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Arnetz BB, Arnetz JE, Kaminski N, Tomlin R, Cole A, Bartlett P, Crawford R, Jameson A. Relationship between Stress and Neuroimmunological Responses and Health Literacy in Newly Diagnosed HIV-Infected Patients: An Exploratory Study. AIDS Res Treat 2024; 2024:3432569. [PMID: 39345356 PMCID: PMC11436276 DOI: 10.1155/2024/3432569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/30/2024] [Accepted: 08/31/2024] [Indexed: 10/01/2024] Open
Abstract
Objectives We aimed to study self-rated health and psycho-neuroimmunological responses during the initial 6 months after testing positive for human immunodeficiency virus (HIV) and its relationship to health literacy, that is, the ability to take in and understand information about one's illness. Health literacy plays a critical role in patients' ability to adhere to antiretroviral treatment (ART). However, there is a lack of studies on the possible impact of HIV-induced proinflammatory processes on health literacy. Methods Twelve patients with newly diagnosed HIV attending an urban Ryan White-funded HIV clinic responded to a questionnaire and had blood samples drawn at baseline (first visit) and after 1, 3, and 6 months, respectively. The questionnaire measured stress, depression, and health literacy. Blood was analyzed for HIV RNA plasma viral load, CD4 cell count, pro- and antistress, and inflammatory markers. Results Complete data for the entire 4 collection periods were available for nine patients. Over the 6-month period, mean viral load decreased from 353,714.83 (standard deviation 870,334.61) to 35.89 (14.04) copies/mL (p < 0.001). CD4 cell count increased from 321.08 (167.96) to 592.44 (300.06) cells/mm3 (p < 0.001). Self-rated stress decreased from a baseline mean of 7.33 (2.29) to 3.56 (3.21), on a 0-10 visual analogue scale, at the 6-month follow-up (p < 0.01). C-reactive protein (CRP) decreased from 5757.05 (3146.86) to 2360.84 (2277.33) ng/mL (p < 0.05). Mean health literacy score at baseline was 17.67 (3.50; scale range 0-20) and did not change during the follow-up period. However, increased stress and decreased CRP (p = 0.05) during the 6-month follow-up predicted higher health literacy scores at 6 months. Conclusion Both stress and proinflammatory processes in newly diagnosed HIV-infected patients might adversely impact patients' health literacy and thus their capacity to align with treatment guidance.
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Affiliation(s)
- Bengt B Arnetz
- Department of Family Medicine Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Judith E Arnetz
- Department of Family Medicine Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Norbert Kaminski
- Department of Pharmacology and Toxicology Michigan State University College of Human Medicine, East Lansing, Michigan, USA
- Institute for Integrative Toxicology Michigan State University, East Lansing, MI, USA
| | - Ryan Tomlin
- Department of Pharmacy Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, USA
| | - Andrew Cole
- Department of Family Medicine Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Pamela Bartlett
- Department of Research & Innovation Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, USA
| | - Robert Crawford
- Institute for Integrative Toxicology Michigan State University, East Lansing, MI, USA
| | - Andrew Jameson
- Department of Medicine Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, USA
- Department of Medicine College of Human Medicine Michigan State University, East Lansing, MI, USA
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Vambheim SM, Kyllo TM, Hegland S, Bystad M. Relaxation techniques as an intervention for chronic pain: A systematic review of randomized controlled trials. Heliyon 2021; 7:e07837. [PMID: 34485731 PMCID: PMC8405991 DOI: 10.1016/j.heliyon.2021.e07837] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/09/2020] [Accepted: 08/17/2021] [Indexed: 12/14/2022] Open
Abstract
Chronic pain increases the risk of sleep disturbances, depression and disability. Even though medical treatments have limited value, the use of prescription-based analgesics have increased over the recent years. It is therefore important to evaluate the effect of non-pharmacological treatments. A systematic search for studies evaluating the effect of relaxation techniques on chronic pain was conducted. Randomized controlled trials were included. Significant effects on pain, or on pain and one or more secondary outcome measure, were found in 21 studies. Four studies found significant effects on secondary outcome measures only. Four studies showed no significant effects on any outcome measure. Thus, most of the studies reported that relaxation techniques reduced pain and/or secondary outcome measures. However, the included studies have evaluated effects across a wide variety of chronic pain conditions and relaxation techniques. Hence, there is a large degree of heterogeneity among the included studies. This complicates the effect evaluation and makes it difficult to draw a clear and unambiguous conclusion. Relaxation techniques are probably most effective when used through regular and continued practice. Future studies should therefore investigate long-term effects of relaxation technique interventions, evaluate the dose-response relationship and examine efficacy differences across pain conditions and interventions.
