Mechanisms of Mind-Body Interaction and Optimal Performance

Comparison of robustness, resilience and intrinsic capacity including prediction of long-term adverse health outcomes: The KORA-Age study

BACKGROUND

Frailty, resilience and intrinsic capacity (IC) are concepts to evaluate older person`s health status, but no comparison of their associations with adverse health outcomes exists. We therefore aimed to assess which concept is most useful for determining long-term health of older adults.

METHODS

Analyses were based on the KORA (Cooperative Health Research in the Region of Augsburg)-Age study (n = 940, 65-93 years). Frailty was evaluated using the physical frailty-phenotype by Fried et al. For comparability to resilience and IC, we chose the protective concept of robustness instead of frailty in the present analysis. Resilience was measured by the 11-item resilience-scale. The IC-score was based on 4 domains (locomotion, cognition, vitality and psychiatric capacities). Associations with falls, disability, and hospitalization at 3-year and 7-year follow-up and with mortality were evaluated by multivariable adjusted logistic and Cox regression. Concept overlaps were illustrated by a Venn-diagram.

RESULTS

In the fully adjusted models, robustness showed significant inverse associations with most outcomes (3-year follow-up: OR (95%CI): disability 0.448 (0.300-0.668), 7-year follow-up: falls 0.477 (0.298-0.764), hospitalization 0.547 (0.349-0.856), and all-cause mortality 0.649 (0.460-0.915)) while resilience and IC showed significant inverse associations with disability only (e.g., 7-year-follow-up: resilience: 0.467 (0.304-0.716), IC: 0.510 (0.329-0.793)). 23% of the participants met the criteria for both robustness and IC while 22% met those for robustness and resilience.

CONCLUSION

Robustness was the most useful concept, showing the strongest protective associations for most adverse health outcomes. IC and resilience showed their main strengths in capturing protective associations for disabilities. Robustness overlapped with resilience and IC, supporting the concept of mind-body-interaction.

Clinical Effects of Yoga and Meditational Practices on the Holistic Health of Chronic Kidney Disease Patients: A Systematic Review

As the world accelerates, sedentary and unhealthy lifestyles have an increasingly negative impact on human physical and emotional well-being. Millions of people globally are thought to have chronic kidney disease (CKD), which is frequently brought on by diabetes, hypertension, and glomerulonephritis. Over time, the illness gets worse and eventually results in irreversible renal failure. A person's life can be seriously affected by CKD in many different ways, including emotionally, socially, physically, and financially. Apart from physiological manifestations like anemia, discomfort, and exhaustion, CKD can also result in psychological problems like anxiety and depression, which can impair one's overall standard of life. Numerous studies have demonstrated the beneficial effects of yoga and meditation on people with chronic renal disease, enhancing their general health and quality of life. Because of therapeutic limitations, familial pressures, financial restraints, and symptoms of end-stage kidney disease, people with CKD frequently experience stress and anxiety. By reducing stress and anxiety, yoga and meditation can help individuals with chronic conditions maintain their health and improve their overall well-being. Recent research has found that yoga can improve blood pressure, sympathetic activity, and basal metabolic rate as well as reduce blood pressure and blood sugar levels by balancing the autonomic nervous system. Furthermore, studies have demonstrated that yoga helps CKD patients live healthier lives by lowering stress, anxiety, and sadness. Healthcare professionals can help patients with chronic renal disease manage their symptoms and enhance their general health and well-being by adding yoga and meditation into their treatment regimens. Modifying lifestyle is essential for both the prevention and treatment of chronic renal disease. CKD often co-occurs with other age-related and sedentary lifestyles and poor diet-related chronic conditions. The dearth of targeted treatment for a large percentage of CKD patients led to the investigation of the therapeutic applications of yoga and meditation in this study. These affordable, non-invasive therapies provide a comprehensive approach to controlling CKD, benefiting both healthy individuals and those with CKD in terms of their physical and mental well-being.

