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Irwin MR, Hoang D, Olmstead R, Sadeghi N, Breen EC, Bower JE, Cole S. Tai Chi compared with cognitive behavioral therapy and the reversal of systemic, cellular and genomic markers of inflammation in breast cancer survivors with insomnia: A randomized clinical trial. Brain Behav Immun 2024; 120:159-166. [PMID: 38777285 DOI: 10.1016/j.bbi.2024.05.022] [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] [Received: 12/01/2023] [Revised: 05/06/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Insomnia contributes to inflammation in breast cancer survivors. This study evaluates whether insomnia treatment reverses inflammation in breast cancer survivors with insomnia. METHODS Participants (n = 90) were randomized to 3 months of Tai Chi (n = 45) or cognitive behavioral therapy for insomnia (CBT-I)(n = 45), and followed for one year post-intervention to 15 month endpoint. Our previous report found that Tai Chi as compared to CBT-I resulted in similar rates of insomnia response and remission over 15 months. Here, we analyze changes in plasma C-reactive protein and pro- and anti-inflammatory cytokines, Toll-like receptor (TLR)-4 stimulated monocyte production of interleukin (IL)-6 and tumor necrosis factor-α (TNF), and cellular pro-inflammatory and anti-viral gene expression (Conserved Transcriptional Response to Adversity RNA profile; CTRA) over 15 months. RESULTS Insomnia treatment resulted in decreases in the TLR-4 stimulated monocyte production of IL-6, TNF, and their co-expression, as well as decreases in the CTRA profile, decreases inflammatory gene transcripts, and increases in anti-viral gene transcripts over 15 months (all P's < 0.01). In addition, as compared to CBT-I, Tai Chi resulted in greater decreases in plasma IL-6 (P < 0.05), and greater decreases in TLR-4 activated monocyte production of IL-6 and co-expression of IL-6 and TNF at 15 month endpoint. CBT-I resulted in greater increases in anti-viral gene transcripts. CONCLUSIONS Administration of either CBT-I or Tai Chi effectively treats insomnia, and shows additional benefits of reducing cellular and genomic markers of inflammation, and increasing anti-viral genomic markers in breast cancer survivors with insomnia. Tai Chi, as compared to CBT-I, yields greater and more durable decreases in systemic- and cellular inflammation. Targeting insomnia might mitigate the risk of inflammation-related co-morbidities in breast cancer survivors.
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Affiliation(s)
- Michael R Irwin
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Danny Hoang
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Nina Sadeghi
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Steve Cole
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
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Menkyova I, Stastna D, Novotna K, Saling M, Lisa I, Vesely T, Slezakova D, Valkovic P. Effect of Tai-chi on balance, mood, cognition, and quality of life in women with multiple sclerosis: A one-year prospective study. Explore (NY) 2024; 20:188-195. [PMID: 37596158 DOI: 10.1016/j.explore.2023.07.011] [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: 02/26/2023] [Revised: 07/22/2023] [Accepted: 07/31/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION One of the most debilitating problems encountered by people with multiple sclerosis (MS) is the loss of balance and coordination. Our study aimed to comprehensively evaluate the effectiveness of one year of Tai-chi exercise in patients with MS using both subjective and objective methods, including posturography. METHODS This was a single-group longitudinal one-year study performed from the 1st of January 2019 to the 1st of January 2020. The primary outcomes of interest were the Mini-Balance Evaluation Systems Test (Mini-BESTest) and static posturography measures as objective methods to detect subtle changes associated with postural control/balance impairment. Secondary outcomes were measures of depression, anxiety, cognitive performance, and quality of life. All objective and subjective parameters were assessed four times: at baseline, and after three, six and 12 months of regular Tai-chi training. The difference was calculated as a subtraction of baseline values from every timepoint value for each measurement. If the normality test was passed, parametric one-sample t-test was used, if failed, Wilcoxon signed ranks test was used to test the difference between the baseline and each timepoint. Alpha was set to 0.017 using Bonferroni correction for multiple comparisons. RESULTS Out of 25 patients with MS enrolled, 15 women with MS (mean age 44.27 years) were included for statistical analyses after completing the 12-month program. After 12 months, significant improvements were found in all objective balance and gait tests: Mini-BESTest (p<0.001), static posturography measures (total area of the centre of foot pressure - TA; p = 0.015), 25 Feet Walk Test (25FWT; p = 0.001), anxiety (Beck Anxiety Inventory - BAI; p = 0.005) and cognition tests (Paced Auditory Serial Addition Test - PASAT; p = 0.003). Measures of depression (Beck Depression Inventory - BDI; p = 0.071), cognition (Symbol Digit Modalities Test - SDMT; p = 0.079), and health-related quality of life (European Quality of Life 5-Dimensions Questionnaire - EQ-5D-5L; p = 0.095) showed a trend of improvement but were not significant, which could be the result of a small sample and increased bias due the type II error. CONCLUSION According to these preliminary results, this study indicates the possible beneficial effects of long-term Tai-chi training on patients with MS. Although these findings need to be confirmed by further studies with a larger sample of participants of both genders and require more rigorous randomized controlled trials (RCT) design, our findings support the recommendation of regular and long-term Tai-chi exercise in patients with MS. CLINICALTRIALS GOV IDENTIFIER (RETROSPECTIVELY REGISTERED) NCT05474209.
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Affiliation(s)
- Ingrid Menkyova
- Second Department of Neurology, Faculty of Medicine, Comenius University Bratislava, University Hospital Bratislava, Slovakia; Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czechia
| | - Dominika Stastna
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czechia
| | - Klara Novotna
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czechia
| | - Marian Saling
- Second Department of Neurology, Faculty of Medicine, Comenius University Bratislava, University Hospital Bratislava, Slovakia
| | - Iveta Lisa
- Second Department of Neurology, Faculty of Medicine, Comenius University Bratislava, University Hospital Bratislava, Slovakia
| | - Tomas Vesely
- Department of Information and Communication Technologies in Medicine, Faculty of Biomedical Engineering, Czech Technical University in Prague, Czechia
| | - Darina Slezakova
- Second Department of Neurology, Faculty of Medicine, Comenius University Bratislava, University Hospital Bratislava, Slovakia
| | - Peter Valkovic
- Second Department of Neurology, Faculty of Medicine, Comenius University Bratislava, University Hospital Bratislava, Slovakia; Centre of Experimental Medicine, Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovakia.
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Laskosky NA, Huston P, Lam WC, Anderson C, Zhong LLD. Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review. BMC Complement Med Ther 2024; 24:78. [PMID: 38321432 PMCID: PMC10845721 DOI: 10.1186/s12906-024-04350-3] [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: 06/25/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health concern. The common functional, psychological, and cognitive changes associated with TBI and recent trends in its management, such as recommending sub-threshold aerobic activity, and multi-modal treatment strategies including vestibular rehabilitation, suggest that Tai Chi/Qigong could be beneficial for TBI. Tai Chi and Qigong are aerobic mind-body practices with known benefits for maintaining health and mitigating chronic disease. To date, no systematic review has been published assessing the safety and effectiveness of Tai Chi/Qigong for traumatic injury. METHODS The following databases were searched: MEDLINE, CINAHL Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All people with mild, moderate, or severe TBI who were inpatients or outpatients were included. All Types of Tai Chi and Qigong, and all comparators, were included. All measured outcomes were included. A priori, we chose "return to usual activities" as the primary outcome measure as it was patient-oriented. Cochrane-based risk of bias assessments were conducted on all included trials. Quality of evidence was assessed using the grading of recommendation, assessment, development, and evaluation (GRADE) system. RESULTS Five trials were assessed; three randomized controlled trials (RCTs) and two non-RCTs; only two trials were conducted in the last 5 years. No trial measured "return to normal activities" or vestibular status as an outcome. Four trials - two RCTs and two non-RCTS - all found Tai Chi improved functional, psychological and/or cognitive outcomes. One RCT had a low risk of bias and a high level of certainty; one had some concerns. One non-RCTs had a moderate risk of bias and the other a serious risk of bias. The one Qigong RCT found improved psychological outcomes. It had a low risk of bias and a moderate level of certainty. Only one trial reported on adverse events and found that none were experienced by either the exercise or control group. CONCLUSION Based on the consistent finding of benefit in the four Tai Chi trials, including one RCT that had a high level of certainty, there is a sufficient signal to merit conducting a large, high quality multi-centre trial on Tai Chi for TBI and test it against current trends in TBI management. Based on the one RCT on TBI and Qigong, an additional confirmatory RCT is indicated. Further research is indicated that reflects current management strategies and includes adverse event documentation in both the intervention and control groups. However, these findings suggest that, in addition to Tai Chi's known health promotion and chronic disease mitigation benefits, its use for the treatment of injury, such as TBI, is potentially a new frontier. SYSTEMATIC REVIEW REGISTRATION PROSPERO [ CRD42022364385 ].
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Affiliation(s)
| | - Patricia Huston
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort (Research), University of Ottawa, Ottawa, Canada
| | - Wai Ching Lam
- School of Chinese Medicine, Hong Kong Baptist University, kowloon tong, Hong Kong, SAR, China
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | | | - Linda L D Zhong
- School of Chinese Medicine, Hong Kong Baptist University, kowloon tong, Hong Kong, SAR, China.
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore.
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Laskosky NA, Huston P, Lam WC, Anderson C, Zheng Y, Zhong LLD. Are tai chi and qigong effective in the treatment of TBI? A systematic review protocol. Front Aging Neurosci 2023; 15:1121064. [PMID: 36949776 PMCID: PMC10025504 DOI: 10.3389/fnagi.2023.1121064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/20/2023] [Indexed: 03/08/2023] Open
Abstract
Background Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health issue. A number of recent trends in managing TBI, such as recommending sub-threshold aerobic activity, tailoring multi-modal treatment strategies, and studying the possible role of low-grade inflammation in those with persistent symptoms, all suggest that the physical and cognitive exercise of tai chi/qigong could have benefit. Method Designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases will be searched: MEDLINE, CINAHL, Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All clinical trials on mild, moderate and/or severe TBI with tai chi and/or qigong as the treatment group and any comparison group, in any setting will be included. Four reviewers will independently select studies; two reviewers for the English and two for the Chinese databases. Cochrane-based risk of bias assessments will be conducted on all included studies. An analysis will then be conducted with the grading of recommendation, assessment, development, and evaluation (GRADE) instrument. Results This review will summarize the clinical trial evidence on tai chi/qigong for TBI including type of TBI, age/sex of participants, type and length of intervention and comparator, outcome measures, and any adverse events. The risk of bias will be considered, and the strengths and weaknesses of each trial will be analyzed. Discussion The results of this review will be considered with respect to whether there is enough evidence of benefit to merit a more definitive randomized controlled trial.Systematic Review Registration: PROSPERO [CRD42022364385].
