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Rodrigues AMDBP, Neto OB, Seguro CS, da Silva WF, Gonzalez RH, Santos DDAT, de Lira CAB, Viana RB. Does yoga improve sexual function? A systematic review and meta-analysis of randomized clinical trials. Complement Ther Clin Pract 2024; 56:101864. [PMID: 38830273 DOI: 10.1016/j.ctcp.2024.101864] [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: 01/05/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Yoga practice can increase blood flow in the genital area, increase muscular strength, and improve body perception, which is related to sexual function. This study aimed to summarize the available evidence about the effects of yoga on sexual function in adults. METHODS Systematic searches of five databases were conducted from inception to April 28, with the last update on September 28, 2023. Randomized clinical trials (RCTs) that compared yoga with nonintervention control groups on sexual function in adults. Risk of bias and certainty of evidence were assessed by the Cochrane risk of bias tool 2, and the GRADE approach, respectively. Summary effect size measures were calculated using a random-effects model estimation and are reported as standardized mean differences and 95% confidence intervals. Reporting followed the PRISMA guidelines. RESULTS Ten RCTs that comprised 730 adults (range mean age, 26.64-68.2 years; 680 [93.2 %] women) were included. For the primary outcome, yoga intervention was associated with a significant small improvement in sexual function (-0.31; -0.47 to -0.15, p = 0.0002), with some concerns about risk of bias in nine RCTs (90%) and low-certainty evidence. Subgroup analyses revealed that yoga interventions performed by women (-0.36; -0.52 to -0.21, p < 0.00001), healthy individuals (-0.38; -0.59 to -0.16, p = 0.0006), or middle-aged individuals (-0.44; -0.63 to -0.25, p < 00001) significantly improved sexual function compared with control groups. CONCLUSION Yoga was associated with a small improvement in sexual function compared with nonintervention control groups in adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
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Affiliation(s)
| | - Octavio Barbosa Neto
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | - Ricardo Hugo Gonzalez
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | - Ricardo Borges Viana
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil.
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Purgato M, Prina E, Ceccarelli C, Cadorin C, Abdulmalik JO, Amaddeo F, Arcari L, Churchill R, Jordans MJ, Lund C, Papola D, Uphoff E, van Ginneken N, Tol WA, Barbui C. Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries. Cochrane Database Syst Rev 2023; 10:CD014722. [PMID: 37873968 PMCID: PMC10594594 DOI: 10.1002/14651858.cd014722.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. OBJECTIVES To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. SELECTION CRITERIA Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. DATA COLLECTION AND ANALYSIS Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. MAIN RESULTS Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants). AUTHORS' CONCLUSIONS The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.
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Affiliation(s)
- Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Caterina Ceccarelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Jd Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Nadja van Ginneken
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Wietse Anton Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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Liu H, Cai K, Wang J, Zhang H. The effects of mindfulness-based interventions on anxiety, depression, stress, and mindfulness in menopausal women: A systematic review and meta-analysis. Front Public Health 2023; 10:1045642. [PMID: 36699873 PMCID: PMC9869042 DOI: 10.3389/fpubh.2022.1045642] [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: 09/15/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Background Mindfulness-based interventions (MBIs) are psychological interventions widely used in menopausal women. Currently, there is no evidence summary on the effectiveness of MBIs on anxiety, depression, stress, and mindfulness in menopausal women. This meta-analysis examines the effectiveness of MBIs in improving anxiety, depression, stress, and mindfulness scores in menopausal women. Methods A systematic search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang, using relevant terms such as MBIs as keywords and covering all studies published before March 13, 2022. The outcomes were anxiety, depression, stress, and mindfulness. The screening and extraction of data were conducted by two independent reviewers. Results A total of 1,138 menopausal women participated in 13 studies. Meta-analysis results showed that MBIs significantly reduced stress in menopausal women (SMD = -0.84, 95% CI: -1.64 to -0.05, p = 0.04), but no statistical differences were found in reducing anxiety (SMD = -0.40, 95% CI: -0.81 to 0.01, p = 0.06) and depression (SMD = -0.19, 95% CI: -0.45 to 0.07, p = 0.16) and in raising the scores of mindfulness (SMD = 0.37, 95% CI: -0.06 to 0.81, p = 0.09) in menopausal women. Conclusion MBIs may reduce stress in menopausal women, but their effect on improving anxiety, depression, and mindfulness needs further validation. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails.
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Liu T, Chen S, Mielke GI, McCarthy AL, Bailey TG. Effects of exercise on vasomotor symptoms in menopausal women: a systematic review and meta-analysis. Climacteric 2022; 25:552-561. [PMID: 35904028 DOI: 10.1080/13697137.2022.2097865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The frequency and severity of menopausal vasomotor symptoms negatively impact quality of life. This systematic review evaluates the potential of exercise to relieve the subjective frequency and severity of vasomotor symptoms. We searched four databases to identify randomized controlled trials (RCTs) that evaluated the effect of structured exercise (e.g. aerobic training) on the severity and/or frequency of vasomotor symptoms in menopausal women. Two reviewers independently screened records for eligibility, extracted data and assessed risks of bias and evidence certainty using the Cochrane tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE). When suitable, data were pooled using random-effect meta-analyses. We appraised 21 RCTs involving 2884 participants. Compared to no-treatment control, exercise significantly improved severity of vasomotor symptoms (10 studies, standardized mean difference [SMD] = 0.25; 95% confidence interval [CI]: 0.04 to 0.47, p = 0.02, very low certainty of evidence); the effect size was attenuated when studies with a high risk of bias were excluded (SMD = 0.11, 95% CI: -0.03 to 0.26, p = 0.13). No significant changes in vasomotor frequency were found between exercise and control (SMD = 0.14, 95% CI: -0.03 to 0.31, p = 0.12, high certainty of evidence). In conclusion, exercise might improve vasomotor symptom severity. Future rigorous RCTs addressing the limitations of current review are warranted to explore the optimal exercise prescription principles to target the severity of vasomotor symptoms.
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Affiliation(s)
- T Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S Chen
- Department of Exercise Physiology, Sport Science School, Beijing Sport University, Beijing, China
| | - G I Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - A L McCarthy
- School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - T G Bailey
- School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
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Susanti HD, Sonko I, Chang PC, Chuang YH, Chung MH. Effects of yoga on menopausal symptoms and sleep quality across menopause statuses: A randomized controlled trial. Nurs Health Sci 2022; 24:368-379. [PMID: 35191141 DOI: 10.1111/nhs.12931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 01/18/2023]
Abstract
This randomized controlled trial investigated the effects of yoga on menopausal symptoms and sleep quality across menopause statuses. Participants were randomly assigned to either the intervention or control group (n = 104 each), and those in the intervention group practiced yoga for 20 weeks. The participants completed the following questionnaires: the Depression, Anxiety, and Stress Scale; Multidimensional Scale of Perceived Social Support; Menopause Rating Scale; and Pittsburgh Sleep Quality Index. The results revealed that yoga effectively decreased menopausal symptoms, with the strongest effects noted in postmenopausal women (mean ± standard deviation: 14.98 ± 7.10), followed by perimenopausal women (6.11 ± 2.07). Yoga significantly improved sleep quality in postmenopausal and perimenopausal women after controlling for social support, depression, anxiety, stress, and menopausal symptoms (p < 0.001). However, yoga did not affect sleep quality in premenopausal women. Overall sleep quality significantly improved in postmenopausal and perimenopausal women. Our data indicate that yoga can help decrease menopausal symptoms, particularly in perimenopausal and postmenopausal women, and improve their health.
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Affiliation(s)
- Henny Dwi Susanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, East Java, Indonesia
| | - Ismaila Sonko
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Ministry of Health and Social Welfare, Banjul, The Gambia
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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6
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Estevao C. The role of yoga in inflammatory markers. Brain Behav Immun Health 2022; 20:100421. [PMID: 35199049 PMCID: PMC8842003 DOI: 10.1016/j.bbih.2022.100421] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 01/03/2023] Open
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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.
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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.)
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Yan LB, Zhang JZ, Zhou Q, Peng FL. Multidimensional analyses of the effect of exercise on women with depression: A meta-analysis. Medicine (Baltimore) 2021; 100:e26858. [PMID: 34414936 PMCID: PMC8382388 DOI: 10.1097/md.0000000000026858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The proportion of women is higher than men in depression. This is mainly due to women's physiological regulation is different from men, especially in puberty, menstruation, pregnancy, menopause, among others. Therefore, treating depressive women is still a health challenge. Besides, recent studies of exercise therapy have a more outstanding performance in treating depression, especially in contrast to drug therapy and psychotherapy. Its main advantages are convenience, quickness, no side effects, real-time, and long-term effectiveness. OBJECTIVE The aim of this study was to systematically review the clinical efficacy of exercise on women with depressive symptoms. METHODS Searching PubMed, The Cochrane Library, and Embase databases to collect randomized controlled trials about exercise in the treatment of depressive women. After literature screening, data extraction, and literature quality evaluation, the meta-analysis of acquirement data was performed with RevMan5.3 software. RESULTS A total of 2294 patients were included in 25 different articles totally. Meta-analysis shows that compared with the control group, exercise could relieve female depression (standard mean difference [95% confidence interval, CI] = -0.64 [-0.89 to -0.39], Z = 4.99, P < .001). Subgroup analysis shows that different types of exercise have significant effects in improving depression symptoms. Exercise therapy has better effect on depressive patients induced by physiology or disease than ordinary depressive patients. CONCLUSION Exercise can significantly improve depressive symptoms in women.