Effects of Warm-up Focused on the Mind-Body on Choral Performance

OBJECTIVE

In choral performance, a wide variety of musical expression is required to deliver the worldview of the work to the audience. Singers need to regulate their mind-body to be in the optimal state, which includes relaxed concentration and flexible kinesthetic controllability in sensation, expression, and vocalization, for the chorus. Therefore, a choral warm-up focused on the mind-body could be crucial for various musical expressions. However, what kind of warm-up helps the singer achieve the optimal condition for the chorus remains unclear. Here, we investigated the effects of a warm-up method focusing on breathing, physical movement, imagery, and the combination of those factors on singing performance.

METHOD

Twenty-five choral singers were randomly assigned to five groups, and then singers for each group online conducted one of five warm-up conditions (breathing / stretching / imagery work / all works / control) and performed singing tasks to evaluate singing performance, including sensation, expression, and vocalization, both subjectively and objectively. Changes in mood were also measured using the second edition of the Profile of Mood States.

RESULTS

The results showed that the warm-up with imagery work or all works could objectively and subjectively enhance singing performance. By contrast, the warm-up with breathing or stretching did not significantly improve performance, but did enhance subjective evaluations in general. In addition, no significant correlations were found between the objective performance evaluations and changes in individual mood.

CONCLUSIONS

These results suggest that a warm-up focusing on mind-body interventions, especially imagery work, may enhance choral performance, thereby providing new insight for the establishment of more effective choral warm-up methods.

Online Left-Hemispheric In-Phase Frontoparietal Theta tACS for the Treatment of Negative Symptoms of Schizophrenia

Negative symptoms represent an unmet need for schizophrenia treatment. The effect of theta frequency transcranial alternating current stimulation (theta-tACS) applied during working memory (WM) tasks on negative symptoms has not been demonstrated as of yet. We conducted a randomized, double-blind, sham-controlled trial of 36 stabilized schizophrenia patients, randomized to receive either twice daily, 6 Hz 2 mA, 20 min sessions of in-phase frontoparietal tACS or sham for five consecutive weekdays. Participants were concurrently engaged in WM tasks during stimulation. The primary outcome measure was the change over time in the Positive and Negative Syndrome Scale (PANSS) negative subscale score measured from baseline through to the 1-month follow-up. Secondary outcome measures were other symptom clusters, neurocognitive performance, and relevant outcomes. The intention-to-treat analysis demonstrated greater reductions in PANSS negative subscale scores at the end of stimulation in the active (−13.84%) than the sham (−3.78%) condition, with a large effect size (Cohen’s d = 0.96, p = 0.006). The positive effect endured for at least one month. Theta-tACS also showed efficacies for cognitive symptoms, WM capacity, and psychosocial functions. Online theta-tACS offers a novel approach to modulate frontoparietal networks to treat negative symptoms of schizophrenia. The promising results require large-scale replication studies in patients with predominantly negative symptoms.

The Role of Future Time Perspective, Body Awareness, and Social Connectedness in the Relationship Between Self-efficacy and Resilience

Defined as the successful adaptation to dynamic environments, resilience is considered a cornerstone of mental health. However, with the underpinnings of resilience not yet fully understood, this manuscript tests the potential contribution of self-efficacy and embeddedness on resilience (explored through validated measures of future time perspective, body awareness, and social connectedness). The convenience sample of 18-to-77-year-old adults included 297 individuals, of which 36 were men and 171 were female. Participants completed online surveys composed of fifty-two questions in total, measuring self-efficacy, resilience, social connectedness, FTP, and body awareness. Resilience was positively related to self-efficacy, future time perspective, and social connectedness—but not to body awareness—and self-efficacy was positively associated with indices of embeddedness. Considering these correlations, and that only self-efficacy significantly predicted resilience, an exploratory model was proposed to test whether embeddedness directly predicted self-efficacy, and whether self-efficacy directly predicted resilience. Structural Equation Modelling suggested a good fit of this model, elucidating the interplay of psychological mechanisms underlying resilience. Thus, we identify potential variables of interest for clinical interventions aimed at increasing resilience and self-efficacy. Theoretical implications and future research are suggested based on these findings.

