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Dundas I, Binder PE. Being able to think when caught in the maelstrom - how adolescents used mindfulness when facing exams. Int J Qual Stud Health Well-being 2024; 19:2375660. [PMID: 38967618 PMCID: PMC11229735 DOI: 10.1080/17482631.2024.2375660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024] Open
Abstract
PURPOSE Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents' accounts of the processes involved. We explored high-school students' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course. METHOD Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS The analyses identified six themes: (1) Noticing and attending to the attention-binding "maelstrom" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) "removing" and "getting rid of" anxious thoughts (4) Being able to "think" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of "unwholesome thoughts" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention. CONCLUSION Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.
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Affiliation(s)
- Ingrid Dundas
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Per-Einar Binder
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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2
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Béquet AJ, Jallais C, Quick J, Ndiaye D, Hidalgo-Muñoz AR. Road to serenity: Individual variations in the efficacy of unobtrusive respiratory guidance for driving stress regulation. APPLIED ERGONOMICS 2024; 120:104334. [PMID: 38876002 DOI: 10.1016/j.apergo.2024.104334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 05/27/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024]
Abstract
Stress impacts driving-related cognitive functions like attention and decision-making, and may arise in automated vehicles due to non-driving tasks. Unobtrusive relaxation techniques are needed to regulate stress without distracting from driving. Tactile wearables have shown efficacy in stress regulation through respiratory guidance, but individual variations may affect their efficacy. This study assessed slow-breathing tactile guidance under different stress levels on 85 participants. Physiological, behavioral and subjective data were collected. The influence of individual variations (e.g., driving habits and behavior, personality) using logistic regression analysis was explored. Participants could follow the guidance and adjust breathing while driving, but subjective efficacy depended on individual variations linked to different efficiency in using the technique, in relation with its attentional cost. An influence of factors linked to the evaluation of context criticality was also found. The results suggest that considering individual and contextual variations is crucial in designing and using such techniques in demanding driving contexts. In this line some design recommendations and insights for further studies are provided.
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Affiliation(s)
- A J Béquet
- Laboratory Ergonomics and Cognitive Sciences Applied to Transport, TS2-LESCOT Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675, Lyon, France.
| | - C Jallais
- Laboratory Ergonomics and Cognitive Sciences Applied to Transport, TS2-LESCOT Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675, Lyon, France
| | - J Quick
- Laboratory Ergonomics and Cognitive Sciences Applied to Transport, TS2-LESCOT Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675, Lyon, France
| | - D Ndiaye
- Laboratory Ergonomics and Cognitive Sciences Applied to Transport, TS2-LESCOT Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675, Lyon, France
| | - A R Hidalgo-Muñoz
- Institute of Neuroscience of Castilla y León (INCYL), University of Salamanca, Spain
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3
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Bischoff H, Kovach C, Kumar S, Bruss J, Tranel D, Khalsa SS. Sensing, feeling and regulating: investigating the association of focal brain damage with voluntary respiratory and motor control. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230251. [PMID: 39005040 DOI: 10.1098/rstb.2023.0251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/26/2024] [Indexed: 07/16/2024] Open
Abstract
Breathing is a complex, vital function that can be modulated to influence physical and mental well-being. However, the role of cortical and subcortical brain regions in voluntary control of human respiration is underexplored. Here we investigated the influence of damage to human frontal, temporal or limbic regions on the sensation and regulation of breathing patterns. Participants performed a respiratory regulation task across regular and irregular frequencies ranging from 6 to 60 breaths per minute (bpm), with a counterbalanced hand motor control task. Interoceptive and affective states induced by each condition were assessed via questionnaire, and autonomic signals were indexed via skin conductance. Participants with focal lesions to the bilateral frontal lobe, right insula/basal ganglia and left medial temporal lobe showed reduced performance relative to individually matched healthy comparisons during the breathing and motor tasks. They also reported significantly higher anxiety during the 60 bpm regular and irregular breathing trials, with anxiety correlating with difficulty in rapid breathing specifically within this group. This study demonstrates that damage to frontal, temporal or limbic regions is associated with abnormal voluntary respiratory and motor regulation and tachypnoea-related anxiety, highlighting the role of the forebrain in affective and motor responses during breathing. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.
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Affiliation(s)
- Henrik Bischoff
- Department of Psychology, University of Stockholm, 10691 Stockholm, Sweden
- Department of Psychology, Carl-von-Ossietzky University Oldenburg, 26129 Oldenburg, Germany
| | - Christopher Kovach
- Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sukbhinder Kumar
- Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
| | - Joel Bruss
- Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Daniel Tranel
- Departments of Neurology and Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK 74119, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA
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4
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He Y, Ge L, Yuan J, Wang Y, Zheng D, Rui A, Song J, Hu L, Wei GX. Interoceptive awareness mediated the effects of a 15-minute diaphragmatic breathing on empathy for pain: A randomized controlled trial. Psychophysiology 2024; 61:e14573. [PMID: 38530127 DOI: 10.1111/psyp.14573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
Although empathy for pain plays an important role in positive interpersonal relationships and encourages engagement in prosocial behavior, it remains largely unknown whether empathy for pain could be effectively altered by psychophysiological techniques. This study aimed to investigate the impact of a single session of diaphragmatic breathing practice on empathy for pain and examine the potential mechanism involving interoceptive awareness. A total of 66 healthy participants were randomly assigned to the intervention group or the control group. The intervention group received a 15-minute diaphragmatic breathing (DB) practice with real-time biofeedback, while the control group was to gaze at a black screen at rest and not engaged in any other activities. Before and after the invention, all participants were instructed to evaluate the intensity and unpleasantness of empathy for pain while watching different pictures with pain or non-pain conditions. The Multidimensional Assessment of Interoceptive Awareness (MAIA) was then administered to measure interoceptive awareness. The results indicated a significant interaction between group and time with regard to empathy for pain and MAIA. The DB group showed a statistically significant decrease in both pain intensity and unpleasantness during the pain picture condition, as well as a noteworthy increase in MAIA scores. The control group did not demonstrate any substantial changes. More importantly, the regulation of attention, a dimension of MAIA, had a significant mediating effect on the impact of diaphragmatic breathing on reported unpleasantness. Diaphragmatic breathing could serve as a simple, convenient, and practical strategy to optimize human empathy for pain that warrants further investigation, which has important implications not only for individuals with impaired empathy for pain but also for the improvement of interoceptive awareness.
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Affiliation(s)
- Yaping He
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Likun Ge
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajin Yuan
- Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision, Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Yingying Wang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Danni Zheng
- School of Psychology, Beijing Sport University, Beijing, China
| | - An Rui
- School of Psychology, Beijing Sport University, Beijing, China
| | - Jun Song
- Experimental Research Center of China Academy of Chinese Medical Sciences, National Chinese Medicine Experts Inheritance Office, Beijing, China
| | - Li Hu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gao-Xia Wei
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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5
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Leo DG, Keller SS, Proietti R. "Close your eyes and relax": the role of hypnosis in reducing anxiety, and its implications for the prevention of cardiovascular diseases. Front Psychol 2024; 15:1411835. [PMID: 39035095 PMCID: PMC11258040 DOI: 10.3389/fpsyg.2024.1411835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Simon S. Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Riccardo Proietti
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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Manser P, de Bruin ED. "Brain-IT": Exergame training with biofeedback breathing in neurocognitive disorders. Alzheimers Dement 2024; 20:4747-4764. [PMID: 38809948 PMCID: PMC11247687 DOI: 10.1002/alz.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION The combination of exergame-based motor-cognitive training with resonance breathing guided by heart-rate variability biofeedback (HRV-BF) targets various relevant mechanisms of action to alleviate the pathological state in mild neurocognitive disorders (mNCD). METHODS This randomized controlled trial (RCT) investigated the effectiveness of adding this novel intervention approach to usual care in mNCD. The individualized intervention was delivered via the "Brain-IT" training concept, which was iteratively co-designed, tested, and refined with patient and public involvement. RESULTS We observed statistically significant effects with large effect sizes for global cognitive performance, immediate verbal recall, and delayed verbal recall in favor of the intervention group. Fifty-five percent of participants showed a clinically relevant improvement in response to training. DISCUSSION Confirmatory RCTs are warranted to investigate whether the observed improvements in cognitive performance translate to affecting the rates of progression to or onset of dementia and test the implementation of the training in clinical practice. HIGHLIGHTS We proposed a novel intervention approach for mild neurocognitive disorders. It combines exergame-based training with biofeedback-guided resonance breathing. Our results confirm the effectiveness of this approach. Fifty-five percent of participants showed a clinically relevant improvement in response to training.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and TechnologyETH ZurichZurichSwitzerland
| | - Eling D. de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Department of HealthOST ‐ Eastern Swiss University of Applied SciencesSt. GallenSwitzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and SocietyKarolinska InstituteHuddingeSweden
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7
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Morin A, Grondin S. Mindfulness and time perception: A systematic integrative review. Neurosci Biobehav Rev 2024; 162:105657. [PMID: 38583653 DOI: 10.1016/j.neubiorev.2024.105657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
Several recent studies have explored the relationships between mindfulness and time perception, an area of research that has become increasingly popular in the last 10-15 years. In this article, we present a systematic integrative review of the evidence on this subject. We also integrate the field's findings into a conceptual framework which considers the multifaceted nature of both mindfulness, and time perception research. To identify the relevant literature, we searched the following databases using relevant keywords: PsycINFO; Medline; EBSCO Host Psychology and Behavioral Sciences Collection; and Web of Science. These searches were last performed on the 4th of May 2022, and additional hand searches were also conducted. To be included, articles had to be in English and contain original data about the potential relationship(s) between mindfulness and time perception. Articles which did not present usable data about the relationship(s) between the variables of interest were excluded. In total, 47 research articles were included in the review (combined sample size of ∼5800 participants). Risks of bias in the selected studies were evaluated using two separate assessment tools designed for this purpose. Through an integrative narrative synthesis, this article reviews how mindfulness may relate to time perception for various reference frames, and for various time perception measures and methods. It also provides new insights by exploring how a wide range of findings can be integrated into a coherent whole, in light of some relevant time perception models and mindfulness theories. Altogether, the reviewed data suggest the existence of complex and multifaceted relationships between mindfulness and time perception, highlighting the importance of considering many factors when planning research or interpreting data in this field. Limitations of the current review include the scarceness of data for certain categories of findings, and the relatively low prevalence of studies with a randomized controlled design in the source literature. This research was partly funded by a grant from the Natural Science and Engineering Research Council of Canada.
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Affiliation(s)
- André Morin
- École de psychologie, Université Laval, Québec, Canada.
| | - Simon Grondin
- École de psychologie, Université Laval, Québec, Canada
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8
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Kim D, Baek S, Kim S, Im S, Kim S. Analysis of breathing patterns to stabilize cardiovascular changes in physical stress environments : inspiration responds to rapid changes in blood pressure. Biomed Eng Lett 2024; 14:813-821. [PMID: 38946807 PMCID: PMC11208350 DOI: 10.1007/s13534-024-00379-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/24/2024] [Accepted: 03/30/2024] [Indexed: 07/02/2024] Open
Abstract
The thoracic nerves form a complex neural network that coordinates involuntary muscles such as breathing and the heart. Breathing has various patterns to maintain homeostasis in the human body. This study analyzes changes in the cardiovascular system and breathing patterns induced by stress caused by various mechanical movements performed in daily life and ultimately, the goal is to propose effective breathing patterns and breathing control methods to maintain cardiovascular homeostasis. The participants' age was 26.97 ± 3.93 years, height was 170.24 ± 8.61 cm, and weight was 65.69 ± 13.55 Kg, and there were 62 men and 38 women. Breathing and electrocardiogram were obtained using HiCard+, a biometric monitoring device. The measured electrocardiogram was analyzed for heartbeat interval, which indicates changes in the cardiovascular system, and standard deviation of normal to normal interval (SDNN) and root mean square of the successive differences (rMSSD), which indicate the activity of the autonomic and parasympathetic nervous systems. For respiration, time changes were analyzed as patterns by calculating inspiration and exhalation times. As a result of this study, rapid changes in blood pressure increased SDNN and rMSSD from 0.053 ± 0.06 and 0.056 ± 0.087 to 0.109 ± 0.114 and 0.125 ± 0.170 s, and induced an increase in spontaneous inspiratory time from 1.46 to 1.51 s (p < 0.05). Ultimately, we hope that the results of this study will be used as a breathing control training technique to prevent and manage rapid cardiovascular changes. Supplementary Information The online version contains supplementary material available at 10.1007/s13534-024-00379-y.
