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Tian S, Liang Z, Qiu F, Yu Y, Mou H, Zhang G, Zhang H. Optimal modalities and doses of mind-body exercise for depressive symptoms in adults: A systematic review of paired analyses, network analyses and dose-response meta-analyses. Appl Psychol Health Well Being 2024. [PMID: 39128853 DOI: 10.1111/aphw.12573] [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: 01/02/2024] [Accepted: 06/14/2024] [Indexed: 08/13/2024]
Abstract
The relative efficacy of various mind-body exercises in the treatment of depressive symptoms remains uncertain. We examined the optimal modalities (Tai Chi, qigong, yoga) and dose of mind-body exercise to improve depressive symptoms in adults. A systematic search of six electronic databases for randomized controlled trials on the relationship between exercise and depression was carried out, encompassing data from their inception up to November 2023. Pairwise analyses, network analyses and dose-response meta-analyses using random-effects models were performed to analyse the effect of exercise on depression. Forty studies were included. Results showed that Yoga [standardised mean difference (SMD) = -0.55; 95% confidence interval (CI): (-0.76, -0.35)] was the most effective form of exercise for improving depressive symptoms, followed by Qigong (SMD = -0.52; 95%CI: -0.92, -0.11) and Tai Chi exercise (SMD = -0.42; 95%CI: -0.71, -0.13). In addition, a non-linear dose-response relationship was found between overall mind-body exercise dose and depression levels and a significant response was observed after 260 METs-min. Our study examined the effectiveness of different types of mind-body exercise in improving depression and found that yoga may be the most effective adjunctive intervention. There was a non-linear dose-response relationship between total exercise and depression levels. However, caution should be exercised in interpreting and applying these results.
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Affiliation(s)
- Shudong Tian
- School of Physical Education, Shandong University, Jinan, China
| | - Zhide Liang
- Department of Physical Education, Qingdao University, Qingdao, China
| | - Fanghui Qiu
- Department of Physical Education, Qingdao University, Qingdao, China
| | - Yingdanni Yu
- School of Physical Education, Shandong University, Jinan, China
| | - Hong Mou
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Gang Zhang
- Shenzhen Shangbu Middle School, Shenzhen, China
| | - Hongzhen Zhang
- School of Physical Education, Shandong University, Jinan, China
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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.
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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
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Moonaz S, Nault D, Cramer H, Ward L. CLARIFY 2021: explanation and elaboration of the Delphi-based guidelines for the reporting of yoga research. BMJ Open 2021; 11:e045812. [PMID: 34353794 PMCID: PMC8344321 DOI: 10.1136/bmjopen-2020-045812] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/07/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Reporting of yoga research often lacks the detail required for clinical application, study replication, summary research and comparative effectiveness studies. METHODS To improve the transparency of reporting yoga interventions, and building on the development of previous reporting guidelines, a group of international yoga research stakeholders developed the consensus-based CheckList stAndardising the Reporting of Interventions For Yoga (CLARIFY) guidelines. RESULTS The 21-item CLARIFY checklist outlines the minimum details considered necessary for high-quality reporting of yoga research. This paper provides a detailed explanation of each of the 21 items of the CLARIFY checklist, together with model examples of how to integrate each item into publications of yoga research. The CLARIFY guideline serves as an extension for existing research reporting guidelines, and is flexible for use across all study designs. CONCLUSION We strongly encourage the uptake of these reporting guidelines by researchers and journals, to facilitate improvements in the transparency and utility of yoga research.