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Affiliation(s)
- Sara Magelssen Vambheim
- Department of Psychology, UiT The Arctic University of Norway, Norway
- Department of Pain Management and Research, Emergency Clinic, Oslo University, Norway
| | | | - Sanne Hegland
- Department of Psychology, UiT The Arctic University of Norway, Norway
| | - Martin Bystad
- Department of Pain Management and Research, Emergency Clinic, Oslo University, Norway
- Department of Geropsychiatry, UNN University Hospital of North Norway, Norway
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Angelov V, Gotova J, Albert E, Tishinov O. Application of the Visualization through Stereoscopic Glasses in the Massage Therapy. EXERCISE MEDICINE 2019. [DOI: 10.26644/em.2019.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Dong X, Li K. The Association Between Musculoskeletal Symptoms and Traditional Chinese Medicine Use Among Chinese Older Adults in the Greater Chicago Area. Gerontol Geriatr Med 2018; 4:2333721418778179. [PMID: 30035189 PMCID: PMC6050610 DOI: 10.1177/2333721418778179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/29/2017] [Accepted: 09/14/2017] [Indexed: 11/16/2022] Open
Abstract
Older adults disproportionately experience musculoskeletal symptoms, which are associated with morbidity and mortality. Traditional Chinese medicine (TCM) is an important part of Chinese culture and for millennia have been used to maintain health. This article aims to examine the association between musculoskeletal symptoms and different subtypes of TCM usage. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study, a community-engaged, epidemiological study of a U.S. Chinese population. Review of systems was used to measure musculoskeletal symptoms. TCM use was measured by using a 5-point scale. Logistic regression analyses were conducted to control for potential confounding factors. Of 3,157 Chinese, older adults aged 60 and older, the mean age was 72.8 (SD = 8.3) and 58.9% were female. Older adults with any musculoskeletal symptoms had greater utilization of overall TCM use (odds ratio [OR] = 2.10, 95% confidence interval [CI] = [1.76, 2.52]), especially massage therapy (OR = 3.41, 95% CI = [2.51, 4.63]), herbal (OR = 2.68, 95% CI = [2.28, 3.14]), and acupuncture (OR = 2.49, 95% CI = [1.87, 3.32]). However, there was no statistically significant association between the presence of musculoskeletal symptoms and Tai-Chi (OR = 1.18, 95% CI = [0.93, 1.50]). This study demonstrated that musculoskeletal symptoms among Chinese older adults were strongly associated with the use of TCM. Future research is needed to examine the effectiveness of TCM in treating musculoskeletal symptoms.
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Affiliation(s)
- XinQi Dong
- Rush University Medical Center, Chicago, IL, USA
| | - Ke Li
- Rush University Medical Center, Chicago, IL, USA
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Crawford C, Boyd C, Paat CF, Price A, Xenakis L, Yang E, Zhang W. The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population. PAIN MEDICINE (MALDEN, MASS.) 2016; 17:1353-1375. [PMID: 27165971 PMCID: PMC4925170 DOI: 10.1093/pm/pnw099] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Pain is multi-dimensional and may be better addressed through a holistic, biopsychosocial approach. Massage therapy is commonly practiced among patients seeking pain management; however, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy in treating pain, function-related and health-related quality of life outcomes across all pain populations. METHODS Key databases were searched from inception through February 2014. Eligible randomized controlled trials were assessed for methodological quality using SIGN 50 Checklist. Meta-analysis was applied at the outcome level. A diverse steering committee interpreted the results to develop recommendations. RESULTS Sixty high quality and seven low quality studies were included in the review. Results demonstrate massage therapy effectively treats pain compared to sham [standardized mean difference (SMD) = -.44], no treatment (SMD = -1.14), and active (SMD = -0.26) comparators. Compared to active comparators, massage therapy was also beneficial for treating anxiety (SMD = -0.57) and health-related quality of life (SMD = 0.14). CONCLUSION Based on the evidence, massage therapy, compared to no treatment, should be strongly recommended as a pain management option. Massage therapy is weakly recommended for reducing pain, compared to other sham or active comparators, and improving mood and health-related quality of life, compared to other active comparators. Massage therapy safety, research challenges, how to address identified research gaps, and necessary next steps for implementing massage therapy as a viable pain management option are discussed.
