1
|
Le Barbenchon E, Trousselard M, Pellissier S, Moisseron-Baudé M, Chachignon P, Bouny P, Touré Cuq E, Jacob S, Vigier C, Hidalgo M, Claverie D, Duffaud AM. Implementation of a Primary Prevention Program for Posttraumatic Stress Disorder in a Cohort of Professional Soldiers (PREPAR): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e47175. [PMID: 38277204 PMCID: PMC10858414 DOI: 10.2196/47175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can manifest after a traumatic event where the individual perceives a threat to his or her life or that of others. Its estimated prevalence in the European population is 0.7% to 1.9%. According to the "dose-response" model, individuals who are most exposed to traumatic events are most at risk of developing PTSD. Hence, it is unsurprising that studies have observed a higher prevalence among the military population, ranging from 10% to 18%, or even up to 45%. This project's overall goal is to evaluate the primary prevention actions that can strengthen the resilience of at-risk professionals, notably military personnel, in the short term, with the medium- to long-term aim of preventing the occurrence of PTSD and improving the patient's prognosis. OBJECTIVE This study's objectives are (1) to design a primary prevention program for PTSD, tailored to the studied military population and compatible with operational constraints; and (2) to implement and validate the Primary Prevention of Posttraumatic Stress Disorder in Military Professionals (PREPARE) program in the short term with operational personnel belonging to the French Mountain Infantry Brigade. METHODS This is a single-center, prospective, randomized, parallel-group controlled cohort study. The cohort is divided into 2 groups: the nonintervention group receives no training, and the intervention group follows a dedicated prevention program (structured into 8 workshops and 2 debriefing and practice reinforcement workshops). Each participant is evaluated 4 times (at inclusion, +4 months, +6 months, and +12 months). During each visit, participants complete several psychosocial questionnaires (which take 15-80 minutes to complete). Samples (a 30-mL blood sample and three 5-mL saliva samples) are collected on 3 occasions: at inclusion, +4 months, and +12 months. Emotional reactivity (electrocardiogram and electrodermal activity) is measured before, during, and after the classic and the emotional Stroop task. RESULTS The project is currently ongoing, and results are expected to be published by the end of 2024. CONCLUSIONS The study adopts an integrative approach to the processes that play a role in the risk of developing PTSD. Our biopsychosocial perspective makes it possible to target levers related to factors specific to the individual and socio-professional factors. The following dimensions are addressed: (1) biophysiology (by studying markers of the neurobiological stress response, wear and tear, and vulnerability phenomena and reinforcing the flexibility of the autonomic nervous system), (2) psychology (by facilitating and measuring the development of flexible coping strategies to deal with stress and evaluating the moderating role of the individual's sense of duty in the development of PTSD), and (3) social (by facilitating community strategies aimed at reducing stigmatization and supporting the use of care by professionals in difficulty, in the institutional context). TRIAL REGISTRATION ClinicalTrials.gov NCT05094531; https://clinicaltrials.gov/study/NCT05094531. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47175.
Collapse
Affiliation(s)
| | - Marion Trousselard
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Sonia Pellissier
- Univ Savoie Mont Blanc, Univ Grenoble Alpes, LIP/PC2S, Grenoble, France
| | - Mathilde Moisseron-Baudé
- School of Practicing Psychologists, Paris, France
- VCR Team, School of Practicing Psychologists, Catholic Institute of Paris - Religion, Culture and Society Reception Team, Paris, France
- Center for Research on Work and Development, Conservatoire National des Arts et Métiers, EA4132, Paris, France
| | - Philippine Chachignon
- Laboratoire de Psychologie Sociale, Aix Marseille Université, Aix-en-Provence, France
| | | | | | - Sandrine Jacob
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Cécile Vigier
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Maud Hidalgo
- Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France
| | - Damien Claverie
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Anais M Duffaud
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| |
Collapse
|
2
|
Eyigör S, Apaydin S, Yesil H, Tanıgor G, Hopanci Bicakli D. Effects of Yoga on Phase Angle and Quality of Life in Patients with Breast Cancer: A Randomized, Single-Blind, Controlled Trial. Complement Med Res 2021; 28:523-532. [PMID: 33794532 DOI: 10.1159/000515494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/19/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Phase angle (PA), a parameter that is obtained from body composition analysis, is an indicator of cellular health status. A lower PA in cancer patients can lead to a decrease in functional status and quality of life (QoL) and increased mortality. Studies have shown that physical activity increases PA. In this study, we aimed to examine the effects of Hatha yoga on PA, body composition, and QoL in patients with breast cancer. METHODS Thirty-one patients were randomized into the yoga (group 1, n = 15) and the control group (group 2, n = 16). Hatha yoga was practiced twice a week for 10 weeks in the intervention group. The PA of the patients was assessed using a body analysis instrument, and QoL was evaluated with an EORTC QLQ questionnaire both before treatment and at week 10. RESULTS Group 1 had significant improvements in the posttreatment EORTC QLQ functional and global scores (p < 0.05). In group 2, a significant improvement was observed in the EORTC QLQ symptom subscale (p = 0.035). PA values did not show any improvements in both groups (p > 0.05). Comparison of the 2 groups revealed no differences. CONCLUSION Yoga may have beneficial effects on QoL in patients with breast cancer but does not have a significant effect on PA. There is a need for further studies to make a definitive statement.