Is Attention Really Effort? Revisiting Daniel Kahneman's Influential 1973 Book Attention and Effort

Daniel Kahneman was not the first to suggest that attention and effort are closely associated, but his 1973 book Attention and Effort, which claimed that attention can be identified with effort, cemented the association as a research paradigm in the cognitive sciences. Since then, the paradigm has rarely been questioned and appears to have set the research agenda so that it is self-reinforcing. In this article, we retrace Kahneman’s argument to understand its strengths and weaknesses. The central notion of effort is not clearly defined in the book, so we proceed by constructing the most secure inferences we can from Kahneman’s argument regarding effort: it is cognitive, objective, metabolic expenditure, and it is attention. Continuing, we find from Kahneman’s argument that effort-attention must be a special case of sympathetic dominance of the autonomic nervous system that is also an increase in metabolic activity in the brain that has crossed a threshold of magnitude. We then weigh this conception of effort against evidence in Kahneman’s book and against more recent evidence, finding that it does not warrant the conclusion that effort can be equated with attention. In support of an alternative perspective, we briefly review diverse studies of behavior, physiology, and neuroscience on attention and effort, including meditation and studies of the LC-NE system, where we find evidence for the following: (1) Attention seems to be associated not with the utilization of metabolic resources per se but with the readying of metabolic resources in the form of adaptive gain modulation. This occurs under sympathetic dominance and can be experienced as effortful. (2) Attention can also occur under parasympathetic dominance, in which case it is likely to be experienced as effortless.

Focusing Attention on Muscle Exertion Increases EEG Coherence in an Endurance Cycling Task

The aim of this study was to examine EEG coherence before, during, and after time to exhaustion (TTE) trials in an endurance cycling task, as well as the effect of effort level and attentional focus (i.e., functional external, functional internal, and dysfunctional internal associative strategies-leading to Type 1, Type 2, and Type 3 performances) on brain functional connectivity. Eleven college-aged participants performed the TTE test on a cycle-ergometer with simultaneous EEG and rate of perceived exertion (RPE) monitoring. EEG data from 32 electrodes were divided into five effort level periods based on RPE values (Baseline, RPE 0-4, RPE 5-8, RPE 9-MAX, and Recovery). Within subjects RM-ANOVA was conducted to examine time to task completion across Type 1, Type 2, and Type 3 performance trials. RM-ANOVA (3 performance types × 5 effort levels) was also performed to compare the EEG coherence matrices in the alpha and beta bands for 13 pairs of electrodes (F3-F4, F3-P3, F4-P4, T7-T8, T7-P3, C3-C4, C3-P3, C4-P4, T8-P4, P3-P4, P3-O1, P4-O2, O2-O1). Significant differences were observed on TTE performance outcomes between Type 1 and Type 3, and between Type 2 and Type 3 performance states (p < 0.05), whereas Type 1 and Type 2 performance states did not differ. No significant main effects were observed on performance type (p > 0.05) for all frequency bands in any pair of electrodes of the coherence matrices. Higher EEG coherence values were observed at rest (Baseline) than during cycling (RPE 0-4, 5-8, 9-MAX) for all pairs of electrodes and EEG frequency bands irrespective of the type of performance (main effect of effort, p < 0.05). Interestingly, we observed a performance × effort interaction in C3-C4 in beta 3 band [F_{(4, 77)} = 2.62, p = 0.038] during RPE 9-MAX for Type 3 performance as compared to Type 1 and Type 2 performances. These findings may have practical implications in the development of performance optimization strategies in cycling, as we found that focusing attention on a core component of the action could stimulate functional connectivity among specific brain areas and lead to enhanced performance.