1
|
Coffee Z, Cheng K, Slebodnik M, Mulligan K, Yu CH, Vanderah TW, Gordon JS. The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:794. [PMID: 38929040 PMCID: PMC11203961 DOI: 10.3390/ijerph21060794] [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: 05/16/2024] [Revised: 06/06/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Despite the lack of evidence, opioids are still routinely used as a solution to long-term management for chronic noncancer pain (CNCP). Given the significant risks associated with long-term opioid use, including the increased number of unregulated opioid pills at large in the opioid ecosystem, opioid cessation or reduction may be the desired goal of the patient and clinician. Viable nonpharmacological interventions (NPIs) to complement and/or replace opioids for CNCP are needed. Comprehensive reviews that address the impact of NPIs to help adults with CNCP reduce opioid use safely are lacking. We conducted a literature search in PubMed, CINAHL, Embase, PsycINFO, and Scopus for studies published in English. The initial search was conducted in April 2021, and updated in January 2024. The literature search yielded 19,190 relevant articles. Thirty-nine studies met the eligibility criteria and underwent data extraction. Of these, nineteen (49%) were randomized controlled trials, eighteen (46%) were observational studies, and two (5%) were secondary analyses. Among adults with CNCP who use opioids for pain management, studies on mindfulness, yoga, educational programs, certain devices or digital technology, chiropractic, and combination NPIs suggest that they might be an effective approach for reducing both pain intensity and opioid use, but other NPIs did not show a significant effect (e.g., hypnosis, virtual reality). This review revealed there is a small to moderate body of literature demonstrating that some NPIs might be an effective and safe approach for reducing pain and opioid use, concurrently.
Collapse
Affiliation(s)
- Zhanette Coffee
- College of Nursing, University of Arizona, Tucson, AZ 85721, USA;
| | - Kevin Cheng
- College of Medicine, University of Arizona, Tucson, AZ 85721, USA;
| | | | - Kimberly Mulligan
- Veterans Health Administration, Central California, Fresno, CA 93706, USA
| | - Chong Ho Yu
- Department of Mathematics, Hawaii Pacific University, Honolulu, HI 96813, USA;
| | - Todd W. Vanderah
- Department of Pharmacology, Comprehensive Center for Pain and Addiction, University of Arizona, Tucson, AZ 85721, USA;
| | - Judith S. Gordon
- College of Nursing, University of Arizona, Tucson, AZ 85721, USA;
| |
Collapse
|
2
|
Theodorakis Y, Hassandra M, Panagiotounis F. Enhancing Substance Use Disorder Recovery through Integrated Physical Activity and Behavioral Interventions: A Comprehensive Approach to Treatment and Prevention. Brain Sci 2024; 14:534. [PMID: 38928533 PMCID: PMC11201577 DOI: 10.3390/brainsci14060534] [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: 05/02/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024] Open
Abstract
The global issue of substance abuse demands ongoing initiatives aligned with the United Nations Sustainable Development Goals. With drug use remaining prevalent worldwide, interventions are critical to addressing the associated health challenges and societal implications. Exercise and physical activities have emerged as integral components of substance use disorder (SUD) treatment, offering promising avenues for prevention, intervention, and recovery. Recent research underscores the efficacy of exercise in reducing substance cravings, promoting abstinence, and improving overall well-being. However, integrating exercise into SUD recovery programs presents challenges such as dropout rates and cultural considerations. This paper synthesizes existing literature on exercise integration into SUD recovery, highlighting strategies for enhancing treatment outcomes and addressing barriers to exercise adherence. Drawing on cognitive-behavioral therapy, experiential learning, motivational interviewing, and goal-setting techniques, the holistic approach outlined in this paper aims to empower individuals both mentally and physically, fostering resilience and supporting long-term recovery. In conclusion, new initiatives need to be taken by advocating for inclusive policies, promoting community engagement, and fostering collaborations across sectors. By doing so, stakeholders can optimize the effectiveness of exercise programs and contribute to sustainable rehabilitation efforts for individuals with SUD.