Collapse
Affiliation(s)
- Sibel Eyigör
- Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Turkey
| | - Sebnem Apaydin
- Department of Medical Pharmacology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hilal Yesil
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyon, Turkey
| | - Goksel Tanıgor
- Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Turkey
| | | |
Collapse
|
3
|
Büssing A, Bretz SV, Beerenbrock Y. Ethical Principles of Yoga Philosophy in Western Yoga Practitioners: Validation of the Yama/Niyama Questionnaire. Complement Med Res 2021; 28:325-335. [PMID: 33461204 DOI: 10.1159/000513026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022]
Abstract
Yoga is mainly known for its postures, while it has a rich philosophical/spiritual background which is often not well known. Particularly the ethical principles of Yoga, the Yamas and Niyamas, are of relevance for Western practitioners also. We thus intended to develop and validate an instrument that operationalizes the Yamas and Niyamas and performed a cross-sectional survey among 901 Yoga practitioners in Germany with standardized instruments. Principal component analysis of the 23-item Yama/Niyama Questionnaire (YaNiQ) pointed to 4 factors with good internal consistencies (Cronbach's α = 0.86, 0.82, 0.85, and 0.63). Best predictors of these factors were conscious presence ("mindfulness") and inner correspondence with Yoga practices. The YaNiQ seems to be suited for Western practitioners and could be a useful measure in future studies which intend to analyze the social and health-related attitudes and behaviors of Yoga practitioners. It can be assumed that the ethical principles are important contributors for lifestyle and behavior changes.
Collapse
Affiliation(s)
- Arndt Büssing
- Professorship Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany,
| | | | - Yvonne Beerenbrock
- Professorship Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| |
Collapse
|
4
|
Kienle GS, Werthmann PG, Grotejohann B, Kaier K, Steinbrenner I, Voigt-Radloff S, Huber R. A multi-centre, parallel-group, randomised controlled trial to assess the efficacy and safety of eurythmy therapy and tai chi in comparison with standard care in chronically ill elderly patients with increased risk of falling (ENTAiER): a trial protocol. BMC Geriatr 2020; 20:108. [PMID: 32183768 PMCID: PMC7076928 DOI: 10.1186/s12877-020-1503-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/03/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In elderly poeple, multimorbidity and polypharmacy increase while sensory, motor and cognitive functions decrease. Falls occur in 30% of people aged 65 years and older at least once per year, with injuries at 10-20%. Reducing falls and enhancing physical, emotional and cognitive capacities are essential for healthy aging despite chronic disease. Eurythmy therapy (EYT) and Tai Chi train balance, mobility and concentrative and sensory capacities. METHODS In eight trial sites (academic or community hospitals), 550 outpatients aged 65 years and older with chronic disease and increased risk of falling (history of imbalance, Berg Balance Scale (BBS) score ≤ 49) will be randomly assigned (1:1:1) to receive either EYT or Tai Chi (each provided in one-hour group sessions, twice, later once per week plus practice at home, for over 24 weeks) added to standard care or standard care alone. Standard care includes a detailed written recommendation on fall prevention and the visit of a primary care doctor. Seniors living a reclusive life or economically disadvantaged elderly will be particularly addressed. A motivation and communication concept supports the trial participants' compliance with trial procedures and practicing. Public and patient representatives are involved in the planning and conduction of the trial. Falls will be documented daily in a diary by the participants. These falls as well as injuries and complications will be ascertained during monthly phone visits. The falls efficacy scale, BBS, cognition (MoCA), Mood (GDS-15), quality of life (SF12), instrumental activities of daily living (IADL), use of medical and non-medical services (FIMA) and adherence will be assessed at months 3, 6, and 12 and inner correspondence with practices (ICPH) at month 6. The trial is funded by the Federal Ministry of Education and Research (BMBF 01GL1805). DISCUSSION This study will determine whether EYT and Tai Chi reduce falls, injurious falls, fear of falling and healthcare utilisation and improve mobility, cognition, mood, quality of life and functional independence. A reduction of fall risk and fear of falling and an improvement of mobility, autonomy, quality of life, mood, and cognition are highly relevant for older people to cope with aging and diseases and to reduce healthcare costs. TRAIL REGISTRATION: www.drks.de. DRKS00016609. Registered 30th July 2019.