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Affiliation(s)
- Daechang Kim
- Department of Medical Biotechnology, Dongguk University, Bio Medi Campus, Ilsandonggu, Goyang si, Gyeonggi-do 10326 Korea
| | - Seungbin Baek
- Department of Medical Device Business, Dongguk University, 32, Dongguk ro, Ilsandonggu, Goyang si, Gyeonggi do 10326 Korea
| | - Seunghui Kim
- Department of Regulatory Science for Bio-Health Medical Device, Dongguk University, 32, Dongguk ro, Ilsandonggu, Goyang si, Gyeonggi do 10326 Korea
| | - Sanghee Im
- Department and Research Institute of Rehabilitation Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Sungmin Kim
- Department of Medical Biotechnology, Dongguk University, Bio Medi Campus, Ilsandonggu, Goyang si, Gyeonggi-do 10326 Korea
- Department of Medical Device Industry, Dongguk University, Seoul, 04620 Korea
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Goral O, Wald IY, Maimon A, Snir A, Golland Y, Goral A, Amedi A. Enhancing interoceptive sensibility through exteroceptive-interoceptive sensory substitution. Sci Rep 2024; 14:14855. [PMID: 38937475 PMCID: PMC11211335 DOI: 10.1038/s41598-024-63231-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Exploring a novel approach to mental health technology, this study illuminates the intricate interplay between exteroception (the perception of the external world), and interoception (the perception of the internal world). Drawing on principles of sensory substitution, we investigated how interoceptive signals, particularly respiration, could be conveyed through exteroceptive modalities, namely vision and hearing. To this end, we developed a unique, immersive multisensory environment that translates respiratory signals in real-time into dynamic visual and auditory stimuli. The system was evaluated by employing a battery of various psychological assessments, with the findings indicating a significant increase in participants' interoceptive sensibility and an enhancement of the state of flow, signifying immersive and positive engagement with the experience. Furthermore, a correlation between these two variables emerged, revealing a bidirectional enhancement between the state of flow and interoceptive sensibility. Our research is the first to present a sensory substitution approach for substituting between interoceptive and exteroceptive senses, and specifically as a transformative method for mental health interventions, paving the way for future research.
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Affiliation(s)
- Oran Goral
- Baruch Ivcher Institute for Brain, Cognition, and Technology, Reichman University, Herzliya, Israel
| | - Iddo Yehoshua Wald
- Baruch Ivcher Institute for Brain, Cognition, and Technology, Reichman University, Herzliya, Israel
- Digital Media Lab, Bremen University, Bremen, Germany
| | - Amber Maimon
- Baruch Ivcher Institute for Brain, Cognition, and Technology, Reichman University, Herzliya, Israel
- Computational Psychiatry and Neurotechnology Lab, Ben Gurion University, Be'er Sheva, Israel
| | - Adi Snir
- Baruch Ivcher Institute for Brain, Cognition, and Technology, Reichman University, Herzliya, Israel
| | - Yulia Golland
- Sagol Center for Brain and Mind, Reichman University, Herzliya, Israel
| | - Aviva Goral
- Baruch Ivcher Institute for Brain, Cognition, and Technology, Reichman University, Herzliya, Israel
| | - Amir Amedi
- Baruch Ivcher Institute for Brain, Cognition, and Technology, Reichman University, Herzliya, Israel.
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Han FY, Shao YJ, Liang Y, Zhang MY, Lu NJ. Vividness of visual imagery is associated with the effect of relaxation response meditation training in elderly people with nonorganic insomnia: A randomized, double-blind, multi-center clinical trial. Exp Gerontol 2024; 194:112486. [PMID: 38879094 DOI: 10.1016/j.exger.2024.112486] [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: 03/26/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND This study aims to explore the efficacy of Relaxation Response Meditation Training (RRMT) on elderly individuals with different levels of vividness of visual imagery. METHODS In this randomized controlled, double-blind, multi-center clinical trial, we recruited a total of 136 elderly individuals who were over 60 years with nonorganic sleep disorders to participate in a 4-week RRMT intervention from October 2020 to October 2022. The intervention occurred twice a week, totaling eight times. These individuals were divided into high and low groups based on the vividness of visual imagery, and then randomly assigned to either the control or intervention groups, as follows: low-visualizers intervention group (LI group); low-visualizers control group (LC group); high-visualizers intervention group (HI group); high-visualizers control group (HC group). Their social and psychological parameters were assessed before and after the intervention by the Pittsburgh Sleep Quality Index (PSQI), the Revised Piper's fatigue scale (RPFS), General well-being scale (GWB), and Satisfaction rating. The alpha waves of patients were also collected through electroencephalogram to assess their level of relaxation. RESULTS Compared to the LI group, the HI group had a greater reduction rate in the PSQI score [25.2 % (18.8 % to 31.7 %), P < 0∙001], shorter sleep latency (P = 0.001), lower frequency of sleep medication (P < 0.001), lower PSQI scores (P < 0.001), and higher GWB scores (P < 0.001). There were significant differences in all indicators in the HI group vs. HC group and in the LI group vs. LC group. In the first five relaxation training sessions, there was no statistically significant difference in the proportion of α waves between the LI group and the LC group; however, from the sixth session onward, we observed a statistically significant difference (t = 2.86, P = 0.019),while The HI group and HC group showing significant differences in the first relaxation training session (t = 4.464, P < 0.001). There was a statistically significant difference in subjective satisfaction between the intervention group and the control group (x2 = 49.605, P < 0.001). CONCLUSION In this study, we found that most elderly people benefitted from RRMT regardless of their vividness of visual imagery. However, low-visualizers experienced slower and less effective results, so these patients may benefit more from alternative approaches.
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Affiliation(s)
- Fu-Yu Han
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing 100017, China.
| | - Yu-Jing Shao
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing 100017, China
| | - Yan Liang
- Zhumadian Traditional Chinese Medicine Hospital, Henan Province 463000,China
| | - Ming-Yue Zhang
- Beidaihe Rest and Recuperation Center of PLA, Qinhuangdao 066001, China
| | - Nan-Jun Lu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing 100017, China
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11
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Chin P, Gorman F, Beck F, Russell BR, Stephan KE, Harrison OK. A systematic review of brief respiratory, embodiment, cognitive, and mindfulness interventions to reduce state anxiety. Front Psychol 2024; 15:1412928. [PMID: 38933581 PMCID: PMC11203600 DOI: 10.3389/fpsyg.2024.1412928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 05/13/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction Anxiety is one of the most prevalent mental health conditions worldwide, and psychotherapeutic techniques can be employed to help manage and mitigate symptoms. While the available therapies are numerous, key strategies often involve cognitive and/or embodiment techniques. Within body-centered methods, breathing-oriented approaches are particularly prevalent, using either attention towards or active control of breathing. As the perception of body states (i.e., interoception) is thought to be an integral component of emotion generation, these embodiment and breathing techniques may be key in addressing the miscommunication between the brain and body that is thought to exist with anxiety. Therefore, we conducted a systematic review and meta-analysis to assess the effects of acute administration of psychological interventions for state anxiety. Results This systematic review was conducted in accordance with the PRISMA statement and registered prospectively in PROSPERO. A literature search for randomized controlled trials was conducted in PubMed, PsycINFO, and Scopus. We considered interventions that focused on cognitive, embodiment or breathing strategies, or a combination of these techniques. Twelve studies met our inclusion criteria, and study characteristics, quality and effect sizes were assessed. A single cognitive study was found to produce a moderate reduction in state anxiety, while moderate to large effects were found across studies assessing embodiment practices. In contrast, studies which utilized breathing-based interventions alone produced inconsistent results, with both attention towards and active control of breathing producing large to no effects depending on the technique employed. Finally, consistent moderate effects were found with combination techniques that involved passive attention (e.g., towards cognitions, body and/or breathing), with active combination techniques producing inconsistent results. Discussion While study numbers are limited regarding brief interventions, cognitive and embodiment techniques are consistently helpful for reducing state anxiety, while breathing-based exercises need to consider the specific technique employed, and how successful this may be for each individual. Furthermore, combined practices such as mindfulness can also be successful, although care must be taken when introducing an active change to one or more elements. PROSPERO Systematic Review Registration Number CRD42024507585 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024507585.
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Affiliation(s)
- Phoebe Chin
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Faye Gorman
- Department of Psychology, University of Otago, Dunedin, New Zealand
- Ngāpuhi, New Zealand
- Ngāti Kahu, New Zealand
| | - Fraser Beck
- Ngāi Tahu, New Zealand
- Optimal Health Model Ltd., Glenorchy, New Zealand
| | | | - Klaas E. Stephan
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Olivia K. Harrison
- Department of Psychology, University of Otago, Dunedin, New Zealand
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
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12
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Bahameish M, Stockman T. Short-Term Effects of Heart Rate Variability Biofeedback on Working Memory. Appl Psychophysiol Biofeedback 2024; 49:219-231. [PMID: 38366274 PMCID: PMC11101506 DOI: 10.1007/s10484-024-09624-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
Drawing upon the well-documented impact of long-term heart rate variability biofeedback (HRVB) on psychophysiological responses, this study seeks to explore the short-term effects arising from a single HRVB session during and after paced breathing exercise. The research aligns with the neurovisceral integration model, emphasizing the link between heart rate variability (HRV) levels and cognitive performance. Therefore, a randomized controlled trial employing a between-subjects design was conducted with 38 participants. Each participant was assigned to either the paced breathing intervention group or the spontaneous breathing control group. The study assessed various parameters such as cardiac vagal tone, evaluated through vagally mediated HRV measures, and working memory, measured using the N-back task. Additionally, participants' affective states were assessed through self-reported questionnaires, specifically targeting attentiveness, fatigue, and serenity. The results notably reveal enhancements in the working memory task and an elevated state of relaxation and attention following the HRVB session, as evidenced by higher averages of correct responses, serenity and attentiveness scores. However, the findings suggest that this observed improvement is not influenced by changes in cardiac vagal tone, as assessed using a simple mediation analysis. In conclusion, this study presents promising insights into the impact of a single HRVB session, laying the foundation for future research advancements in this domain.
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Affiliation(s)
- Mariam Bahameish
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
| | - Tony Stockman
- School of Electronics Engineering and Computer Science, Queen Mary University of London, London, UK
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13
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Sarwal R, Dhamija RK, Jain K, Basavaraddi IV. Effect of pranayama on perceived stress, well-being and quality of life of frontline healthcare professionals on COVID-19 duty: A quasi-randomised clinical trial. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024. [PMID: 38808479 DOI: 10.1002/ijop.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/10/2024] [Indexed: 05/30/2024]
Abstract
Healthcare professionals (HCPs) had to perform their duties under extremely trying circumstances during the COVID-19 pandemic. High expectations further increased HCP's stress, which had an adverse impact on their mental health. The present quasi-randomised clinical trial examined how a specially designed pranayama regimen practised for 4 weeks affected the mental health of frontline, exposed HCPs in terms of perceived stress, wellness and quality of life. A total of 280 frontline HCPs on COVID-19 duties in five public hospitals of Delhi, India participated in this study. The intervention (n = 123) and control (n = 127) groups were alternately allocated. Data on perceived, self-reported mental health of HCPs were collected at baseline and post-test at the end-line (after 28 days of practice). We report that the intervention group (n = 123) had a substantial lower perceived stress at post-test at the end-line in comparison to the control group (n = 127, p-value: .028). Their overall WHO Quality-of-Life score also improved, of which the score on psychological domain increased significantly (p-value: .019). Accordingly, we conclude that a 28-day practice of the pranayama by the frontline HCPs in COVID-19 hospitals significantly decreased their level of perceived stress and enhanced their psychological quality of life.
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Affiliation(s)
| | | | - Khushbu Jain
- Department of Allied Sciences, Morarji Desai National Institute of Yoga, New Delhi, India
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14
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Antonelli M, Donelli D. Evaluating qigong as integrative support for COVID-19 and Long-COVID-19 rehabilitation: a systematic review. Front Psychol 2024; 15:1403130. [PMID: 38807958 PMCID: PMC11130475 DOI: 10.3389/fpsyg.2024.1403130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction Amidst the ongoing global impact of COVID-19 on public health, there is an increasing focus on holistic strategies encompassing integrative therapies and rehabilitation techniques, particularly in addressing the challenges posed by Long-COVID-19. This review investigates the potential of Qigong, an ancient Chinese practice characterized by gentle movements, controlled breathing, and meditative elements, within the context of COVID-19. Methods A systematic search of PubMed, EMBASE, Web of Science, Scopus, and Google Scholar was conducted to identify pertinent clinical studies. Results Following thorough database scrutiny, nine studies were identified as meeting the eligibility criteria. Across the spectrum of COVID-19 severity, individuals engaging in qigong practice exhibited notable enhancements in both physical and psychological wellbeing, evidenced by ameliorated respiratory symptoms, reduced anxiety levels, enhanced sleep quality, bolstered mental wellbeing, and augmented health-related quality of life. Moreover, qigong training, whether employed independently or in conjunction with other therapies, demonstrated beneficial effects on Long-COVID-19 symptoms, encompassing persistent respiratory issues, dizziness, sleep disturbances, and compromised health-related quality of life. Discussion This review underscores the necessity for further investigation to quantify and standardize the contribution of Qigong to COVID-19 recovery and rehabilitation. Such endeavors aim to integrate this accessible and low-impact practice into public health strategies and comprehensive treatment regimens. Systematic review registration The review protocol was registered in the Open Science Framework under the following doi: 10.17605/OSF.IO/7K5X6 (URL: https://osf.io/7k5x6).