Collapse
Affiliation(s)
- Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece;
| | - Mary Hassandra
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece;
| | | |
Collapse
|
3
|
Liu H, Liu S, Xiong L, Luo B. Effects of traditional Chinese exercise on sleep quality: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e35767. [PMID: 37933009 PMCID: PMC10627671 DOI: 10.1097/md.0000000000035767] [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: 06/03/2023] [Accepted: 10/03/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The efficacy of traditional Chinese exercise (TCE)-based interventions in the improvement of sleep quality is controversial. In this systematic review, we aimed to summarize randomized controlled trials (RCTs) that outline the effects of TCE on sleep quality. METHODS Five databases (Web of Science, Embase, PubMed, Medline, and China National Knowledge Infrastructure) were searched for literature published before July 2022. RCTs examining TCE interventions were included. The treatment effects were estimated using a random-effect meta-analysis model with mean differences (MDs). There were 2 outcome scales for sleep quality; however, because they were extremely contrastive to be analyzed by standard MD, the scales were analyzed separately to ensure the accuracy of the results. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023421314). RESULTS Twenty studies were included for analysis at last. The outcome was calculated using the Verran and Snyder-Halpern Sleep Scale (MD: 344.17, 95% confidence interval: 316.95 to 371.39, P < .00001) and Pittsburgh Sleep Quality Index to measure sleep quality (MD: -2.24, 95% confidence interval: -3.05 to -1.43, P < .00001), both showed improvement effect. In subgroup analysis, for patients with fibromyalgia, normal older adults, and non-Hodgkin lymphoma, chronic fatigue syndrome-like illness, knee osteoarthritis, nasopharyngeal carcinoma, pausimenia, insomnia, TCE could improve sleep quality. However, there was no significant improvement in stroke patients, breast cancer patients, normal college students, and episodic migraine patients. Tai Chi had greater effects in improving sleep quality than Qigong. In addition, the participants practice site, duration, and age did not influence the effects of TCE. CONCLUSION TCE can improve sleep quality in specific populations in specific populations clinical applications. Tai chi should be considered first to improve sleep quality. However, further extensive trials and rigorous study designs should be conducted to strengthen the findings of this study. In addition, considering the large heterogeneity, the findings of our study should be interpreted cautiously.
Collapse
Affiliation(s)
- Haoyu Liu
- Capital University of Physical Education and Sports, Haidian, Beijing, China
| | - Siling Liu
- School of Sport and Art, Shenzhen Technology University, Shenzhen, Guangdong province, China
| | - Lu Xiong
- Jiangxi Institute of Applied Science and Technology, Nanchang, Jiangxi province, China
| | - Bingquan Luo
- Capital University of Physical Education and Sports, Haidian, Beijing, China
| |
Collapse
|
4
|
Martínez-Calderon J, Casuso-Holgado MJ, Muñoz-Fernandez MJ, Garcia-Muñoz C, Heredia-Rizo AM. Yoga-based interventions may reduce anxiety symptoms in anxiety disorders and depression symptoms in depressive disorders: a systematic review with meta-analysis and meta-regression. Br J Sports Med 2023; 57:1442-1449. [PMID: 37369553 DOI: 10.1136/bjsports-2022-106497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE To summarise the effect of mind-body exercises on anxiety and depression symptoms in adults with anxiety or depressive disorders. DESIGN Systematic review with meta-analysis and meta-regression. DATA SOURCES Five electronic databases were searched from inception to July 2022. Manual searches were conducted to explore clinical trial protocols, secondary analyses of clinical trials and related systematic reviews. ELIGIBILITY CRITERIA Randomised clinical trials evaluating qigong, tai chi or yoga styles with anxiety or depression symptoms as the outcomes were included. No intervention, waitlist or active controls were considered as control groups. The risk of bias and the certainty of the evidence were assessed. Meta-analyses, meta-regressions and sensitivity analyses were performed. RESULTS 23 studies, comprising 22 different samples (n=1420), were included. Overall, meta-analyses showed yoga interventions were superior to controls in reducing anxiety symptoms in anxiety disorders. Furthermore, yoga-based interventions decreased depression symptoms in depressive disorders after conducting sensitivity analyses. No differences between groups were found in the rest of the comparisons. However, the certainty of the evidence was judged as very low for all outcomes due to concerns of high risk of bias, indirectness of the evidence, inconsistency and imprecision of the results. In addition, there was marked heterogeneity among yoga-based interventions and self-reported tools used to evaluate the outcomes of interest. CONCLUSION Although yoga-based interventions may help to improve mental health in adults diagnosed with anxiety or depressive disorders, methodological improvements are needed to advance the quality of clinical trials in this field. PROSPERO REGISTRATION NUMBER CRD42022347673.