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Affiliation(s)
- Lin-Bo Yan
- Institutional affiliation: Guangxi Normal University
| | | | - Qian Zhou
- Institutional affiliation: Guangxi Normal University
| | - Feng-Lin Peng
- College of Physical Education and Health, Guangxi Normal University, Guilin 541000, China
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9
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Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology. Biomolecules 2021; 11:biom11050708. [PMID: 34068722 PMCID: PMC8151888 DOI: 10.3390/biom11050708] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped. Studies show that women's brains are more sensitive to factors affecting mental health such as depression and stress than men's brains. In women, poor mental health increases the risk of cardiovascular disease, and conversely, cardiovascular disease increases the incidence of mental illness such as depression. In connection with mental health and cardiovascular health, the presence of gender differences in brain activation, cortisol secretion, autonomic nervous system, vascular health and inflammatory response has been observed. This connection suggests that strategies to manage women's mental health can contribute to preventing cardiovascular disease. Mind-body interventions, such as meditation, yoga and qigong are forms of exercise that strive to actively manage both mind and body. They can provide beneficial effects on stress reduction and mental health. They are also seen as structurally and functionally changing the brain, as well as affecting cortisol secretion, blood pressure, heart rate variability, immune reactions and reducing menopausal symptoms, thus positively affecting women's cardiovascular health. In this review, we investigate the link between mental health, brain activation, HPA axis, autonomic nervous system, blood pressure and immune system associated with cardiovascular health in women and discuss the effects of mind-body intervention in modulating these factors.
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Bahçecioğlu Turan G, Tan M. The effect of yoga on respiratory functions, symptom control and life quality of asthma patients: A randomized controlled study. Complement Ther Clin Pract 2019; 38:101070. [PMID: 31679902 DOI: 10.1016/j.ctcp.2019.101070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/16/2019] [Accepted: 10/25/2019] [Indexed: 12/18/2022]
Abstract
AIM This study was conducted to find out the effect of yoga applied to asthma patients on the patients' respiratory functions, symptom control and quality of life. METHODS The sample of the study consisted of a total of randomly chosen 112 asthma patients, 56 in the experimental group and 56 in the control group, who met the research criteria and who agreed to participate in the study. A total of 12 yoga sessions, 2 sessions a week for 6 weeks, was applied to the patients in the experimental group. The patients in the control group did not receive any intervention. RESULTS In the intragroup comparison of average pre-test and post-test scores of respiratory function and Asthma Control Test (ACT) and Asthma Quality of Life Scale (AQLQ) total and sub-dimension scores of the patients in the experimental and control group, the difference was found to be statistically significant (p < 0.05). In addition, post-test score averages were found to increase in the experimental group, while they were found to decrease in the control group. CONCLUSION It was found that yoga influenced respiratory functions, symptom control and quality of life positively in asthma patients. The clinical trial registration number is NCT04107415/https://clinicaltrials.gov/ct2/show/NCT04107415.
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Affiliation(s)
- Gülcan Bahçecioğlu Turan
- Ataturk University, Faculty of Nursing, Department of Internal Medicine Nursing, Erzurum, Turkey.
| | - Mehtap Tan
- Ataturk University, Faculty of Nursing, Department of Internal Medicine Nursing, Erzurum, Turkey.
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Johnson A, Roberts L, Elkins G. Complementary and Alternative Medicine for Menopause. J Evid Based Integr Med 2019; 24:2515690X19829380. [PMID: 30868921 PMCID: PMC6419242 DOI: 10.1177/2515690x19829380] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Menopause is associated with problematic symptoms, including hot flashes, sleep problems, mood disorders, sexual dysfunction, weight gain, and declines in cognitive functioning. Many women seek complementary and alternative medicine (CAM) for symptom management. This article critically reviews the existing literature on CAM treatments most commonly used for menopausal symptoms. Electronic searches were conducted to identify relevant, English-language literature published through March 2017. Results indicate that mind and body practices may be of benefit in reducing stress and bothersomeness of some menopausal symptoms. In particular, hypnosis is a mind-body intervention that has consistently shown to have a clinically significant effect on reducing hot flashes. Evidence is mixed in regard to the efficacy of natural products and there are some safety concerns. Health care providers should consider the evidence on CAM in providing an integrative health approach to menopausal symptom management.
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Figueira OA, Figueira HA, Figueira JA, Garcia AA, Figueira AA, Neto GM, Dantas EHM. Depression in Climacteric Women: Most Meaningful Symptoms. Health (London) 2019. [DOI: 10.4236/health.2019.114034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Wong C, Yip BHK, Gao T, Lam KYY, Woo DMS, Yip ALK, Chin CY, Tang WPY, Choy MMT, Tsang KWK, Ho SC, Ma HSW, Wong SYS. Mindfulness-Based Stress Reduction (MBSR) or Psychoeducation for the Reduction of Menopausal Symptoms: A Randomized, Controlled Clinical Trial. Sci Rep 2018; 8:6609. [PMID: 29700350 PMCID: PMC5919973 DOI: 10.1038/s41598-018-24945-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 04/10/2018] [Indexed: 11/10/2022] Open
Abstract
Psychological and behavioural interventions may be effective in reducing menopause-related symptoms. This randomized controlled trial aimed to evaluate the effectiveness of Mindfulness-based Stress Reduction (MBSR) in reducing menopause-related symptoms by comparing with an active control group, the menopause education control (MEC). Symptomatic peri-menopausal and post-menopausal women with mild to moderate symptoms were recruited. The primary outcome was overall menopausal symptoms measured by modified Greene Climacteric Scale (GCS). Secondary outcomes include subscales of the GCS perceived stress, mindfulness and health related Quality of Life. All outcome measures were collected at baseline, 2 months (immediately post intervention), 5 and 8 months (3 and 6 months post intervention respectively). Both MBSR (n = 98) and MEC (n = 99) groups reported a reduction in total GCS score at 8 months. Between group analysis show significant symptom score reduction in MBSR group on Anxiety and Depression subscales of GCS. No differences were found between groups on other GCS subscales and majority of the secondary outcome measures. The findings show that menopausal symptoms in both MBSR and MEC significantly reduced over the study period. MBSR show a greater reduction of psychological symptoms of depression and anxiety above active controls but do not reduce other somatic, urogenital and vasomotor symptoms.
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Affiliation(s)
- Carmen Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Benjamin Hon-Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ting Gao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Kitty Yu Yuk Lam
- CUHK Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Annie Lai King Yip
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chloe Yu Chin
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | - Katrina Wai Key Tsang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Suzanne C Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | | | - Samuel Yeung Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Elhosary EAM, Ewidea MM, Ahmed HAH, El Khatib A. Effect of aerobic exercises versus laser acupuncture in treatment of postmenopausal hot flushes: a randomized controlled trial. J Phys Ther Sci 2018; 30:328-331. [PMID: 29545706 PMCID: PMC5851375 DOI: 10.1589/jpts.30.328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/29/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To compare the effect of aerobic exercises versus laser acupuncture in
treatment of postmenopausal hot flushes. [Subjects and Methods] This study was designed as
single blind randomized controlled trial. A total of 48 postmenopausal women complained of
hot flushes. Their ages ranged between 45 to 55 years and were randomly assigned into 2
equal groups: group (A), which received an aerobic exercises, and group (B), which
received laser acupuncture. Both groups recieved 3 sessions per week for two months. The
level of follicular stimulating hormone, lutelizing hormone, and hot flushes dairy card
were assessed the severity of hot flahes before and after treatment program. [Results]
There were Significant reduction in FSH, LH, and menopausal daily hot flush scale in group
A compared with group B at the post treatment. [Conclusion] Eight week program of an
aerobic exercises yields improvement in FSH, LH, and decrease in severity of hot flushes
assessed by hot flush dairy card than laser acupuncture in the treatment of postmenopausal
hot flashes.
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Affiliation(s)
| | - Mahmoud Mohamed Ewidea
- Department of Basic Science, Faculty of Physical Therapy, Kafrelsheikh University, Egypt
| | | | - Ayman El Khatib
- Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Lebanon
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Grensman A, Acharya BD, Wändell P, Nilsson GH, Falkenberg T, Sundin Ö, Werner S. Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:80. [PMID: 29510704 PMCID: PMC5839058 DOI: 10.1186/s12906-018-2141-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 02/22/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout. METHODS Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18-65 years and were on 50%-100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon's rank sum and Wilcoxon's sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen's D. RESULTS Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each. CONCLUSIONS A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity. TRIAL REGISTRATION July 22, 2012, retrospectively registered. ClinicalTrails.gov NCT01168661 . FUNDING Stockholm County Council, grant 2003-5.
