and Community Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Maggie L. Grabow
- Department of Family Medicine and Community Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Cathy Middlecamp
- Nelson Institute for Environmental Studies, University of Wisconsin - Madison, Madison, WI, USA
| | - Beth Wortzel
- Harmonia Center for Psychotherapy, Madison, WI, USA
| | - Kaitlin Tetrault
- Department of Biostatistics, University of Wisconsin - Madison, Madison, WI, USA
| | - Kevin M. Riordan
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin - Madison, Madison, WI, USA
| | - Simon Goldberg
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin - Madison, Madison, WI, USA
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El Aoufy K, Pezzutto A, Pollina A, Rasero L, Bambi S, Bellando-Randone S, Guiducci S, Maddali-Bongi S, Matucci Cerinic M. Systemic Sclerosis Patients Experiencing Mindfulness-Based Stress Reduction Program: The Beneficial Effect on Their Psychological Status and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2512. [PMID: 36767877 PMCID: PMC9915443 DOI: 10.3390/ijerph20032512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Psychological concerns in Systemic Sclerosis (SSc) patients represent an important issue and should be addressed through non-pharmacological treatments. Thus, the aim of the present study was to assess the effects of the Mindfulness-Based Stress Reduction (MBSR) program on psychological variables and the perspectives and experiences of patients with an SSc diagnosis. Notably, 32 SSc patients were enrolled and assigned to either the intervention (MBSR) group or the waitlist group. Inclusion criteria were (i) age ≥ 18 years, SSc diagnosis according to EULAR/ACR diagnostic criteria and informed consent. Exclusion criteria were previous participation in any Mind-Body Therapy or psychiatric diagnosis. Quantitative and qualitative outcomes were investigated through clinometric questionnaires and individual interviews. MBSR did not significantly impact outcomes such as physical functionality, anxiety, hopelessness, depression, physical health status, perceived stress, mindfulness and mental health status. For the anger evaluation, statistically significant differences are found for both controlling and expressing anger, indicating that the MBSR program had a favorable impact. As for qualitative results, more awareness of daily activities, stress reduction in terms of recognizing the causes and implementing self-strategies to prevent them, adherence to therapy, and recognition of the effect of medication on their bodies were reported. In conclusion, it is important to highlight the absence of negative or side effects of the MBSR program and the positive impact on patients' experience and perspective; thus, we suggest this approach should be taken into account for SSc patients.
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Affiliation(s)
- Khadija El Aoufy
- Department of Experimental and Clinical Medicine, University of Florence, Viale largo Brambilla 3, 50134 Florence, Italy
- Department of Geriatric Medicine, Division of Rheumatology AOUC, 50134 Florence, Italy
| | | | - Alessandra Pollina
- Center for Mindfulness Certified MBSR, University of Massachusetts, Worcester, MA 01605, USA
| | - Laura Rasero
- Department of Health Science, University of Florence, 50134 Florence, Italy
| | - Stefano Bambi
- Department of Health Science, University of Florence, 50134 Florence, Italy
| | - Silvia Bellando-Randone
- Department of Experimental and Clinical Medicine, University of Florence, Viale largo Brambilla 3, 50134 Florence, Italy
- Department of Geriatric Medicine, Division of Rheumatology AOUC, 50134 Florence, Italy
| | - Serena Guiducci
- Department of Experimental and Clinical Medicine, University of Florence, Viale largo Brambilla 3, 50134 Florence, Italy
- Department of Geriatric Medicine, Division of Rheumatology AOUC, 50134 Florence, Italy
| | - Susanna Maddali-Bongi
- Department of Experimental and Clinical Medicine, University of Florence, Viale largo Brambilla 3, 50134 Florence, Italy
| | - Marco Matucci Cerinic
- Department of Experimental and Clinical Medicine, University of Florence, Viale largo Brambilla 3, 50134 Florence, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, 20132 Milan, Italy
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Leça S, Tavares I. Research in Mindfulness Interventions for Patients With Fibromyalgia: A Critical Review. Front Integr Neurosci 2022; 16:920271. [PMID: 35965601 PMCID: PMC9368585 DOI: 10.3389/fnint.2022.920271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Fibromyalgia is one of the most common causes of widespread chronic pain. It has a huge impact on the quality of life, namely because it appears earlier in life than most of the chronic pain conditions. Furthermore, emotional-cognitive distress factors, such as depression and anxiety, are a common feature in patients with fibromyalgia. The neurobiological mechanisms underlying fibromyalgia remain mostly unknown. Among non-pharmacological treatments, cognitive-behavioral therapy has been used during the last decade, namely with the enrolment of patients in programs of mindfulness-based stress reduction (MBSR) and in mindfulness-based interventions (MBI). We critically analyzed the literature to search for scientific evidence for the use of MBI in fibromyalgia. The studies were evaluated as to several outcomes of fibromyalgia improvement along with aspects of the study design which are currently considered relevant for research in mindfulness. We conclude that despite the sparsity of well-structured longitudinal studies, there are some promising results showing that the MBI are effective in reducing the negative aspects of the disease. Future design of studies using MBI in fibromyalgia management should be critically discussed. The importance of active controls, evaluation of sustained effects along with investigation of the subserving neurobiological mechanisms and detailed reports of possible adverse effects should be considered.