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Affiliation(s)
| | - Patricia Huston
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort (Research), University of Ottawa, Ottawa, ON, Canada
| | - Wai Ching Lam
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | | | - Ya Zheng
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Linda L. D. Zhong
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
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Siddarth P, Abikenari M, Grzenda A, Cappelletti M, Oughli H, Liu C, Millillo MM, Lavretsky H. Inflammatory Markers of Geriatric Depression Response to Tai Chi or Health Education Adjunct Interventions. Am J Geriatr Psychiatry 2023; 31:22-32. [PMID: 36175271 PMCID: PMC10865899 DOI: 10.1016/j.jagp.2022.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Underlying inflammation is associated with an increased risk of depression in older adults. In this study, we examined the role of inflammatory biomarkers in antidepressant response in depressed older adults undergoing adjunct Tai Chi Chih (TCC) or Health education interventions. METHODS Older adults aged 60 years and above with a diagnosis of major depression were randomized to 12 weeks of TCC versus Health and Wellness Education (HEW) as an adjunct therapy to their stable antidepressant treatment regimen. A panel of 19 cytokine/chemokines was measured at baseline and 12 weeks. Five factors were derived using factor analysis. General linear models were estimated to examine the change in factor scores and the association of these changes on depression remission rates, controlling for age, sex, and body mass index. RESULTS Of the 170 randomized participants (TCC: n = 85 and HEW: n = 85), 55 TCC and 58 HEW completed the 3-month assessment. The groups did not differ at baseline in any measure. At follow-up, neither the changes in cytokine/chemokines scores nor the depression remission rate differed significantly between TCC and HEW. However, remitters and non-remitters differed significantly in changes in a factor composed of growth-regulated oncogene protein-alpha (GRO-alpha), epidermal growth factor (EGF), and soluble CD40 ligand (sCD40L). GRO-alpha and EGF levels (in both groups) were significantly increased in remitters compared to non-remitters. CONCLUSION Changes in certain cytokines/chemokines may accompany improvement in depressive symptoms in older adults. Future studies will need to explore the role of these molecules in remission of late-life depression.
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Affiliation(s)
- Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA
| | - Matthew Abikenari
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA
| | - Adrienne Grzenda
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA
| | - Monica Cappelletti
- Department of Pathology and Laboratory Medicine, UCLA Immunogenetics Center (MC), Los Angeles, CA
| | - Hanadi Oughli
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA
| | - Claire Liu
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA
| | - Michaela M Millillo
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior, UCLA (PS, MA, AG, HO, CL, MM, HL), Los Angeles, CA.
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Yang J, Wang Y, He S, Peng X, Wang C, Li N, Liao Y. Relationship between Tai Chi and clinical outcomes in elderly patients with COVID-19: a protocol for systematic review and dose-response meta-analysis. BMJ Open 2022; 12:e066803. [PMID: 36523226 PMCID: PMC9748512 DOI: 10.1136/bmjopen-2022-066803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION COVID-19 has posed a serious threat to people worldwide, especially the older adults, since its discovery. Tai Chi as a traditional Chinese exercisethat belongs to traditional Chinese medicine has proven its effectiveness against COVID-19. However, no high-quality evidence is found on the dose-response relationships between Tai Chi and clinical outcomes in patients with COVID-19. This study will evaluate and determine the clinical evidence of Tai Chi as a treatment in elderly patients with COVID-19. METHODS AND ANALYSIS The following electronic bibliographical databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP Database and Wanfang Database will be screened from their inception date to 30 June 2022. All eligible randomised controlled trials or controlled clinical trials related to Tai Chi for elderly patients with COVID-19 will be included. The primary outcomes are forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio (FEV1%). The secondary outcomes are the time of main symptoms disappearance, length of hospital stay, serum levels of interleukin (IL)-6, IL-1b and tumour necrosis factor-α, and adverse event rate. Two independent reviewers will select the studies, extract the data, and analyse them on EndNote V.X9.0 and Stata V.12.1. The robust error meta-regression model will be used to establish the dose-response relationships between Tai Chi and clinical outcomes. The heterogeneity and variability will be analysed by I2 and τ2 statistics. Risk of bias, subgroup analysis and sensitivity analysis will also be performed. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluation, and the risk of bias will be evaluated by using the Physiotherapy Evidence Database Scale. ETHICS AND DISSEMINATION This study will review published data; thus, obtaining ethical approval and consent is unnecessary. The results will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42022327694.
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Affiliation(s)
- Jinfeng Yang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Yang Wang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Sheng He
- Department of Rehabilitation Medicine, General Hospital of Western Theater Command of Chinese People's Liberation Army, Chengdu, Sichuan, China
| | - Xiao Peng
- Department of Rehabilitation Medicine, No.1 Orthopaedic Hospital of Chengdu, Chengdu, Sichuan, China
| | - Chun Wang
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Na Li
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yuanpeng Liao
- Department of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
- Affiliated Hospital of Chengdu Sport University, Chengdu Sport University, Chengdu, Sichuan, China
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Kilpatrick LA, Siddarth P, Milillo MM, Krause-Sorio B, Ercoli L, Narr KL, Lavretsky H. Impact of Tai Chi as an adjunct treatment on brain connectivity in geriatric depression. J Affect Disord 2022; 315:1-6. [PMID: 35905792 PMCID: PMC10182814 DOI: 10.1016/j.jad.2022.07.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND As an adjunct to antidepressant treatment, Tai Chi Chih (TCC) is superior to health education and wellness (HEW) training in improving the general health of patients with geriatric depression (GD). This study investigated the brain connectivity changes associated with TCC and HEW in combination with antidepressant treatment in patients with GD. METHODS Forty patients with GD under stable antidepressant treatment underwent TCC training (n = 21) or HEW training (n = 19) for 12 weeks, and completed baseline and 3-month follow-up resting state magnetic resonance imaging scans. Within-group and between-group differences in parcel-to-parcel connectivity changes with intervention were evaluated by general linear modeling. Relationships between significant connectivity changes and symptom/resilience improvement were evaluated by partial least squares correlation analysis. RESULTS Significantly greater increases in connectivity with TCC than with HEW (FDR-corrected p < .05) were observed for 167 pairwise connections, most frequently involving the default mode network (DMN). In both groups, increased connectivity involving largely DMN regions was significantly and positively correlated with improvement in symptoms/resilience. LIMITATIONS The sample size was relatively small, mainly due to neuroimaging contraindications (e.g., implants). Additionally, the standard antidepressant treatment varied greatly among patients, adding heterogeneity. CONCLUSIONS Non-pharmacological adjuncts, such as TCC, may enhance DMN connectivity changes associated with improved depressive symptoms and psychological resilience in the treatment of GD.
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Affiliation(s)
- Lisa A Kilpatrick
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA, USA
| | - Prabha Siddarth
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Michaela M Milillo
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Beatrix Krause-Sorio
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Linda Ercoli
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Katherine L Narr
- Department of Neurology, Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
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Zhang J, Liu Y, Li Z, Bian Y, Zhou Q, Shan C, Qi R. Research progress on the effect and mechanism of Tai Ji Quan in the treatment of post-stroke depression. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2022. [DOI: 10.1007/s11726-022-1341-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Derry-Vick HM, Johnston CD, Brennan-Ing M, Burchett CO, Glesby N, Zhu YS, Siegler EL, Glesby MJ. Pain Is Associated With Depressive Symptoms, Inflammation, and Poorer Physical Function in Older Adults With HIV. Psychosom Med 2022; 84:957-965. [PMID: 35980785 PMCID: PMC9553263 DOI: 10.1097/psy.0000000000001119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 03/11/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE People living with HIV (PLWH) frequently experience pain, which often co-occurs with psychological symptoms and may impact functional outcomes. We investigated cross-sectional associations between pain, depressive symptoms, and inflammation, and then explored whether pain was related to poorer physical function among older PLWH. METHODS We examined data from PLWH aged 54 to 78 years ( n = 162) recruited from a single outpatient program for a larger study on HIV and aging. Participants reported depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) and then attended a biomedical visit in which they reported past-month pain (Medical Outcomes Study-HIV pain subscale), completed physical function assessments, and provided blood samples (assayed for interleukin 6, interferon-γ, tumor necrosis factor α, and C-reactive protein). Links between pain, depressive symptoms, inflammation, and physical function were tested using linear regression models. RESULTS PLWH with greater depressive symptoms experienced more pain than did those with fewer depressive symptoms ( B = 1.31, SE = 0.28, p < .001), adjusting for age, sex, race, body mass index, smoking, disease burden, time since HIV diagnosis, and medication use. Higher composite cytokine levels were associated with worse pain ( B = 5.70, SE = 2.54, p = .027 in adjusted model). Poorer physical function indicators, including slower gait speed, weaker grip strength, recent falls, and prefrail or frail status, were observed among those with worse pain. Exploratory mediation analyses suggested that pain may partially explain links between depressive symptoms and several physical function outcomes. CONCLUSIONS Pain is a potential pathway linking depressive symptoms and inflammation to age-related health vulnerabilities among older PLWH; longitudinal investigation of this pattern is warranted. PLWH presenting with pain may benefit from multidisciplinary resources, including behavioral health and geriatric medicine approaches.