Collapse
Affiliation(s)
- Javier Martínez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Maria Jesus Muñoz-Fernandez
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Physiotherapy, University School Francisco Maldonado, Sevilla, Spain
| | - Cristina Garcia-Muñoz
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| |
Collapse
|
5
|
Zhang J, Su Q, Li SC. Qigong Exercise Balances Oxygen Supply and Acid-Base to Modulate Hypoxia: A Perspective Platform toward Preemptive Health & Medicine. Med Sci (Basel) 2023; 11:medsci11010021. [PMID: 36976529 PMCID: PMC10057714 DOI: 10.3390/medsci11010021] [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: 09/21/2022] [Revised: 01/14/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
Qigong is a meditative movement with therapeutic effects and is commonly practiced in Eastern medicine. A growing body of evidence validates its health benefits, leading to mechanistic questions about how it works. We propose a novel mechanism by which the “acid” caused by hypoxia affects metabolism, and the way it is neutralized through Qigong practice involves the body’s blood flow and vasculature modifications. Specifically, Qigong exercise generates an oxygen supply and acid-base balance against the hypoxic effects of underlying pathological conditions. We also propose that Qigong exercise mediated and focused on the local hypoxia environment of tissues might normalize the circulation of metabolic and inflammation accumulation in the tumor tissue and restore the normal metabolism of tissues and cells through calm, relaxation, and extreme Zen-style breathing that gravitates toward preemptive health and medicine. Thus, we propose the mechanisms of action related to Qigong, intending to unify Eastern and Western exercise theory.
Collapse
Affiliation(s)
- Junjie Zhang
- School of Physical Training and Physical Therapy, Shenzhen University, Shenzhen 518060, Guangdong, China
| | - Qingning Su
- Center of Bioengineering, School of Medicine, Shenzhen University, Shenzhen 518060, Guangdong, China
| | - Shengwen Calvin Li
- Neuro-Oncology and Stem Cell Research Laboratory (NSCL), CHOC Children’s Research Institute (CCRI), Children’s Hospital of Orange County (CHOC), 1201 W. La Veta Ave., Orange, CA 92868-3874, USA
- Department of Neurology, School of Medicine, University of California-Irvine (UCI), 200 S Manchester Ave Ste 206, Orange, CA 92868, USA
- Correspondence: ; Tel.: +1-714-509-4964; Fax: +1-714-509-4318
| |
Collapse
|
6
|
Li X, Geng J, Du X, Si H, Wang Z. Relationship Between the Practice of Tai Chi for More Than 6 Months With Mental Health and Brain in University Students: An Exploratory Study. Front Hum Neurosci 2022; 16:912276. [PMID: 35814952 PMCID: PMC9263293 DOI: 10.3389/fnhum.2022.912276] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
To study whether Tai Chi (TC) practice can improve the brain connectivity of the prefrontal lobe of college students, the positive psychological capital questionnaires and resting EEG signals were acquired from 50 college students including 25 TC practitioners and 25 demographically matched TC healthy controls. The results showed that the score of the positive psychological capital questionnaire of the TC group was significantly higher than that of the control group, and the node degree of the frontal lobe and temporal lobe of both groups was positively correlated with the score of the positive psychological capital questionnaire. In addition, the response time of the TC group under auditory stimulation was significantly shorter than that of the control group, and there was a significant positive correlation between response time and its characteristic path length, and a significant negative correlation with global efficiency. Meanwhile, during the selected range of sparsity, the difference in global network parameters between two groups is significant in the alpha band. Under all single sparsity, the clustering coefficient, global efficiency, and local efficiency of the TC group have a higher trend, while the characteristic path length tended to be shorter. In the analysis of the local characteristics of the resting brain functional network, it was found that the node degree of the frontal lobe and temporal lobe of the TC group was higher, and the difference was significant in some nodes. These results all point to the fact that TC practice has a certain impact on specific brain areas of the brain.
Collapse
Affiliation(s)
- Xiaoyuan Li
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, China
- School of Physical Education, Zhengzhou University, Zhengzhou, China
| | - Jintao Geng
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, China
| | - Xiaoyu Du
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, China
| | - Hongyu Si
- School of Physical Education, Zhengzhou University, Zhengzhou, China
- *Correspondence: Hongyu Si,
| | - Zhenlong Wang
- School of Life Sciences, Zhengzhou University, Zhengzhou, China
- Zhenlong Wang,
| |
Collapse
|