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Affiliation(s)
- Salomé Leça
- Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Isaura Tavares
- Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- Institute of Molecular and Cell Biology, University of Porto, Porto, Portugal
- I3S–Institute of Investigation and Innovation in Health, University of Porto, Porto, Portugal
- *Correspondence: Isaura Tavares,
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7
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Brown L, Rando AA, Eichel K, Van Dam NT, Celano CM, Huffman JC, Morris ME. The Effects of Mindfulness and Meditation on Vagally Mediated Heart Rate Variability: A Meta-Analysis. Psychosom Med 2021; 83:631-640. [PMID: 33395216 PMCID: PMC8243562 DOI: 10.1097/psy.0000000000000900] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Heart rate variability (HRV) is a marker of autonomic nervous system function associated with both physical and mental health. Many studies have suggested that mindfulness and meditation-based interventions (MBIs) are associated with improvements in HRV, but findings are mixed, and to date, no comprehensive meta-analysis has synthesized results. METHODS Systematic literature searches were conducted using PsycINFO, Embase, Medline, CINAHL, ERIC, and Scopus to identify randomized controlled trials (RCTs) investigating the effects of predominantly seated MBIs on resting-state vagally mediated HRV. Risk of bias was judged using the Cochrane Risk of Bias tool. RESULTS Nineteen RCTs met the criteria for inclusion in the meta-analysis. Random-effects meta-analysis found that MBIs were not efficacious in increasing vagally mediated resting-state HRV relative to control conditions (Hedges g = 0.38, 95% confidence interval [CI] = -0.014 to 0.77). When removing an outlier (g = 3.22), the effect size was reduced, CI narrowed, and findings remained nonsignificant (g = 0.19, 95% CI = -0.02 to 0.39). High heterogeneity in results (I2 = 89.12%) could not be explained by a priori-determined moderators including intervention duration, study setting, and control type. CONCLUSIONS There is currently insufficient evidence to indicate that MBIs lead to improvements in vagally mediated HRV over control conditions. Future large, well-designed RCTs with low risk of methodological bias could help add to the current evidence to elucidate any role MBIs might play in impacting HRV.
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Affiliation(s)
- Lydia Brown
- La Trobe University, Melbourne, VIC, Australia
- Melbourne School of Psychological sciences, University of Melbourne, Parkville, VIC, Australia
- North Eastern Rehabilitation Centre, Healthscope Hospitals, Melbourne, VIC, Australia
| | | | - Kristina Eichel
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Nicholas T. Van Dam
- Melbourne School of Psychological sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher M. Celano
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jeff C. Huffman
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Meg E. Morris
- La Trobe University, Melbourne, VIC, Australia
- North Eastern Rehabilitation Centre, Healthscope Hospitals, Melbourne, VIC, Australia
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Coles ML, Uziel Y. Juvenile primary fibromyalgia syndrome: A Review- Treatment and Prognosis. Pediatr Rheumatol Online J 2021; 19:74. [PMID: 34006290 PMCID: PMC8130260 DOI: 10.1186/s12969-021-00529-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
Juvenile primary fibromyalgia syndrome (JPFS) is a chronic musculoskeletal pain syndrome affecting children and adolescents. In part one of this review, we discussed the epidemiology, etiology, pathogenesis, clinical manifestations and diagnosis of JPFS. Part two focuses on the treatment and prognosis of JPFS. Early intervention is important. The standard of care is multidisciplinary, combining various modalities-most importantly, exercise and cognitive behavioral therapy. Prognosis varies and symptoms may persist into adulthood.