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Król M, Kupnicka P, Bosiacki M, Chlubek D. Mechanisms Underlying Anti-Inflammatory and Anti-Cancer Properties of Stretching-A Review. Int J Mol Sci 2022; 23:ijms231710127. [PMID: 36077525 PMCID: PMC9456560 DOI: 10.3390/ijms231710127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 02/07/2023] Open
Abstract
Stretching is one of the popular elements in physiotherapy and rehabilitation. When correctly guided, it can help minimize or slow down the disabling effects of chronic health conditions. Most likely, the benefits are associated with reducing inflammation; recent studies demonstrate that this effect from stretching is not just systemic but also local. In this review, we present the current body of knowledge on the anti-inflammatory properties of stretching at a molecular level. A total of 22 papers, focusing on anti-inflammatory and anti-cancer properties of stretching, have been selected and reviewed. We show the regulation of oxidative stress, the expression of pro- and anti-inflammatory genes and mediators, and remodeling of the extracellular matrix, expressed by changes in collagen and matrix metalloproteinases levels, in tissues subjected to stretching. We point out that a better understanding of the anti-inflammatory properties of stretching may result in increasing its importance in treatment and recovery from diseases such as osteoarthritis, systemic sclerosis, and cancer.
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Affiliation(s)
- Małgorzata Król
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Patrycja Kupnicka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
- Correspondence:
| | - Mateusz Bosiacki
- Chair and Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University, Żołnierska 54, 71-210 Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
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11
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Zhao H, He Z, Yun H, Wang R, Liu C. A Meta-Analysis of the Effects of Different Exercise Modes on Inflammatory Response in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10451. [PMID: 36012088 PMCID: PMC9407701 DOI: 10.3390/ijerph191610451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to investigate the effects of different exercise modes on improving inflammatory response in the elderly. For the research methodology, databases such as CNKI (China National Knowledge Infrastructure), Wanfang Data, Pubmed, Web of Science, and EBSCO were selected for searching. The Cochrane Risk of Bias (ROB) tool was used to evaluate the methodological quality of the included studies, and RevMan5.4.1 analysis software was applied for the statistical analysis. A total of 31 studies (20 randomized controlled trials and 11 self-controlled trials) with 1528 subjects were included. The results of this meta-analysis showed that aerobic exercise, resistance exercise, aerobic + resistance exercise, and HIIT all significantly reduced the levels of IL-6, TNF-α, and CRP in the elderly, and the improvement effects of aerobic + resistance exercise on IL-6, HIIT on TNF-α, and resistance exercise on CRP in the elderly were better than those of the other three exercise modes, respectively. In conclusion, aerobic exercise, resistance exercise, aerobic + resistance exercise, and HIIT all contribute to ameliorating the inflammatory status of the elderly, among which resistance exercise is a noteworthy exercise mode for the elderly to improve inflammatory status.
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Affiliation(s)
- Haotian Zhao
- Department of Physical Education, Jiangnan University, Wuxi 214122, China
| | - Zhijian He
- Department of Sports Teaching and Research, Lanzhou University, Lanzhou 730000, China
| | - Hezhang Yun
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Ruifu Wang
- Department of Physical Education, Beijing Forestry University, Beijing 100083, China
| | - Chang Liu
- School of Sport Science, Beijing Sport University, Beijing 100084, China
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12
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Tai chi improves depressive symptoms among community-dwelling older persons by mediating BDNF methylation: A preliminary study. Geriatr Nurs 2022; 44:137-142. [DOI: 10.1016/j.gerinurse.2022.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/23/2022]
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13
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Lavretsky H, Milillo MM, Kilpatrick L, Grzenda A, Wu P, Nguyen SA, Ercoli LM, Siddarth P. A Randomized Controlled Trial of Tai Chi Chih or Health Education for Geriatric Depression. Am J Geriatr Psychiatry 2022; 30:392-403. [PMID: 34404606 DOI: 10.1016/j.jagp.2021.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Geriatric depression is difficult to treat and frequently accompanied by treatment resistance, suicidal ideations and polypharmacy. New adjunctive mind-body treatment strategies can improve clinical outcomes in geriatric depression and reduce risk for side-effects of pharmacological treatments. METHODS We conducted a 3-month randomized controlled trial to assess the efficacy and tolerability of combining Tai Chi Chih (TCC) or Health Education and Wellness training (HEW) with the stable standard antidepressant treatment on mood and cognitive functioning in depressed older adults (NCT02460666). Primary outcome was change in depression as assessed by the Hamilton Rating Scale for Depression (HAM-D) post-treatment. Remission was defined as HAM-D ≤ 6; naturalistic follow-up continued for 6 months. We also assessed psychological resilience, health-related quality of life and cognition. RESULTS Of the 178 randomized participants, 125 completed the 3-month assessment and 117 completed the 6-month assessment. Dropout and tolerability did not differ between groups. Remission rate within TCC was 35.5% and 33.3%, compared to 27.0% and 45.8% in HEW, at 3 and 6 months respectively (χ2(1) = 1.0, p = 0.3; χ2(1) = 1.9, p =0.2). Both groups improved significantly on the HAM-D at 3 and 6 months. TCC demonstrated a greater improvement in general health compared to HEW. CONCLUSIONS Both TCC and HEW combined with a standard antidepressant treatment improved symptoms of depression in older adults. While TCC was superior to HEW in improving general health, we did not find group differences in improvement in mood and cognition.
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Affiliation(s)
- Helen Lavretsky
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA.
| | - Michaela M Milillo
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Lisa Kilpatrick
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Adrienne Grzenda
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Pauline Wu
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Sarah A Nguyen
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Linda M Ercoli
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Prabha Siddarth
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
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14
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Effects of Tai Chi on biomarkers and their implication to neurorehabilitation – a systemic review. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.101391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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15
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Zhuang SZ, Chen PJ, Han J, Xiao WH. Beneficial Effects and Potential Mechanisms of Tai Chi on Lower Limb Osteoarthritis: A Biopsychosocial Perspective. Chin J Integr Med 2021; 29:368-376. [PMID: 34921649 DOI: 10.1007/s11655-021-3529-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 01/15/2023]
Abstract
Lower limb osteoarthritis (OA) is a chronic, multifactorial disease characterized by impaired physical function, chronic pain, compromised psychological health and decreased social functioning. Chronic inflammation plays a critical role in the pathophysiology of OA. Tai Chi is a type of classical mind-body exercise derived from ancient Chinese martial arts. Evidence supports that Tai Chi has significant benefits for relieving lower limb OA symptoms. Using a biopsychosocial framework, this review aims to elucidate the beneficial effects of Tai Chi in lower limb OA and disentangle its potential mechanisms from the perspective of biology, psychology, and social factors. Complex biomechanical, biochemical, neurological, psychological, and social mechanisms, including strengthening of muscles, proprioception improvement, joint mechanical stress reduction, change of brain activation and sensitization, attenuation of inflammation, emotion modulation and social support, are discussed.
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Affiliation(s)
- Shu-Zhao Zhuang
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Pei-Jie Chen
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Jia Han
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Wei-Hua Xiao
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
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16
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Ding Y, Xu X. Effects of regular exercise on inflammasome activation-related inflammatory cytokine levels in older adults: a systematic review and meta-analysis. J Sports Sci 2021; 39:2338-2352. [PMID: 34121608 DOI: 10.1080/02640414.2021.1932279] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Exercise has been found to play important roles in regulating inflammation, although the mechanisms are unclear. The present systematic review and meta-analysis aimed to investigate whether regular exercise could regulate inflammation through inflammasome activation signalling in older adults. Five databases were searched, and 19 randomised controlled trials (RCTs) studying effects of regular exercise on inflammasome activation-related inflammatory cytokines interleukin (IL)-1β and IL-18 and other key molecules involved in inflammasome activation signalling such as NOD-like receptor family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), caspase-1 in older adults aged 50 years or older were included. The results showed that regular exercise could significantly decrease the levels of IL-1β and IL-18, important end-products of inflammasome activation in older adults. Subgroup analyses showed that aerobic exercise is the most effective training modality, and low-to-moderate intensity and mixed intensity are better compared with high intensity to decrease IL-1β and IL-18. The effect of regular exercise on key molecules involved in inflammasome activation signalling including NLRP3, ASC and caspase-1 is understudied and needs to be further investigated. These findings demonstrate that regular exercise could effectively decrease inflammasome activation-related inflammatory cytokine levels in older adults.
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Affiliation(s)
- Yijian Ding
- Department of Physical Education, Nanjing University of Science & Technology, Nanjing, P. R. China
| | - Xi Xu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing, P. R. China
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17
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The Effect of Tai Chi Chuan on Emotional Health: Potential Mechanisms and Prefrontal Cortex Hypothesis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5549006. [PMID: 34007290 PMCID: PMC8110391 DOI: 10.1155/2021/5549006] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 12/31/2022]
Abstract
Deep involvement in the negative mood over long periods of time likely results in emotional disturbances/disorders and poor mental health. Tai Chi Chuan (TCC) is regarded as a typical mind-body practice combining aerobic exercise and meditation to prevent and treat negative mood. Although there are an increasing number of TCC studies examining anxiety, depression, and mental stress, the mechanisms underlying these negative emotions are not fully understood. This review study examined TCC studies related to emotional health from both clinical patients and healthy individuals. Next, several potential mechanisms from physiological, psychological, and neurological perspectives were evaluated based on direct and indirect research evidence. We reviewed recent functional magnetic resonance imaging studies, which demonstrated changes in brain anatomy and function, mainly in the prefrontal cortex, following TCC practice. Finally, the effects of TCC on emotion/mental health is depicted with a prefrontal cortex hypothesis that proposed “an immune system of the mind” indicating the role of the prefrontal cortex as a flexible hub in regulating an individual's mental health. The prefrontal cortex is likely a key biomarker among the multiple complex neural correlates to help an individual manage negative emotions/mental health. Future research is needed to examine TCC effects on mental health by examining the relationship between the executive control system (mainly prefrontal cortex) and limbic network (including amygdala, insula, and hippocampal gyrus).