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Affiliation(s)
- Astrid Grensman
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, 141 83 Stockholm, Sweden
| | - Bikash Dev Acharya
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, 141 83 Stockholm, Sweden
| | - Per Wändell
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, 141 83 Stockholm, Sweden
| | - Gunnar H. Nilsson
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, 141 83 Stockholm, Sweden
| | - Torkel Falkenberg
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Research Group Integrative Care, Karolinska Institutet, Stockholm, Sweden
- Centre for Social Sustainability, Karolinska Institutet, Stockholm, Sweden
| | - Örjan Sundin
- Faculty of Human Sciences, Department of Social Sciences, Mid Sweden University, Östersund, Sweden
| | - Sigbritt Werner
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Yoga for menopausal symptoms-A systematic review and meta-analysis. Maturitas 2017; 109:13-25. [PMID: 29452777 DOI: 10.1016/j.maturitas.2017.12.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/23/2017] [Accepted: 12/05/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To systematically review and meta-analyze the effectiveness of yoga for menopausal symptoms. METHODS Medline (via PubMed), the Cochrane Central Register of Controlled Trials, and Scopus were screened through to February 21, 2017 for randomized controlled trials (RCTs) comparing the effects of yoga on menopausal symptoms to those of no treatment or active comparators. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Two authors independently assessed risk of bias using the Cochrane risk of bias tool. RESULTS Thirteen RCTs with 1306 participants were included. Compared with no treatment, yoga reduced total menopausal symptoms (SMD=-1.05; 95% CI -1.57 to -0.53), psychological (SMD=-0.75; 95% CI -1.17 to -0.34), somatic (SMD=-0.65; 95% CI -1.05 to -0.25), vasomotor (SMD=-0.76; 95% CI -1.27 to -0.25), and urogenital symptoms (SMD=-0.53; 95% CI -0.81 to -0.25). Compared with exercise controls, only an effect on vasomotor symptoms was found (SMD=-0.45; 95% CI -0.87 to -0.04). Effects were robust against selection bias, but not against detection and attrition bias. No serious adverse events were reported. CONCLUSION Yoga seems to be effective and safe for reducing menopausal symptoms. Effects are comparable to those of other exercise interventions.
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Stefanopoulou E, Grunfeld EA. Mind-body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review. J Psychosom Obstet Gynaecol 2017; 38:210-225. [PMID: 27832718 DOI: 10.1080/0167482x.2016.1235147] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Mind-body therapies are commonly recommended to treat vasomotor symptoms, such as hot flushes and night sweats (HFNS). The purpose of this systematic review was to evaluate the available evidence to date for the efficacy of different mind-body therapies to alleviate HFNS in healthy menopausal women and breast cancer survivors. Randomized controlled trials (RCTs) were identified using seven electronic search engines, direct searches of specific journals and backwards searches through reference lists of related publications. Outcome measures included HFNS frequency and/or severity or self-reported problem rating at post-treatment. The methodological quality of all studies was systematically assessed using predefined criteria. Twenty-six RCTs met the inclusion criteria. Interventions included yoga (n = 5), hypnosis (n = 3), mindfulness (n = 2), relaxation (n = 7), paced breathing (n = 4), reflexology (n = 1) and cognitive behavioural therapy (CBT) (n = 4). Findings were consistent for the effectiveness of CBT and relaxation therapies for alleviating troublesome vasomotor symptoms. For the remaining interventions, although some trials indicated beneficial effects (within groups) at post-treatment and/or follow up, between group findings were mixed and overall, methodological differences across studies failed to provide convincing supporting evidence. Collectively, findings suggest that interventions that include breathing and relaxation techniques, as well as CBT, can be beneficial for alleviating vasomotor symptoms. Additional large, methodologically rigorous trials are needed to establish the efficacy of interventions on vasomotor symptoms, examine long-term outcomes and understand how they work.
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Affiliation(s)
- Evgenia Stefanopoulou
- a Section of Health Psychology, Institute of Psychiatry, Psychology and Neuroscience , King's College London , London , UK
| | - Elizabeth Alice Grunfeld
- b Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences , Coventry University , Coventry , UK
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Shepherd-Banigan M, Goldstein KM, Coeytaux RR, McDuffie JR, Goode AP, Kosinski AS, Van Noord MG, Befus D, Adam S, Masilamani V, Nagi A, Williams JW. Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: An umbrella systematic review and meta-analysis. Complement Ther Med 2017; 34:156-164. [PMID: 28917368 DOI: 10.1016/j.ctim.2017.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/05/2017] [Accepted: 08/17/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Vasomotor symptoms (VMS), commonly reported during menopausal transition, negatively affect psychological health and health-related quality of life (HRQoL). While hormone therapy is an effective treatment, its use is limited by concerns about possible harms. Thus, many women with VMS seek nonhormonal, nonpharmacologic treatment options. However, evidence to guide clinical recommendations is inconclusive. This study reviewed the effectiveness of yoga, tai chi and qigong on vasomotor, psychological symptoms, and HRQoL in peri- or post-menopausal women. DESIGN MEDLINE, Cochrane Database of Systematic Reviews, EMBASE, CINAHL and the Allied and Complementary Medicine Database were searched. Researchers identified systematic reviews (SR) or RCTs that evaluated yoga, tai chi, or qigong for vasomotor, psychological symptoms, and health-related quality of life (HRQoL) in peri- or post-menopausal women. Data were abstracted on study design, participants, interventions and outcomes. Risk of bias (ROB) was assessed and updated meta-analyses were performed. RESULTS We identified one high-quality SR (5 RCTs, 582 participants) and 3 new RCTs (345 participants) published after the SR evaluating yoga for vasomotor, psychological symptoms, and HRQoL; no studies evaluated tai chi or qigong. Updated meta-analyses indicate that, compared to controls, yoga reduced VMS (5 trials, standardized mean difference (SMD) -0.27, 95% CI -0.49 to -0.05) and psychological symptoms (6 trials, SDM -0.32; 95% CI -0.47 to -0.17). Effects on quality of life were reported infrequently. Key limitations are that adverse effects were rarely reported and outcome measures lacked standardization. CONCLUSIONS Results from this meta-analysis suggest that yoga may be a useful therapy to manage bothersome vasomotor and psychological symptoms.
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Affiliation(s)
- M Shepherd-Banigan
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.
| | - K M Goldstein
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA
| | - R R Coeytaux
- Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA
| | - J R McDuffie
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA
| | - A P Goode
- Department of Physical Therapy, Duke University Medical Center 2200 W. Main Street Durham, NC 27705, USA
| | - A S Kosinski
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, 8 Duke University Medical Center, Durham, MC 27703, USA
| | - M G Van Noord
- Duke University Medical Center Library, Durham, NC 27708, USA
| | - D Befus
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA
| | - S Adam
- Department of Medicine, Division of Hematology Oncology, Duke University Medical Center, 8 Duke University Medical Center, Durham, NC 27703, USA
| | - V Masilamani
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - A Nagi
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - J W Williams
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA
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Chan SC, Chan CC, Derbie AY, Hui I, Tan DG, Pang MY, Lau SC, Fong KN. Chinese Calligraphy Writing for Augmenting Attentional Control and Working Memory of Older Adults at Risk of Mild Cognitive Impairment: A Randomized Controlled Trial. J Alzheimers Dis 2017; 58:735-746. [DOI: 10.3233/jad-170024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sam C.C. Chan
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Chetwyn C.H. Chan
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Abiot Y. Derbie
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Irene Hui
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Davynn G.H. Tan
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Marco Y.C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Stephen C.L. Lau
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Kenneth N.K. Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Buchanan DT, Landis CA, Hohensee C, Guthrie KA, Otte JL, Paudel M, Anderson GL, Caan B, Freeman EW, Joffe H, LaCroix AZ, Newton KM, Reed SD, Ensrud KE. Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes. J Clin Sleep Med 2017; 13:11-18. [PMID: 27707450 DOI: 10.5664/jcsm.6376] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 09/07/2016] [Indexed: 01/31/2023]
Abstract
STUDY OBJECTIVES To determine effects of yoga and aerobic exercise compared with usual activity on objective assessments of sleep in midlife women. METHODS Secondary analyses of a randomized controlled trial in the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network conducted among 186 late transition and postmenopausal women aged 40-62 y with hot flashes. Women were randomized to 12 w of yoga, supervised aerobic exercise, or usual activity. The mean and coefficient of variation (CV) of change in actigraph sleep measures from each intervention group were compared to the usual activity group using linear regression models. RESULTS Baseline values of the primary sleep measures for the entire sample were mean total sleep time (TST) = 407.5 ± 56.7 min; mean wake after sleep onset (WASO) = 54.6 ± 21.8 min; mean CV for WASO = 37.7 ± 18.7 and mean CV for number of long awakenings > 5 min = 81.5 ± 46.9. Changes in the actigraphic sleep outcomes from baseline to weeks 11-12 were small, and none differed between groups. In an exploratory analysis, women with baseline Pittsburgh Sleep Quality Index higher than 8 had significantly reduced TST-CV following yoga compared with usual activity. CONCLUSIONS This study adds to the currently scant literature on objective sleep outcomes from yoga and aerobic exercise interventions for this population. Although small effects on self-reported sleep quality were previously reported, the interventions had no statistically significant effects on actigraph measures, except for potentially improved sleep stability with yoga in women with poor self-reported sleep quality.