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Affiliation(s)
- Maya Levy Coles
- grid.415250.70000 0001 0325 0791Department of Pediatrics, Meir Medical Center, Pediatric Rheumatology Unit, Kfar Saba, Israel
| | - Yosef Uziel
- Department of Pediatrics, Meir Medical Center, Pediatric Rheumatology Unit, Kfar Saba, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Systematic scoping review of interactions between analgesic drug therapy and mindfulness-based interventions for chronic pain in adults: current evidence and future directions. Pain Rep 2020; 5:e868. [PMID: 33251471 PMCID: PMC7690768 DOI: 10.1097/pr9.0000000000000868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/29/2020] [Accepted: 09/22/2020] [Indexed: 01/17/2023] Open
Abstract
Supplemental Digital Content is Available in the Text. None of the mindfulness-based clinical trials for chronic pain included in this review analyzed the interaction effects between mindfulness interventions and concomitant analgesic drug therapies. Most patients with chronic pain do not find adequate pain relief with a single treatment, and accumulating evidence points to the added benefits of rational combinations of different treatments. Given that psychological therapies, such as mindfulness-based interventions (MBIs), are often delivered in conjunction with concomitant analgesic drug therapies (CADTs), this systematic scoping review examines the evidence for any interactions between MBIs and CADTs. The protocol for this review has been published and registered. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, and PsycINFO databases were searched until July 2019. We included randomized controlled trials that evaluated the efficacy of MBIs for the treatment of chronic pain. A total of 40 randomized controlled trials (2978 participants) were included. Thirty-nine of 40 (97.5%) included mindfulness-based clinical trials allowed the use of CADTs. However, only 6 of these 39 (15.4%) trials provided adequate details of what these CADTs were, and only 4 (10.3%) trials controlled for CADTs. Of great relevance to this review, none of the included trials analyzed the interactions between MBIs and the CADTs to determine whether they have an additive, synergistic, or antagonistic effect on chronic pain. Adverse events were inconsistently reported, and no judgment could be made about safety. Future trials assessing the interactions between MBIs and CADTs, with better harms reporting, are needed to better define the role of MBIs in the management of chronic pain.
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Bernier Carney KM, Young EE, Guite JW, Starkweather AR. A Systematic Review of Biological Mechanisms and Chronic Pain Outcomes During Stress Reduction Interventions. Biol Res Nurs 2020; 22:205-216. [PMID: 32174159 DOI: 10.1177/1099800420907964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nonpharmacologic stress reduction interventions provide an opportunity to modify chronic pain trajectories; however, the biological mechanisms underlying these interventions are poorly understood. OBJECTIVES To examine clinical literature published in 2012-2018 with the goals of (1) identifying which biological mechanisms or biomarkers are currently being measured in nonpharmacologic stress reduction intervention studies for individuals with chronic pain and (2) evaluating the evidence to determine whether these stress reduction interventions lead to changes in (a) pain outcomes and/or (b) measured biomarkers. DATA SOURCES Scientific articles in the electronic databases PubMed/Medline, Cumulative Index of Nursing and Allied Health Literature, PsychINFO, and SCOPUS following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. STUDY SELECTION Randomized controlled trials and quasi-experimental studies that recruited subjects with a chronic pain condition, examined a relationship between a nonpharmacologic stress reduction intervention and pain-related outcome(s), and included measurement of a biomarker. RESULTS The 13 articles that met inclusion criteria spanned four nonpharmacologic stress reduction categories: mindfulness-based stress reduction, physical exercise, manual therapies, and biofeedback. Methods for studying biomarkers included measuring biological samples, neurological function, and autonomic control. Although all studies investigated both biological measures and pain outcomes, only three demonstrated an association between the biomarker(s) and pain-related outcomes. CONCLUSIONS The results of this review highlight the complex nature of stress-pain relationships and the lack of rigorous clinical research identifying specific stress-related biological factors that modulate pain outcomes. Stress reduction interventions remain a favorable method for symptom management in patients living with chronic pain, but consistency in study measures and design is needed for robust evaluation.