Collapse
Affiliation(s)
- G S Kienle
- Center for Complementary Medicine; Institute for Infection Prevention and Hospital Epidemiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- IFAEMM at the University of Witten/Herdecke, Freiburg, Germany.
| | - P G Werthmann
- Center for Complementary Medicine; Institute for Infection Prevention and Hospital Epidemiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- IFAEMM at the University of Witten/Herdecke, Freiburg, Germany
| | - B Grotejohann
- Clinical Trials Unit, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K Kaier
- Institute of Medical Biometry and Statistics, Division Methods in Clinical Epidemiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - I Steinbrenner
- Clinical Trials Unit, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - S Voigt-Radloff
- Center for Geriatric Medicine and Gerontology Freiburg, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Huber
- Center for Complementary Medicine; Institute for Infection Prevention and Hospital Epidemiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
5
|
Dutheil F, Chaplais E, Vilmant A, Courteix D, Duche P, Abergel A, Pfabigan DM, Han S, Mobdillon L, Vallet GT, Mermillod M, Boudet G, Obert P, Izem O, Miolanne-Debouit M, Farigon N, Pereira B, Boirie Y. Stress management in obesity during a thermal spa residential programme (ObesiStress): protocol for a randomised controlled trial study. BMJ Open 2019; 9:e027058. [PMID: 31874865 PMCID: PMC7008425 DOI: 10.1136/bmjopen-2018-027058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Stress and obesity are two public health issues. The relationship between obesity and stress is biological through the actions of stress on the major hormones that regulate appetite (leptin and ghrelin). Many spa resorts in France specialise in the treatment of obesity, but no thermal spa currently proposes a specific programme to manage stress in obesity. The ObesiStress protocol has been designed to offer a new residential stress management programme. This thermal spa treatment of obesity implements stress management strategies as suggested by international recommendations. METHODS AND ANALYSIS 140 overweight or obese participants with a Body Mass Index of >25 kg/m2 and aged over 18 years will be recruited. Participants will be randomised into two groups: a control group of usual practice (restrictive diet, physical activity and thermal spa treatment) and an intervention group with stress management in addition to the usual practice. In the present protocol, parameters will be measured on five occasions (at inclusion, at the beginning of the spa (day 0), at the end of the spa (day 21), and at 6 and 12 months). The study will assess the participants' heart rate variability, cardiac remodelling and function, electrodermal activity, blood markers, anthropometric profile, body composition, psychology and quality of life via the use of questionnaires and bone parameters. ETHICS AND DISSEMINATION The ObesiStress protocol complies with the ethics guidelines for Clinical Research and has been approved by the ethics committee (CPP Sud-Est VI, Clermont-Ferrand - ANSM: 2016-A01774-47). This study aimed to highlight the efficacy of a 21-day thermal spa residential programme of stress management in obesity through objective measurements of well-being and cardiovascular morbidity. Results will be disseminated during several research conferences and articles published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03578757.
Collapse
Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Elodie Chaplais
- Université de Lorraine, Laboratory "Development, Adaption and Disability" (DevAH - EA 3450), Nancy, France
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical research and Innovation Department (DRCI), Biostatistics, Clermont-Ferrand, France
| | - Audrey Vilmant
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Daniel Courteix
- Université Clermont Auvergne, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P - EA 3533), Clermont-Ferrand, France
| | - Pascale Duche
- Université de Toulon, Laboratory of Impact of Physical Activity on Health (IAPS), Toulon, France
| | - Armand Abergel
- Université Clermont Auvergne, CNRS, UMR 6284, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Hepatology Gastroenterology, Clermont-Ferrand, France
| | - Daniela M Pfabigan
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Shihui Han
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Laurie Mobdillon
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Guillaume T Vallet
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, LPNC, CNRS, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Gil Boudet
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Philippe Obert
- Université d'Avignon, Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Avignon, France
| | - Omar Izem
- Université d'Avignon, Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Avignon, France
| | - Magalie Miolanne-Debouit
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| | - Nicolas Farigon
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical research and Innovation Department (DRCI), Biostatistics, Clermont-Ferrand, France
| | - Yves Boirie
- Université Clermont Auvergne, INRA, CRNH, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| |
Collapse
|
6
|
Kröz M, Mehl A, Didwiszus A, Gelin-Kröz B, Reif M, Berger B, Ten Brink F, Zerm R, Girke M, Gutenbrunner C, Büssing A. Reliability and first validity of the inner correspondence questionnaire for painting therapy (ICPTh) in a sample of breast cancer patients. Complement Ther Med 2019; 42:355-360. [PMID: 30670266 DOI: 10.1016/j.ctim.2018.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 01/31/2023] Open
Abstract
Objectives Art therapy (ArT) such as mindfulness-oriented painting therapy is increasingly used in psychosomatic, oncological integrative and rehabilitative medicine. Though it remains unknown how ArT works, we hypothesize that an engaged participation with painting ('Inner-Correspondence') contributes to improved symptom scores. In the context of a comprehensive cohort study for breast cancer survivors with cancer-related fatigue, we developed a patient-reported outcome measure to assess 'Inner Correspondence' with painting therapy and conducted a first validation study. Design A 24-item questionnaire on 'Inner Correspondence' (ICPTh) was administered after ten weeks of intervention and at six month followup together with concurrent scales (Inner Correspondence and Peaceful Harmony, Cancer Fatigue Scale, Hospital Anxiety and Depression Scale, Internal Coherence Scale). Statistical assessment included reliability- and factor analyses. Results A total of n = 68 BC (mean age, 58.2 years, SD = 8.7) participated in the preliminary validation study. Exploratory factor analysis revealed a robust 22-item scale with an unambiguous four-factor solution explaining 78% of total variance and the following subsales: 1) therapy congruence and relaxation (11 items), 2) inner development and mood (6 items), 3) artistic skill (3 items) and 4) task congruence (2 items). The 22-item ICPTh yielded high reliability (Cronbach's alpha = .966, item-total correlation = .497 - .883, test-retest reliability = .888). Conclusions We present a reliable instrument to measure 'Inner Correspondence' with painting therapy. Due to the small sample size and sample selection further validation studies are indicated.