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Affiliation(s)
- Diana Taibi Buchanan
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA
| | - Carol A Landis
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA
| | - Chancellor Hohensee
- MsFLASH Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Katherine A Guthrie
- MsFLASH Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Julie L Otte
- Science of Nursing Care, School of Nursing, Indiana University, Indianapolis, IN
| | - Misti Paudel
- National Opinion Research Center, University of Chicago, Health Care Department, Bethesda, MD
| | - Garnet L Anderson
- MsFLASH Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Bette Caan
- Division of Research, Kaiser Permanente Medical Program of Northern California, Oakland, CA
| | - Ellen W Freeman
- Departments of Obstetrics/Gynecology and Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Hadine Joffe
- Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA
| | - Andrea Z LaCroix
- Division of Epidemiology, School of Medicine, University of California San Diego, San Diego, CA
| | | | - Susan D Reed
- Departments of Obstetrics/Gynecology and Epidemiology, School of Medicine, University of Washington, Seattle, WA
| | - Kristine E Ensrud
- Division of Epidemiology and Community Health, Department of Medicine, University of Minnesota, Minneapolis, MN.,Department of Medicine, VA Health Care System, Minneapolis, MN
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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.
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Affiliation(s)
| | | | - Jane Mortimer
- School of Psychology, University of Adelaide, Australia
| | | | - Sarah Cohen-Woods
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
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Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause 2016; 22:1155-72; quiz 1173-4. [PMID: 26382310 DOI: 10.1097/gme.0000000000000546] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To update and expand The North American Menopause Society's evidence-based position on nonhormonal management of menopause-associated vasomotor symptoms (VMS), previously a portion of the position statement on the management of VMS. METHODS NAMS enlisted clinical and research experts in the field and a reference librarian to identify and review available evidence. Five different electronic search engines were used to cull relevant literature. Using the literature, experts created a document for final approval by the NAMS Board of Trustees. RESULTS Nonhormonal management of VMS is an important consideration when hormone therapy is not an option, either because of medical contraindications or a woman's personal choice. Nonhormonal therapies include lifestyle changes, mind-body techniques, dietary management and supplements, prescription therapies, and others. The costs, time, and effort involved as well as adverse effects, lack of long-term studies, and potential interactions with medications all need to be carefully weighed against potential effectiveness during decision making. CONCLUSIONS Clinicians need to be well informed about the level of evidence available for the wide array of nonhormonal management options currently available to midlife women to help prevent underuse of effective therapies or use of inappropriate or ineffective therapies. Recommended: Cognitive-behavioral therapy and, to a lesser extent, clinical hypnosis have been shown to be effective in reducing VMS. Paroxetine salt is the only nonhormonal medication approved by the US Food and Drug Administration for the management of VMS, although other selective serotonin reuptake/norepinephrine reuptake inhibitors, gabapentinoids, and clonidine show evidence of efficacy. Recommend with caution: Some therapies that may be beneficial for alleviating VMS are weight loss, mindfulness-based stress reduction, the S-equol derivatives of soy isoflavones, and stellate ganglion block, but additional studies of these therapies are warranted. Do not recommend at this time: There are negative, insufficient, or inconclusive data suggesting the following should not be recommended as proven therapies for managing VMS: cooling techniques, avoidance of triggers, exercise, yoga, paced respiration, relaxation, over-the-counter supplements and herbal therapies, acupuncture, calibration of neural oscillations, and chiropractic interventions. Incorporating the available evidence into clinical practice will help ensure that women receive evidence-based recommendations along with appropriate cautions for appropriate and timely management of VMS.
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Stretch it and lose it: the potential benefits of a stretching intervention for the reduction of menopausal symptoms. Menopause 2016; 23:821-2. [PMID: 27404033 DOI: 10.1097/gme.0000000000000715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cramer H, Lauche R, Langhorst J, Dobos G. Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials. Complement Ther Med 2016; 25:178-87. [DOI: 10.1016/j.ctim.2016.02.015] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 02/18/2016] [Accepted: 02/18/2016] [Indexed: 12/20/2022] Open
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Jorge MP, Santaella DF, Pontes IMO, Shiramizu VKM, Nascimento EB, Cabral A, Lemos TMAM, Silva RH, Ribeiro AM. Hatha Yoga practice decreases menopause symptoms and improves quality of life: A randomized controlled trial. Complement Ther Med 2016; 26:128-35. [PMID: 27261993 DOI: 10.1016/j.ctim.2016.03.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Yoga practice includes a group of specific psychophysical techniques. Although previous studies showed beneficial effects of yoga for health and rehabilitation, improving quality of life, there are few studies on the possible therapeutic application of yoga during the climacteric period. The purpose of this study was to investigate the psychophysiological effects of Hatha Yoga regular practice in post-menopausal women. METHODS Eighty-eight post-menopausal women volunteered for this 12-week trial. They were randomly assigned to one of three groups: control (no intervention), exercise, and yoga. Questionnaires were applied in order to evaluate climacteric syndrome (Menopause Rating Scale), stress (Lipp Stress Symptom Inventory), quality of life (Brief World Health Organization Quality of Life), depression (Beck Depression Inventory) and anxiety (State/Trait Anxiety Inventories). Physiological changes were evaluated through hormone levels (cortisol, FSH, LH, progesterone and estradiol). RESULTS At 12 weeks, yoga practitioners showed statistically lower scores for menopausal symptoms, stress levels and depression symptoms, as well as significantly higher scores in quality of life when compared to control and exercise groups. Only control group presented a significant increase in cortisol levels. The yoga and exercise groups showed decreased levels of FSH and LH when compared to control group. CONCLUSIONS These results suggest that yoga promotes positive psychophysiological changes in post-menopausal women and may be applied as a complementary therapy towards this population.
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Affiliation(s)
- Márcia P Jorge
- Federal University of Rio Grande of Norte, Natal, Brazil.
| | | | | | | | | | - Alícia Cabral
- Federal University of Rio Grande of Norte, Natal, Brazil.
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Abstract
OBJECTIVE This case report aimed to evaluate 4 months of yoga practice on the quality of life (QOL) and estradiol levels of two postmenopausal women. METHODS Participants were clinically healthy postmenopausal women, with follicle-stimulating hormone levels greater than or equal to 30 mIU/mL and a body mass index lower than 30 kg/m. The participants practiced yoga for 4 months in two 1-hour sessions per week. RESULTS The participants exhibited an abnormal estrogen-level increase after 4 months of yoga practice and showed QOL improvements. CONCLUSIONS In some cases, yoga practice can affect the female neuroendocrine system, increasing estrogen and improving QOL.
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Pascoe MC, Bauer IE. A systematic review of randomised control trials on the effects of yoga on stress measures and mood. J Psychiatr Res 2015; 68:270-82. [PMID: 26228429 DOI: 10.1016/j.jpsychires.2015.07.013] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 07/10/2015] [Accepted: 07/10/2015] [Indexed: 12/19/2022]
Abstract
Stress related disorders such as depression and anxiety are leading sources of disability worldwide, and current treatment methods such as conventional antidepressant medications are not beneficial for all individuals. There is evidence that yoga has mood-enhancing properties possibly related to its inhibitory effects on physiological stress and inflammation, which are frequently associated with affective disorders. However the biological mechanisms via which yoga exerts its therapeutic mood-modulating effects are largely unknown. This systematic review investigates the effects of yoga on sympathetic nervous system and hypothalamic pituitary adrenal axis regulation measures. It focuses on studies collecting physiological parameters such as blood pressure, heart rate, cortisol, peripheral cytokine expression and/or structural and functional brain measures in regions involved in stress and mood regulation. Overall the 25 randomised control studies discussed provide preliminary evidence to suggest that yoga practice leads to better regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system, as well as a decrease in depressive and anxious symptoms in a range of populations. Further research is warranted to confirm these preliminary findings and facilitate implementation in clinical settings.