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Jeffrey S, McClelland T, Carus C, Graham C. Relaxation and chronic pain: A critical review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.6.289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah Jeffrey
- Physiotherapy lecturer and undergraduate admissions tutor, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Tracy McClelland
- Senior lecturer, Research and Knowledge Transfer and Health Team Lead – Nursing, University of Bradford, Bradford, UK
| | - Catherine Carus
- Physiotherapy lecturer, programme lead for SSPRD and Certificate of Higher Education in Professional Support, University of Bradford, Bradford, UK
| | - Claire Graham
- Programme lead and lecturer for Sport Rehabilitation, University of Bradford, Bradford, UK
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Abstract
This article reviews the existing, peer-reviewed evidence for the use of relaxation and mindfulness in both acute and chronic pain.There is some evidence that relaxation can reduce pain outcomes in both acute and chronic pain, however there is evidence that these improvements are not maintained over time.More limited research suggests that mindfulness can lead to improvements in psychological measures and physical functioning and these improvements appear to be maintained at follow-up.Further research is needed. Both researchers and practitioners need to be clearer on the outcomes that their techniques best facilitate and the processes which are active within them.
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Bervoets DC, Luijsterburg PAJ, Alessie JJN, Buijs MJ, Verhagen AP. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. J Physiother 2015; 61:106-16. [PMID: 26093806 DOI: 10.1016/j.jphys.2015.05.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 05/04/2015] [Accepted: 05/20/2015] [Indexed: 11/25/2022] Open
Abstract
QUESTION Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? DESIGN Systematic review of randomised clinical trials. PARTICIPANTS People with musculoskeletal disorders. INTERVENTIONS Massage therapy (manual manipulation of the soft tissues) as a stand-alone intervention. OUTCOME The primary outcomes were pain and function. RESULTS The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579) per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain. CONCLUSIONS Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident.
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Affiliation(s)
- Diederik C Bervoets
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
| | - Pim A J Luijsterburg
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
| | | | | | - Arianne P Verhagen
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
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Persson AL, Veenhuizen H, Zachrison L, Gard G. Relaxation as treatment for chronic musculoskeletal pain – a systematic review of randomised controlled studies. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/174328808x356366] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Gay CW, Alappattu MJ, Coronado RA, Horn ME, Bishop MD. Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials. J Pain Res 2013; 6:7-22. [PMID: 23403507 PMCID: PMC3569047 DOI: 10.2147/jpr.s37272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Muscle-biased therapies (MBT) are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration. METHODS A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type. RESULTS Reports from 24 randomized controlled trials (23 articles) were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain sensitivity. Short-term modulation of pain sensitivity was associated with short-term beneficial effects on clinical pain. Intensity of MBT, but not duration, was linked with change in pain sensitivity. A meta-analysis was conducted on 17 studies that assessed the effect of MBT on pressure pain thresholds. The results suggest that MBT had a favorable effect on pressure pain thresholds when compared with no-treatment and sham/inert groups, and effects comparable with those of other active treatments. CONCLUSION The evidence supports the use of pain sensitivity measures by future research to help elucidate optimal therapeutic parameters for MBT as an intermediate physiologic marker.