Collapse
Affiliation(s)
- M Kröz
- Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089 Berlin, Germany; Research Institute Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany; Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany; Institute of Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| | - A Mehl
- Research Institute Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
| | - A Didwiszus
- Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089 Berlin, Germany; Research Institute Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
| | - B Gelin-Kröz
- Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089 Berlin, Germany; Research Institute Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
| | - M Reif
- Society for Clinical Research, Hardenbergstraße 19, 10623, Berlin, Germany.
| | - B Berger
- Institute of Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| | - F Ten Brink
- Clinic for Rehabilitative Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - R Zerm
- Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089 Berlin, Germany; Research Institute Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
| | - M Girke
- Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089 Berlin, Germany; Research Institute Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
| | - C Gutenbrunner
- Clinic for Rehabilitative Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - A Büssing
- Institute of Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| |
Collapse
|
7
|
Vergeer I, Bennie JA, Charity MJ, Harvey JT, van Uffelen JGZ, Biddle SJH, Eime RM. Participation trends in holistic movement practices: a 10-year comparison of yoga/Pilates and t'ai chi/qigong use among a national sample of 195,926 Australians. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:296. [PMID: 28587599 PMCID: PMC5461749 DOI: 10.1186/s12906-017-1800-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 05/19/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND In recent decades, the evidence supporting the physical and mental health benefits of holistic movement practices such as yoga and t'ai chi have become increasingly established. Consequently, investigating the participation prevalence and patterns of these practices is a relevant pursuit in the public health field. Few studies have provided population-level assessment of participation rates, however, and even fewer have focused on patterns over time. The purpose of this study was to examine participation prevalence and trends in yoga/Pilates and t'ai chi/qigong over a ten-year period in a nationally representative sample of Australians aged 15 years and over, with particular attention to sex and age. A secondary purpose was to juxtapose these findings with participation trends in traditional fitness activities over the same period. METHODS Data comprised modes and types of physical activity, age, and sex variables collected through the Exercise, Recreation and Sport Survey (ERASS), a series of independent cross-sectional Australia-wide surveys conducted yearly between 2001 and 2010. For each year, weighted population estimates were calculated for those participating in yoga/Pilates, t'ai chi/qigong, and fitness activities (e.g. aerobics, calisthenics). Linear regression and multiple logistic regression analyses were used to examine trends in prevalence rates over time and differences among sex and age (15-34; 35-54; 55+ years) groups, respectively. RESULTS Average prevalence rates between 2001 and 2010 were 3.0% (95% CI 2.9-3.1) for yoga/Pilates, 0.6% (95% CI 0.5-0.6) for t'ai chi/qigong, and 19.2% (95% CI 18.9-19.4) for fitness activities. Across the decade, overall participation rates remained relatively stable for yoga/Pilates and t'ai chi/qigong, while increasing linearly for fitness activities. For both genders and in all three age groups, participation in fitness activities increased, whereas only in the 55+ age group was there a significant increase in yoga/Pilates participation; participation in t'ai chi/qigong declined significantly in the two younger age groups. CONCLUSIONS Participation rates in yoga/Pilates and t'ai chi/qigong in Australia were low and relatively stable. As fitness activities increased in popularity across the decade, holistic movement practices did not. These findings point to the need to investigate activity-specific barriers and facilitators to participation, including intrapersonal, interpersonal, organisational, and environmental factors.