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Affiliation(s)
| | - Erin E Young
- Department of Anesthesiology, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Jessica W Guite
- Center for Advancement in Managing Pain Affiliate, School of Nursing, University of Connecticut, Storrs, CT, USA
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Voluntary upregulation of heart rate variability through biofeedback is improved by mental contemplative training. Sci Rep 2019; 9:7860. [PMID: 31133673 PMCID: PMC6536553 DOI: 10.1038/s41598-019-44201-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 05/09/2019] [Indexed: 11/09/2022] Open
Abstract
Regulation of the parasympathetic nervous system, indexed through high frequency heart rate variability (HF-HRV), is indicative of physical and psychological health. However, little is known about the trainability of this capacity. We investigated the effects of a 9-month mental training program (the ReSource Project; n = 298) on voluntary HF-HRV upregulation, assessed with a novel biofeedback procedure. The program consisted of attentional, interoceptive, socio-affective and socio-cognitive training elements, all of which potentially influence parasympathetic regulation. Based on known links between oxytocin and parasympathetic activity, we also explored the relationship of HF-HRV upregulation to the oxytocin receptor system. We found that HF-HRV during the biofeedback session increased after 3 months of training, concomitant with prolonged respiration cycles. Breathing-controlled changes in HF-HRV upregulation, indicative of improved parasympathetic control, were significantly increased after 6 months of training. Homozygous risk allele carriers (AA) of the oxytocin receptor gene polymorphism rs53576 showed initially lower parasympathetic control, but fully compensated for their initial deficits through the training. No changes were found for HF-HRV at rest. Our data demonstrate that a mental training intervention extending over several months can increase the capacity for voluntary regulation of HF-HRV, with important implications for improving individual and societal health.
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Meyer JD, Torres ER, Grabow ML, Zgierska AE, Teng HY, Coe CL, Barrett BP. Benefits of 8-wk Mindfulness-based Stress Reduction or Aerobic Training on Seasonal Declines in Physical Activity. Med Sci Sports Exerc 2019; 50:1850-1858. [PMID: 30113538 PMCID: PMC6130204 DOI: 10.1249/mss.0000000000001636] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mindfulness-based stress reduction (MBSR) and aerobic exercise training (AET) programs improve health and well-being. Exercise participation has been related to mindfulness and may be altered by MBSR training.
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Affiliation(s)
- Jacob D Meyer
- Department of Kinesiology, Iowa State University, Ames, IA
| | | | - Maggie L Grabow
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI
| | - Aleksandra E Zgierska
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI
| | - Hao Yang Teng
- Department of Statistics, University of Wisconsin-Madison, Madison, WI
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI
| | - Bruce P Barrett
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI
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13
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Behaviour change interventions targeting physical activity in adults with fibromyalgia: a systematic review. Rheumatol Int 2019; 39:805-817. [DOI: 10.1007/s00296-019-04270-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/28/2019] [Indexed: 10/27/2022]
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Schneider J, Malinowski P, Watson PM, Lattimore P. The role of mindfulness in physical activity: a systematic review. Obes Rev 2019; 20:448-463. [PMID: 30468299 DOI: 10.1111/obr.12795] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/28/2018] [Accepted: 09/30/2018] [Indexed: 02/05/2023]
Abstract
Despite continued public health campaigns to promote physical activity, a majority of the population is inactive. In recent years, mindfulness-based approaches have been used in health and lifestyle interventions for physical activity promotion. We conducted a systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to investigate the evidence for the potential of mindfulness-based approaches for physical activity. We searched electronic databases for papers that met eligibility criteria and identified 40 studies for inclusion. Evidence from cross-sectional studies (n = 20) indicated a positive relationship between dispositional mindfulness and physical activity, particularly with psychological factors related to physical activity. Five studies found that the mindfulness-physical activity relationship was mediated by stress, psychological flexibility, negative affect and shame, satisfaction and state mindfulness. Evidence from mindfulness-based interventions (n = 20) suggested positive between-subjects effects on physical activity, but interventions varied in duration, session length, group size, delivery, content and follow-up. Mindfulness-based interventions were more likely to be successful if they were physical activity-specific and targeted psychological factors related to physical activity. The body of research shows a need for more methodologically rigorous studies to establish the effect of mindfulness on physical activity and to identify potential mechanisms involved in the mindfulness-physical activity relationship reliably.