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Affiliation(s)
- Charles W Gay
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Meryl J Alappattu
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Rogelio A Coronado
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Maggie E Horn
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL
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Rapaport MH, Schettler P, Bresee C. A preliminary study of the effects of repeated massage on hypothalamic-pituitary-adrenal and immune function in healthy individuals: a study of mechanisms of action and dosage. J Altern Complement Med 2012; 18:789-97. [PMID: 22775448 DOI: 10.1089/acm.2011.0071] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study gathers preliminary data about the biologic effects of repeated Swedish massage therapy compared to a light-touch control condition. DESIGN The study design was a 5-week comparison of repeated Swedish massage and light touch on oxytocin (OT), arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocyte markers, and mitogen-stimulated cytokine function. SETTING The setting was an outpatient research unit in an academic medical center. PARTICIPANTS The study subjects were medically and psychiatrically healthy young adults. INTERVENTION The study comprised 45 minutes of Swedish massage or light touch, using highly specified and identical protocols, either weekly or twice weekly for 5 weeks. OUTCOME MEASURES The outcome measures were mean differences between massage and light touch on OT, AVP, ACTH, CORT, lymphocyte markers, and cytokine levels. RESULTS Compared to the touch control condition, weekly Swedish massage stimulated a sustained pattern of increased circulating phenotypic lymphocyte markers and decreased mitogen-stimulated cytokine production, similar to what was previously reported for a single massage session, while having minimal effect on hypothalamic-pituitary-adrenal function. Twice-weekly massage produced a different response pattern with increased OT levels, decreased AVP, and decreased CORT but little effect on circulating lymphocyte phenotypic markers and a slight increase in mitogen-stimulated interferon-γ, tumor necrosis factor-α, interleukin (IL)-1b and IL-2 levels, suggesting increased production of pro-inflammatory cytokines. CONCLUSIONS There are sustained cumulative biologic actions for the massage and touch interventions that persist for several days or a week, and these differ profoundly depending on the dosage (frequency) of sessions. Confirmatory studies in larger samples are needed.
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Affiliation(s)
- Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
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Hainline B. Neuropathic Pain. Pain Manag 2011. [DOI: 10.1016/b978-1-4377-0721-2.00023-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Emerging research in neuroscience is bridging the gap between mind and body. Thought is brain based and influences brain function. The continuum and bidirectionality of mind and body, thought and brain, emotions and physiology forms the basis of understanding neuropathic pain, a neuropsychiatric condition with myriad clinical manifestations.
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Kwon WA, Kim DD, Lee JH. The Effects of Massage and Static Stretching on Cervical Range of Motion in Their 20s of Normal Adult. ACTA ACUST UNITED AC 2010. [DOI: 10.5762/kais.2010.11.11.4346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cardenas DD, Felix ER. Pain after Spinal Cord Injury: A Review of Classification, Treatment Approaches, and Treatment Assessment. PM R 2009; 1:1077-90. [DOI: 10.1016/j.pmrj.2009.07.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Revised: 06/29/2009] [Accepted: 07/07/2009] [Indexed: 10/20/2022]
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Wiholm C, Arnetz BB. Stress management and musculoskeletal disorders in knowledge workers: The possible mediating effects of stress hormones. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14038190500494683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lolak S, Connors GL, Sheridan MJ, Wise TN. Effects of progressive muscle relaxation training on anxiety and depression in patients enrolled in an outpatient pulmonary rehabilitation program. PSYCHOTHERAPY AND PSYCHOSOMATICS 2008; 77:119-25. [PMID: 18230945 DOI: 10.1159/000112889] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND This prospective, randomized controlled trial examined the effect of progressive muscle relaxation (PMR) training on anxiety and depression in patients with chronic breathing disorders receiving pulmonary rehabilitation (PR). METHODS Eighty-three subjects with chronic breathing disorders entering the 8-week PR program were randomly assigned to a standard care or intervention group. The standard program included 2 days per week of exercise, education and psychosocial support delivered by a multidisciplinary team. The intervention group received additional sessions of PMR training using a prerecorded tape for 25 min/week during weeks 2-8. Primary outcome measures were levels of anxiety and depression evaluated by the Hospital Anxiety and Depression Scale. RESULTS For anxiety, there was an overall significant improvement within each group over time (p < 0.0001). There was no statistically significant group-time interaction (p = 0.17) and no statistically significant difference between the groups (p = 0.22), despite lower scores for every time point in the PMR group. For depression, there was an overall significant improvement within each group over time (p < 0.0001). Although the difference between the groups (p = 0.09) and group-time interaction (p = 0.07) did not reach statistical significance, the results again favored the PMR group for weeks 5-8. Depression scores were lower for the PMR throughout weeks 1-8. CONCLUSIONS PR is effective in reducing anxiety and depressive level in chronic lung patients. Our findings suggest that adding structured PMR training to a well-established PR program may not confer additional benefit in the further reduction of anxiety and depression in patients receiving PR.