Collapse
Affiliation(s)
- Ineke Vergeer
- Institute for Resilient Regions, University of Southern Queensland, Springfield Campus, PO Box 4393, Raceview, QLD 4305 Australia
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
| | - Jason A. Bennie
- Institute for Resilient Regions, University of Southern Queensland, Springfield Campus, PO Box 4393, Raceview, QLD 4305 Australia
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
| | - Melanie J. Charity
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
- Faculty of Health, Federation University Australia, Ballarat, VIC Australia
| | - Jack T. Harvey
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
- Faculty of Health, Federation University Australia, Ballarat, VIC Australia
| | - Jannique G. Z. van Uffelen
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
- Department of Kinesiology, Physical Activity, Sports and Health Research Group, KU Leuven - University of Leuven, B-3000 Leuven, Belgium
| | - Stuart J. H. Biddle
- Institute for Resilient Regions, University of Southern Queensland, Springfield Campus, PO Box 4393, Raceview, QLD 4305 Australia
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
| | - Rochelle M. Eime
- Institute of Sport, Exercise and Active Living (ISEAL), Active Living & Public Health Program, Victoria University, Melbourne, VIC Australia
- Faculty of Health, Federation University Australia, Ballarat, VIC Australia
| |
Collapse
|
8
|
Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev 2017; 1:CD010802. [PMID: 28045199 PMCID: PMC6465041 DOI: 10.1002/14651858.cd010802.pub2] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long-term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer-related impairments and has been shown to improve physical and mental health in people with different cancer types. OBJECTIVES To assess effects of yoga on health-related quality of life, mental health and cancer-related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment. SEARCH METHODS We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions. SELECTION CRITERIA Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non-metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient-reported instruments, including health-related quality of life, depression, anxiety, fatigue or sleep disturbances. DATA COLLECTION AND ANALYSIS Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random-effects model meta-analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi2 test and the I2 statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention. MAIN RESULTS We included 24 studies with a total of 2166 participants, 23 of which provided data for meta-analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.Seventeen studies that compared yoga versus no therapy provided moderate-quality evidence showing that yoga improved health-related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD -0.48, 95% CI -0.75 to -0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD -0.25, 95% CI -0.40 to -0.09; six studies, 657 participants). The funnel plot for health-related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD -0.13, 95% CI -0.31 to 0.05; seven studies, 496 participants; low-quality evidence) or anxiety (pooled SMD -0.53, 95% CI -1.10 to 0.04; six studies, 346 participants; very low-quality evidence) in the short term and had no medium-term effects on health-related quality of life (pooled SMD 0.10, 95% CI -0.23 to 0.42; two studies, 146 participants; low-quality evidence) or fatigue (pooled SMD -0.04, 95% CI -0.36 to 0.29; two studies, 146 participants; low-quality evidence). Investigators reported no serious adverse events.Four studies that compared yoga versus psychosocial/educational interventions provided moderate-quality evidence indicating that yoga can reduce depression (pooled SMD -2.29, 95% CI -3.97 to -0.61; four studies, 226 participants), anxiety (pooled SMD -2.21, 95% CI -3.90 to -0.52; three studies, 195 participants) and fatigue (pooled SMD -0.90, 95% CI -1.31 to -0.50; two studies, 106 participants) in the short term. Very low-quality evidence showed no short-term effects on health-related quality of life (pooled SMD 0.81, 95% CI -0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD -0.21, 95% CI -0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety-related data.Three studies that compared yoga versus exercise presented very low-quality evidence showing no short-term effects on health-related quality of life (pooled SMD -0.04, 95% CI -0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD -0.21, 95% CI -0.66 to 0.25; three studies, 233 participants); no trial provided safety-related data. AUTHORS' CONCLUSIONS Moderate-quality evidence supports the recommendation of yoga as a supportive intervention for improving health-related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low-quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.
Collapse
Affiliation(s)
- Holger Cramer
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Romy Lauche
- University of Technology SydneyAustralian Research Centre in Complementary and Integrative Medicine235‐253 Jones StreetUltimoAustralia2007
| | - Petra Klose
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Silke Lange
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Jost Langhorst
- University of Duisburg‐EssenDepartment of Integrative Gastroenterology, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Gustav J Dobos
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | | |
Collapse
|
9
|
Gaiswinkler L, Unterrainer H. The relationship between yoga involvement, mindfulness and psychological well-being. Complement Ther Med 2016; 26:123-7. [DOI: 10.1016/j.ctim.2016.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/26/2016] [Accepted: 03/16/2016] [Indexed: 11/25/2022] Open
|
10
|
Trousselard M, Dutheil F, Naughton G, Cosserant S, Amadon S, Dualé C, Schoeffler P. Stress among nurses working in emergency, anesthesiology and intensive care units depends on qualification: a Job Demand-Control survey. Int Arch Occup Environ Health 2015; 89:221-9. [PMID: 26112796 DOI: 10.1007/s00420-015-1065-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/09/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The nurse stress literature reports an overwhelming culture of acceptance and expectation of work stressors, ironically linked to the control of the workplace to effectively and proactively manage stress. The stressors involved in delivering "stress management" have been well studied in nursing-related workplaces, especially in acute care settings in accordance with the Karasek Job Demand-Control-Support (JDCS) model. However, little is known about the effects of specificity of an acute care unit and the level of qualifications on stress experienced by nurses. METHODS A survey using the JDCS model was conducted among 385 nurses working in three different acute care units (anesthesiology, emergency and intensive care unit) from a university hospital. Specific questions explored variables such as gender, acute care units, level of qualification and working experience. RESULTS Two hundred questionnaires were returned. A high level of job strain was highlighted without a gender effect and in the absence of isostrain. Nurses from acute care units were located in the high stress quadrant of the JDCS model. Conversely, other nurses were commonly located in the "active" quadrant. Independent of acute care settings, the highest level of education was associated with the highest job strain and the lowest level of control. CONCLUSIONS In an acute care setting, a high level of education was a key factor for high job stress and was associated with a perception of a low control in the workplace, both of which may be predictors of adverse mental health. In particular, the lack of control has been associated with moral distress, a frequently reported characteristic of acute care settings. To enhance the personal and professional outcomes of the advanced registered nurses, strategies for supporting nurses manage daily stressors in acute care are urgently required.