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Affiliation(s)
- Michele Antonelli
- Department of Public Health, Azienda Unitá Sanitaria Locale – Istituto di Ricovero e Cura a Carattere Scientifico of Reggio Emilia, Reggio Emilia, Italy
| | - Davide Donelli
- Cardiology Unit, University Hospital of Parma, Parma, Italy
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15
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Williams LA, Tzelios K, Masser B, Thijsen A, van Dongen A, Davison TE. A virtual reality paradigm simulating blood donation serves as a platform to test interventions to promote donation. Sci Rep 2024; 14:10334. [PMID: 38710774 DOI: 10.1038/s41598-024-60578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Effective interventions that support blood donor retention are needed. Yet, integrating an intervention into the time-pressed and operationally sensitive context of a blood donation center requires justification for disruptions to an optimized process. This research provides evidence that virtual reality (VR) paradigms can serve as a research environment in which interventions can be tested prior to being delivered in blood donation centers. Study 1 (N = 48) demonstrated that 360°-video VR blood donation environments elicit a similar profile of emotional experience to a live donor center. Presence and immersion were high, and cybersickness symptoms low. Study 2 (N = 134) was an experiment deploying the 360°-video VR environments to test the impact of an intervention on emotional experience and intentions to donate. Participants in the intervention condition who engaged in a suite of tasks drawn from the process model of emotion regulation (including attentional deployment, positive reappraisal, and response modulation) reported more positive emotion than participants in a control condition, which in turn increased intentions to donate blood. By showing the promise for benefitting donor experience via a relatively low-cost and low-resource methodology, this research supports the use of VR paradigms to trial interventions prior to deployment in operationally-context field settings.
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Affiliation(s)
| | | | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Australia
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, Australia
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Amanda Thijsen
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, Australia
| | - Anne van Dongen
- Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
| | - Tanya E Davison
- Monash Art, Design and Architecture, Monash University, Melbourne, Australia
- Research and Innovation, Silverchain, Melbourne, Australia
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16
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Neri B, Callara AL, Vanello N, Menicucci D, Zaccaro A, Piarulli A, Laurino M, Norbu N, Kechok J, Sherab N, Gemignani A. Report from a Tibetan Monastery: EEG neural correlates of concentrative and analytical meditation. Front Psychol 2024; 15:1348317. [PMID: 38756494 PMCID: PMC11098278 DOI: 10.3389/fpsyg.2024.1348317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
The positive effects of meditation on human wellbeing are indisputable, ranging from emotion regulation improvement to stress reduction and present-moment awareness enhancement. Changes in brain activity regulate and support these phenomena. However, the heterogeneity of meditation practices and their cultural background, as well as their poor categorization limit the generalization of results to all types of meditation. Here, we took advantage of a collaboration with the very singular and precious community of the Monks and Geshes of the Tibetan University of Sera-Jey in India to study the neural correlates of the two main types of meditation recognized in Tibetan Buddhism, namely concentrative and analytical meditation. Twenty-three meditators with different levels of expertise underwent to an ecological (i.e., within the monastery) EEG acquisition consisting of an analytical and/or concentrative meditation session at "their best," and with the only constraint of performing a 5-min-long baseline at the beginning of the session. Time-varying power-spectral-density estimates of each session were compared against the baseline (i.e., within session) and between conditions (i.e., analytical vs. concentrative). Our results showed that concentrative meditation elicited more numerous and marked changes in the EEG power compared to analytical meditation, and mainly in the form of an increase in the theta, alpha and beta frequency ranges. Moreover, the full immersion in the Monastery life allowed to share the results and discuss their interpretation with the best scholars of the Monastic University, ensuring the identification of the most expert meditators, as well as to highlight better the differences between the different types of meditation practiced by each of them.
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Affiliation(s)
- Bruno Neri
- Dipartimento di Ingegneria dell’Informazione, University of Pisa, Pisa, Italy
| | - Alejandro Luis Callara
- Dipartimento di Ingegneria dell’Informazione, University of Pisa, Pisa, Italy
- Research Center “E. Piaggio”, University of Pisa, Pisa, Italy
| | - Nicola Vanello
- Dipartimento di Ingegneria dell’Informazione, University of Pisa, Pisa, Italy
- Research Center “E. Piaggio”, University of Pisa, Pisa, Italy
| | - Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Andrea Zaccaro
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Andrea Piarulli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | | | - Ngawang Norbu
- Sera Jey Monastic University for Advanced Buddhist Studies & Practice, Bylakuppe, Mysore, India
| | - Jampa Kechok
- Sera Jey Monastic University for Advanced Buddhist Studies & Practice, Bylakuppe, Mysore, India
| | - Ngawang Sherab
- Sera Jey Monastic University for Advanced Buddhist Studies & Practice, Bylakuppe, Mysore, India
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Chawla M. 4 C's Approach to Meaningful and Lasting Positive Behavior Change. Am J Lifestyle Med 2024; 18:431-434. [PMID: 38737883 PMCID: PMC11082866 DOI: 10.1177/15598276231204287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Making intentional and sustainable positive behavior changes is difficult for most individuals. Knowledge and even expert coaching have shown meager results in guiding individuals towards a healthier diet and lifestyle. It is clear from the current research that additional approaches, which can help stem the tide of obesity and other chronic diseases, are needed. This article introduces a systematic process-based approach which focuses on the 4C's, Clarity, Commitment, Compassion, and Consistency. It is essential for individuals to have Clarity before they begin their health journey. Clarity must address, what do I want to change, why, and how am I going to make the change. Commitment highlights the importance of following a process-based approach that focuses on small incremental changes which over time can lead to remarkable results. Compassion is the necessary ingredient which allows individuals to continue the journey despite setbacks. By staying committed to the process, by practicing self-compassion, and by finding a healthy community, the individual is slowly able to achieve Consistency in achieving and then maintaining a healthier diet and lifestyle.
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Affiliation(s)
- Munish Chawla
- Voluntary Clinical Faculty, UH College of Medicine, Bellaire, TX, USA (MC)
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18
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Liu YY, Lu HB, Li YJ, Wang ZY, Liu YH, Qiao S, Xie J. Effects of mindful breathing training combined with diary-based rehabilitation guidance in lung cancer patients undergoing surgery: A randomized controlled trial. Complement Ther Clin Pract 2024; 55:101849. [PMID: 38522328 DOI: 10.1016/j.ctcp.2024.101849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND AND PURPOSE Lung cancer surgery patients experience severe physical and mental symptoms, which seriously affect their quality of life and prognosis. Mindful breathing training is a promising strategy to improve their symptoms, but its effectiveness is affected by training compliance, and diary-based rehabilitation instruction has been shown to help improve training compliance. Therefore, the aim of this study was to evaluate the effects of mindful breathing training combined with diary-based rehabilitation guidance on improving perioperative outcomes in lung cancer surgery patients. MATERIALS AND METHODS This single-center, assessor-blinded, prospective, three-arm randomized controlled trial was conducted from November 1, 2021 to November 1, 2022. Patients diagnosed with primary non-small cell lung cancer and scheduled for thoracoscopic surgery were randomly allocated to the combined intervention group, the mindful breathing group or the control group, with 34 patients in each group. The control group received routine care, while the mindful breathing group received mindful breathing training and routine care. The combined intervention group received both mindful breathing training and diary-based rehabilitation guidance, along with routine care. RESULTS The per-protocol analysis revealed that patients in the mindful breathing group experienced statistically significant improvements in dyspnea, fatigue and anxiety. Patients in the combined intervention group had statistically significant improvements in dyspnea, fatigue, anxiety, depression, exercise self-efficacy and training compliance. CONCLUSION This study provides evidence that mindful breathing training combined with diary-based rehabilitation guidance can be effective in improving perioperative outcomes in lung cancer patients. It can be applied in clinical practice in the future.
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Affiliation(s)
- Yan-Yan Liu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
| | - Han-Bing Lu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
| | - Ya-Jie Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
| | - Zi-Yu Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
| | - Yu-Han Liu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
| | - Shuai Qiao
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
| | - Jiao Xie
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
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19
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Zaccaro A, della Penna F, Mussini E, Parrotta E, Perrucci MG, Costantini M, Ferri F. Attention to cardiac sensations enhances the heartbeat-evoked potential during exhalation. iScience 2024; 27:109586. [PMID: 38623333 PMCID: PMC11016802 DOI: 10.1016/j.isci.2024.109586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/17/2024] Open
Abstract
Respiration and cardiac activity intricately interact through complex physiological mechanisms. The heartbeat-evoked potential (HEP) is an EEG fluctuation reflecting the cortical processing of cardiac signals. We recently found higher HEP amplitude during exhalation than inhalation during a task involving attention to cardiac sensations. This may have been due to reduced cardiac perception during inhalation and heightened perception during exhalation through attentional mechanisms. To investigate relationships between HEP, attention, and respiration, we introduced an experimental setup that included tasks related to cardiac and respiratory interoceptive and exteroceptive attention. Results revealed HEP amplitude increases during the interoceptive tasks over fronto-central electrodes. When respiratory phases were taken into account, HEP increases were primarily driven by heartbeats recorded during exhalation, specifically during the cardiac interoceptive task, while inhalation had minimal impact. These findings emphasize the role of respiration in cardiac interoceptive attention and could have implications for respiratory interventions to fine-tune cardiac interoception.
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Affiliation(s)
- Andrea Zaccaro
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesca della Penna
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Elena Mussini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Eleonora Parrotta
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Marcello Costantini
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesca Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
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20
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Maqsood R, Schofield S, Bennett AN, Khattab A, Bull AMJ, Fear NT, Boos CJ. Exploratory analysis of spontaneous versus paced breathing on heart rate variability in veterans with combat-related traumatic injury. PM R 2024. [PMID: 38634349 DOI: 10.1002/pmrj.13164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Respiration is a crucial determinant of autonomic balance and heart rate variability (HRV). The comparative effect of spontaneous versus paced breathing on HRV has been almost exclusively explored in healthy adults and never been investigated in an injured military cohort. OBJECTIVE To examine the effect of spontaneous versus paced breathing on HRV in veterans with combat-related traumatic injury (CRTI). DESIGN Observational cohort study. SETTING ArmeD serVices trAuma rehabilitatioN outComE (ADVANCE) study, Stanford Hall, UK. PARTICIPANTS The sample consisted of 100 randomly selected participants who sustained CRTI (eg, amputation) during their deployment (Afghanistan 2003-2014) and were recruited into the ongoing ADVANCE prospective cohort study. INTERVENTION Not applicable. MAIN OUTCOME MEASURE HRV was recorded using a single-lead ECG. HRV data were acquired during a sequential protocol of 5-minute spontaneous breathing followed immediately by 5 minutes of paced breathing (six cycles/minute) among fully rested and supine participants. HRV was reported using time domain (root mean square of successive differences), frequency domain (low frequency and high frequency) and nonlinear (sample entropy) measures. The agreement between HRV during spontaneous versus paced breathing was examined using the Bland-Altman analysis. RESULTS The mean age of participants was 36.5 ± 4.6 years. Resting respiratory rate was significantly higher with spontaneous versus paced breathing (13.4 ± 3.4 vs. 7.6 ± 2.0 breaths/minute; p < .001), respectively. Resting mean heart rate and root mean square of successive differences were significantly higher with paced breathing than spontaneous breathing (p < .001). Paced breathing significantly increased median low frequency power than spontaneous breathing (p < .001). No significant difference was found in the absolute power of high frequency between the two breathing protocols. The Bland-Altman analysis revealed poor agreement between HRV values during spontaneous and paced breathing conditions with wide limits of agreement. CONCLUSION Slow-paced breathing leads to higher HRV than spontaneous breathing and could overestimate resting "natural-state" HRV.