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Affiliation(s)
- Sermsak Lolak
- Department of Psychiatry, Inova Fairfax Hospital, Falls Church, VA, USA.
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da Silva GD, Lorenzi-Filho G, Lage LV. Effects of yoga and the addition of Tui Na in patients with fibromyalgia. J Altern Complement Med 2008; 13:1107-13. [PMID: 18166122 DOI: 10.1089/acm.2007.0615] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to verify whether techniques of yoga with and without the addition of Tui Na might improve pain and the negative impact of fibromyalgia (FMS) on patients' daily life. DESIGN Forty (40) FMS women were randomized into two groups, Relaxing Yoga (RY) and Relaxing Yoga plus Touch (RYT), for eight weekly sessions of stretching, breathing, and relaxing yogic techniques. RYT patients were further submitted to manipulative techniques of Tui Na. OUTCOME MEASURE Outcome measures comprised the Fibromyalgia Impact Questionnaire (FIQ), pain threshold at the 18 FMS tender points, and a verbal graduation of pain assessed before treatment and on the followup. The visual analog scale (VAS) for pain was assessed before and after each session and on the follow-up. RESULTS Seventeen (17) RYT and 16 RY patients completed the study. Both RY and RYT groups showed improvement in the FIQ and VAS scores, which decreased on all sessions. The RYT group showed lower VAS and verbal scores for pain on the eighth session, but this difference was not maintained on the follow-up. Conversely, RY VAS and verbal scores were significantly lower just on the follow-up. CONCLUSIONS These study results showed that yogic techniques are valid therapeutic methods for FMS. Touch addition yielded greater improvement during the treatment. Over time, however, RY patients reported less pain than RYT. These results suggest that a passive therapy may possibly decrease control over FMS symptoms.
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Affiliation(s)
- Gerson D da Silva
- Rheumatology Division and Pulmonary Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
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Reid MC, Papaleontiou M, Ong A, Breckman R, Wethington E, Pillemer K. Self-management strategies to reduce pain and improve function among older adults in community settings: a review of the evidence. PAIN MEDICINE 2008; 9:409-24. [PMID: 18346056 DOI: 10.1111/j.1526-4637.2008.00428.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CONTEXT Self-management strategies for pain hold substantial promise as a means of reducing pain and improving function among older adults with chronic pain, but their use in this age group has not been well defined. OBJECTIVE To review the evidence regarding self-management interventions for pain due to musculoskeletal disorders among older adults. DESIGN We searched the Medline and Cumulative Index to Nursing and Allied Health Literature databases to identify relevant articles for review and analyzed English-language articles that presented outcome data on pain, function, and/or other relevant endpoints and evaluated programs/strategies that could be feasibly implemented in the community. Abstracted information included study sample characteristics, estimates of treatment effect, and other relevant outcomes when present. RESULTS Retained articles (N = 27) included those that evaluated programs sponsored by the Arthritis Foundation and other programs/strategies including yoga, massage therapy, Tai Chi, and music therapy. Positive outcomes were found in 96% of the studies. Proportionate change in pain scores ranged from an increase of 18% to a reduction of 85% (median = 23% reduction), whereas change in disability scores ranged from an increase of 2% to a reduction of 70% (median = 19% reduction). Generalizability issues identified included limited enrollment of ethnic minority elders, as well as non-ethnic elders aged 80 and above. CONCLUSIONS Our results suggest that a broad range of self-management programs may provide benefits for older adults with chronic pain. Research is needed to establish the efficacy of the programs in diverse age and ethnic groups of older adults and identify strategies that maximize program reach, retention, and methods to ensure continued use of the strategies over time.