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18
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Tylutka A, Morawin B, Gramacki A, Zembron-Lacny A. Lifestyle exercise attenuates immunosenescence; flow cytometry analysis. BMC Geriatr 2021; 21:200. [PMID: 33752623 PMCID: PMC7986285 DOI: 10.1186/s12877-021-02128-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
Background Interaction of physical activity and overall immune profile is very complex and depends on the intensity, duration and frequency of undertaken physical activity, the exposure to cytomegalovirus (CMV) infection and the age-related changes in the immune system. Daily physical activity, which particularly influences immunity, declines dramatically with age. Therefore, the aim of the study was to explain whether physical activity sustained throughout life can attenuate or reverse immunosenescence. Methods Ninety-nine older adults (60–90 years) were recruited for the study. According to the 6-min walk test (6WMT), the Åstrand-Ryhming bike test (VO2max) and Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, the individuals were classified as physically active (n = 34) and inactive (n = 20) groups. The analysis of T lymphocytes between active vs. inactive participants was performed using eight-parameter flow cytometry. Results Analysis of the baseline peripheral naïve and memory T lymphocytes showed a significant relationship of lifestyle exercise with the CD4/CD8 ratio. Above 50% of physically active participants demonstrated the CD4/CD8 ratio ≥ 1 or ≤ 2.5 contrary to the inactive group who showed the ratio < 1. The older adults with the result of 6WMT > 1.3 m/s and VO2max > 35 mL/kg/min had a significantly higher CD4+CD45RA+ T lymphocyte percentage and also a higher ratio of CD4+CD45RA+/CD4+CD45RO+. Interestingly, in active older adults with IgG CMV+ (n = 30) the count of CD4+CD45RA+ T lymphocytes was higher than in the inactive group with IgG CMV+ (n = 20). Conclusion Based on the flow cytometry analysis, we concluded that lifestyle exercise could lead to rejuvenation of the immune system by increasing the percentage of naïve T lymphocytes or by reducing the tendency of the inverse CD4/CD8 ratio.
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Affiliation(s)
- Anna Tylutka
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 28 Zyty Str., 65-046, Zielona Gora, Poland
| | - Barbara Morawin
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 28 Zyty Str., 65-046, Zielona Gora, Poland
| | - Artur Gramacki
- Faculty of Computer, Electrical and Control Engineering, Institute of Control and Computation Engineering University of Zielona Gora, Zielona Gora, Poland
| | - Agnieszka Zembron-Lacny
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 28 Zyty Str., 65-046, Zielona Gora, Poland.
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19
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Challenges in researching the immune pathways between early life adversity and psychopathology. Dev Psychopathol 2021; 32:1597-1624. [DOI: 10.1017/s0954579420001157] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractExposure to childhood adversity is a critical risk factor for the development of psychopathology. A growing field of research examines how exposure to childhood adversity is translated into biological risk for psychopathology through alterations in immune system functioning, most notably heightened levels of inflammation biomarkers. Though our knowledge about how childhood adversity can instantiate biological risk for psychopathology is growing, there remain many challenges and gaps in the field to understand how inflammation from childhood adversity contributes to psychopathology. This paper reviews research on the inflammatory outcomes arising from childhood adversity and presents four major challenges that future research must address: (a) the measurement of childhood adversity, (b) the measurement of inflammation, (c) the identification of mediators between childhood adversity and inflammation, and (d) the identification of moderators of inflammatory outcomes following childhood adversity. We discuss synergies and inconsistencies in the literature to summarize the current understanding of the association between childhood adversity, a proinflammatory phenotype, and the biological risk for psychopathology. We discuss the clinical implications of the inflammatory links between childhood adversity and psychopathology, including possibilities for intervention. Finally, this review conclude by delineates future directions for research, including issues of how best to detect, prevent, and understand these “hidden wounds” of childhood adversity.
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20
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Miller KJ, Areerob P, Hennessy D, Gonçalves-Bradley DC, Mesagno C, Grace F. Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials. F1000Res 2020; 9:1325. [PMID: 34158928 PMCID: PMC8191520 DOI: 10.12688/f1000research.27123.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12
th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis (
n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’
g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’
g = -0.06,
PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’
g = -0.12,
PrI = -0.95, 0.72), mind-body versus resistance (Hedges’
g = -0.06,
PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults. Registration: PROSPERO
CRD42018115866 (23/11/2018).
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Affiliation(s)
- Kyle J Miller
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Pinyadapat Areerob
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Declan Hennessy
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | | | - Christopher Mesagno
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Fergal Grace
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
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21
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Miller KJ, Areerob P, Hennessy D, Gonçalves-Bradley DC, Mesagno C, Grace F. Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials. F1000Res 2020; 9:1325. [PMID: 34158928 PMCID: PMC8191520 DOI: 10.12688/f1000research.27123.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 08/29/2023] Open
Abstract
Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges' g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges' g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges' g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges' g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults. Registration: PROSPERO CRD42018115866 (23/11/2018).
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Affiliation(s)
- Kyle J. Miller
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Pinyadapat Areerob
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Declan Hennessy
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | | | - Christopher Mesagno
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Fergal Grace
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
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22
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Li H, Chen J, Xu G, Duan Y, Huang D, Tang C, Liu J. The Effect of Tai Chi for Improving Sleep Quality: A Systematic Review and Meta-analysis. J Affect Disord 2020; 274:1102-1112. [PMID: 32663938 DOI: 10.1016/j.jad.2020.05.076] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 03/31/2020] [Accepted: 05/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sleep quality is a major concern around the world, yet currently there are no recognized non-pharmacological treatments. A systematic review and meta-analysis investigated Tai Chi's effect on patients with sleep complaints, both those with insomnia and those with other conditions. METHODS 4 English language databases (MEDLINE, EMBASE, PsycINFO, and CENTRAL) and 4 Chinese databases (CNKI, CBM, VIP, and Wanfang Data) were searched from database inception through June 23, 2019. Searches were conducted in both English and Chinese language. Meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. Risk of bias for each study was accounted for according to the Cochrane Handbook. RESULTS Twenty randomized controlled studies from five countries covering 1,703 patients were included and divided into two control groups. Tai Chi had a significant effect on the Pittsburgh Sleep Quality Index (PSQI) compared with non-treatment and active treatment groups. Moreover, the articles were divided into groups according to Tai Chi styles. Both 24-form Yang-style Tai Chi and 8-form Yang-style Tai Chi had significant effects on PSQI. LIMITATIONS One limitation of our work was that there were some forms of insomnia for which conclusions could not be drawn. Also, no relationship between efficacy and any of the factors could be elucidated. CONCLUSIONS Compared with non-therapeutic and other active treatments, Tai Chi has a positive effect on improving sleep quality. In-depth analysis showed that 24-form and 8-form Yang style Tai Chi have significant positive effects on sleep quality, as assessed by PSQI.
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Affiliation(s)
- Huanjie Li
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
| | - Juexuan Chen
- American Academy of Acupuncture and Oriental Medicine, Address:1925 West County Road B2, Roseville, Minnesota, United States; Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Address: No.232 Waihuandong Road, Panyu District, Guangzhou, 510006, China.
| | - Guangzhen Xu
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
| | - Yuting Duan
- Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Address: 3/F, Jockey Club School of Chinese Medicine Building, 7 Baptist University Road, Kowloon Tong, Hong Kong SAR, China; Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Address: No.232 Waihuandong Road, Panyu District, Guangzhou, 510006, China.
| | - Danxuan Huang
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Address: No.232 Waihuandong Road, Panyu District, Guangzhou, 510006, China.
| | - Jihong Liu
- Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine, Address: No.6 Qinren Road, Chancheng District, Foshan, 528000, China.
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Feng F, Tuchman S, Denninger JW, Fricchione GL, Yeung A. Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults. Am J Geriatr Psychiatry 2020; 28:812-819. [PMID: 32425471 PMCID: PMC7227578 DOI: 10.1016/j.jagp.2020.05.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 01/25/2023]
Abstract
The elderly are at high risk of contracting respiratory infectious diseases, including COVID-19 infection. The recent pandemic has the potential to cause significant physical and mental damage in older adults. Similarly to other mind-body exercises in Traditional Chinese medicine, Qigong features regulation of breath rhythm and pattern, body movement and posture, and meditation. Given these traits, Qigong has the potential to play a role in the prevention, treatment, and rehabilitation of respiratory infections, such as COVID-19. Potential mechanisms of action include stress reduction, emotion regulation, strengthening of respiratory muscles, reduction of inflammation, and enhanced immune function. Three forms of Qigong; abdominal breathing, Ba Duan Jin and Liu Zi Jue, all of which are gentle, smooth, and simple for the elderly to practice, are recommended in this context.
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Affiliation(s)
- Fan Feng
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Sylvie Tuchman
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA
| | - John W. Denninger
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Gregory L. Fricchione
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Albert Yeung
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA; Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA.
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24
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Traditional Chinese exercise for cancer-related sleep disturbance: A systematic review and descriptive analysis of randomized controlled trials. Complement Ther Clin Pract 2020; 40:101197. [DOI: 10.1016/j.ctcp.2020.101197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 12/21/2022]
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Azevedo DC, Ferreira PH, Santos HDO, Oliveira DR, Souza JVLD, Costa LOP. Baseline characteristics did not identify people with low back pain who respond best to a Movement System Impairment-Based classification treatment. Braz J Phys Ther 2020; 24:358-364. [PMID: 31230988 PMCID: PMC7352034 DOI: 10.1016/j.bjpt.2019.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 01/01/2023] Open
Abstract
STUDY DESIGN Secondary analysis of data from a randomized controlled trial. BACKGROUND Treatment based on the Movement System Impairment-Based classification for chronic low back pain results in the same benefit when compared to other forms of exercise. It is possible that participant's characteristics measured at baseline can identify people with chronic low back pain who would respond best to a treatment based on the Movement System Impairment model. OBJECTIVES To assess if specific characteristics of people with chronic low back pain measured at baseline can modify the effects of a treatment based on the Movement System Impairment model on pain and disability. METHODS Four variables assessed at baseline that could potentially modify the treatment effects of the treatment based on the Movement System Impairment model were selected (age, educational status, physical activity status and STarT back tool classification). Separate univariate models were used to investigate a possible modifier treatment effect of baseline participant's characteristics on pain and disability after the treatment. Findings of interaction values above 1 point for the outcome mean pain intensity or above 3 points for disability (Roland Morris questionnaire) were considered clinically relevant. RESULTS Linear regression analyses for the outcomes of pain and disability did not show interaction values considered clinically relevant for age, educational status, physical activity status and STarT back tool classification. CONCLUSION Age, educational status, physical activity status and STarT back tool classification did not modify the effects of an 8-week treatment based on the Movement System Impairment model in patients with chronic low back pain. Registered at www.clinicaltrials.gov: NCT02221609 (https://clinicaltrials.gov/ct2/show/NCT02221609).