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Affiliation(s)
- Rabeea Maqsood
- Department of Medical Sciences and Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Susie Schofield
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Alexander N Bennett
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Loughborough, UK
| | - Ahmed Khattab
- Department of Medical Sciences and Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Anthony M J Bull
- Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, London, UK
| | - Nicola T Fear
- The Academic Department of Military Mental Health, King's College London, London, UK
| | - Christopher J Boos
- Department of Medical Sciences and Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
- Department of Cardiology, University Hospitals Dorset, Poole Hospital, Poole, UK
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21
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Cheese MD, Kass D, Hammaker K. The efficacy of a virtual and in-person mindfulness-based intervention course on university students' during COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38592806 DOI: 10.1080/07448481.2024.2334078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 02/22/2024] [Indexed: 04/11/2024]
Abstract
Objective: The purpose of this research was to evaluate the impact of a mindfulness-based intervention (MBI) on university students during the COVID-19 pandemic. Methods and participants: There were 53 participants who voluntarily enrolled in a mindfulness course at a regional state university (24 virtual and 29 in-person) and 56 in the control group. Participants completed surveys at the beginning and end of the course on mindfulness, life satisfaction, and resilience. Results: Results revealed that the in-person group showed significantly higher mindfulness, life satisfaction, and resilience over the course of the semester. The virtual group showed increases across all three variables as well, but only significantly improved on resilience. Conclusion: Results indicate that the inclusion of MBIs in university courses may be a cost-effective and proactive means to support the mental health and well-being of college students, and that in-person delivery may be a more effective modality.
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Affiliation(s)
- Melissa D Cheese
- Department of English, Commonwealth University of Pennsylvania, Bloomsburg, Pennsylvania, USA
| | - Darrin Kass
- Department of Management, Commonwealth University of Pennsylvania, Bloomsburg, Pennsylvania, USA
| | - Kristi Hammaker
- Student Health and Wellness, Commonwealth University of Pennsylvania, Bloomsburg, Pennsylvania, USA
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22
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Cong L, Yu X, Huang M, Sun J, Lv H, Zhang T, Dang W, Teng C, Xiong K, Ma J, Hu W, Wang J, Cheng S. Enhancing emotion regulation: investigating the efficacy of transcutaneous electrical acupoint stimulation at PC6 in reducing fear of heights. Front Psychol 2024; 15:1371014. [PMID: 38633874 PMCID: PMC11021653 DOI: 10.3389/fpsyg.2024.1371014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
This study investigated the impact of transcutaneous electrical acupoint stimulation (TEAS) at Neiguan acupoint (PC6) on the physiological and behavioral responses of participants exposed in virtual height. 40 participants were included in the study and were randomly assigned to either a control group or an intervention group. Participants had an immersive experience with a VR interactive platform that provided somatosensory interaction in height stimulation scenes. Psychological scores, behavioral and cognitive performance, and physiological responses were recorded and analyzed. The results indicated that the intervention group had significantly lower fear scores compared to the control group. Analysis of heart rate variability revealed that the intervention group exhibited improved heart rate variability, indicating enhanced cardiovascular function and emotion regulation. The behavioral and cognitive results demonstrated that the intervention group exhibited higher left eye openness, faster reaction times, and greater movement distance, suggesting enhanced attentional focus, cognitive processing, and reduced avoidance behaviors. These findings suggest that TEAS at PC6 can effectively reduce fear and improve the regulation of physiological and behavioral responses to negative emotional stimuli.
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Affiliation(s)
- Lin Cong
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Xiao Yu
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Meiqing Huang
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Jicheng Sun
- Center for Military Medicine Innovation, Air Force Medical University, Xi’an, China
| | - Hao Lv
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Taihui Zhang
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Weitao Dang
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Chaolin Teng
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Kaiwen Xiong
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Jin Ma
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Wendong Hu
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
| | - Jianqi Wang
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Shan Cheng
- School of Aerospace Medicine, Air Force Medical University, Xi’an, China
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23
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Orgil Z, Karthic A, Bell NF, Heisterberg LM, Williams SE, Ding L, Kashikar-Zuck S, King CD, Olbrecht VA. Feasibility and Acceptability of Biofeedback-Based Virtual Reality System Use in Children and Adolescents Undergoing Surgery: Phase 1 of a Pilot Observational Study. JMIR Perioper Med 2024. [PMID: 38742940 DOI: 10.2196/48959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Biofeedback-based virtual reality (VR-BF) is a novel, nonpharmacologic method for teaching patients how to control their breathing, which in turn increases heart rate variability (HRV) and may reduce pain. Unlike traditional forms of biofeedback (BF), VR-BF is delivered through a gamified virtual reality environment, increasing the accessibility of BF. This is the first study to systematically integrate VR-BF use in the pediatric perioperative setting, with the ultimate goal of evaluating the efficacy of VR-BF to reduce pain, anxiety, and opioid consumption once feasibility and acceptability has been established. OBJECTIVE The primary objective was to develop a clinical trial protocol for VR-BF use in the pediatric perioperative setting, including preoperative education/training and postoperative application of VR-BF in children undergoing surgery. A secondary objective was to evaluate the patient/parent experience with VR-BF. METHODS A total of 23 patients (12-18 years of age) scheduled for surgery at Nationwide Children's Hospital were recruited using purposive sampling. Following training, participants independently completed a daily, 10-minute VR-BF session for seven days before surgery and during their inpatient stay. Participants could use VR-BF up to two weeks after hospital discharge. Patient and session-level data of VR-BF usage and achievement of target HRV parameters were measured to identify the optimal frequency and duration of sessions before and after surgery for this population. Standardized questionnaires and semi-structured interviews were conducted to obtain qualitative information about patients' experiences with VR-BF. RESULTS Patient-level data indicated that the highest odds of achieving 1 session under target HRV parameters was after 4 sessions (OR 4 vs. 3 sessions=5.1, 95% CI 1.3-20.6; OR 3 vs. 2 sessions=16.6, 95% CI 1.2-217.0). Session-level data showed that a session duration of 9 to 10 minutes provided the greatest odds of achieving 1 session under target HRV parameters (OR 9 vs. 8 minutes=1.3, 95% CI 1.1-1.7; OR 8 vs. 7 minutes=1.4, 95% CI 1.1-1.8; OR 10 vs. 9 minutes=1.0, 95% CI 0.9-1.2). Qualitative data revealed patient satisfaction with the VR-BF technology, particularly in managing perioperative stress (n=17, 85%). Few patients reported VR-BF as beneficial for pain (n=8, 40%). CONCLUSIONS Children and adolescents undergoing surgery successfully learned behavioral strategies with VR-BF with once-daily 10-minute sessions for 5 days. To integrate VR-BF as a therapeutic intervention in a subsequent clinical trial, patients will be instructed to complete three 10-minute sessions a day for 7 days after surgery. CLINICALTRIAL ClinicalTrials.gov; NCT04943874; https://clinicaltrials.gov/ct2/show/NCT04943874.
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Affiliation(s)
- Zandantsetseg Orgil
- Department of Clinical Research Services, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, US
| | - Anitra Karthic
- The Ohio State University College of Medicine, Columbus, US
| | - Nora F Bell
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, US
| | | | - Sara E Williams
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, US
| | - Lili Ding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, US
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, US
| | - Susmita Kashikar-Zuck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, US
- Pediatric Pain Research Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, US
| | - Christopher D King
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, US
- Pediatric Pain Research Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, US
| | - Vanessa A Olbrecht
- Department of Anesthesiology & Perioperative Medicine, Nemours Children's Health, Delaware Valley, 1600 Rockland Road, Wilmington, US
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24
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Newman DB, Gordon AM, O'Bryan J, Mendes WB. Stress reduction experiments in daily life: Scaling from the lab to the world. J Exp Psychol Gen 2024; 153:1076-1092. [PMID: 38358707 PMCID: PMC11001525 DOI: 10.1037/xge0001546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Paced breathing-longer exhalation than inhalation-can show short-term improvement of physiologic responses and affective well-being, though most studies have relied on narrow sample demographics, small samples, and control conditions that fail to address expectancy effects. We addressed these limitations through an app-based experiment where participants were randomly assigned to paced breathing or sham control (hand closure) conditions. We first validated the conditions in an online sample (N = 201; Study 1) and in a lab environment (N = 72; Study 2). In the primary app-based experiment, participants (N = 3,277; Study 3) completed 3 days of baseline assessments that included three check-ins each day in which we obtained heart rate and blood pressure responses using an optic sensor and assessed current stress and emotions. Participants were then randomly assigned to either the paced breathing or hand closure condition for the next 6 days. Relative to baseline days, both conditions were associated with increased positive emotions and perceived coping, and reduced blood pressure. Moreover, the increase in positive emotions and perceived coping was not evident among a comparison sample (N = 2,600) who completed check-ins but did not participate in either of the paced breathing or sham-control conditions. However, their blood pressure declined over time, suggesting that the continual monitoring of one's blood pressure may result in detectable decreases. Our results highlight the importance of designing experiments with appropriately matched control conditions and suggest that changes associated with techniques like paced breathing, in part, may stem from positive incidental features of the technique. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- David B Newman
- Department of Psychology and Neuroscience, Baylor University
| | | | - Julia O'Bryan
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
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25
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Vanutelli ME, Grigis C, Lucchiari C. Breathing Right… or Left! The Effects of Unilateral Nostril Breathing on Psychological and Cognitive Wellbeing: A Pilot Study. Brain Sci 2024; 14:302. [PMID: 38671954 PMCID: PMC11048276 DOI: 10.3390/brainsci14040302] [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: 01/31/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
The impact of controlled breathing on cognitive and affective processing has been recognized since ancient times, giving rise to multiple practices aimed at achieving different psychophysical states, mostly related to mental clarity and focus, stress reduction, and relaxation. Previous scientific research explored the effects of forced unilateral nostril breathing (UNB) on brain activity and emotional and cognitive functions. Some evidence concluded that it had a contralateral effect, while other studies presented controversial results, making it difficult to come to an unambiguous interpretation. Also, a few studies specifically addressed wellbeing. In the present study, we invited a pilot sample of 20 participants to take part in an 8-day training program for breathing, and each person was assigned to either a unilateral right nostril (URNB) or left nostril breathing condition (ULNB). Then, each day, we assessed the participants' wellbeing indices using their moods and mind wandering scales. The results revealed that, after the daily practice, both groups reported improved wellbeing perception. However, the effect was specifically related to the nostril involved. URNB produced more benefits in terms of stress reduction and relaxation, while ULNB significantly and increasingly reduced mind-wandering occurrences over time. Our results suggest that UNB can be effectively used to increase wellbeing in the general population. Additionally, they support the idea that understanding the effects of unilateral breathing on wellbeing and cognition requires a complex interpretive model with multiple brain networks to address bottom-up and top-down processes.
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Affiliation(s)
- Maria Elide Vanutelli
- Department of Philosophy “Piero Martinetti”, Università degli Studi di Milano, 20122 Milan, Italy; (M.E.V.); (C.G.)
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Chiara Grigis
- Department of Philosophy “Piero Martinetti”, Università degli Studi di Milano, 20122 Milan, Italy; (M.E.V.); (C.G.)
| | - Claudio Lucchiari
- Department of Philosophy “Piero Martinetti”, Università degli Studi di Milano, 20122 Milan, Italy; (M.E.V.); (C.G.)
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26
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Sharma NK, Li H, Aoyagi K, Ritchey S, Mohr E, Burton DC, Arnold PM, Colgrove Y. Tailored Yoga Intervention for Postlumbar Spine Surgical Pain Management: A Feasibility Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 38513063 DOI: 10.1089/jicm.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Introduction: Severe pain, anxiety, and high opioid use are common following lumbar spine surgery (LSS). Yoga helps to reduce pain and anxiety, but it has not been considered for postsurgical care. The authors developed and tested the feasibility of a tailored yoga program designed for individuals undergoing LSS and explored clinical feasibility of yoga intervention on measures of pain, function, psychological status, and opioid use. Methods: Individuals scheduled for LSS were randomized into yoga versus control groups presurgery. Participants in the yoga group received tailored yoga sessions plus usual care, whereas participants in the control group received usual care only during the hospital stay post-LSS. In-person daily yoga sessions were individually presented and performed in the participant's hospital room. Feasibility was assessed by recruitment and retention rates, rate of yoga session completion, tolerance to yoga intervention, and ability to carry out planned assessment. Exploratory clinical outcomes included pain, psychological measures, Timed-Up-and-Go test, gait distance, and opioid use, during the hospital stay post-LSS. Results: Forty-one participants were enrolled, of which 30 completed. There were no dropouts. Planned assessments were completed within 45 min, suggesting no excessive burden on participants. Baseline variables were similar across both groups. The majority of participants participated in yoga intervention on the day of surgery or one day after surgery with acceptance rate of 100%. Participants showed good tolerance to yoga intervention on 0-4 tolerance scale and by their reports of exploratory clinical outcomes. Conclusion: This study indicates feasibility for a modified yoga program for postoperative care following LSS due to participant tolerance and retention. The results provide preliminary framework for future confirmatory studies that can assess the potential benefits of yoga in reducing pain, catastrophizing behavior, and opioid use and improving function. A modified yoga program focusing on diaphragmatic breathing, relaxation, and core isometric contraction exercises can be an important adjunct intervention for patients undergoing LSS. CTR Number: This trial was registered in UMIN CTR (https://rctportal.niph.go.jp/en/) with registration number: UMIN000032595.