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Affiliation(s)
- M Carrington Reid
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
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Tsao JCI. Effectiveness of massage therapy for chronic, non-malignant pain: a review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2007; 4:165-79. [PMID: 17549233 PMCID: PMC1876616 DOI: 10.1093/ecam/nel109] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Accepted: 12/04/2006] [Indexed: 11/28/2022]
Abstract
Previous reviews of massage therapy for chronic, non-malignant pain have focused on discrete pain conditions. This article aims to provide a broad overview of the literature on the effectiveness of massage for a variety of chronic, non-malignant pain complaints to identify gaps in the research and to inform future clinical trials. Computerized databases were searched for relevant studies including prior reviews and primary trials of massage therapy for chronic, non-malignant pain. Existing research provides fairly robust support for the analgesic effects of massage for non-specific low back pain, but only moderate support for such effects on shoulder pain and headache pain. There is only modest, preliminary support for massage in the treatment of fibromyalgia, mixed chronic pain conditions, neck pain and carpal tunnel syndrome. Thus, research to date provides varying levels of evidence for the benefits of massage therapy for different chronic pain conditions. Future studies should employ rigorous study designs and include follow-up assessments for additional quantification of the longer-term effects of massage on chronic pain.
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Affiliation(s)
- Jennie C I Tsao
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, USA.
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Nickel C, Lahmann C, Muehlbacher M, Pedrosa Gil F, Kaplan P, Buschmann W, Tritt K, Kettler C, Bachler E, Egger C, Anvar J, Fartacek R, Loew T, Rother W, Nickel M. Pregnant women with bronchial asthma benefit from progressive muscle relaxation: a randomized, prospective, controlled trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2006; 75:237-43. [PMID: 16785773 DOI: 10.1159/000092894] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Asthma is a serious medical problem in pregnancy and is often associated with stress, anger and poor quality of life. The aim of this study was to determine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters, heart rate, anger and health-related quality of life in pregnant women with bronchial asthma. METHODS We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week randomized, prospective, controlled trial. Thirty-two were selected for PMR, and 32 received a placebo intervention. The systolic blood pressure, forced expiratory volume in the first second, peak expiratory flow and heart rate were tested, and the State-Trait Anger Expression Inventory and Health Survey (SF-36) were employed. RESULTS According to the intend-to-treat principle, a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR. The heart rate showed a significant increase in the coefficient of variation, root mean square of successive differences and high frequency ranges, in addition to a significant reduction in low and middle frequency ranges. A significant reduction on three of five State-Trait Anger Expression Inventory scales, and a significant increase on seven of eight SF-36 scales were observed. CONCLUSIONS PMR appears to be an effective method to improve blood pressure, lung parameters and heart rate, and to decrease anger levels, thus enhancing health-related quality of life in pregnant women with bronchial asthma.
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Affiliation(s)
- Cerstin Nickel
- Clinic for Psychosomatic Medicine, Inntalklinik, Simbach/Inn, Germany.
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Abstract
PURPOSE To review randomized trials of relaxation interventions used for the treatment of pain in adults and to synthesize evidence regarding the efficacy of specific techniques. DESIGN Integrative review. METHODS A literature search was conducted using the terms "relaxation" and "pain" in CINAHL, Medline, and PsychInfo from 1996 to March 2005. Studies were reviewed and categorized based on the type of relaxation intervention (progressive muscle relaxation [PMR], autogenic training, jaw relaxation, rhythmic breathing, and other relaxation exercises), and summarized with respect to various study characteristics and results. FINDINGS Researchers reported support for relaxation interventions in 8 of the 15 studies reviewed. The most frequently supported technique was progressive muscle relaxation, particularly for arthritis pain. Investigators reported support for jaw relaxation and a systematic relaxation intervention for relieving postoperative pain. Little evidence was found for autogenic training, and no support for rhythmic breathing or other relaxation techniques. CONCLUSIONS Most of the studies reviewed had weaknesses in methodology, which limited the ability to draw conclusions about interventions. Further research is needed to confirm positive findings related to PMR, jaw relaxation, and systematic relaxation, to address questions related to the dose-response relationship and the individual differences that might influence response to relaxation interventions. These and other relaxation techniques require testing in carefully designed and conducted trials.
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Lewis M, Johnson MI. The clinical effectiveness of therapeutic massage for musculoskeletal pain: a systematic review. Physiotherapy 2006. [DOI: 10.1016/j.physio.2006.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Neuropathic pain is a neuropsychiatric condition in which pain is initiated or caused by a primary lesion or dysfunction in the nervous system. Understanding the complexity of neuropathic pain becomes the cornerstone for appropriate diagnosis and management. Diagnosis must take into account comorbid conditions. Successful management depends on realistic patient and physician expectations and an individualized, multidisciplinary approach.