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Affiliation(s)
- Michaela C Pascoe
- Institute of Neuroscience and Physiology, Dept. of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy at University of Gothenburg, Sweden.
| | - Isabelle E Bauer
- University of Texas Health Science Center, Department of Psychiatry and Behavioral Science, Houston, TX, USA
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Cramer H, Ward L, Saper R, Fishbein D, Dobos G, Lauche R. The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Epidemiol 2015; 182:281-93. [PMID: 26116216 DOI: 10.1093/aje/kwv071] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/16/2015] [Indexed: 12/27/2022] Open
Abstract
As yoga has gained popularity as a therapeutic intervention, its safety has been questioned in the lay press. Thus, this review aimed to systematically assess and meta-analyze the frequency of adverse events in randomized controlled trials of yoga. MEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through February 2014. Of 301 identified randomized controlled trials of yoga, 94 (1975-2014; total of 8,430 participants) reported on adverse events. Life-threatening, disabling adverse events or those requiring intensive treatment were defined as serious and all other events as nonserious. No differences in the frequency of intervention-related, nonserious, or serious adverse events and of dropouts due to adverse events were found when comparing yoga with usual care or exercise. Compared with psychological or educational interventions (e.g., health education), more intervention-related adverse events (odds ratio = 4.21, 95% confidence interval: 1.01, 17.67; P = 0.05) and more nonserious adverse events (odds ratio = 7.30, 95% confidence interval: 1.91, 27.92; P < 0.01) occurred in the yoga group; serious adverse events and dropouts due to adverse events were comparable between groups. Findings from this review indicate that yoga appears as safe as usual care and exercise. The adequate reporting of safety data in future randomized trials of yoga is crucial to conclusively judge its safety.
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Nosaka M, Okamura H. A Single Session of an Integrated Yoga Program as a Stress Management Tool for School Employees: Comparison of Daily Practice and Nondaily Practice of a Yoga Therapy Program. J Altern Complement Med 2015; 21:444-9. [DOI: 10.1089/acm.2014.0289] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michiyo Nosaka
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Okamura
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Shahabi L, Naliboff BD, Shapiro D. Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study. PSYCHOL HEALTH MED 2015; 21:176-88. [PMID: 26086986 DOI: 10.1080/13548506.2015.1051557] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.
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Affiliation(s)
- Leila Shahabi
- a Department of Medicine , University of California , Los Angeles , CA , USA
| | - Bruce D Naliboff
- a Department of Medicine , University of California , Los Angeles , CA , USA
| | - David Shapiro
- b Department of Psychiatry and Biobehavioral Sciences , University of California , Los Angeles , CA , USA
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Abstract
OBJECTIVE This study aims to obtain preliminary data on the efficacy of yoga for reducing self-reported menopausal hot flashes in a randomized study including an attention control group. METHODS We randomized 54 late perimenopausal women (2-12 mo of amenorrhea) and postmenopausal women (>12 mo of amenorrhea)--aged 45 to 58 years and who experienced at least four hot flashes per day, on average, for at least 4 weeks--to one of three groups: yoga, health and wellness education (HW), and wait list (WL). Yoga and HW classes consisted of weekly 90-minute classes for 10 weeks. All women completed daily hot flash diaries throughout the trial (10 wk) to track the frequency and severity of hot flashes. The mean hot flash index score is based on the number of mild, moderate, severe, and very severe hot flashes. RESULTS Hot flash frequency declined significantly across time for all three groups, with the strongest decline occurring during the first week. There was no overall significant difference in hot flash frequency decrease over time by treatment groups, but the yoga and HW groups followed similar patterns and showed greater decreases than the WL group. On week 10, women in the yoga group reported an approximately 66% decrease in hot flash frequency, women in the HW group reported a 63% decrease, and women in the WL group reported a 36% decrease. The hot flash index showed a similar pattern. CONCLUSIONS Results suggest that yoga can serve as a behavioral option for reducing hot flashes but may not offer any advantage over other types of interventions.
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Cramer H, Rabsilber S, Lauche R, Kümmel S, Dobos G. Yoga and meditation for menopausal symptoms in breast cancer survivors-A randomized controlled trial. Cancer 2015; 121:2175-84. [PMID: 25739642 DOI: 10.1002/cncr.29330] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/25/2014] [Accepted: 02/10/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Breast cancer survivors have only very limited treatment options for menopausal symptoms. The objective of this trial was to evaluate the effects of a 12-week traditional Hatha yoga and meditation intervention on menopausal symptoms in breast cancer survivors. METHODS Patients were randomly assigned either to a 12-week yoga and meditation intervention or to usual care. The primary outcome measure was total menopausal symptoms (Menopause Rating Scale [MRS] total score). Secondary outcome measures included MRS subscales, quality of life (Functional Assessment of Cancer Therapy-Breast), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression, and anxiety (Hospital Anxiety and Depression Scale). Outcomes were assessed at week 12 and week 24 after randomization. RESULTS In total, 40 women (mean age ± standard deviation, 49.2 ± 5.9 years) were randomized to yoga (n = 19) or to usual care (n = 21). Women in the yoga group reported significantly lower total menopausal symptoms compared with the usual care group at week 12 (mean difference, -5.6; 95% confidence interval, -9.2 to -1.9; P = .004) and at week 24 (mean difference, -4.5; 95% confidence interval, -8.3 to -0.7; P = .023). At week 12, the yoga group reported less somatovegetative, psychological, and urogenital menopausal symptoms; less fatigue; and improved quality of life (all P < .05). At week 24, all effects persisted except for psychological menopausal symptoms. Short-term effects on menopausal symptoms remained significant when only women who were receiving antiestrogen medication (n = 36) were analyzed. Six minor adverse events occurred in each group. CONCLUSIONS Yoga combined with meditation can be considered a safe and effective complementary intervention for menopausal symptoms in breast cancer survivors. The effects seem to persist for at least 3 months.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Center in Complementary and Integrative Medicine, Faculty of Health, University of Technology-Sydney, Sydney, Australia
| | - Sybille Rabsilber
- Department of Gynecology, Certified Breast Center, Malteser Hospital St. Anna, Duisburg, Germany.,Interdisclipinary Breast Cancer Center, Kliniken Essen-Mitte, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Center in Complementary and Integrative Medicine, Faculty of Health, University of Technology-Sydney, Sydney, Australia
| | - Sherko Kümmel
- Interdisclipinary Breast Cancer Center, Kliniken Essen-Mitte, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Comparison of biopsychosocial functioning of women of different nationalities in the perimenopausal period. MENOPAUSE REVIEW 2014; 13:339-43. [PMID: 26327876 PMCID: PMC4352915 DOI: 10.5114/pm.2014.47987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/10/2014] [Accepted: 11/18/2014] [Indexed: 11/17/2022]
Abstract
Introduction The perimenopausal age is a time of many changes in women's health. Changes in women's health affect all spheres of life, because health is not merely the absence of disease or infirmity but full psychological, physical and social well-being. Presentation and comparison of the biopsychosocial functioning of women of different races and nationalities in perimenopause, identification of the most common menopause symptoms occurring among women and their needs. Material and methods Work supported with research examples. Using the PubMed database, the medical literature was searched for works that contain the key words menopause and race or ethnicity published between 1996 and 2013 and available in English. Literature in Polish is a supplementary issue. Results Various demographic processes taking place in the countries of Africa, North and South America, Asia and Europe are the basis for observing the situation in perimenopausal women in these countries. Caucasian women living in North America and Europe most often experience the negative symptoms of menopause, hindering daily functioning, and women living in urbanized countries in Asia best assess their health condition, both psychosocial and physical. Conclusions Biopsychosocial functioning of women varies among countries. Developing countries should be given the necessary support and financial information to ensure the health and quality of life in perimenopausal women. In most countries of the world there has been observed the need to promote women's health, particularly research aimed at prevention, increasing physical activity and attention to nutrition.
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Abstract
BACKGROUND Evidence suggests that many perimenopausal and early postmenopausal women will experience menopausal symptoms; hot flushes are the most common. Symptoms caused by fluctuating levels of oestrogen may be alleviated by hormone therapy (HT), but a marked global decline in its use has resulted from concerns about the risks and benefits of HT. Consequently, many women are seeking alternatives. As large numbers of women are choosing not to take HT, it is increasingly important to identify evidence-based lifestyle modifications that have the potential to reduce vasomotor menopausal symptoms. OBJECTIVES To examine the effectiveness of any type of exercise intervention in the management of vasomotor symptoms in symptomatic perimenopausal and postmenopausal women. SEARCH METHODS Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials (RCTs): Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley Internet interface), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), the Science Citation Index and the Social Science Citation Index (Web of Science), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (Ovid) and SPORTDiscus. Searches include findings up to 3 March 2014. SELECTION CRITERIA RCTs in which any type of exercise intervention was compared with no treatment/control or other treatments in the management of menopausal vasomotor symptoms in symptomatic perimenopausal/postmenopausal women. DATA COLLECTION AND ANALYSIS Five studies were deemed eligible for inclusion. Two review authors independently selected the studies, and three review authors independently extracted the data. The primary review outcome was vasomotor symptoms, defined as hot flushes and/or night sweats. We combined data to calculate standardised mean differences (SMDs) with 95% confidence intervals (CIs). Statistical heterogeneity was assessed using the I(2) statistic. We assessed the overall quality of the evidence for main comparisons using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods. MAIN RESULTS We included five RCTs (733 women) comparing exercise with no active treatment, exercise with yoga and exercise with HT. The evidence was of low quality: Limitations in study design were noted, along with inconsistency and imprecision. In the comparison of exercise versus no active treatment (three studies, n = 454 women), no evidence was found of a difference between groups in frequency or intensity of vasomotor symptoms (SMD -0.10, 95% CI -0.33 to 0.13, three RCTs, 454 women, I(2) = 30%, low-quality evidence). Nor was any evidence found of a difference between groups in the frequency or intensity of vasomotor symptoms when exercise was compared with yoga (SMD -0.03, 95% CI -0.45 to 0.38, two studies, n = 279 women, I(2) = 61%, low-quality evidence). It was not possible to include one of the trials in the meta-analyses; this trial compared three groups: exercise plus soy milk, soy milk only and control; results favoured exercise relative to the comparators, but study numbers were small. One trial compared exercise with HT, and the HT group reported significantly fewer flushes in 24 hours than the exercise group (mean difference 5.8, 95% CI 3.17 to 8.43, 14 participants). None of the trials found evidence of a difference between groups with respect to adverse effects, but data were very scanty. AUTHORS' CONCLUSIONS Evidence was insufficient to show whether exercise is an effective treatment for vasomotor menopausal symptoms. One small study suggested that HT is more effective than exercise. Evidence was insufficient to show the relative effectiveness of exercise when compared with HT or yoga.