Collapse
Affiliation(s)
- Marion Trousselard
- Neurophysiology of Stress, Armies' Biomedical Research Institute, Armies' Health Service, Bretigny sur Orge, France.
| | - Frédéric Dutheil
- Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France.
- School of Exercise Science, Faculty of Health, Australian Catholic University, Melbourne, VIC, 3065, Australia.
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France.
- University Clermont Auvergne, 63000, Clermont-Ferrand, France.
| | - Geraldine Naughton
- School of Exercise Science, Faculty of Health, Australian Catholic University, Melbourne, VIC, 3065, Australia.
| | - Sylvie Cosserant
- Anesthésie-Réanimation, Pôle BLOC-ARCHI, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France.
| | - Sylvie Amadon
- Anesthésie-Réanimation, Pôle BLOC-ARCHI, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France.
| | - Christian Dualé
- Centre de Pharmacologie Clinique, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France.
- Inserm, CIC1405, 63003, Clermont-Ferrand, France.
| | - Pierre Schoeffler
- University Clermont Auvergne, 63000, Clermont-Ferrand, France.
- Anesthésie-Réanimation, Pôle BLOC-ARCHI, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France.
| |
Collapse
|
11
|
Gaiswinkler L, Unterrainer HF, Fink A, Kapfhammer HP. [The relationship between Yoga Immersion, psychological well-being and psychiatric symptoms]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2015; 29:29-35. [PMID: 25752248 DOI: 10.1007/s40211-015-0139-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 02/20/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND In recent years positive effects of Yoga (as a kind of spiritual exercise) in regards to subjective well-being and physical health can be found as well documented in the literature. METHOD Based on a construct-psychological approach a newly developed scale for the assessment of Yoga involvement (immersion) was validated on a sample of 233 non-clinical subjects (210 females) by means of socio-demographic and well established psychometric parameters of psychological well-being and psychiatric symptoms. Furthermore, the group of yoga practitioners was compared with a control group consisting of 93 gymnastics practitioners (83 women) with respect to these parameters. RESULTS The amount of Yoga Immersion (YI) can be reliably assessed by means of the one-dimensional YI-scale (10 items) and shows to be strongly correlated with Mindfulness (r = .56; p < .01), Inner Correspondence (r = .61; p < .01) and Religious/Spiritual Well-being (r = .68; p < .01). Furthermore highly yoga-immersive practitioners exhibited a significant higher amount of psychological well-being (p < .01) compared to marginally/moderately yoga-immersive and gymnastics practitioners. The Yoga-group also showed a lower amount of psychiatric symptoms (e.g. depression; p < .01). CONCLUSIONS The globally postulated positive relationship between Yoga-practicing and mental health could be confirmed; thereby the impact of YI can be assumed as central. Further randomized controlled trial research focusing on the health/disease-related aspects of YI might be conducted especially in clinical groups.
Collapse
Affiliation(s)
- Lisza Gaiswinkler
- Zentrum für Integrative Suchtforschung (Verein Grüner Kreis), Institut für Psychologie, Karl-Franzens-Universität Graz, Rudolfplatz 9, 1010, Wien, Österreich
| | | | | | | |
Collapse
|
12
|
Cramer H, Rabsilber S, Lauche R, Kümmel S, Dobos G. Yoga and meditation for menopausal symptoms in breast cancer survivors-A randomized controlled trial. Cancer 2015; 121:2175-84. [PMID: 25739642 DOI: 10.1002/cncr.29330] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/25/2014] [Accepted: 02/10/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Breast cancer survivors have only very limited treatment options for menopausal symptoms. The objective of this trial was to evaluate the effects of a 12-week traditional Hatha yoga and meditation intervention on menopausal symptoms in breast cancer survivors. METHODS Patients were randomly assigned either to a 12-week yoga and meditation intervention or to usual care. The primary outcome measure was total menopausal symptoms (Menopause Rating Scale [MRS] total score). Secondary outcome measures included MRS subscales, quality of life (Functional Assessment of Cancer Therapy-Breast), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression, and anxiety (Hospital Anxiety and Depression Scale). Outcomes were assessed at week 12 and week 24 after randomization. RESULTS In total, 40 women (mean age ± standard deviation, 49.2 ± 5.9 years) were randomized to yoga (n = 19) or to usual care (n = 21). Women in the yoga group reported significantly lower total menopausal symptoms compared with the usual care group at week 12 (mean difference, -5.6; 95% confidence interval, -9.2 to -1.9; P = .004) and at week 24 (mean difference, -4.5; 95% confidence interval, -8.3 to -0.7; P = .023). At week 12, the yoga group reported less somatovegetative, psychological, and urogenital menopausal symptoms; less fatigue; and improved quality of life (all P < .05). At week 24, all effects persisted except for psychological menopausal symptoms. Short-term effects on menopausal symptoms remained significant when only women who were receiving antiestrogen medication (n = 36) were analyzed. Six minor adverse events occurred in each group. CONCLUSIONS Yoga combined with meditation can be considered a safe and effective complementary intervention for menopausal symptoms in breast cancer survivors. The effects seem to persist for at least 3 months.