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Affiliation(s)
- J Schneider
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - P Malinowski
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - P M Watson
- Research Institute for Sport and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - P Lattimore
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, UK
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15
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Abstract
The primary aim of this study was to evaluate activity rhythms in fibromyalgia syndrome (FMS) and their association with FMS-related symptoms. We hypothesized that stronger and more consistent activity rhythms would be associated with reduced symptom severity and presentation in FMS. Two hundred ninety-two patients with FMS (mean age = 45.1 ± 11.1; 272 women) provided a 7-day actigraphy recording and responses to questionnaires addressing degree of pain, fatigue, mood, and physical impairment. Using a simple cosine model, we extracted Amplitude (activity range), Phi (time at maximum), Mesor (mean activity), and their variabilities (across days) from each participant's actigraphy. The clinical and actigraphic measures were operationally independent. There was a significant canonical relationship between activity rhythm parameters and clinical FMS measures (r = 0.376, R = 0.14, P < 0.001). The set of Mesor, Amplitude, and Phi activity parameters remained associated with clinical measures when controlled statistically for both demographics and activity variability (P < 0.001). Each activity parameter provided unique discrimination of the clinical set by multivariate test (P = 0.003, 0.018, and 0.007 for Amplitude, Phi, and Mesor, respectively). These results revealed that better pain, fatigue, mood, physical impairment, and sleep outcomes were associated with higher activity range and more rhythmicity (Amplitude), increased mean activity (Mesor), and with earlier timing of peak activity (Phi). Exploratory analyses revealed significantly worse sleep for individuals with low Amplitude and more delayed Phi.
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16
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Pascoe MC, Thompson DR, Jenkins ZM, Ski CF. Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. J Psychiatr Res 2017; 95:156-178. [PMID: 28863392 DOI: 10.1016/j.jpsychires.2017.08.004] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 08/07/2017] [Accepted: 08/07/2017] [Indexed: 02/08/2023]
Abstract
Meditation is a popular form of stress management, argued to mediate stress reactivity. However, many studies in this field commonly fail to include an active control group. Given the frequency with which people are selecting meditation as a form of self-management, it is important to validate if the practice is effective in mediating stress-reactivity using well-controlled studies. Thus, we aimed to conduct a meta-analysis investigating the neurobiological effects of meditation, including focused attention, open monitoring and automatic self-transcending subtypes, compared to an active control, on markers of stress. In the current meta-analysis and systematic review, we included randomised controlled trials comparing meditation interventions compared to an active control on physiological markers of stress. Studied outcomes include cortisol, blood pressure, heart-rate, lipids and peripheral cytokine expression. Forty-five studies were included. All meditation subtypes reduced systolic blood pressure. Focused attention meditations also reduced cortisol and open monitoring meditations also reduced heart rate. When all meditation forms were analysed together, meditation reduced cortisol, C - reactive protein, blood pressure, heart rate, triglycerides and tumour necrosis factor-alpha. Overall, meditation practice leads to decreased physiological markers of stress in a range of populations.
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Affiliation(s)
- Michaela C Pascoe
- Department of Cancer Experiences, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3000, Australia.
| | - Zoe M Jenkins
- Mental Health Service, St. Vincent's Hospital, Melbourne, VIC 3065, Australia.
| | - Chantal F Ski
- Mental Health Service, St. Vincent's Hospital, Melbourne, VIC 3065, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia.
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