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Affiliation(s)
- Amanda Daley
- Primary Care Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK, B15 2TT
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Cramer H, Lauche R, Dobos G. Characteristics of randomized controlled trials of yoga: a bibliometric analysis. Altern Ther Health Med 2014; 14:328. [PMID: 25183419 PMCID: PMC4161862 DOI: 10.1186/1472-6882-14-328] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/19/2014] [Indexed: 12/18/2022]
Abstract
Background A growing number of randomized controlled trials (RCTs) have investigated the therapeutic value of yoga interventions. This bibliometric analysis aimed to provide a comprehensive review of the characteristics of the totality of available randomized yoga trials. Methods All RCTs of yoga were eligible. Medline/PubMed, Scopus, the Cochrane Library, IndMED, and the tables of content of yoga specialty journals not listed in medical databases were screened through February 2014. Bibliometric data, data on participants, and intervention were extracted and analyzed descriptively. Results Published between 1975 and 2014, a total of 366 papers were included, reporting 312 RCTs from 23 different countries with 22,548 participants. The median study sample size was 59 (range 8–410, interquartile range = 31, 93). Two hundred sixty-four RCTs (84.6%) were conducted with adults, 105 (33.7%) with older adults and 31 (9.9%) with children. Eighty-four RCTs (26.9%) were conducted with healthy participants. Other trials enrolled patients with one of 63 varied medical conditions; the most common being breast cancer (17 RCTs, 5.4%), depression (14 RCTs, 4.5%), asthma (14 RCTs, 4.5%) and type 2 diabetes mellitus (13 RCTs, 4.2%). Whilst 119 RCTs (38.1%) did not define the style of yoga used, 35 RCTs (11.2%) used Hatha yoga and 30 RCTs (9.6%) yoga breathing. The remaining 128 RCTs (41.0%) used 46 varied yoga styles, with a median intervention length of 9 weeks (range 1 day to 1 year; interquartile range = 5, 12). Two hundred and forty-four RCTs (78.2%) used yoga postures, 232 RCTs (74.4%) used breath control, 153 RCTs (49.0%) used meditation and 32 RCTs (10.3%) used philosophy lectures. One hundred and seventy-four RCTs (55.6%) compared yoga with no specific treatment; 21 varied control interventions were used in the remaining RCTs. Conclusions This bibliometric analysis presents the most complete up-to-date overview on published randomized yoga trials. While the available research evidence is sparse for most conditions, there was a marked increase in published RCTs in recent years. Electronic supplementary material The online version of this article (doi:10.1186/1472-6882-14-328) contains supplementary material, which is available to authorized users.
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Sharma B, Hankey A, Nagilla N, Meenakshy KB, Nagendra HR. Can yoga practices benefit health by improving organism regulation? Evidence from electrodermal measures of acupuncture meridians. Int J Yoga 2014; 7:32-40. [PMID: 25035605 PMCID: PMC4097913 DOI: 10.4103/0973-6131.123477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: To document and explain Yoga's effects on acupuncture meridian energies. To understand mechanisms behind Yoga's efficacy by testing links between yoga and traditional Chinese medicine. Materials and Methods: The study compared two groups of yoga practitioners: Novice and experienced. Novices consisted of 33 volunteers from a Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) yoga instructor training module and the experienced practitioners were 20 resident SVYASA students. The intervention was 3 weeks of a yoga training program, new for the novices, but the lifestyle of the experienced group, who were therefore assessed only once. Novices were assessed on day 2 and 23 of their program at SVYASA's Yoga Medicine Hospital, making their data a pre-post, self-as-control, prospective study. Main outcome measures were mean acumeridian energy levels assessed by AcuGraph3 measures of electrodermal resistance at acupoints; additionally, gender differences, standard deviations (SDs) of all measures, and comparison of post and experienced group data. Results: Averaged energy levels significantly improved in all 24 meridians (maximum P = 0.032, 4-P < 0.01, and 19-P < 0.001). Females improved more than males (P < 0.05), both ending at similar levels to experienced practitioners, whose SDs were lower than novices on 19/24 meridians (mean F = 3.715, P = 0.0022), and 4/5 average variables. Conclusions: AcuGraph3 electrodermal measures contain substantial information, P << 0.00001. Yoga-lifestyle practice can increase and balance acumeridian energies; long-term practice decreases group SD's. These three suggest reasons why yoga practice impacts health: One, increased prana levels are important; two and three, improved physiological regulation is the key. Further studies relating traditional Indian and Chinese medical systems are needed.
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Affiliation(s)
- Bhawna Sharma
- Divisions of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore, Karnataka, India
| | - Alex Hankey
- Divisions of Yoga and Physical Sciences, Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore, Karnataka, India
| | - Niharika Nagilla
- Divisions of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore, Karnataka, India
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Schmalzl L, Crane-Godreau MA, Payne P. Movement-based embodied contemplative practices: definitions and paradigms. Front Hum Neurosci 2014; 8:205. [PMID: 24782738 PMCID: PMC3995074 DOI: 10.3389/fnhum.2014.00205] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/24/2014] [Indexed: 12/30/2022] Open
Abstract
Over the past decades, cognitive neuroscience has witnessed a shift from predominantly disembodied and computational views of the mind, to more embodied and situated views of the mind. These postulate that mental functions cannot be fully understood without reference to the physical body and the environment in which they are experienced. Within the field of contemplative science, the directing of attention to bodily sensations has so far mainly been studied in the context of seated meditation and mindfulness practices. However, the cultivation of interoceptive, proprioceptive and kinesthetic awareness is also said to lie at the core of many movement-based contemplative practices such as Yoga, Qigong, and Tai Chi. In addition, it likely plays a key role in the efficacy of modern somatic therapeutic techniques such as the Feldenkrais Method and the Alexander Technique. In the current paper we examine how these practices are grounded in the concepts of embodiment, movement and contemplation, as we look at them primarily through the lens of an enactive approach to cognition. Throughout, we point to a series of challenges that arise when Western scientists study practices that are based on a non-dualistic view of mind and body.
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Affiliation(s)
- Laura Schmalzl
- Department of Family and Preventive Medicine, University of California San DiegoLa Jolla, CA, USA
- VA San Diego Healthcare SystemLa Jolla, CA, USA
| | - Mardi A. Crane-Godreau
- Department of Microbiology and Immunology, Geisel School of Medicine at DartmouthLebanon, NH, USA
- Research and Development Service, Veteran's Administration Medical CenterWhite River Junction, VT, USA
| | - Peter Payne
- Department of Microbiology and Immunology, Geisel School of Medicine at DartmouthLebanon, NH, USA
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Newton KM, Reed SD, Guthrie KA, Sherman KJ, Booth-LaForce C, Caan B, Sternfeld B, Carpenter JS, Learman LA, Freeman EW, Cohen LS, Joffe H, Anderson GL, Larson JC, Hunt JR, Ensrud KE, LaCroix AZ. Efficacy of yoga for vasomotor symptoms: a randomized controlled trial. Menopause 2014; 21:339-46. [PMID: 24045673 PMCID: PMC3871975 DOI: 10.1097/gme.0b013e31829e4baa] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to determine the efficacy of yoga in alleviating vasomotor symptoms (VMS) frequency and bother. METHODS This study was a three-by-two factorial, randomized controlled trial. Eligible women were randomized to yoga (n = 107), exercise (n = 106), or usual activity (n = 142), and were simultaneously randomized to a double-blind comparison of ω-3 fatty acid (n = 177) or placebo (n = 178) capsules. Yoga intervention consisted of 12 weekly 90-minute yoga classes with daily home practice. Primary outcomes were VMS frequency and bother assessed by daily diaries at baseline, 6 weeks, and 12 weeks. Secondary outcomes included insomnia symptoms (Insomnia Severity Index) at baseline and 12 weeks. RESULTS Among 249 randomized women, 237 (95%) completed 12-week assessments. The mean baseline VMS frequency was 7.4 per day (95% CI, 6.6 to 8.1) in the yoga group and 8.0 per day (95% CI, 7.3 to 8.7) in the usual activity group. Intent-to-treat analyses included all participants with response data (n = 237). There was no difference between intervention groups in the change in VMS frequency from baseline to 6 and 12 weeks (mean difference [yoga--usual activity] from baseline at 6 wk, -0.3 [95% CI, -1.1 to 0.5]; mean difference [yoga--usual activity] from baseline at 12 wk, -0.3 [95% CI, -1.2 to 0.6]; P = 0.119 across both time points). Results were similar for VMS bother. At week 12, yoga was associated with an improvement in insomnia symptoms (mean difference [yoga - usual activity] in the change in Insomnia Severity Index, 1.3 [95% CI, -2.5 to -0.1]; P = 0.007). CONCLUSIONS Among healthy women, 12 weeks of yoga class plus home practice, compared with usual activity, do not improve VMS frequency or bother but reduce insomnia symptoms.