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Affiliation(s)
- Daniel Camara Azevedo
- Programa de Mestrado e Doutorado em Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil; Departamento de Fisioterapia, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil.
| | | | | | - Daniel Ribeiro Oliveira
- Departamento de Fisioterapia, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Joao Victor Leite de Souza
- Departamento de Fisioterapia, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leonardo Oliveira Pena Costa
- Programa de Mestrado e Doutorado em Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil; Musculoskeletal Division, The George Institute for Global Health, Sydney, NSW, Australia
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Oh B, Bae K, Lamoury G, Eade T, Boyle F, Corless B, Clarke S, Yeung A, Rosenthal D, Schapira L, Back M. The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. MEDICINES (BASEL, SWITZERLAND) 2020; 7:E39. [PMID: 32629903 PMCID: PMC7400467 DOI: 10.3390/medicines7070039] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 12/13/2022]
Abstract
Background: Effective preventative health interventions are essential to maintain well-being among healthcare professionals and the public, especially during times of health crises. Several studies have suggested that Tai Chi and Qigong (TQ) have positive impacts on the immune system and its response to inflammation. The aim of this review is to evaluate the current evidence of the effects of TQ on these parameters. Methods: Electronic searches were conducted on databases (Medline, PubMed, Embase and ScienceDirect). Searches were performed using the following keywords: "Tai Chi or Qigong" and "immune system, immune function, immunity, Immun*, inflammation and cytokines". Studies published as full-text randomized controlled trials (RCTs) in English were included. Estimates of change in the levels of immune cells and inflammatory biomarkers were pooled using a random-effects meta-analysis where randomised comparisons were available for TQ versus active controls and TQ versus non-active controls. Results: Nineteen RCTs were selected for review with a total of 1686 participants and a range of 32 to 252 participants within the studies. Overall, a random-effects meta-analysis found that, compared with control conditions, TQ has a significant small effect of increasing the levels of immune cells (SMD, 0.28; 95% CI, 0.13 to 0.43, p = 0.00), I2 = 45%, but not a significant effect on reducing the levels of inflammation (SMD, -0.15; 95% CI, -0.39 to 0.09, p = 0.21), I2 = 85%, as measured by the systemic inflammation biomarker C-reactive protein (CRP) and cell mediated biomarker cytokines. This difference in results is due to the bidirectional regulation of cytokines. An overall risk of bias assessment found three RCTs with a low risk of bias, six RCTs with some concerns of bias, and ten RCTs with a high risk of bias. Conclusions: Current evidence indicates that practising TQ has a physiologic impact on immune system functioning and inflammatory responses. Rigorous studies are needed to guide clinical guidelines and harness the power of TQ to promote health and wellbeing.
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Affiliation(s)
- Byeongsang Oh
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Kyeore Bae
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- Center for Immunity and Pain, Kwanghye Hospital, Seoul 06174, Korea
| | - Gillian Lamoury
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Thomas Eade
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Frances Boyle
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Brian Corless
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
| | - Stephen Clarke
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
| | - Albert Yeung
- Harvard Medical School, Boston, MA 02115, USA; (A.Y.); (D.R.)
| | - David Rosenthal
- Harvard Medical School, Boston, MA 02115, USA; (A.Y.); (D.R.)
| | - Lidia Schapira
- Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Michael Back
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards NSW 2065 Australia; (K.B.); (G.L.); (T.E.); (B.C.); (S.C.); (M.B.)
- The Mater Hospital, North Sydney NSW 2060, Australia;
- Sydney Medical School, University of Sydney, Sydney NSW 2060, Australia
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Gómez-Rubio P, Trapero I. The Beneficial Effect of Physical Exercise on Inflammatory Makers in Older Individuals. Endocr Metab Immune Disord Drug Targets 2020; 21:1008-1016. [PMID: 32504508 DOI: 10.2174/1871530320666200606225357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 11/22/2022]
Abstract
Old age is associated with a loss of motor functions and a general progressive decline in cognitive functions. Physical exercise is one of the ways in which inflammatory levels in general can be reduced, and therefore physical exercise can be considered a biological aging decelerator. In this article, we examine the relationships between physical exercise and inflammatory markers reported for the different physical exercise protocols that have been used in studies with older individuals, as well as the effects of these regimens. The different types of exercises programmed, and methods used to implement them were very heterogeneous in the articles we analysed. Both, the aerobic exercise and resistance training protocols produced a decrease in plasma levels of IL-6, CRP and TNF-α, and an increase of IL-10 plasma levels as a chronic effect. However, the acute-response of physical exercise appeared to be an initial increase in IL-6 expression and plasma IL-6 levels. Continuing with these exercise programs usually subsequently achieved a chronic response in which there was a decrease in both the basal levels of IL-6, CRP and TNF-α, and the IL-6 produced as acute responses. Regardless of the type of exercise performed, it seems that the exercise parameters, intensity, duration, subject variables, fitness, and level of inflammation are key factors in achieving the expected balance between proinflammatory and anti-inflammatory cytokines.
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Affiliation(s)
| | - Isabel Trapero
- Department of Nursing, University of Valencia, Valencia, Spain
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Dao Yin (a.k.a. Qigong): Origin, Development, Potential Mechanisms, and Clinical Applications. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:3705120. [PMID: 31772593 PMCID: PMC6854271 DOI: 10.1155/2019/3705120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/13/2019] [Indexed: 01/18/2023]
Abstract
Dao Yin is a form of exercise combining physical movements, mental focus, and breathing originated in ancient China. In this review, we introduce the history in the development and the scope of Dao Yin, the relationship between Dao Yin with Taoist culture and Qigong, and the potential mechanisms of how Dao Yin promotes health and alleviate illnesses. Empirical research studies using Dao Yin for treatment of lumbar spondylosis, peripheral musculoskeletal diseases, cervical spondylosis, heart diseases, central nervous system disorders, immunological dysfunction, and psychological disorders are detailed.
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Nuño V, Siu A, Deol N, Juster RP. Osteopathic Manipulative Treatment for Allostatic Load Lowering. J Osteopath Med 2019; 119:646-654. [PMID: 31566692 DOI: 10.7556/jaoa.2019.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context Limited research has been done to examine osteopathic manipulative treatment (OMT) effects on modulating a compilation of allostatic load (AL) biomarkers that work to measure the body's multisystem response to homeostatic deviation. Objective To examine the efficacy of OMT on graduate students' overall health through an objective index of representative AL biomarkers. Methods A within-subject pre- and postintervention study was conducted at Touro University College of Osteopathic Medicine in California during the fall 2017 semester. Graduate students enrolled in the Masters of Science in Medical Health Sciences program volunteered to participate in the study and received treatment by an osteopathic physician. The participants were evaluated using the following measures: Trier Inventory for the Assessment of Chronic Stress; diurnal urine cortisol and catecholamines; dried blood glycated hemoglobin, dehydroepiandrosterone, high-density lipoprotein, and high-sensitivity C-reactive protein; blood pressure, body mass index, and waist-to-hip ratio before (preintervention) and after (postintervention) OMT. Results The study consisted of 1 man (participant 1) and 1 woman (participant 2) aged 23 and 22 years, respectively. Participants were enrolled in the same academic program and received 3 OMT sessions in 7 weeks. Analysis of AL biomarkers revealed a decrease in overall AL scores from preintervention to postintervention in participant 1 (from 7 to 4) and participant 2 (from 9 to 7). Analysis of Trier Inventory for the Assessment of Chronic Stress scores revealed a decrease in self-perceived stress from preintervention to postintervention in participant 1 (from 18 to 15) and in participant 2 (from 40 to 13). Conclusion The OMT protocol used in the current study decreased measures of overall AL and self-perceived stress in both participants. This finding suggests that OMT may represent a reasonable modality to reduce AL and self-perceived stress in graduate students. Since the current study is limited by its small sample size, further research is warranted.
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Modulatory effects of different exercise modalities on the functional connectivity of the periaqueductal grey and ventral tegmental area in patients with knee osteoarthritis: a randomised multimodal magnetic resonance imaging study. Br J Anaesth 2019; 123:506-518. [PMID: 31395306 DOI: 10.1016/j.bja.2019.06.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Knee osteoarthritis is a prevalent disorder with unsatisfactory treatment options. Both physical and mindful exercises may be able to relieve its pain symptoms. We compared the modulatory effects of different exercise modalities on the periaqueductal grey (PAG) and ventral tegmental area (VTA), which play important roles in descending opioidergic pathways and reward/motivation systems in patients with knee osteoarthritis. METHODS We recruited and randomised 140 patients into Tai Chi, Baduanjin, stationary cycling, and health education control groups for 12 weeks. Knee injury and Osteoarthritis Outcome Score (KOOS), functional and structural MRI, and blood biomarkers were measured at the beginning and end of the experiment. We used the PAG and VTA as seeds in resting-state functional connectivity (rsFC) analysis. RESULTS Compared with the control group: (i) all exercises significantly increased KOOS pain sub-scores (pain reduction) and serum programmed death 1 (PD-1) concentrations; (ii) all exercises decreased right PAG rsFC with the medial orbital prefrontal cortex, and the decreased rsFC was associated with improvements in knee pain; and (iii) grey matter volume in the medial orbital prefrontal cortex was significantly increased in all exercise groups. There was also significantly decreased rsFC between the left VTA and the medial orbital prefrontal cortex in the Tai Chi and Baduanjin groups. CONCLUSIONS Exercise can simultaneously modulate the rsFC of the descending opioidergic pathway and reward/motivation system and blood inflammation markers. Elucidating the shared and unique mechanisms of different exercise modalities may facilitate the development of exercise-based interventions for chronic pain. CLINICAL TRIAL REGISTRATION ChiCTR-IOR-16009308.