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Affiliation(s)
- Brian Hainline
- Department of Neurology, New York University School of Medicine, NY, USA.
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Maclaren JE, Cohen LL. Teaching Behavioral Pain Management to Healthcare Professionals: A Systematic Review of Research in Training Programs. THE JOURNAL OF PAIN 2005; 6:481-92. [PMID: 16084462 DOI: 10.1016/j.jpain.2005.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Accepted: 03/21/2005] [Indexed: 11/17/2022]
Abstract
UNLABELLED Pain is a common and potentially debilitating condition. Whereas there is vast literature on developmentally appropriate behavioral techniques for pain management, results of curriculum evaluations and knowledge surveys reveal a dearth of awareness of these strategies in healthcare professionals. As a result, the development and evaluation of pain management training programs are important endeavors. Results of studies evaluating such programs are promising and suggest that training might be an effective means of impacting healthcare professionals' knowledge, attitudes, and even patient care. These results must be interpreted with caution, however, because the literature contains several conceptual and methodologic limitations. These limitations, in combination with the wide diversity in program components, format of delivery, and research methods, preclude definitive conclusions on the most practical and effective means to provide training. To address this question, further systematic work on the development and evaluation of pain management training programs is warranted. PERSPECTIVE To address the problems of dissemination of behavioral pain management techniques, the development and evaluation of pain management training programs are important endeavors. The current article presents a systematic review of studies evaluating such programs and provides recommendations for future systematic work in this area.
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Affiliation(s)
- Jill E Maclaren
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Sherman KJ, Cherkin DC, Kahn J, Erro J, Hrbek A, Deyo RA, Eisenberg DM. A survey of training and practice patterns of massage therapists in two US states. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2005; 5:13. [PMID: 15955245 PMCID: PMC1182347 DOI: 10.1186/1472-6882-5-13] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2005] [Accepted: 06/14/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND Despite the growing popularity of therapeutic massage in the US, little is known about the training or practice characteristics of massage therapists. The objective of this study was to describe these characteristics. METHODS As part of a study of random samples of complementary and alternative medicine (CAM) practitioners, we interviewed 226 massage therapists licensed in Connecticut and Washington state by telephone in 1998 and 1999 (85% of those contacted) and then asked a sample of them to record information on 20 consecutive visits to their practices (total of 2005 consecutive visits). RESULTS Most massage therapists were women (85%), white (95%), and had completed some continuing education training (79% in Connecticut and 52% in Washington). They treated a limited number of conditions, most commonly musculoskeletal (59% and 63%) (especially back, neck, and shoulder problems), wellness care (20% and 19%), and psychological complaints (9% and 6%) (especially anxiety and depression). Practitioners commonly used one or more assessment techniques (67% and 74%) and gave a massage emphasizing Swedish (81% and 77%), deep tissue (63% and 65%), and trigger/pressure point techniques (52% and 46%). Self-care recommendations, including increasing water intake, body awareness, and specific forms of movement, were made as part of more than 80% of visits. Although most patients self-referred to massage, more than one-quarter were receiving concomitant care for the same problem from a physician. Massage therapists rarely communicated with these physicians. CONCLUSION This study provides new information about licensed massage therapists that should be useful to physicians and other healthcare providers interested in learning about massage therapy in order to advise their patients about this popular CAM therapy.
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Affiliation(s)
- Karen J Sherman
- Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA
- Department of Epidemiology, University of Washington, Seattle, Washington 98195, USA
| | - Daniel C Cherkin
- Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA
- Departments of Family Medicine and Health Services, University of Washington, Seattle, Washington 98195, USA
| | - Janet Kahn
- Department of Psychiatry, University of Vermont, Burlington, Vermont, 05405, USA
| | - Janet Erro
- Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA
| | - Andrea Hrbek
- Harvard Medical School Osher Institute and Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, Massachusetts 02215, USA
| | - Richard A Deyo
- Departments of Medicine and Health Services, University of Washington, Seattle, Washington, USA
| | - David M Eisenberg
- Harvard Medical School Osher Institute and Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, Massachusetts 02215, USA
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28
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Overholser JC. Contemporary Psychotherapy: Moving Beyond a Therapeutic Dialogue. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2004. [DOI: 10.1007/s10879-004-2531-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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