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Affiliation(s)
| | - Susan D. Reed
- Departments of Obstetrics/Gynecology and Epidemiology, University of Washington School of Medicine, Seattle, WA
| | | | | | | | - Bette Caan
- Division of Research, Kaiser Permanent Medical Program of Northern California, Oakland, CA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanent Medical Program of Northern California, Oakland, CA
| | | | - Lee A. Learman
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN
| | - Ellen W. Freeman
- Department of Obstetrics/Gynecology, University of Pennsylvania, Philadelphia, PA
| | | | | | - Garnet L. Anderson
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Joseph C. Larson
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Julie R. Hunt
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kristine E. Ensrud
- Department of Medicine, VA Medical Center / Division of Epidemiology and Community Health University of Minnesota, Minneapolis, MN
| | - Andrea Z. LaCroix
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA
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Reed SD, Guthrie KA, Newton KM, Anderson GL, Booth-LaForce C, Caan B, Carpenter JS, Cohen LS, Dunn AL, Ensrud KE, Freeman EW, Hunt JR, Joffe H, Larson JC, Learman LA, Rothenberg R, Seguin RA, Sherman KJ, Sternfeld BS, LaCroix AZ. Menopausal quality of life: RCT of yoga, exercise, and omega-3 supplements. Am J Obstet Gynecol 2014; 210:244.e1-11. [PMID: 24215858 DOI: 10.1016/j.ajog.2013.11.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 10/07/2013] [Accepted: 11/06/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the efficacy of 3 nonhormonal therapies for the improvement of menopause-related quality of life in women with vasomotor symptoms. STUDY DESIGN We conducted a 12-week 3 × 2 randomized, controlled, factorial design trial. Peri- and postmenopausal women, 40-62 years old, were assigned randomly to yoga (n = 107), exercise (n = 106), or usual activity (n = 142) and also assigned randomly to a double-blind comparison of omega-3 (n = 177) or placebo (n = 178) capsules. We performed the following interventions: (1) weekly 90-minute yoga classes with daily at-home practice, (2) individualized facility-based aerobic exercise training 3 times/week, and (3) 0.615 g omega-3 supplement, 3 times/day. The outcomes were assessed with the following scores: Menopausal Quality of Life Questionnaire (MENQOL) total and domain (vasomotor symptoms, psychosocial, physical and sexual). RESULTS Among 355 randomly assigned women who average age was 54.7 years, 338 women (95%) completed 12-week assessments. Mean baseline vasomotor symptoms frequency was 7.6/day, and the mean baseline total MENQOL score was 3.8 (range, 1-8 from better to worse) with no between-group differences. For yoga compared to usual activity, baseline to 12-week improvements were seen for MENQOL total -0.3 (95% confidence interval, -0.6 to 0; P = .02), vasomotor symptom domain (P = .02), and sexuality domain (P = .03) scores. For women who underwent exercise and omega-3 therapy compared with control subjects, improvements in baseline to 12-week total MENQOL scores were not observed. Exercise showed benefit in the MENQOL physical domain score at 12 weeks (P = .02). CONCLUSION All women become menopausal, and many of them seek medical advice on ways to improve quality of life; little evidence-based information exists. We found that, among healthy sedentary menopausal women, yoga appears to improve menopausal quality of life; the clinical significance of our finding is uncertain because of the modest effect.
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Cavallera GM, Gatto M, Boari G. Personality, cognitive styles and Morningness-Eveningness disposition in a sample of Yoga trainees. Med Sci Monit 2014; 20:238-46. [PMID: 24531385 PMCID: PMC3930599 DOI: 10.12659/msm.889030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Yoga is a psychophysical, spiritual science of holistic living, aiming towards body and mind development; it can influence well-being, cognitive processes, personality (Gunas), psychophysiological parameters, and human health. Since it has been observed that Morningness-Eveningness disposition is associated with personality, and that personality can characterize people practicing Yoga, in this exploratory study we posited that Morningness-Eveningness might be associated with personality in Yoga trainees. Since Yoga can have influences over cognitive perspectives, and since it has been observed that Morningness-Eveningness disposition can associate with cognitive processes, we investigated a sample of Yoga trainees with reference to relationship with styles of learning and thinking (relevant aspects of cognitive functioning) and also with Morningness-Eveningness disposition. Material/Method We tested 184 Yoga trainees using the following questionnaires: Styles of Learning and Thinking (Torrance), Big Five Questionnaire (Caprara, Barbaranelli, Borgogni), and reduced Morningness-Eveningness Questionnaire (Natale). Results We found that Morning types score significantly higher than Evening types on Conscientiousness, Friendliness, Scrupulousness, Openness to Culture, emotional Stability, emotion Control, they score higher than intermediate types on Conscientiousness, Friendliness, Scrupulousness. Moreover, data showed that the high majority of subjects, also with reference to Morningness-Eveningness disposition, have right-sided styles of learning and thinking, pointing out a tendency towards right-sided cognitive precessing in the whole sample. Personality traits of the Yoga trainees were also investigated. Conclusions Data are discussed with reference to existing literature, psychological and neuroscientific perspectives are suggested, previous studies about Yoga published on Medical Science Monitor are also considered.
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Affiliation(s)
| | - Massimo Gatto
- , Yoga High School of Specialization "Yoga e Oltre", Milano, Italy
| | - Giuseppe Boari
- Department of Statistics, Catholic University of Sacred Heart, Milano, Italy
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Kumar A, Archana E, Pai A, Nayak G, Shenoy RP, Rao A. Serum mineral status and climacteric symptoms in perimenopausal women before and after Yoga therapy, an ongoing study. J Midlife Health 2014; 4:225-9. [PMID: 24381464 PMCID: PMC3872669 DOI: 10.4103/0976-7800.122251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Many women report an increased level of anxiety, irritability and mood swings during their perimenopausal state. Studies show that physically active people can reduce their anxiety and depression by practicing yoga. Serum minerals such as calcium, copper and magnesium and the ferro-oxidase, ceruloplasmin play an important role in the body during the perimenopausal period. OBJECTIVE The objective of this study is to assess the serum mineral status, anthropometric parameters and climacteric symptoms in perimenopausal women before and after yoga intervention. SUBJECTS AND METHODS A total of 30 subjects with perimenopausal symptoms, aged between 40 and 60 years (49.43 ± 6.15) were included in the study. Yoga intervention was given on a daily basis (45 min duration) for 12 weeks. The climacteric symptoms were assessed by Greene's climacteric scale and biochemical parameters were analyzed spectrophotometrically. RESULTS A significant decrease in the waist hip ratio (P < 0.036) and body mass index (P < 0.036) was observed after yoga intervention. Systolic (P < 0.064) and diastolic (P < 0.082) blood pressure (BP) showed marginal decrease after yoga therapy. Climacteric symptoms improved significantly (P < 0.001) after yoga intervention. A significant increase (P < 0.001) in serum calcium and copper and a marked decrease in serum magnesium (P < 0.05) and ceruloplasmin (P < 0.028) levels was observed, post yoga therapy. Serum magnesium negatively correlated (r = -0.467, P < 0.035) with systolic BP after yoga intervention. CONCLUSION The overall changes observed in the mineral status and climacteric symptoms suggest that yoga therapy protocol can be effectively used to improve the quality of life in perimenopausal women.