Collapse
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Center in Complementary and Integrative Medicine, Faculty of Health, University of Technology-Sydney, Sydney, Australia
| | - Sybille Rabsilber
- Department of Gynecology, Certified Breast Center, Malteser Hospital St. Anna, Duisburg, Germany.,Interdisclipinary Breast Cancer Center, Kliniken Essen-Mitte, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Center in Complementary and Integrative Medicine, Faculty of Health, University of Technology-Sydney, Sydney, Australia
| | - Sherko Kümmel
- Interdisclipinary Breast Cancer Center, Kliniken Essen-Mitte, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
13
|
Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety 2013; 30:1068-83. [PMID: 23922209 DOI: 10.1002/da.22166] [Citation(s) in RCA: 323] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 07/10/2013] [Accepted: 07/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mind-body medical interventions are commonly used to cope with depression and yoga is one of the most commonly used mind-body interventions. The aim of this review was to systematically assess and meta-analyze the effectiveness of yoga for depression. METHODS Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through January 2013. Randomized controlled trials (RCTs) of yoga for patients with depressive disorders and individuals with elevated levels of depression were included. Main outcomes were severity of depression and remission rates, secondary outcomes were anxiety, quality of life, and safety. RESULTS Twelve RCTs with 619 participants were included. Three RCTs had low risk of bias. Regarding severity of depression, there was moderate evidence for short-term effects of yoga compared to usual care (standardized mean difference (SMD) = -0.69; 95% confidence interval (CI) -0.99, -0.39; P < .001), and limited evidence compared to relaxation (SMD = -0.62; 95%CI -1.03, -0.22; P = .003), and aerobic exercise (SMD = -0.59; 95% CI -0.99, -0.18; P = .004). Limited evidence was found for short-term effects of yoga on anxiety compared to relaxation (SMD = -0.79; 95% CI -1.3, -0.26; P = .004). Subgroup analyses revealed evidence for effects in patients with depressive disorders and in individuals with elevated levels of depression. Due to the paucity and heterogeneity of the RCTs, no meta-analyses on long-term effects were possible. No RCT reported safety data. CONCLUSIONS Despite methodological drawbacks of the included studies, yoga could be considered an ancillary treatment option for patients with depressive disorders and individuals with elevated levels of depression.
Collapse
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | | | | | | |
Collapse
|
14
|
Cramer H, Krucoff C, Dobos G. Adverse events associated with yoga: a systematic review of published case reports and case series. PLoS One 2013; 8:e75515. [PMID: 24146758 PMCID: PMC3797727 DOI: 10.1371/journal.pone.0075515] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 08/14/2013] [Indexed: 01/14/2023] Open
Abstract
While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.
Collapse
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- * E-mail:
| | - Carol Krucoff
- Duke Integrative Medicine, Duke University, Durham, North Carolina, United States of America
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
15
|
Cramer H, Lauche R, Langhorst J, Paul A, Michalsen A, Dobos G. Predictors of yoga use among internal medicine patients. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 13:172. [PMID: 23849549 PMCID: PMC3717114 DOI: 10.1186/1472-6882-13-172] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 07/11/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. METHODS A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. RESULTS Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. CONCLUSION Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.
Collapse
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Anna Paul
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Andreas Michalsen
- Immanuel Hospital Berlin, Department of Internal and Complementary Medicine,
Berlin, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte,
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
16
|
Quality of life and mental health in patients with chronic diseases who regularly practice yoga and those who do not: a case-control study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:702914. [PMID: 23840263 PMCID: PMC3690235 DOI: 10.1155/2013/702914] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/13/2013] [Accepted: 05/23/2013] [Indexed: 11/17/2022]
Abstract
While clinical trials have shown evidence of efficacy of yoga in different chronic diseases, subjective health benefits associated with yoga practice under naturalistic conditions have not yet been investigated. The aim of this study was to investigate associations of regular yoga practice with quality of life and mental health in patients with chronic diseases. Using a case-control design, patients with chronic diseases who regularly practiced yoga were selected from a large observational study and compared to controls who did not regularly practice yoga and who were matched individually to each case on gender, main diagnosis, education, and age (within 5 years). Patients' quality of life (SF-36 questionnaire), mental health (Hospital Anxiety and Depression Scale), life satisfaction, and health satisfaction (Questionnaire for Life Satisfaction) were assessed. Patients who regularly practiced yoga (n = 186) had a better general health status (P = 0.012), a higher physical functioning (P = 0.001), and physical component score (P = 0.029) on the SF-36 than those who did not (n = 186). No group differences were found for the mental scales of the SF-36, anxiety, depression, life satisfaction, or health satisfaction. In conclusion, practicing yoga under naturalistic conditions seems to be associated with increased physical health but not mental health in chronically diseased patients.