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Kohut M. Exercise and psychoneuroimmunology. Curr Opin Behav Sci 2019. [DOI: 10.1016/j.cobeha.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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You T, Ogawa EF. Effects of T'ai Chi on Chronic Systemic Inflammation. J Altern Complement Med 2019; 25:656-658. [PMID: 31135175 DOI: 10.1089/acm.2019.0136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tongjian You
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA
| | - Elisa F Ogawa
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA
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Zheng G, Qiu P, Xia R, Lin H, Ye B, Tao J, Chen L. Effect of Aerobic Exercise on Inflammatory Markers in Healthy Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Aging Neurosci 2019; 11:98. [PMID: 31080412 PMCID: PMC6497785 DOI: 10.3389/fnagi.2019.00098] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 04/10/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Chronic inflammation plays a significant role in accelerating the aging process and is closely associated with the initiation and progression of a broad range of age-related diseases. Physical exercise is considered beneficial in alleviating these conditions, but the effects of aerobic exercise on inflammatory markers in a healthy population should be furtherly clarified. Objective: The purpose of this systematic review and meta-analysis was to evaluate the effect of aerobic exercise on inflammatory markers in middle-aged and older adults. Methods: The literature search was conducted utilizing PubMed, Web of Science, Embase, and the Cochrane Library from their inception through April 2018, and the reference lists were screened to identify appropriate studies. Only randomized controlled trials that investigated the effect of aerobic exercise on inflammatory markers in middle-aged and older adults were eligible for this review. Results: Eleven studies involving 1,250 participants were retrieved from the databases for analysis. The pooled results showed that aerobic exercise significantly reduced inflammatory markers (C-reactive protein (CRP): SMD = 0.53, 95% CI 0.26–0.11, p = 0.0002; tumor necrosis factor-alpha (TNF-α): SMD = 0.75, 95% CI 0.31–1.19, p = 0.0007; interleukin 6 (IL-6): SMD = 0.75, 95% CI 0.31–1.19, p = 0.0007). No significant improvement was found in relation to interleukin 4 (IL-4). Conclusions: Aerobic exercise may have a positive effect on reduction of CRP, TNF-α, and IL-6 in middle-aged and older adults. Further randomized controlled trials (RCTs) need to be conducted to determine the effect of aerobic exercise on additional inflammatory markers in the population of middle-aged and older adults.
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Affiliation(s)
- Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China.,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Pingting Qiu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Rui Xia
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Huiying Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Bingzhao Ye
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China.,Fujian Key Laboratory of Rehabilitation Technology, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
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Kong J, Wilson G, Park J, Pereira K, Walpole C, Yeung A. Treating Depression With Tai Chi: State of the Art and Future Perspectives. Front Psychiatry 2019; 10:237. [PMID: 31031663 PMCID: PMC6474282 DOI: 10.3389/fpsyt.2019.00237] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/28/2019] [Indexed: 01/05/2023] Open
Abstract
Major depressive disorder (MDD) is one of the most prevalent mental illnesses in America. Current treatments for MDD are unsatisfactory given high non-response rates, high relapse rates, and undesirable side effects. Accumulating evidence suggests that Tai Chi, a popular mind-body intervention that originated as a martial art, can significantly regulate emotion and relieve the symptoms of mood disorders. In addition, the availability of instructional videos and the development of more simplified and less structured Tai Chi has made it a promising low-intensity mind-body exercise. In this article, we first examine a number of clinical trials that implemented Tai Chi as a treatment for depression. Then, we explore several mechanisms by which Tai Chi may alleviate depressive symptoms, hypothesizing that the intervention may modulate the activity and connectivity of key brain regions involved in mood regulation, reduce neuro-inflammatory sensitization, modulate the autonomic nervous system, and regulate hippocampal neurogenesis. Finally, we discuss common challenges of the intervention and possible ways to address them. Specifically, we pose developing a simplified and tailored Tai Chi protocol for patients with depression, comparatively investigating Tai Chi with other mind-body interventions such as yoga and Baduanjin, and developing new mind-body interventions that merge the advantages of multiple mind-body exercises.
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Affiliation(s)
- Jian Kong
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Georgia Wilson
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Joel Park
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Kaycie Pereira
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Courtney Walpole
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
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Sola-Rodríguez S, Gavilán-Carrera B, Vargas-Hitos JA, Sabio JM, Morillas-de-Laguno P, Soriano-Maldonado A. Physical Fitness and Body Composition in Women with Systemic Lupus Erythematosus. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E57. [PMID: 30795629 PMCID: PMC6410128 DOI: 10.3390/medicina55020057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 11/17/2022]
Abstract
Background and objectives: Higher physical fitness is associated with a more favorable weight and body composition in the general population, although this association has not been studied in patients with systemic lupus erythematosus (SLE). The aim of the present study was to examine the association of different components of physical fitness with body composition in women with SLE with mild disease activity. Materials and Methods: This cross-sectional study included 77 women with SLE (43.2 ± 13.8 years old) and clinical stability during the previous 6 months. Body composition (including body mass index (BMI), fat mass index (FMI), waist circumference, waist-to-height ratio and waist-to-hip ratio) was assessed using a stadiometer, an anthropometric tape, and a bioimpedance device. Physical fitness included cardiorespiratory fitness (Siconolfi step test and 6 min walk test), muscular strength (handgrip strength test as upper body measure and 30 s chair stand as lower body measure), and flexibility (back-scratch test). Participants with a fitness level equal or above the median of the study sample were categorized as "fit" and those below the median were categorized as "unfit". Linear regression assessed the association of physical fitness with body composition parameters. Results: Cardiorespiratory fitness and upper body muscular strength were negatively associated with BMI, FMI, waist circumference, and waist-to-height ratio (all, p < 0.05). Lower body muscular strength and flexibility were negatively related to FMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio (all, p < 0.05). These relationships were still significant after controlling for age, disease duration, accrual damage, and SLE activity. Overall, fit patients presented significantly lower values in all body composition parameters compared to unfit patients (all, p < 0.05). Conclusions: The main findings of the present study suggest that physical fitness is inversely associated with body composition in women with SLE. Given the cross-sectional nature of this study, future clinical trials should study the causal pathways underlying these relationships.
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Affiliation(s)
- Sergio Sola-Rodríguez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería 04120, Spain.
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.
| | - José Antonio Vargas-Hitos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada 18014, Spain.
| | - José Mario Sabio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada 18014, Spain.
| | - Pablo Morillas-de-Laguno
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería 04120, Spain.
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, 04120, Spain.
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Irwin MR, Olmstead R, Carrillo C, Sadeghi N, Nicassio P, Ganz PA, Bower JE. Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. J Clin Oncol 2017; 35:2656-2665. [PMID: 28489508 PMCID: PMC5549450 DOI: 10.1200/jco.2016.71.0285] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response-that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression. Results Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months ( P = .02) and at months 3 ( P = .02) and 6 ( P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups. Conclusion CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.
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Affiliation(s)
- Michael R. Irwin
- All authors: University of California Los Angeles, Los Angeles, CA
| | - Richard Olmstead
- All authors: University of California Los Angeles, Los Angeles, CA
| | - Carmen Carrillo
- All authors: University of California Los Angeles, Los Angeles, CA
| | - Nina Sadeghi
- All authors: University of California Los Angeles, Los Angeles, CA
| | - Perry Nicassio
- All authors: University of California Los Angeles, Los Angeles, CA
| | - Patricia A. Ganz
- All authors: University of California Los Angeles, Los Angeles, CA
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Safakhah HA, Moradi Kor N, Bazargani A, Bandegi AR, Gholami Pourbadie H, Khoshkholgh-Sima B, Ghanbari A. Forced exercise attenuates neuropathic pain in chronic constriction injury of male rat: an investigation of oxidative stress and inflammation. J Pain Res 2017; 10:1457-1466. [PMID: 28721088 PMCID: PMC5499951 DOI: 10.2147/jpr.s135081] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Initial peripheral/central nerve injuries, such as chronic constriction injury (CCI)/spinal cord injury, are often compounded by secondary mechanisms, including inflammation and oxidative stress, which may lead to chronic neuropathic pain characterized by hyperalgesia or allodynia. On the other hand, exercise as a behavioral and non-pharmacological treatment has been shown to alleviate chronic neuropathic pain. Therefore, this study was conducted to examine whether or not exercise reduces neuropathic pain through modifying oxidative stress and inflammation in chronic constriction injury of the sciatic nerve. MATERIALS AND METHODS Wistar male rats weighing 200±20 g were randomly divided into five groups (normal, sham, CCI, pre-CCI exercise, and post-CCI exercise group). Sciatic nerve of anesthetized rats was loosely ligated to induce CCI, and they were then housed in separate cages. The rats ran on treadmill at a moderate speed for 3 weeks. Mechanical allodynia and thermal hyperalgesia were determined using von Frey filament and plantar test, respectively. Tumor necrosis factor-alpha (TNF-α) assayed in the cerebrospinal fluid, malondialdehyde, and total antioxidant capacity were measured in the serum using Western blot test, thiobarbituric acid, and ferric reducing ability of plasma (FRAP), respectively. RESULTS The mechanical allodynia (P=0.024) and thermal hyperalgesia (P=0.002) in the CCI group were higher than those in the sham group. Exercise after CCI reduced (P=0.004) mechanical allodynia and thermal hyperalgesia (P=0.025) compared with the CCI group. Moreover, the level of FRAP in the CCI group was (P=0.001) lower than that in the sham group, and post-CCI exercise reversed FRAP amount toward the control level (P=0.019). The amount of malondialdehyde did not differ between groups. Level of TNF-α increased in the CCI group (P=0.0002) compared with sham group and post-CCI exercise could reverse it toward the level of control (P=0.005). CONCLUSION Post CCI-exercise but not pre CCI-exercise reduces CCI-induced neuropathic pain. One of the possible involved mechanisms is increasing the total antioxidant capacity and reducing the amount of TNF-α.