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Affiliation(s)
- Neena K Sharma
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Haiyin Li
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Kosaku Aoyagi
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Physical Therapy and Movement Science, College of Health Sciences, University of Texas at El Paso, El Paso, Texas, USA
| | - Shannon Ritchey
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Elisa Mohr
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Douglas C Burton
- Department of Orthopedic Surgery, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Paul M Arnold
- Department of Neurosurgery, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Yvonne Colgrove
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
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Chhajer R, Dagar C. Examining the impact of a restorative breath-based intervention " Sudarshan Kriya Yoga" at work: a field experiment. Front Psychol 2024; 15:1327119. [PMID: 38505368 PMCID: PMC10949861 DOI: 10.3389/fpsyg.2024.1327119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/09/2024] [Indexed: 03/21/2024] Open
Abstract
Background Human capital plays a crucial role in the success of an organization and further contributes to the broader goals of growth and development of society. In this regard, it is essential to ensure the well-being of employees at the workplace. Given the positive impact of yoga on psycho-physiological aspects of health, this study aims to examine the impact of a breath-based yogic intervention, Sudarshan Kriya Yoga (SKY), on stress, anxiety, thriving, general health, emotional well-being, social well-being, and psychological well-being among employees of a leading manufacturing firm in India. Methods Undertaking a randomized-control experiment design (n = 64), we examined the impact of SKY on stress, anxiety, thriving, general health, and emotional, social, and psychological well-being. Two certified instructors conducted the SKY intervention in a retreat format over 3 days. Results The analysis demonstrated positive outcomes across various aspects of participants' well-being, i.e., it significantly reduced their stress and anxiety and increased the levels of thriving, general health, and emotional, social, and psychological well-being. These findings are valuable for understanding the potential benefits of the SKY intervention. Discussion The findings provide support for considering SKY as a potential well-being intervention for employers at the workplace and society at large. Further exploration, implementation, and research in diverse contexts will be crucial to fully understand the long-term impact and scalability of the SKY intervention in promoting holistic well-being.
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Affiliation(s)
- Raina Chhajer
- Humanities and Social Sciences Area, Indian Institute of Management, Indore, India
| | - Chirag Dagar
- XLRI - Xavier School of Management, Jamshedpur, India
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28
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Doornich JB, Lynch HM. The mindful leader: a review of leadership qualities derived from mindfulness meditation. Front Psychol 2024; 15:1322507. [PMID: 38505367 PMCID: PMC10948432 DOI: 10.3389/fpsyg.2024.1322507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/29/2024] [Indexed: 03/21/2024] Open
Abstract
Mindfulness has been practiced by global leaders and companies as an efficient way to build effective leadership. Because of its popularity, plus the lack of a comprehensive theoretical framework that explains it in a leadership context, the research literature has called for a coherent account of the qualities that is derived by those leaders that practice mindfulness. Here, we aim to answer that call, by clarifying what leadership qualities can develop from practicing mindfulness. We report on a semi-systematic literature review of extant research, covering 19 research articles published between 2000 and 2021, plus other relevant supporting literature from the disciplines of leadership and neuropsychology. Our proposed framework consists of three main qualities of the mindful leader: attention, awareness, and authenticity. We call them the "three pillars of mindful leaders." We also propose that mindfulness meditation must be integrated into our proposed framework, as we are convinced that leaders who hope to benefit from these qualities must integrate a regular mindfulness meditation practice into their daily leadership life.
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29
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Dada T, Gwal RS, Mahalingam K, Chandran DS, Angmo D, Gupta S, Velpandian T, Deepak KK. Effect of "365 Breathing Technique" on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial. J Glaucoma 2024; 33:149-154. [PMID: 38194285 DOI: 10.1097/ijg.0000000000002356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Abstract
PRCIS Patients with primary open angle glaucoma were advised to follow the "365 breathing technique" for 6 weeks in addition to their pharmacological glaucoma treatment. It helped to reduce intraocular pressure (IOP), stress biomarker-cortisol, and improve autonomic dysfunction. OBJECTIVE To study the effect of the "365 breathing technique" on IOP, autonomic functions, and stress biomarkers in patients with primary open angle glaucoma. METHODS In this randomized, controlled, interventional trial, after randomization, 40 patients in the intervention group followed "365 breathing" (three times a day, breathing rate: 6 cycles/min for 5 min) in addition to their pharmacological glaucoma treatment and 40 patients in the control group continued only with their pharmacological glaucoma treatment. IOP, serum cortisol, heart rate variability (HRV), and heart rate response to deep breathing test (DBT) were recorded at preintervention and 6 weeks postintervention. RESULTS The mean IOP, serum cortisol, parameters of the HRV test, and DBT were comparable between the two groups at baseline. At the 6-week follow-up, in the intervention group, mean IOP was significantly lower (16.09 ± 2.24 vs 18.38 ± 1.58 mm Hg, P = 0.03) and serum cortisol were significantly lower (13.20 ± 3.11 vs 14.95 ± 2.60 mcg/dL, P = 0.038) compared with the control group. In the HRV test, time domain analysis showed a significant difference in the root mean square of the successive difference between RR interval values between both groups at 6 weeks ( P = 0.015) pointing towards higher postintervention parasympathetic activation in the intervention group. In frequency domain analysis (HRV test), the ratio of the low-frequency component to the high-frequency component was significantly lower in the intervention group at 6 weeks (1.65 vs 1.79, P = 0.019) indicating a shift in sympathovagal balance towards greater vagal modulation.There was a significant increase in delta heart rate ( P = 0.019) and expiratory:inspiratory ratio ( P = 0.011) in the intervention group at 6 weeks when compared with baseline values, indicating improved parasympathetic reactivity to DBT. CONCLUSION "365 breathing" technique can reduce IOP and serum cortisol, and improve autonomic dysfunction in patients with glaucoma.
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Affiliation(s)
| | | | | | - Dinu Santha Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Kishore K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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30
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Liu H, Wiedman CM, Lovelace-Chandler V, Gong S, Salem Y. Deep Diaphragmatic Breathing-Anatomical and Biomechanical Consideration. J Holist Nurs 2024; 42:90-103. [PMID: 36734111 DOI: 10.1177/08980101221149866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Deep diaphragmatic breathing (DDB) involves slow and fully contraction of the diaphragm with expansion of the belly during inhalation, and slow and fully contraction of the abdominal muscles with reduction of the belly during exhalation. It is the key component of the holistic mind-body exercises commonly used for patients with multimorbidity. Purpose: The purpose of this study was to re-visit and address the fundamental anatomical and biomechanical consideration of the DDB with the relevant literature. Method: Peer-reviewed publications from last the 15 years were retrieved, reviewed, and analyzed. Findings: In this article, we described the updated morphological and anatomical characteristics of the diaphragm. Then, we elucidated in a biomechanical approach how and why the DDB can work on the gastrointestinal, cardiopulmonary, and nervous systems as well as on regulating the intra-abdominopelvic pressure and mind-body interaction to coordinate the diaphragm-pelvic floor-abdominal complex for a variety of physical and physiological activities. Conclusion: Understanding of this updated DDB knowledge may help holistic healthcare professionals including holistic nurses provide better patient education and care management during the DDB or DDB-based mind-body intervention time.
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Affiliation(s)
- Howe Liu
- Physical Therapy Program, Allen College, Waterloo, IA, USA
| | | | | | - Suzhen Gong
- Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yasser Salem
- Physical Therapy Program, Hofstra University, Hempstead, NY, USA
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31
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Cortez-Vázquez G, Adriaanse M, Burchell GL, Ostelo R, Panayiotou G, Vlemincx E. Virtual Reality Breathing Interventions for Mental Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Appl Psychophysiol Biofeedback 2024; 49:1-21. [PMID: 38236355 PMCID: PMC10869395 DOI: 10.1007/s10484-023-09611-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/19/2024]
Abstract
Breathing exercises have been shown to reduce mental health problems among clinical and non-clinical populations. Although virtual reality (VR) breathing interventions are assumed to have potential benefits, it remains unclear whether VR breathing interventions are more effective at improving mental health than non-VR breathing interventions. We conducted a systematic literature search in six electronic databases (Web of Science, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Scopus, and PubMed) from inception to 30th September, 2022. We included randomized controlled trials in adults evaluating effects of VR compared to non-VR breathing interventions on primary outcomes of mental health (stress, anxiety and mood), and secondary outcomes of physiological stress measures (e.g., heart rate (HR), heart rate variability (HRV)). Within these selected studies, we explored differences in likeability and future use between VR and non-VR breathing interventions. 2.848 records were identified of which 65 full-text articles were assessed. Six RCTs were included, of which five were suitable for meta-analyses. Comparing VR to non-VR breathing interventions, there were no significant differences in overall mental health, stress, anxiety or mood, nor in HR or HRV. There was no evidence that participants liked VR breathing interventions more than non-VR, nor would use them more in the future. These results suggest that there is no evidence that VR breathing interventions are more effective than non-VR in improving mental health outcomes, HR, HRV. Further research is required to determine whether there may be advantages to longer-term VR-implementation and practice, and explore possible mechanisms.
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Affiliation(s)
- Gabriela Cortez-Vázquez
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marcel Adriaanse
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Raymond Ostelo
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC location, Vrije Universiteit, Amsterdam, The Netherlands
| | - Georgia Panayiotou
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Elke Vlemincx
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands.
- Health Psychology, KU Leuven, Leuven, Belgium.
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32
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DeGraves BS, Titley H, Duan Y, Thorne TE, Banerjee S, Ginsburg L, Salma J, Hegadoren K, Angel C, Keefe J, Lanius R, Estabrooks CA. Workforce resilience supporting staff in managing stress: A coherent breathing intervention for the long-term care workforce. J Am Geriatr Soc 2024; 72:753-766. [PMID: 38156430 DOI: 10.1111/jgs.18727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/14/2023] [Accepted: 11/12/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Staff in long-term care (LTC) homes have long-standing stressors, such as short staffing and high workloads. These stressors increased during the COVID-19 pandemic; better resources are needed to help staff manage stress and well-being. The purpose of this study was to evaluate the effect of a simple stress management strategy (coherent breathing). METHODS We conducted a pre-post intervention study to evaluate a self-managed coherent breathing intervention from February to September 2022. The intervention included basic (breathing only) and comprehensive (breathing plus a biofeedback device) groups. Six hundred eighty-six participants were initially recruited (359 and 327 in the comprehensive and basic groups respectively) from 31 LTC homes in Alberta, Canada. Two hundred fifty-four participants completed pre-and post-intervention questionnaires (142 [55.9%] in comprehensive and 112 [44.1%] in basic). Participants were asked to use coherent breathing based on a schedule increasing from 2 to 10 min daily, 5-7 times a week over 8 weeks. Participants completed self-administered online questionnaires pre- and post-intervention to assess outcomes-stress, psychological distress, anxiety, depression, resilience, insomnia, compassion satisfaction, compassion fatigue, and burnout. We used a mixed-effects regression model to test the main effect of time (pre- and post-intervention) and group while testing the interaction between time and group and controlling for covariates. RESULTS We found statistically significant changes from pre- to post-intervention in stress (b = -2.5, p < 0.001, 95% CI = -3.1, -1.9), anxiety (b = -0.5, p < 0.001, 95% CI = -0.7, -0.3), depression (b = -0.4, p < 0.001, 95% CI = -0.6, -0.2), insomnia (b = -1.5, p < 0.001, 95% CI = -2.1, -0.9), and resilience (b = 0.2, p < 0.001, 95% CI = 0.1, 0.2). We observed no statistically significant differences between the two intervention groups on any outcome. CONCLUSIONS Our findings suggest that coherent breathing is a promising strategy for improving stress-related outcomes and resilience. This intervention warrants further, more rigorous testing.
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Affiliation(s)
| | - Heather Titley
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Trina E Thorne
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Liane Ginsburg
- School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Jordana Salma
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Cybele Angel
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Janice Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Ruth Lanius
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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You M, Laborde S, Ackermann S, Borges U, Dosseville F, Mosley E. Influence of Respiratory Frequency of Slow-Paced Breathing on Vagally-Mediated Heart Rate Variability. Appl Psychophysiol Biofeedback 2024; 49:133-143. [PMID: 38063977 DOI: 10.1007/s10484-023-09605-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 02/16/2024]
Abstract
Breathing techniques, particularly slow-paced breathing (SPB), have gained popularity among athletes due to their potential to enhance performance by increasing cardiac vagal activity (CVA), which in turn can help manage stress and regulate emotions. However, it is still unclear whether the frequency of SPB affects its effectiveness in increasing CVA. Therefore, this study aimed to investigate the effects of a brief SPB intervention (i.e., 5 min) on CVA using heart rate variability (HRV) measurement as an index. A total of 75 athletes (22 female; Mage = 22.32; age range = 19-31) participated in the study, attending one lab session where they performed six breathing exercises, including SPB at different frequencies (5 cycles per minute (cpm), 5.5 cpm, 6 cpm, 6.5 cpm, 7 cpm), and a control condition of spontaneous breathing. The study found that CVA was significantly higher in all SPB conditions compared to the control condition, as indexed by both root mean square of the successive differences (RMSSD) and low-frequency HRV (LF-HRVms2). Interestingly, LF-HRVms2 was more sensitive in differentiating the respiratory frequencies than RMSSD. These results suggest that SPB at a range of 5 cpm to 7 cpm can be an effective method to increase CVA and potentially improve stress management and emotion regulation in athletes. This short SPB exercise can be a simple yet useful tool for athletes to use during competitive scenarios and short breaks in competitions. Overall, these findings highlight the potential benefits of incorporating SPB into athletes' training and competition routines.