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Affiliation(s)
- Alok Kumar
- Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka, India
| | - E Archana
- Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka, India
| | - Akshatha Pai
- Department of Biochemistry, Melaka Manipal Medical College, Manipal, Karnataka, India
| | - Gayathry Nayak
- Department of Yoga, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Revathi P Shenoy
- Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka, India
| | - Anjali Rao
- Department of Biochemistry, Melaka Manipal Medical College, Manipal, Karnataka, India
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Chugh-Gupta N, Baldassarre FG, Vrkljan BH. A systematic review of yoga for state anxiety: considerations for occupational therapy. Can J Occup Ther 2013; 80:150-70. [PMID: 24224228 DOI: 10.1177/0008417413500930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND State anxiety can result from a variety of life situations. This type of anxiety can disrupt occupational engagement and performance, thereby affecting rehabilitation and recovery. Occupational therapists need to address the connection between mind-body-spirit and its relationship to performance and engagement in meaningful occupations. Yoga, when used as an adjunct to therapy, has the potential to address state anxiety. PURPOSE The aim was to systematically review the evidence concerning the effectiveness of yoga as a treatment approach for state anxiety. METHODS Six electronic databases, the authors' own files, and the references of included studies from 1990 to July 2011 were searched. FINDINGS A total of 25 unique studies represented by 26 publications made up the sample: two systematic reviews; 16 randomized controlled trials, and seven prospective, controlled, non-randomized studies. Evidence suggests yoga can be a viable therapeutic option for reducing state anxiety in certain situations. IMPLICATIONS In making the determination to recommend yoga as an intervention, occupational therapists should consider the client's circumstances and values as well as the type and intensity of the yoga program.
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Affiliation(s)
- Neha Chugh-Gupta
- School of Rehabilitation Science, McMaster University, IAHS Bldg, Rm. 450, 1400 Main St. West, Hamilton, ON, Canada L8S IC7
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Woods NF, Mitchell ES, Schnall JG, Cray L, Ismail R, Taylor-Swanson L, Thomas A. Effects of mind-body therapies on symptom clusters during the menopausal transition. Climacteric 2013; 17:10-22. [PMID: 23937432 DOI: 10.3109/13697137.2013.828198] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Although most women experience symptom clusters during the menopausal transition and early postmenopause, investigators reporting clinical trial effects for hot flushes often omit co-occurring symptoms. Our aim was to review controlled clinical trials of mind-body therapies for hot flushes and at least one other co-occurring symptom from these groups: sleep, cognitive function, mood, and pain. METHODS An experienced reference librarian performed an extensive search of PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for randomized controlled trials reported in English between 2004 and July 2011. Of 1193 abstracts identified, 58 trials examining effectiveness of therapies for hot flushes and at least one additional co-occurring symptom of interest were identified. RESULTS Eight trials (ten publications) examined relaxation, yoga, or exercise. Physical activity/exercise trials (six) yielded mixed results; only one significantly reduced hot flushes and mood symptoms. Of two relaxation therapy trials, only mindfulness-based stress reduction training reduced sleep and mood symptoms and had within-group treatment effects on hot flushes. Yoga (one trial) significantly reduced hot flushes and improved cognitive symptoms more than exercise, and also had within-group effects on sleep and pain symptoms. CONCLUSIONS Studies of mind-body therapies for hot flushes increasingly measure multiple symptom outcomes, but few report treatment effects in ways that allow clinicians to consider symptom clusters when prescribing therapies. Future studies need to measure and report results for individual symptoms or group like symptoms together into subscales rather than use subscales with mixed dimensions. Trials with larger numbers of participants are essential to allow evaluation of these therapies on multiple co-occurring symptoms.
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Affiliation(s)
- N F Woods
- * Biobehavioral Nursing, University of Washington
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Abstract
OBJECTIVE Paced breathing (slow, deep, diaphragmatic breathing) reduces central sympathetic activity and facilitates the relaxation response. The present study was designed to assess the feasibility of and to obtain initial efficacy estimates of two paced-breathing programs, compared with usual breathing, for the frequency and severity of hot flashes. METHODS We designed a 9-week, randomized, three-arm, parallel-group, blinded (investigator) phase II clinical trial. Using an audio CD, participants in the active arms practiced paced breathing at 6 breaths/minute for 15 minutes, either once or twice a day, whereas the control arm practiced usual breathing at 14 breaths/minute for 10 minutes/day. Feasibility was assessed through self-report questionnaires; percent reduction and effect size estimates were determined using changes in hot flash frequency and scores within each group. RESULTS Of the 92 eligible participants, 68 (74%) completed the study. Most women reported that the intervention was easy to do (79%) and of appropriate duration (71%). They could practice exercises as taught (61%) and could practice on most days (65%). Participants in all arms reported hot flash reductions during the 9 weeks: 52% for paced breathing twice a day, 42% for paced breathing once a day, and 46% for usual breathing. CONCLUSIONS The paced-breathing intervention is feasible. Although paced breathing twice a day seems to be the most helpful dose, efforts to intensify paced breathing once a day may be more practical for widespread dissemination. The efficacy and overall clinical impact of paced-breathing exercises on hot flash reduction require further evaluation in an adequately powered, placebo-controlled, randomized phase III clinical trial.
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Sternfeld B, LaCroix A, Caan BJ, Dunn AL, Newton KM, Reed SD, Guthrie KA, Booth-LaForce C, Sherman KJ, Cohen L, Freeman MP, Carpenter JS, Hunt JR, Roberts M, Ensrud KE. Design and methods of a multi-site, multi-behavioral treatment trial for menopausal symptoms: the MsFLASH experience. Contemp Clin Trials 2013; 35:25-34. [PMID: 23462342 PMCID: PMC3670607 DOI: 10.1016/j.cct.2013.02.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/12/2013] [Accepted: 02/17/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Behavioral strategies are recommended for menopausal symptoms, but little evidence exists regarding efficacy. PURPOSE Describe design and methodology of a randomized controlled 3 by 2 factorial trial of yoga, exercise and omega-3 fatty acids. METHODS Women from three geographic areas with a weekly average of ≥14 hot flashes/night sweats, who met exclusion/inclusion criteria, were randomized to 12weeks of: 1) yoga classes and daily home practice; 2) supervised, facility-based aerobic exercise training; or 3) usual activity. Women in each arm were further randomized to either omega-3 supplement or placebo. Standardized training, on-going monitoring, and site visits were adopted to ensure consistency across sites and fidelity to the intervention. Participant adherence to the intervention protocol was monitored continuously, and retention was actively encouraged by staff. Information on adverse events was systematically collected. RESULTS Of 7377 women who responded to mass mailings, 355 (4.8%) were randomized; mean age was 54.7 (sd=3.7), 26.2% were African American, 81.7% were post-menopausal, and mean baseline frequency of daily hot flashes/night sweats was 7.6 (sd=3.8). Adherence of ≥80% was 59% for yoga, 77% for exercise training, and 80% for study pills. Final week 12 data were collected from 95.2% CONCLUSIONS Conducting a multi-site, multi-behavioral randomized trial for menopausal symptoms is challenging but feasible. Benefits included cost-effective study design, centralized recruitment, and methodologic standardization.
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Affiliation(s)
- Barbara Sternfeld
- Division of Research, Kaiser Permanente, Oakland, CA, United States.
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McPheeters C, Gregg J. Treatment Options for Hot Flashes in the HIV-Positive Menopausal Patient. J Nurse Pract 2013. [DOI: 10.1016/j.nurpra.2012.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lefkowits CC, Arnold RM. Hot Flashes in Palliative Care, Part 3 #263. J Palliat Med 2013; 16:203-4. [DOI: 10.1089/jpm.2013.9528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Maharana S, Nagarathna R, Padmalatha V, Nagendra HR, Hankey A. The Effect of Integrated Yoga on Labor Outcome: A Randomized Controlled Study. INTERNATIONAL JOURNAL OF CHILDBIRTH 2013. [DOI: 10.1891/2156-5287.3.3.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND:Antenatal yoga has been found to be useful and reported to have many beneficial effects. The objective of this study was to investigate the effect of yoga on labor outcome.METHODS:This randomized two-armed active control study recruited 96 women with normal pregnancy. The experimental group practiced integrated yoga and the control group practiced standard antenatal exercises (1 hr/day), from 18 to 20 weeks of gestation until term.RESULTS:The first stage of labor was 4.71 ± 0.59 and 6.19 ± 0.79 hr in yoga and control groups, respectively (p< .001, independent samplesttest); the second stage was 23.41 ± 7.68 min in yoga and 55.19 ± 10.87 min in control group (p< .001); the third stage took 9.07 ± 2.35 min in yoga and 12.96 ± 2.86 min in control group (p< .001). Fewer number of women in yoga group required epidural analgesia (p< .001). The cesarean sections (7/51 in yoga and 18/45 in control;p= .004) and complications of pregnancy (intrauterine growth restriction [IUGR], pregnancy-induced hypertension [PIH], and preterm labor) were fewer (p= .010) in yoga than in control group. Birth weight of babies (p< .001) was higher and Apgar scores (p< .001) were better in yoga as compared to the control group.CONCLUSION:Yoga during pregnancy decreases the duration of all stages of labor, complications of pregnancy, need for epidural analgesia, and cesarean sections; it also improves birth weight and Apgar scores of the infant.
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