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Affiliation(s)
- Hossein Ali Safakhah
- Department of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.,Research Center of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Nasroallah Moradi Kor
- Research Center of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.,Student Research Committee, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Atiyeh Bazargani
- Student Research Committee, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Ahmad Reza Bandegi
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | | | | | - Ali Ghanbari
- Research Center of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
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Bower JE, Irwin MR. Mind-body therapies and control of inflammatory biology: A descriptive review. Brain Behav Immun 2016; 51:1-11. [PMID: 26116436 PMCID: PMC4679419 DOI: 10.1016/j.bbi.2015.06.012] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 12/31/2022] Open
Abstract
The use of mind-body therapies, including Tai Chi, Qigong, yoga, and meditation, has grown steadily in recent years. These approaches have been shown to be effective in reducing symptoms and improving quality of life, and research has begun to examine the impact of these therapies on biological processes, including inflammation. A review of 26 randomized controlled trials was conducted to describe the effects of mind-body therapies (MBTs) on circulating, cellular, and genomic markers of inflammation. This qualitative evaluation showed mixed effects of MBTs on circulating inflammatory markers, including CRP and IL-6, and on measures of stimulated cytokine production. More consistent findings were seen for genomic markers, with trials showing decreased expression of inflammation-related genes and reduced signaling through the proinflammatory transcription factor NF-κB. Potential mechanisms for these effects are discussed, including alterations in neuroendocrine, neural, and psychological and behavioral processes.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, UCLA, United States; Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, United States; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, United States.
| | - Michael R Irwin
- Department of Psychology, UCLA, United States; Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, United States; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, United States
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Berrueta L, Muskaj I, Olenich S, Butler T, Badger GJ, Colas RA, Spite M, Serhan CN, Langevin HM. Stretching Impacts Inflammation Resolution in Connective Tissue. J Cell Physiol 2015; 231:1621-7. [PMID: 26588184 DOI: 10.1002/jcp.25263] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 11/18/2015] [Indexed: 12/12/2022]
Abstract
Acute inflammation is accompanied from its outset by the release of specialized pro-resolving mediators (SPMs), including resolvins, that orchestrate the resolution of local inflammation. We showed earlier that, in rats with subcutaneous inflammation of the back induced by carrageenan, stretching for 10 min twice daily reduced inflammation and improved pain, 2 weeks after carrageenan injection. In this study, we hypothesized that stretching of connective tissue activates local pro-resolving mechanisms within the tissue in the acute phase of inflammation. In rats injected with carrageenan and randomized to stretch versus no stretch for 48 h, stretching reduced inflammatory lesion thickness and neutrophil count, and increased resolvin (RvD1) concentrations within lesions. Furthermore, subcutaneous resolvin injection mimicked the effect of stretching. In ex vivo experiments, stretching of connective tissue reduced the migration of neutrophils and increased tissue RvD1 concentration. These results demonstrate a direct mechanical impact of stretching on inflammation-regulation mechanisms within connective tissue.
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Affiliation(s)
- Lisbeth Berrueta
- Department of Medicine, Division of Preventive Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Igla Muskaj
- Department of Medicine, Division of Preventive Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sara Olenich
- Department of Medicine, Division of Preventive Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Taylor Butler
- Department of Medicine, Division of Preventive Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gary J Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont
| | - Romain A Colas
- Department of Anesthesiology, Center for Experimental Therapeutics and Reperfusion Injury, Perioperative and Pain Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Matthew Spite
- Department of Anesthesiology, Center for Experimental Therapeutics and Reperfusion Injury, Perioperative and Pain Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Charles N Serhan
- Department of Anesthesiology, Center for Experimental Therapeutics and Reperfusion Injury, Perioperative and Pain Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Helene M Langevin
- Department of Medicine, Division of Preventive Medicine, Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Neurological Sciences, University of Vermont College of Medicine, Vermont
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Irwin MR, Olmstead R, Breen EC, Witarama T, Carrillo C, Sadeghi N, Arevalo JMG, Ma J, Nicassio P, Bootzin R, Cole S. Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial. Biol Psychiatry 2015; 78:721-9. [PMID: 25748580 PMCID: PMC4524803 DOI: 10.1016/j.biopsych.2015.01.010] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 01/06/2015] [Accepted: 01/23/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sleep disturbance is associated with activation of systemic and cellular inflammation, as well as proinflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults with insomnia is not known. METHODS In this randomized trial, 123 older adults with insomnia were randomly assigned to cognitive-behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or sleep seminar education active control condition for 2-hour sessions weekly over 4 months with follow-up at 7 and 16 months. We measured C-reactive protein (CRP) at baseline and months 4 and 16; toll-like receptor-4 activated monocyte production of proinflammatory cytokines at baseline and months 2, 4, 7, and 16; and genome-wide transcriptional profiling at baseline and month 4. RESULTS As compared with sleep seminar education active control condition, CBT-I reduced levels of CRP (months 4 and 16, ps < .05), monocyte production of proinflammatory cytokines (month 2 only, p < .05), and proinflammatory gene expression (month 4, p < .01). TCC marginally reduced CRP (month 4, p = .06) and significantly reduced monocyte production of proinflammatory cytokines (months 2, 4, 7, and 16; all ps < .05) and proinflammatory gene expression (month 4, p < .001). In CBT-I and TCC, TELiS promoter-based bioinformatics analyses indicated reduced activity of nuclear factor-κB and AP-1. CONCLUSIONS Among older adults with insomnia, CBT-I reduced systemic inflammation, TCC reduced cellular inflammatory responses, and both treatments reduced expression of genes encoding proinflammatory mediators. The findings provide an evidence-based molecular framework to understand the potential salutary effects of insomnia treatment on inflammation, with implications for inflammatory disease risk.
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Affiliation(s)
- Michael R Irwin
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Psychology, University of California, Los Angeles.
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine
| | - Tuff Witarama
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience
| | - Carmen Carrillo
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience
| | - Nina Sadeghi
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience
| | - Jesusa M G Arevalo
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Jeffrey Ma
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Perry Nicassio
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine
| | - Richard Bootzin
- Department of Psychology, University of Arizona, Tucson, Arizona
| | - Steve Cole
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California
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Irwin MR, Olmstead R, Breen EC, Witarama T, Carrillo C, Sadeghi N, Arevalo JMG, Ma J, Nicassio P, Ganz PA, Bower JE, Cole S. Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial. J Natl Cancer Inst Monogr 2015; 2014:295-301. [PMID: 25749595 DOI: 10.1093/jncimonographs/lgu028] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Mind-body therapies such as Tai Chi are widely used by breast cancer survivors, yet effects on inflammation are not known. This study hypothesized that Tai Chi Chih (TCC) would reduce systemic, cellular, and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia (CBT-I). METHODS In this randomized trial for the treatment of insomnia, 90 breast cancer survivors with insomnia were assigned to TCC or CBT-I for 2-hour sessions weekly for 3 months. At baseline and postintervention, blood samples were obtained for measurement of C-reactive protein and toll-like receptor-4-activated monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF), with a random subsample (n = 48) analyzed by genome-wide transcriptional profiling. RESULTS Levels of C-reactive protein did not change in the TCC and CBT-I groups. Levels of toll-like receptor-4-activated monocyte production of IL-6 and TNF combined showed an overall reduction in TCC versus CBT-I (P < .02), with similar effects for IL-6 (P = .07) and TNF (P < .05) alone. For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells, expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I (P = .001). TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor, nuclear factor-κB, in structuring these differences. CONCLUSIONS Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship.
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Affiliation(s)
- Michael R Irwin
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB).
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Tuff Witarama
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Carmen Carrillo
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Nina Sadeghi
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Jesusa M G Arevalo
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Jeffrey Ma
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Perry Nicassio
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Patricia A Ganz
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
| | - Steve Cole
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC); Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA; Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG); Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC); Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB)
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Hewett ZL, Cheema BS, Pumpa KL, Smith CA. The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:428427. [PMID: 26504475 PMCID: PMC4609431 DOI: 10.1155/2015/428427] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 11/18/2022]
Abstract
Bikram yoga is a style of hatha yoga involving a standarized series of asanas performed to an instructional dialogue in a heated environment (40.6°C, 40% humidity). Several studies evaluating the effect of Bikram yoga on health-related outcomes have been published over the past decade. However, to date, there are no comprehensive reviews of this research and there remains a lack of large-scale, robustly-designed randomised controlled trials (RCT) of Bikram yoga training. The purpose of this review is to contextualise and summarise trials that have evaluated the effects of Bikram yoga on health and to provide recommendations for future research. According to published literature, Bikram yoga has been shown to improve lower body strength, lower and upper body range of motion, and balance in healthy adults. Non-RCTs report that Bikram yoga may, in some populations, improve glucose tolerance, bone mineral density, blood lipid profile, arterial stiffness, mindfulness, and perceived stress. There is vast potential for further, improved research into the effects of Bikram yoga, particularly in unhealthy populations, to better understand intervention-related adaptations and their influence on the progression of chronic disease. Future research should adhere to CONSORT guidelines for better design and reporting to improve research quality in this field.
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Affiliation(s)
- Zoe L. Hewett
- School of Science and Health, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
| | - Birinder S. Cheema
- School of Science and Health, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
- The National Institute of Complementary Medicine, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
| | - Kate L. Pumpa
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT 2617, Australia
| | - Caroline A. Smith
- The National Institute of Complementary Medicine, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
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Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song Y. Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2015; 4:JAHA.115.002014. [PMID: 26116691 PMCID: PMC4608087 DOI: 10.1161/jaha.115.002014] [Citation(s) in RCA: 423] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease. METHODS AND RESULTS Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more. CONCLUSIONS This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.
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Affiliation(s)
- Xiaochen Lin
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.)
| | - Xi Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
| | - Jianjun Guo
- Center for the Youth Sport Research and Development, China Institute of Sport Science, Beijing, China (J.G.)
| | - Christian K Roberts
- Geriatrics, Research, Education and Clinical Centers, VA Greater Los Angeles Healthcare System, Los Angeles, CA (C.K.R.)
| | - Steve McKenzie
- Department of Kinesiology, Center for Physical Activity in Wellness and Prevention, Indiana University-Purdue University at Indianapolis, IN (S.M.K.)
| | - Wen-Chih Wu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.)
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.) Division of Endocrinology, Department of Medicine, Rhode Island Hospital, Providence, RI (S.L.)