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Affiliation(s)
- Min You
- School of Teacher Education, University of Weifang, Weifang, China.
- UFR Psychologie, UR 3918 CERREV, Université de Caen Normandie, Caen, 14032, France.
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University, Cologne, Germany
- UFR STAPS, UR 7480 VERTEX, Université de Caen Normandie, Caen, 14032, France
| | - Stefan Ackermann
- Department of Performance Psychology, Institute of Psychology, German Sport University, Cologne, Germany
| | - Uirassu Borges
- Department of Health & Social Psychology, Institute of Psychology, German Sport University, Cologne, Germany
| | - Fabrice Dosseville
- UFR STAPS, UR 7480 VERTEX, Université de Caen Normandie, Caen, 14032, France
- CNDAPS, Colombelles, F-14460, France
| | - Emma Mosley
- Department of Rehabilitation and Sport Sciences, School of Sport, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
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Nakamura NH, Oku Y, Fukunaga M. "Brain-breath" interactions: respiration-timing-dependent impact on functional brain networks and beyond. Rev Neurosci 2024; 35:165-182. [PMID: 37651646 DOI: 10.1515/revneuro-2023-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/06/2023] [Indexed: 09/02/2023]
Abstract
Breathing is a natural daily action that one cannot do without, and it sensitively and intensely changes under various situations. What if this essential act of breathing can impact our overall well-being? Recent studies have demonstrated that breathing oscillations couple with higher brain functions, i.e., perception, motor actions, and cognition. Moreover, the timing of breathing, a phase transition from exhalation to inhalation, modulates specific cortical activity and accuracy in cognitive tasks. To determine possible respiratory roles in attentional and memory processes and functional neural networks, we discussed how breathing interacts with the brain that are measured by electrophysiology and functional neuroimaging: (i) respiration-dependent modulation of mental health and cognition; (ii) respiratory rhythm generation and respiratory pontomedullary networks in the brainstem; (iii) respiration-dependent effects on specific brainstem regions and functional neural networks (e.g., glutamatergic PreBötzinger complex neurons, GABAergic parafacial neurons, adrenergic C1 neurons, parabrachial nucleus, locus coeruleus, temporoparietal junction, default-mode network, ventral attention network, and cingulo-opercular salience network); and (iv) a potential application of breathing manipulation in mental health care. These outlines and considerations of "brain-breath" interactions lead to a better understanding of the interoceptive and cognitive mechanisms that underlie brain-body interactions in health conditions and in stress-related and neuropsychiatric disorders.
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Affiliation(s)
- Nozomu H Nakamura
- Division of Physiome, Department of Physiology, Hyogo Medical University, 1-1, Mukogawa cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshitaka Oku
- Division of Physiome, Department of Physiology, Hyogo Medical University, 1-1, Mukogawa cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Masaki Fukunaga
- Section of Brain Function Information, National Institute of Physiological Sciences, 38 Nishigonaka Myodaiji, Okazaki, Aichi 444-8585, Japan
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Bischoff H, Kovach C, Kumar S, Bruss J, Tranel D, Khalsa SS. Sensing, Feeling, and Regulating: Investigating the Association of Focal Brain Damage with Voluntary Respiratory and Motor Control. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.16.562254. [PMID: 37905134 PMCID: PMC10614780 DOI: 10.1101/2023.10.16.562254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Breathing is a complex, vital function that can be modulated to influence physical and mental well-being. However, the role of cortical and subcortical brain regions in voluntary control of human respiration is underexplored. Here we investigated the influence of damage to human frontal, temporal, or limbic regions on the sensation and regulation of breathing patterns. Participants performed a respiratory regulation task across regular and irregular frequencies ranging from 6 to 60 breaths per minute (bpm), with a counterbalanced hand motor control task. Interoceptive and affective states induced by each condition were assessed via questionnaire and autonomic signals were indexed via skin conductance. Participants with focal lesions to the bilateral frontal lobe, right insula/basal ganglia, and left medial temporal lobe showed reduced performance than individually matched healthy comparisons during the breathing and motor tasks. They also reported significantly higher anxiety during the 60-bpm regular and irregular breathing trials, with anxiety correlating with difficulty in rapid breathing specifically within this group. This study demonstrates that damage to frontal, temporal, or limbic regions is associated with abnormal voluntary respiratory and motor regulation and tachypnea-related anxiety, highlighting the role of the forebrain in affective and motor responses during breathing. Highlights Impaired human respiratory regulation is associated with cortical/subcortical brain lesionsFrontolimbic/temporal regions contribute to rhythmic breathing and hand motor controlFrontolimbic/temporal damage is associated with anxiety during tachypnea/irregular breathingThe human forebrain is vital for affective and interoceptive experiences during breathing.
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Kobayashi R, Negoro H. Acute effects of the 4-4-8 breathing technique on arterial stiffness in healthy young men. Cardiol J 2024; 31:418-426. [PMID: 38348911 PMCID: PMC11229811 DOI: 10.5603/cj.96299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 12/01/2023] [Accepted: 12/23/2023] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Increased arterial stiffness is a risk factor for cardiovascular disease. Slow, deep breathing decreases blood pressure related to arterial stiffness. The objective of the present study was to determine the acute effects of a single session of slow breathing on arterial stiffness, blood pressure, and cardiac autonomic function. METHODS Fifteen healthy men (20 ± 0 years) were administered (a) a slow breathing condition (12 consecutive breaths of 4 s of inhalation, 4 s of pause, and 8 s of exhalation through the nose, approximately 5 min per breath) and (b) a control, two-condition crossover design. Carotid-femoral artery pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), brachial blood pressure, high frequency (HF) and low frequency (LF) were measured at baseline, 30 min, 60 min and 24 h after respiratory control. RESULTS Brachial-ankle PWV and brachial systolic pressure on the 4-4-8 breathing trial decreased after 30 min of respiratory control compared to baseline (p < 0.05), but did not change on the CON trial. Carotid-femoral PWV on both trials was unchanged; HF on the 4-4-8 breathing trial increased (p < 0.05) and LF decreased (p < 0.05) after 30 min of respiratory control compared to baseline, but was unchanged on the CON trial. CONCLUSIONS These results suggest that slow breathing techniques may be effective in modulating autonomic function and improving arterial stiffness in healthy young adults.
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Affiliation(s)
- Ryota Kobayashi
- Department of Natural and Environmental Science, Teikyo University of Science, Tokyo, Japan.
| | - Hideyuki Negoro
- Department of Medicine, Nara Medical University, Nara, Japan
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Weber J, Heming M, Apolinário-Hagen J, Liszio S, Angerer P. Comparison of the Perceived Stress Reactivity Scale with physiological and self-reported stress responses during ecological momentary assessment and during participation in a virtual reality version of the Trier Social Stress Test. Biol Psychol 2024; 186:108762. [PMID: 38311307 DOI: 10.1016/j.biopsycho.2024.108762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
Valid approaches to conveniently measure stress reactivity are needed due to the growing evidence of its health-impairing effects. This study examined whether the Perceived Stress Reactivity Scale (PSRS) predicts cardiovascular and psychological responses to psychosocial stressors during daily life and during a virtual reality (VR) Trier Social Stress Test (TSST). Medical students answered a standardized baseline questionnaire to assess perceived stress reactivity by the PSRS. The PSRS asks participants to rate the intensity of their typical affective responses to common stressors during daily life. They were further asked to participate in a VR-TSST and in an ecological momentary assessment (EMA) over a period of three consecutive workdays during daily life. Blood pressure and self-reported stress were repeatedly, heart rate variability (HRV) continuously measured during the VR-TSST and EMA. Furthermore, participants repeatedly assessed task demands, task control and social conflict during the EMA. Data was analysed using multilevel analysis and multiple linear regression. Results indicate that the PSRS moderates associations between blood pressure (but not HRV) and demands and control during daily life. Furthermore, the PSRS directly predicted self-reported stress, but did not moderate associations between self-reported stress and demands, control and social conflict. The PSRS did not predict physiological and self-reported stress responses to the VR-TSST. This study partly confirmed convergent validity of the PSRS to stress reactivity in daily life. Furthermore, the lack of association between the PSRS and stress responses to the VR-TSST calls for future studies to search for reliable and valid ways to assess stress reactivity.
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Affiliation(s)
- Jeannette Weber
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany.
| | - Meike Heming
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | - Jennifer Apolinário-Hagen
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | - Stefan Liszio
- Center for Children and Youth Medicine, University Hospital Essen, Germany
| | - Peter Angerer
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
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Giridharan S, Pandiyan B, Kumar NV, Soumian S. Effects of Pranayama on Cancer Patients: A Narrative Review of Clinical Outcomes. Cureus 2024; 16:e54688. [PMID: 38524027 PMCID: PMC10960562 DOI: 10.7759/cureus.54688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Pranayama, a set of yogic breathing techniques, is being studied as a potential supportive care option for cancer patients. This review intends to evaluate the effectiveness of Pranayama in enhancing the quality of life and well-being of cancer patients based on evidence from randomized controlled trials. We thoroughly searched databases for studies published between 2013 and 2023. We focused on randomized controlled trials that compared Pranayama interventions with non-yoga control groups. We assessed the primary outcomes, including psychological well-being, quality of life, physiological parameters, and treatment-related side effects. The review indicates that practicing Pranayama can lead to significant improvements in antioxidant levels, stress, anxiety, sleep quality, and overall quality of life for cancer patients. However, the evidence comes from a limited number of studies, which vary in sample sizes and methodologies. Pranayama shows promise as a complementary therapy for cancer patients, potentially enhancing their well-being and quality of life. Nonetheless, the current evidence base is limited, necessitating further research with larger sample sizes and more rigorous study designs to confirm these findings and elucidate the underlying mechanisms.
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Affiliation(s)
| | - Bhuvana Pandiyan
- Psychiatry Department, Worcestershire and Herefordshire Health and Care NHS Trust, Hereford, GBR
| | | | - Soni Soumian
- General Surgery Department, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
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Merlin Q, Vacher P, Mourot L, Levillain G, Martinent G, Nicolas M. Psychophysiological Effects of Slow-Paced Breathing on Adolescent Swimmers' Subjective Performance, Recovery States, and Control Perception. J Funct Morphol Kinesiol 2024; 9:23. [PMID: 38390923 PMCID: PMC10885016 DOI: 10.3390/jfmk9010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
This study examined the effect of a Slow-Paced Breath (i.e., 6 breaths per minute) without Biofeedback (SPB-NoHRVB) protocol on semi-elite adolescent swimmers' psychological and physiological states during a seven-week ecological training period. A linear mixed-effects multilevel regression analysis approach was used with 13 adolescent national-level swimmers. Athletes were randomly assigned to an intervention group (n = 7) and a control group (n = 6). Seven waves of assessments were completed weekly during a seven-week training preparation in ecological conditions. During the protocol, swimmers completed subjective quantitative measures (RESTQ-36-R-Sport; cognitive perceived stress and control states about the training process, training subjective performance, and subjective internal training load) and physiological heart rate (HR) (HR of exercise, absolute and normalized HR recovery during the first 60 s of recovery; HRR60 and nHRR60) and heart rate variability (HRV) (MeanRR, RMSSD, LFnu and HFnu, LF/HF ration) tests (through a submaximal heart rate (5'-5' test) once a week. Results revealed that the SPB-NoHRVB protocol significantly predicts biopsychosocial recovery states, cognitive perception of control, and training subjective performance (i.e., a significant effect of the SPB-NoHRVB protocol with the dependent variables simple time trajectories). However, no significant effects were found for biopsychosocial stress scales, cognitively perceived stress, HR, or HRV markers. Our results suggest that SPB-NoHRVB induces simple evolutions over time for crucial variables in athletes' adaptation to the training process (i.e., cognitive appraisals and biopsychosocial states). In contrast, it highlights that SPB-NoHRVB does not induce better stress states. This specific effect on the resource component is an exciting result that will be discussed in the manuscript.