Collapse
|
17
|
Effects of yoga interventions on fatigue: a meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:124703. [PMID: 22991569 PMCID: PMC3443845 DOI: 10.1155/2012/124703] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 07/25/2012] [Accepted: 07/26/2012] [Indexed: 12/05/2022]
Abstract
Background. Researchers aimed at systematically reviewing and meta-analyzing the effectiveness of yoga interventions for fatigue. Methods. PubMed/Medline was searched until January 2012 for controlled clinical studies. Two reviewers independently extracted the data. The methodological quality of the studies was assessed. A meta-analysis was performed. Results. Nineteen clinical studies (total n = 948) were included in this review. Investigated yoga styles included Hatha, Iyengar, Asanas, Patanjali, Sahaja, and Tibetan yoga. Participants were suffering from cancer, multiple sclerosis, dialysis, chronic pancreatitis, fibromyalgia, asthma, or were healthy. Yoga had a small positive effect on fatigue (SMD = 0.27, 59% CI = 0.23–0.31). Seven studies received 4 points on the Jadad score. There were baseline differences in at least 5 studies. Conclusion. Overall, the effects of yoga interventions on fatigue were only small, particularly in cancer patients. Although yoga is generally a safe therapeutic intervention and effective to attenuate other health-related symptoms, this meta-analysis was not able to define the powerful effect of yoga on patients suffering from fatigue. Treatment effects of yoga could be improved in well-designed future studies. According to the GRADE recommendations assessing the overall quality of evidence, there is a moderate effect of the confidence placed in the estimates of the effects discussed here.
Collapse
|
18
|
Development of Specific Aspects of Spirituality during a 6-Month Intensive Yoga Practice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:981523. [PMID: 22852023 PMCID: PMC3407840 DOI: 10.1155/2012/981523] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 05/13/2012] [Indexed: 11/21/2022]
Abstract
The majority of research on yoga focuses on its psychophysiological and therapeutic benefits, while the spiritual aspects are rarely addressed. Changes of specific aspects of spirituality were thus investigated among 160 individuals (91% women, mean age 40.9 ± 8.3 years; 57% Christians) starting a 2-year yoga teacher training. We used standardized questionnaires to measure aspects of spirituality (ASP), mindfulness (FMI—Freiburg Mindfulness Inventory), life satisfaction (BMLSS—Brief Multidimensional Life Satisfaction Scale), and positive mood (lightheartedness/relief). At the start of the course, scores of the respective ASP subscales for search for insight/wisdom, transcendence conviction, and conscious interactions/compassion were high, while those for religious orientation were low. Within the 6 month observation period, both conscious interactions/compassion (effect size, Cohen's d = .33), Religious orientation (d = .21), Lightheartedness/Relief (d = .75) and mindfulness (d = .53) increased significantly. Particularly non-religious/non-spiritual individuals showed moderate effects for an increase of conscious interactions/compassion. The results from this study suggest that an intensive yoga practice (1) may significantly increase specific aspects of practitioners' spirituality, mindfulness, and mood, (2) that these changes are dependent in part on their original spiritual/religious self-perception, and (3) that there are strong correlations amongst these constructs (i.e., conscious interactions/compassion, and mindfulness).
Collapse
|
19
|
Büssing A, Ostermann T, Lüdtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. THE JOURNAL OF PAIN 2011; 13:1-9. [PMID: 22178433 DOI: 10.1016/j.jpain.2011.10.001] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 09/28/2011] [Indexed: 01/16/2023]
Abstract
UNLABELLED We searched databases for controlled clinical studies, and performed a meta-analysis on the effectiveness of yoga interventions on pain and associated disability. Five randomized studies reported single-blinding and had a higher methodological quality; 7 studies were randomized but not blinded and had moderate quality; and 4 nonrandomized studies had low quality. In 6 studies, yoga was used to treat patients with back pain; in 2 studies to treat rheumatoid arthritis; in 2 studies to treat patients with headache/migraine; and 6 studies enrolled individuals for other indications. All studies reported positive effects in favor of the yoga interventions. With respect to pain, a random effect meta-analysis estimated the overall treatment effect at SMD = -.74 (CI: -.97; -.52, P < .0001), and an overall treatment effect at SMD = -.79 (CI: -1.02; -.56, P < .0001) for pain-related disability. Despite some limitations, there is evidence that yoga may be useful for several pain-associated disorders. Moreover, there are hints that even short-term interventions might be effective. Nevertheless, large-scale further studies have to identify which patients may benefit from the respective interventions. PERSPECTIVE This meta-analysis suggests that yoga is a useful supplementary approach with moderate effect sizes on pain and associated disability.
Collapse
Affiliation(s)
- Arndt Büssing
- Center for Integrative Medicine, Faculty of Medicine, University of Witten/Herdecke, Herdecke, Germany.
| | | | | | | |
Collapse
|