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
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Carroll JE, Seeman TE, Olmstead R, Melendez G, Sadakane R, Bootzin R, Nicassio P, Irwin MR. Improved sleep quality in older adults with insomnia reduces biomarkers of disease risk: pilot results from a randomized controlled comparative efficacy trial. Psychoneuroendocrinology 2015; 55:184-92. [PMID: 25770704 PMCID: PMC4422640 DOI: 10.1016/j.psyneuen.2015.02.010] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 02/12/2015] [Accepted: 02/17/2015] [Indexed: 12/23/2022]
Abstract
IMPORTANCE Sleep disturbances have been linked to increased morbidity and mortality, yet it is unknown whether improving sleep quality in older adult patients with insomnia alters biomarkers of diabetes and cardiovascular disease risk. OBJECTIVE Determine the comparative efficacy of cognitive behavioral therapy (CBT), tai chi chih (TCC), and a sleep seminar control (SS) to reduce multisystem biomarkers of disease risk in older adults with insomnia. DESIGN Randomized controlled comparative efficacy trial. SETTING Los Angeles community. PARTICIPANTS A population-based sample of 109 older adults with chronic and primary insomnia. INTERVENTION Random assignment to CBT, TCC, or SS for 2-h group sessions weekly over 4 months with a 16-month evaluation (1 year after follow-up). MAIN OUTCOME(S) AND MEASURE(S) Multisystem biological risk comprised of 8 biomarkers: high-density lipoprotein, low-density lipoprotein, triglycerides, hemoglobinA1c, glucose, insulin, C-reactive protein, and fibrinogen. Using clinical laboratory cutoffs defined as abnormal, a multisystem risk score was computed representing a sum of the deviation around the cutoffs across the 8 biomarkers. In addition, high risk grouping was classified if subjects exhibited 4 or more biomarkers in the abnormal laboratory range. RESULTS An interaction of time-by-treatment-by-high risk group was found (F(4, 197.2)=3.14, p=.02) in which both TCC (p=.04) and CBT (p=.001) showed significantly lower risk scores as compared to SS at 16-months. CBT reduced risk of being in the high risk group at 4-months (odds ratio [OR]=.21 [95% CI, .03-1.47], p<.10) and at 16-months (OR=.06 [95% CI, .005-.669]; p<.01). TCC reduced the risk at 16-months (OR=.10 [95% CI, .008-1.29]; p<.05) but not at 4 months. Of participants who were classified in the high risk category at baseline, improvements in sleep quality, as defined by a clinical severity threshold, reduced the likelihood of being in the high risk group at 16-months, OR=.08 (95% CI, .008-.78); p=.01. CONCLUSIONS AND RELEVANCE Participants classified as having high multisystem biological risk at entry and assigned to CBT or TCC show improvements in risk scores after one year follow-up. Given that these clinical biomarkers are associated with cardiovascular, metabolic, and inflammatory disease risk, improving sleep quality has the potential to reduce the risk of chronic disease in older adults with insomnia. Clinical Trial Registration # and name—ClinicalTrials.gov: NCT00280020, Behavioral Treatment of Insomnia in Aging
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Affiliation(s)
- Judith E Carroll
- University of California, Los Angeles-Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA, USA.
| | - Teresa E Seeman
- University of California, Los Angeles, Division of Geriatrics, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Richard Olmstead
- University of California, Los Angeles-Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Gerson Melendez
- University of California, Los Angeles-Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Ryan Sadakane
- University of California, Los Angeles-Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Richard Bootzin
- University of Arizona, Department of Psychology, Tucson, AZ, USA
| | - Perry Nicassio
- University of California, Los Angeles-Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Michael R Irwin
- University of California, Los Angeles-Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA, USA.
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Tai chi chuan exercise for patients with breast cancer: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:535237. [PMID: 25793000 PMCID: PMC4352428 DOI: 10.1155/2015/535237] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 12/21/2014] [Indexed: 11/23/2022]
Abstract
Objective. Tai Chi Chuan (TCC) is a form of aerobic exercise that may be an effective therapy for improving psychosomatic capacity among breast cancer survivors. This meta-analysis analyzed the available randomized controlled trials (RCTs) on the effects of TCC in relieving treatment-related side effects and quality of life in women with breast cancer. Methods. RCTs were searched in PubMed, Embase, Web of Science, and Cochrane Library through April 2014. Data were analyzed on pathology (pain, interleukin-6, and insulin-like growth factor 1), physical capacity (handgrip, limb physical fitness, and BMI), and well-being (physical, social, emotional, and general quality of life). Results. Nine RCTs, including a total of 322 breast cancer patients, were examined. Compared with control therapies, the pooled results suggested that TCC showed significant effects in improving handgrip dynamometer strength, limb elbow flexion (elbow extension, abduction, and horizontal adduction). No significant differences were observed in pain, interleukin-6, insulin-like growth factor, BMI, physical well-being, social or emotional well-being, or general health-related quality of life. Conclusion. The short-term effects of TCC may have potential benefits in upper limb functional mobility in patients with breast cancer. Additional randomized controlled trials with longer follow-up are needed to provide more reliable evidence.
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Ambrose KR, Golightly YM. Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best Pract Res Clin Rheumatol 2015; 29:120-30. [PMID: 26267006 PMCID: PMC4534717 DOI: 10.1016/j.berh.2015.04.022] [Citation(s) in RCA: 282] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chronic pain broadly encompasses both objectively defined conditions and idiopathic conditions that lack physical findings. Despite variance in origin or pathogenesis, these conditions are similarly characterized by chronic pain, poor physical function, mobility limitations, depression, anxiety, and sleep disturbance, and they are treated alone or in combination by pharmacologic and non-pharmacologic approaches, such as physical activity (aerobic conditioning, muscle strengthening, flexibility training, and movement therapies). Physical activity improves general health, disease risk, and progression of chronic illnesses such as cardiovascular disease, type 2 diabetes, and obesity. When applied to chronic pain conditions within appropriate parameters (frequency, duration, and intensity), physical activity significantly improves pain and related symptoms. For chronic pain, strict guidelines for physical activity are lacking, but frequent movement is preferable to sedentary behavior. This gives considerable freedom in prescribing physical activity treatments, which are most successful when tailored individually, progressed slowly, and account for physical limitations, psychosocial needs, and available resources.
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Affiliation(s)
- Kirsten R Ambrose
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Abstract
Sleep quality is important to health, and increasingly viewed as critical in promoting successful, resilient aging. In this review, the interplay between sleep and mental and physical health is considered with a focus on the role of inflammation as a biological pathway that translates the effects of sleep on risk of depression, pain and chronic disease risk in aging. Given that sleep regulates inflammatory biologic mechanisms with effects on mental and physical health outcomes, the potential of interventions that target sleep to reduce inflammation and promote health in aging is also discussed.
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Affiliation(s)
- Michael R Irwin
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience , University of California , Los Angeles, CA , USA ; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California , Los Angeles, CA , USA
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Irwin MR, Olmstead R, Carrillo C, Sadeghi N, Breen EC, Witarama T, Yokomizo M, Lavretsky H, Carroll JE, Motivala SJ, Bootzin R, Nicassio P. Cognitive behavioral therapy vs. Tai Chi for late life insomnia and inflammatory risk: a randomized controlled comparative efficacy trial. Sleep 2014; 37:1543-52. [PMID: 25142571 DOI: 10.5665/sleep.4008] [Citation(s) in RCA: 190] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES To investigate the comparative efficacy of cognitive behavioral therapy (CBT), Tai Chi Chih (TCC), and sleep seminar education control (SS) on the primary outcome of insomnia diagnosis, and secondary outcomes of sleep quality, fatigue, depressive symptoms, and inflammation in older adults with insomnia. DESIGN Randomized controlled, comparative efficacy trial. SETTING Los Angeles community. PATIENTS 123 older adults with chronic and primary insomnia. INTERVENTIONS Random assignment to CBT, TCC, or SS for 2-hour group sessions weekly over 4 months with follow-up at 7 and 16 months. MEASUREMENTS Insomnia diagnosis, patient-reported outcomes, polysomnography (PSG), and high-sensitivity C-reactive protein (CRP) levels. RESULTS CBT performed better than TCC and SS in remission of clinical insomnia as ascertained by a clinician (P < 0.01), and also showed greater and more sustained improvement in sleep quality, sleep parameters, fatigue, and depressive symptoms than TCC and SS (all P values < 0.01). As compared to SS, CBT was associated with a reduced risk of high CRP levels (> 3.0 mg/L) at 16 months (odds ratio [OR], 0.26 [95% CI, 0.07-0.97] P < 0.05). Remission of insomnia was associated with lower levels of CRP (P < 0.05) at 16 months. TCC was associated with improvements in sleep quality, fatigue, and depressive symptoms as compared to SS (all P's < 0.05), but not insomnia remission. PSG measures did not change. CONCLUSIONS Treatment of late-life insomnia is better achieved and sustained by cognitive behavioral therapies. Insomnia treatment and remission reduces a marker of inflammatory risk, which has implications for cardiovascular morbidity and diabetes observed with sleep disturbance in epidemiologic surveys.
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50
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Campo RA, Light KC, O'Connor K, Nakamura Y, Lipschitz D, LaStayo PC, Pappas LM, Boucher KM, Irwin MR, Hill HR, Martins TB, Agarwal N, Kinney AY. Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial. J Cancer Surviv 2014; 9:115-25. [PMID: 25164513 DOI: 10.1007/s11764-014-0395-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 08/07/2014] [Indexed: 01/12/2023]
Abstract
PURPOSE Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, and cortisol) are important in this population. Tai chi chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases. METHODS Sixty-three senior female cancer survivors (M age = 67 years, SD = 7.15) with physical functioning limitations (SF-12 physical functioning ≤80 or role-physical ≤72) were randomized to 12-weeks (60-min, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention. RESULTS Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP, p = 0.002) and cortisol area-under-curve (AUC, p = 0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (p's > 0.05). CONCLUSIONS This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings. IMPLICATIONS FOR CANCER SURVIVORS Senior survivors' have an increased risk for chronic diseases; however, TCC interventions may help reduce associated risk factors.
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Affiliation(s)
- Rebecca A Campo
- Program on Integrative Medicine, Department of Physical Medicine & Rehabilitation, University of North Carolina at Chapel Hill, CB# 7200, Chapel Hill, NC, 27599-7200, USA,
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