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Affiliation(s)
- Quentin Merlin
- Laboratory Psy-DREPI (EA 7458), University of Bourgogne Franche-Comté, 21000 Dijon, France
| | - Philippe Vacher
- Research Center for Education Learning and Didactics (EA 3875), Faculty of Sports Science, University Brest, 29200 Brest, France
- Maison des Sciences de l'Homme de Bretagne, Fe, MSHB, 35043 Rennes, France
| | - Laurent Mourot
- SINERGIES, Université de Franche-Comté, 25000 Besançon, France
- Plateforme Exercice Performance Santé Innovation, Université de Franche-Comté, 25000 Besançon, France
| | - Guillaume Levillain
- Research Center for Education Learning and Didactics (EA 3875), Faculty of Sports Science, University Brest, 29200 Brest, France
| | - Guillaume Martinent
- Laboratory L-VIS (EA 7428), University of Claude Bernard Lyon 1, 69200 Lyon, France
| | - Michel Nicolas
- Laboratory Psy-DREPI (EA 7458), University of Bourgogne Franche-Comté, 21000 Dijon, France
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Liang WM, Ji YX, Xiao J, Truskauskaitė I, Hendrixson A, Bai ZM, Ruksenas O. Respiratory patterns and physical fitness in healthy adults: a cross-sectional study. BMC Public Health 2024; 24:228. [PMID: 38243241 PMCID: PMC10797802 DOI: 10.1186/s12889-024-17687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The altered respiratory patterns have a significant impact on our health. However, the links between respiration patterns during spontaneous breathing and physical fitness remain unknown. Therefore, we sought to examine how the respiratory pattern during spontaneous breathing interacts with physical fitness. METHODS A total of 610 participants (aged 20-59 years) were enrolled; 163 men (age = 41 ± 11) and 401 women (age = 42 ± 9) were included for analysis. The parameters of the respiration pattern were respiration rate (RR) and inhalation/exhalation (I/E) ratio. The physical fitness components were body size, visuomotor reaction time, balance, flexibility, hand grip strength, back extension strength, vertical jump height, number of push-ups, number of sit-ups, and the maximum rate of oxygen consumption. The data were analyzed separately for two gender groups. Participants within each gender group were further divided into two age categories (young: 20-39 years, middle-aged: 40-59 years) for the analysis, and both correlational and comparative tests were used to solidify the results. RESULTS Neither RRs nor the I/E ratios were substantially correlated with physical fitness in women. In addition, the I/E ratios showed no significant correlation with physical fitness in young men, while the results from correlational and comparative tests were inconsistent in middle-aged men. Consistently, men with lower RRs exhibited significantly shorter visuomotor reaction times in two age groups, and demonstrated significantly higher vertical jump heights in the middle-aged group. CONCLUSIONS In women, respiratory patterns were not correlated with physical fitness. The relationship between middle-aged men's I/E ratios and their physical fitness warrants further investigation. Men with lower RRs may have better visual-motor coordination and/or sustained attention, while middle-aged men with lower RRs may also have greater leg explosive power and neuromuscular coordination, which should be considered for physical assessment and health improvement.
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Affiliation(s)
- Wen-Ming Liang
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yu-Xuan Ji
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Xiao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
| | | | | | - Zhen-Min Bai
- Department of Sports Rehabilitation, School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Ryabkova VA, Rubinskiy AV, Marchenko VN, Trofimov VI, Churilov LP. Similar Patterns of Dysautonomia in Myalgic Encephalomyelitis/Chronic Fatigue and Post-COVID-19 Syndromes. PATHOPHYSIOLOGY 2024; 31:1-17. [PMID: 38251045 PMCID: PMC10801610 DOI: 10.3390/pathophysiology31010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND There is a considerable overlap between the clinical presentation of post-COVID-19 condition (PCC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Many of their common symptoms can be linked to dysregulation of the autonomic nervous system (dysautonomia). This study aimed to objectively assess autonomic function in a general group of patients with PCC and in a group of patients with ME/CFS whose disease was not related to COVID-19. We hypothesize that the similarity in the chronic symptoms of patients with PCC and ME/CFS extends to objective autonomic nervous system abnormalities. METHODS Synchronous recordings of an electrocardiogram and continuous dynamics of blood pressure in the digital artery using the Penaz method were obtained using the spiroarteriocardiorhythmography method in 34 patients diagnosed with ME/CFS, in whom the onset of the disease was not associated with COVID-19, 29 patients meeting the PCC definition and 32 healthy controls. Heart rate variability (HRV) and systolic and diastolic blood pressure variability (BPV) were assessed at rest and in tests with fixed respiratory rates. Indicators of baroreflex regulation (baroreflex effectiveness index and baroreflex sensitivity) were additionally determined at rest. RESULTS The total power and power of low-frequency and high-frequency of RR interval variability at rest as well as baroreflex sensitivity were significantly lower both in PCC and ME/CFS patients compared to healthy controls. Several diagnostic prediction models for ME/CFS were developed based on HRV parameters. During slow breathing, the HRV parameters returned to normal in PCC but not in ME/CFS patients. The correlation analysis revealed a close relationship of HRV, BPV parameters and baroreflex sensitivity with fatigue, but not with HADS depressive/anxiety symptoms in the ME/CFS and PCC patients. CONCLUSIONS A similar pattern of HRV and baroreflex failure with signs of a pathological acceleration of age-dependent dysautonomia was identified in the ME/CFS and PCC patients. The clinical, diagnostic and therapeutic implications of these findings are discussed, in light of previously described relationships between inflammation, vascular pathology, atherosclerotic cardiovascular disease and autonomic dysfunction.
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Affiliation(s)
- Varvara A. Ryabkova
- Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, 199034 Saint-Petersburg, Russia;
- Department of Pathology, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
- Department of Hospital Therapy Named after Academician M.V. Chernorutskii, Research Institute of Rheumatology and Allergology, Pavlov First Saint Petersburg State Medical University, 197022 Saint-Petersburg, Russia; (V.N.M.); (V.I.T.)
| | - Artemiy V. Rubinskiy
- Department of Medical Rehabilitation and Adaptive Physical Culture, Pavlov First Saint Petersburg State Medical University, 197022 Saint-Petersburg, Russia;
| | - Valeriy N. Marchenko
- Department of Hospital Therapy Named after Academician M.V. Chernorutskii, Research Institute of Rheumatology and Allergology, Pavlov First Saint Petersburg State Medical University, 197022 Saint-Petersburg, Russia; (V.N.M.); (V.I.T.)
| | - Vasiliy I. Trofimov
- Department of Hospital Therapy Named after Academician M.V. Chernorutskii, Research Institute of Rheumatology and Allergology, Pavlov First Saint Petersburg State Medical University, 197022 Saint-Petersburg, Russia; (V.N.M.); (V.I.T.)
| | - Leonid P. Churilov
- Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, 199034 Saint-Petersburg, Russia;
- Department of Pathology, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
- Laboratory of Microangiopathic Mechanisms of Atherogenesis, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
- Saint Petersburg Research Institute of Phthisiopulmonology, 191036 Saint Petersburg, Russia
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Karunarathne LJU, Amarasiri WADL, Fernando ADA. Respiratory function in healthy long-term meditators: a systematic review. Syst Rev 2024; 13:1. [PMID: 38167382 PMCID: PMC10759765 DOI: 10.1186/s13643-023-02412-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is a paucity of data on effects of long-term meditation on respiration. This systematic review summarized selected respiratory function parameters in healthy long-term meditators (LTMs) at rest, during meditation and their associations with meditation practice variables. METHODS A systematic search of PubMed, EMBASE (Ovid), Scopus, Proquest Dissertation and Thesis Global databases, CENTRAL, and Google Scholar was performed from year 1950 to August 15th, 2023. Keywords "meditation," "long-term meditation," and respiratory/pulmonary/lung function and spirometry were used. Controlled-trials and observational studies exploring respiratory parameters in healthy LTMs published in English were included. Two independent reviewers selected studies, extracted data, and assessed the quality of the evidence. The Joanna-Briggs Institute Critical Appraisal Tools and the Single-Case Reporting Guideline In BEhavioural Interventions Statement were used to assess the methodological quality of the included studies. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Effect estimates of some outcomes were synthesized using alternative methods and data for other outcomes synthesized narratively as a meta-analysis was not possible. RESULTS Nine studies comprising 3 case-control, 3 cross-sectional, and 3 single-subject study designs, involving 433 participants that met the eligibility criteria, were included. Two studies reported slower resting RR among LTMs compared to controls [SMD = - 2.98, 95% CI (- 4.48 to - 1.47), overall-effect (z-score) = 3.88 (p < 0.001), I2 = 69%] with similar trend reported in the third study (MD = - 1.6, p = 0.053). Three studies reported slower RR in LTMs during meditation compared to baseline. Slower resting RR and mean RR change during meditation compared to baseline significantly negatively associated with meditation experience. PEFR was significantly higher in LTMs than controls [MD = 1.67, 95% CI (0.19-3.15), z-score = 2.21 (p = 0.03)]. No significant difference was observed in tidal volume [SDM = 0.93, 95% CI (- 1.13 to 2.99), z-score = 0.89 (p = 0.37), I2 = 96%] and vital capacity [SDM = 1.25, 95% CI (- 0.45 to 2.95), z-score = 1.44 (p = 0.15), I2 = 94%] of LTMs compared to controls. CONCLUSIONS Long-term meditation appears to be associated with slower baseline RR, and immediate reduction in RR during meditation, where greater practice amplifies the effects. Evidence on spirometry parameters in LTMs with ≥ 3 years of practice was limited.
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Affiliation(s)
- L J U Karunarathne
- Department of Physical Medicine, National Hospital of Colombo, Colombo, 00700, Sri Lanka.
| | - W A D L Amarasiri
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka
| | - A D A Fernando
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka
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Zhang J, Li WC, Braithwaite G, Blundell J. Practice effects of a breathing technique on pilots' cognitive and stress associated heart rate variability during flight operations. Stress 2024; 27:2361253. [PMID: 38859613 DOI: 10.1080/10253890.2024.2361253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/22/2024] [Indexed: 06/12/2024] Open
Abstract
Commercial pilots endure multiple stressors in their daily and occupational lives which are detrimental to psychological well-being and cognitive functioning. The Quick coherence technique (QCT) is an effective intervention tool to improve stress resilience and psychophysiological balance based on a five-minute paced breathing exercise with heart rate variability (HRV) biofeedback. The current research reports on the application of QCT training within an international airline to improve commercial pilots' psychological health and support cognitive functions. Forty-four commercial pilots volunteered in a one-month training programme to practise self-regulated QCT in day-to-day life and flight operations. Pilots' stress index, HRV time-domain and frequency-domain parameters were collected to examine the influence of QCT practice on the stress resilience process. The results demonstrated that the QCT improved psychophysiological indicators associated with stress resilience and cognitive functions, in both day-to-day life and flight operation settings. HRV fluctuations, as measured through changes in RMSSD and LF/HF, revealed that the resilience processes were primarily controlled by the sympathetic nervous system activities that are important in promoting pilots' energy mobilization and cognitive functions, thus QCT has huge potential in facilitating flight performance and aviation safety. These findings provide scientific evidence for implementing QCT as an effective mental support programme and controlled rest strategy to improve pilots' psychological health, stress management, and operational performance.
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Affiliation(s)
- Jingyi Zhang
- Safety and Accident Investigation Centre, Cranfield University, Bedfordshire, UK
| | - Wen-Chin Li
- Safety and Accident Investigation Centre, Cranfield University, Bedfordshire, UK
| | - Graham Braithwaite
- Safety and Accident Investigation Centre, Cranfield University, Bedfordshire, UK
| | - James Blundell
- Safety and Accident Investigation Centre, Cranfield University, Bedfordshire, UK
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Gawlik KS, Teall AM, Zeno R, Newtz C, Conrad K, Kolcun K, Bobek H, Deerhake A, Sullivan K, Rengers B, O'Hara S. Integrating wellness into curricula using the ten dimensions of wellness as a framework. J Prof Nurs 2024; 50:73-82. [PMID: 38369375 DOI: 10.1016/j.profnurs.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 02/20/2024]
Abstract
Burnout is a public health crisis that persists at the expense of clinician well-being, the healthcare workforce, and the quality of care provided. Clinician well-being is a professional imperative, yet nursing students still report higher levels of burnout than non-nursing students. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student mental health requires a coordinated and sustained effort from nurse educators and academic leaders. This article aims to inspire nurse educators to take the first or next steps toward integrating wellness into nursing curricula. The ten dimensions of wellness provide a framework for wellness programming. Practical strategies aligned with each dimension are offered. As an exemplar, the Banding Together for Wellness program is summarized, including innovative incentives for student participation. Over the past five years, 426 (approximately 54 %) undergraduate nursing students voluntarily completed the program. While best practices may vary by institution, the strategies and resources offered herein can support nurse educators in the classroom, lab, and clinical setting as we all work to foster personal and professional well-being in nursing students. Nurse educators can be instrumental in cultivating the knowledge, skills, and attitudes required for life-long self-care, well-being, and nursing practice.
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Affiliation(s)
- Kate Sustersic Gawlik
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA.
| | - Alice M Teall
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Rosie Zeno
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Christa Newtz
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Katey Conrad
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Kaitlyn Kolcun
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Heidi Bobek
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Ann Deerhake
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Kelly Sullivan
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Brooke Rengers
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Susan O'Hara
- College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
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45
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Johnson E, Corrick S, Isley S, Vandermeer B, Dolgoy N, Bates J, Godfrey E, Soltys C, Muir C, Vohra S, Tandon P. Mind-body internet and mobile-based interventions for depression and anxiety in adults with chronic physical conditions: A systematic review of RCTs. PLOS DIGITAL HEALTH 2024; 3:e0000435. [PMID: 38261600 PMCID: PMC10805319 DOI: 10.1371/journal.pdig.0000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
This review summarizes the effectiveness of scalable mind-body internet and mobile-based interventions (IMIs) on depression and anxiety symptoms in adults living with chronic physical conditions. Six databases (MEDLINE, PsycINFO, SCOPUS, EMBASE, CINAHL, and CENTRAL) were searched for randomized controlled trials published from database inception to March 2023. Mind-body IMIs included cognitive behavioral therapy, breathwork, meditation, mindfulness, yoga or Tai-chi. To focus on interventions with a greater potential for scale, the intervention delivery needed to be online with no or limited facilitation by study personnel. The primary outcome was mean change scores for anxiety and depression (Hedges' g). In subgroup analyses, random-effects models were used to calculate pooled effect size estimates based on personnel support level, intervention techniques, chronic physical condition, and survey type. Meta-regression was conducted on age and intervention length. Fifty-six studies met inclusion criteria (sample size 7691, mean age of participants 43 years, 58% female): 30% (n = 17) neurological conditions, 12% (n = 7) cardiovascular conditions, 11% cancer (n = 6), 43% other chronic physical conditions (n = 24), and 4% (n = 2) multiple chronic conditions. Mind-body IMIs demonstrated statistically significant pooled reductions in depression (SMD = -0.33 [-0.40, -0.26], p<0.001) and anxiety (SMD = -0.26 [-0.36, -0.17], p<0.001). Heterogeneity was moderate. Scalable mind-body IMIs hold promise as interventions for managing anxiety and depression symptoms in adults with chronic physical conditions without differences seen with age or intervention length. While modest, the effect sizes are comparable to those seen with pharmacological therapy. The field would benefit from detailed reporting of participant demographics including those related to technological proficiency, as well as further evaluation of non-CBT interventions. Registration: The study is registered with PROSPERO ID #CRD42022375606.
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Affiliation(s)
- Emily Johnson
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
| | - Shaina Corrick
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
| | - Serena Isley
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
| | - Ben Vandermeer
- Department of Medicine, University of Alberta, Edmonton, Alberta
| | - Naomi Dolgoy
- Faculty of Rehabilitation Science, Edmonton, Alberta
| | - Jack Bates
- Faculty of Science, University of Alberta, Edmonton, Alberta
| | - Elana Godfrey
- Faculty of Science, University of Toronto, Toronto, Ontario
| | - Cassidy Soltys
- Faculty of Science, University of Alberta, Edmonton, Alberta
| | - Conall Muir
- Faculty of Science, University of Alberta, Edmonton, Alberta
| | - Sunita Vohra
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Puneeta Tandon
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
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46
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Sun Y, Tabeshian R, Mustafa H, Zehr EP. Using Martial Arts Training as Exercise Therapy Can Benefit All Ages. Exerc Sport Sci Rev 2024; 52:23-30. [PMID: 37699015 DOI: 10.1249/jes.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Martial arts training focuses on whole-body movement patterning, philosophy, interpersonal interactions, and functional self-defense. Such training has positive impacts on physical, psychological, and cognitive well-being in older adults and children with and without clinical conditions. We hypothesize that martial arts training can be delivered as a form of exercise therapy for people at all ages to enhance overall health.
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Affiliation(s)
| | - Roza Tabeshian
- Department of Motor Behavior, University of Isfahan, Isfahan, Iran
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47
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Schoffl J, Arora M, Pozzato I, McBain C, Rodrigues D, Vafa E, Middleton J, Davis GM, Gustin SM, Bourke J, Kifley A, Krassioukov AV, Cameron ID, Craig A. Heart Rate Variability Biofeedback in Adults with a Spinal Cord Injury: A Laboratory Framework and Case Series. J Clin Med 2023; 12:7664. [PMID: 38137732 PMCID: PMC10743967 DOI: 10.3390/jcm12247664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Heart rate variability biofeedback (HRV-F) is a neurocardiac self-regulation therapy that aims to regulate cardiac autonomic nervous system activity and improve cardiac balance. Despite benefits in various clinical populations, no study has reported the effects of HRV-F in adults with a spinal cord injury (SCI). This article provides an overview of a neuropsychophysiological laboratory framework and reports the impact of an HRV-F training program on two adults with chronic SCI (T1 AIS A and T3 AIS C) with different degrees of remaining cardiac autonomic function. The HRV-F intervention involved 10 weeks of face-to-face and telehealth sessions with daily HRV-F home practice. Physiological (HRV, blood pressure variability (BPV), baroreflex sensitivity (BRS)), and self-reported assessments (Fatigue Severity Scale, Generalised Anxiety Disorder Scale, Patient Health Questionnaire, Appraisal of Disability and Participation Scale, EuroQol Visual Analogue Scale) were conducted at baseline and 10 weeks. Participants also completed weekly diaries capturing mood, anxiety, pain, sleep quality, fatigue, and adverse events. Results showed some improvement in HRV, BPV, and BRS. Additionally, participants self-reported some improvements in mood, fatigue, pain, quality of life, and self-perception. A 10-week HRV-F intervention was feasible in two participants with chronic SCI, warranting further investigation into its autonomic and psychosocial effects.
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Affiliation(s)
- Jacob Schoffl
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Mohit Arora
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Ilaria Pozzato
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Candice McBain
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Dianah Rodrigues
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Elham Vafa
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia;
| | - James Middleton
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Glen M. Davis
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia;
| | - Sylvia Maria Gustin
- NeuroRecovery Research Hub, University of New South Wales, Sydney, NSW 2052, Australia;
- The Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW 2052, Australia
| | - John Bourke
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Annette Kifley
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Andrei V. Krassioukov
- ICORD, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Ian D. Cameron
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Ashley Craig
- John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia; (M.A.); (I.P.); (C.M.); (D.R.); (E.V.); (J.M.); (J.B.); (A.K.); (I.D.C.); (A.C.)
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
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48
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Fincham GW, Strauss C, Cavanagh K. Effect of coherent breathing on mental health and wellbeing: a randomised placebo-controlled trial. Sci Rep 2023; 13:22141. [PMID: 38092805 PMCID: PMC10719279 DOI: 10.1038/s41598-023-49279-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
Breathwork may offer simple tools for stress resilience. We conducted the largest parallel randomised-controlled trial on breathwork to date (NCT05676658) wherein 400 participants on the research platform Prolific were randomised, in blocks of 2 via remote software, to coherent breathing at ~ 5.5 breaths/min or a matched attention-placebo at 12 breaths/min, for ~ 10 min/day over 4 weeks. Participants were blinded to their allocated interventions, both of which were paced with equal inhalation:exhalation ratios. There were no differences on credibility and expectancy of benefit between conditions. At the primary timepoint post-intervention for the primary outcome subjective stress, there was no significant group by time interaction (F(1,377) = 0.089, p = 0.765, ηp2 < 0.001) nor main effect of group (F = 0.002, p = 0.961, ηp2 < 0.001), however there was a significant main effect of time (F = 72.1, p < 0.001, ηp2 = 0.161). Similar results were found at 1-month follow-up for stress and for secondary outcomes of anxiety, depression and wellbeing. There were overall improvements on these mental health and wellbeing outcomes from baseline to post-intervention and follow-up across both groups, yet the magnitude of this improvement was not different between arms. Accordingly, we found no measurable effect of coherent breathing over and above a well-designed breathwork placebo at improving mental health and wellbeing. Methodological considerations and recommendations for robust future research are discussed. Funder: Sasakawa Young Leaders Fellowship Fund, Tokyo, Japan.
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Affiliation(s)
- Guy W Fincham
- Department of Psychology, University of Sussex, Brighton, UK.
- Brighton & Sussex Medical School, University of Sussex, Brighton, UK.
| | - Clara Strauss
- Department of Psychology, University of Sussex, Brighton, UK
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Kate Cavanagh
- Department of Psychology, University of Sussex, Brighton, UK
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
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49
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Jyskä I, Turunen M, Chaychi Maleki A, Karppa E, Palmu S, Viik J, Mäkelä J, Puura K. Effects of Using Guided Deep Breathing Exercises in a Virtual Natural Environment to Reduce Stress during Pediatric Treatment. Healthcare (Basel) 2023; 11:3140. [PMID: 38132030 PMCID: PMC10743274 DOI: 10.3390/healthcare11243140] [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: 10/31/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
There exists a need for new methods to address treatment anxiety in pediatrics-at the same time, deep breathing exercises and virtual natural environments have both been known to have stress-reducing qualities. This article reports the combined effect of these two methods in a pediatric setting. A feasibility study was conducted in a local hospital. The study had a within-subjects design, and it included 21 child patients aged 8 to 12 years old, who used a virtual reality (VR) relaxation application developed for this purpose during an intravenous cannulation procedure related to their treatment. The key findings highlight a statistically very significant stress reduction associated with the utilized VR intervention, demonstrated by heart rate variability measurements (SDNN, p < 0.001; RMSSD, p = 0.002; Stress Index, p < 0.001; LF/HF ratio, p = 0.010). This effect was consistent regardless of the level of general anxiety or the level of needle phobia of the patient, and no adverse effects were observed. The results show the strong potential of using deep breathing exercises in virtual natural environments for addressing treatment anxiety related to invasive pediatric procedures.
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Affiliation(s)
- Ilmari Jyskä
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Markku Turunen
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Arash Chaychi Maleki
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Elina Karppa
- TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (E.K.); (S.P.); (K.P.)
- Department of Pediatrics, Tampere University Hospital, Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
| | - Sauli Palmu
- TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (E.K.); (S.P.); (K.P.)
- Department of Pediatrics, Tampere University Hospital, Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
| | - Jari Viik
- Finnish Cardiovascular Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland;
| | - John Mäkelä
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Kaija Puura
- TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (E.K.); (S.P.); (K.P.)
- Department of Child Psychiatry, Tampere University Hospital, Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
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50
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Jyskä I, Turunen M, Chaychi Maleki A, Karppa E, Palmu S, Mäkelä J, Puura K. Design and User Experience of VirNE Application: Deep Breathing Exercise in a Virtual Natural Environment to Reduce Treatment Anxiety in Pediatrics. Healthcare (Basel) 2023; 11:3129. [PMID: 38132019 PMCID: PMC10743239 DOI: 10.3390/healthcare11243129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Treatment anxiety is a serious problem among child patients. A few studies have addressed this issue with virtual reality solutions, with promising results; however, the applications used have generally been designed for entertainment instead of this purpose. This article studies the potential of using deep breathing exercises in a virtual natural environment to address this issue, with a focus on design approach and user experience. It presents the VirNE-Virtual Natural Environments relaxation application, which is based on known stress-reduction methods, and a feasibility study conducted with it in a local hospital. The study had a within-subjects design, and it included 21 eight to twelve-year-old child patients, who used the application during an intravenous cannulation procedure related to their treatment. The study found good user acceptance and user experience both among the child patients and pediatricians, with the perceived usefulness of the method being higher among the patients with increased levels of anxiety or needle phobia. In addition, a clear stress-reducing effect was found. This offers proof-of-concept for the multidisciplinary design approach based on existing scientific knowledge regarding the desired effect for pediatric virtual reality applications for this use context.
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Affiliation(s)
- Ilmari Jyskä
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Markku Turunen
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Arash Chaychi Maleki
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Elina Karppa
- TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (E.K.); (S.P.); (K.P.)
- Department of Pediatrics, Tampere University Hospital, Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
| | - Sauli Palmu
- TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (E.K.); (S.P.); (K.P.)
- Department of Pediatrics, Tampere University Hospital, Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
| | - John Mäkelä
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences, Tampere University, FI-33014 Tampere, Finland; (M.T.); (A.C.M.); (J.M.)
| | - Kaija Puura
- TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (E.K.); (S.P.); (K.P.)
- Department of Child Psychiatry, Tampere University Hospital, Central Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
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