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Affiliation(s)
- Steffany Moonaz
- Department of Integrative Health Research, Maryland University of Integrative Health, Laurel, Maryland, USA
| | - Daryl Nault
- Department of Integrative Health Research, Maryland University of Integrative Health, Laurel, Maryland, USA
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Lesley Ward
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle Upon Tyne, Northumberland, UK
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Duong V, Daniel MS, Ferreira ML, Fritsch CG, Hunter DJ, Wang X, Wei N, Nicolson PJA. Measuring adherence to unsupervised, conservative treatment for knee osteoarthritis: A systematic review. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100171. [PMID: 36474984 PMCID: PMC9718095 DOI: 10.1016/j.ocarto.2021.100171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/26/2021] [Indexed: 01/11/2023] Open
Abstract
Objective To describe the measurement of adherence to unsupervised, conservative treatments for knee osteoarthritis (OA), including the methods of adherence measurement, parameters for assessing adherence and any values used to quantify adherence. Methods A systematic review with search terms related to knee OA, conservative treatments and adherence was conducted. The protocol was registered with the International Prospective Register of Systematic Reviews (registration number CRD42020158188). Seven electronic databases (MEDLINE, AMED, EMBASE, CINAHL, SportDiscus, PsychINFO, PEDro) were searched from inception to February 02, 2021. Studies that included unsupervised, conservative treatment(s) for knee OA measuring adherence were eligible. Studies were independently screened for inclusion by two researchers. Data was extracted by one researcher and verified by a second researcher. Extracted data included: study type, population, type of treatment, adherence measurement methods, time-points, recall, parameters and values used to quantify adherence. Results Of 5033 references identified, 242 studies comprising of 261 treatments were included in the review. The majority of studies were randomised controlled trials investigating therapeutic exercise (n = 107, 41.0%). The most common adherence measurement across all treatments was through self-reported diary (n = 137, 52.5%) and the most common parameter was assessing the frequency of the treatment (n = 79, 30.3%). Only a small number of studies provided values for quantifying satisfactory adherence (n = 26, 9.3%). Conclusion There is a wide variety in the reporting of adherence to conservative treatments for knee OA and standardised methods for measuring and reporting adherence are needed. Developing a tool to measure adherence to conservative treatments for knee OA is a priority.
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Affiliation(s)
- Vicky Duong
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
| | - Matthew S. Daniel
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
| | - Manuela L. Ferreira
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
| | - Carolina G. Fritsch
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
| | - David J. Hunter
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
| | - Xia Wang
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
| | - Ni Wei
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
- Department of Rheumatology, Dongfang Hospital, Beijing, University of Chinese Medicine, China
| | - Philippa JA. Nicolson
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Australia
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom
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Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS. Predictors of and barriers to adherence in a 16-week randomised controlled trial of Bikram yoga in stressed and sedentary adults. Complement Ther Med 2018; 42:374-380. [PMID: 30670270 DOI: 10.1016/j.ctim.2018.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bikram yoga may enhance health outcomes in healthy adults and those at risk for chronic disease, however, challenges remain in achieving optimal adherence to this practice. This study investigated factors influencing adherence to a 16-week Bikram yoga intervention in stressed and sedentary adults. METHODS Experimental group participants (n = 29) were instructed to attend 3-5 Bikram yoga classes weekly for 16 weeks. Baseline demographics, behaviours and health measures were investigated as predictors of adherence. Barriers were assessed via documentation of adverse events, and exit survey responses. RESULTS Participants (38.2 ± 10.1 years) were predominantly overweight-obese (83%), female (79%), and attended 27 ± 18 classes. Higher adherence was associated with older age (p = 0.094), less pain (p = 0.011), fewer physical limitations (p = 0.011), poorer blood lipid profile, and higher heart rate variability (HRV; total power, (p = 0.097)). In multi-variable analysis, three variables: age (β = 0.492, p = 0.006), HRV (β = 0.413, p = 0.021) and pain (β = 0.329, p = 0.048) remained predictors of adherence. Difficulty committing to the trial, lack of enjoyment and adverse events were barriers to adherence. CONCLUSIONS These findings should be considered in the development of future Bikram yoga trials to facilitate higher levels of adherence, which may enhance health outcomes and inform community practice. Future trials should investigate and address additional barriers and facilitators of Bikram yoga practice.
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Affiliation(s)
- Zoe L Hewett
- School of Science and Health, Western Sydney University, Penrith, New South Wales, 2751, Australia.
| | - Kate L Pumpa
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, 2617, Australia.
| | - Caroline A Smith
- National Institute of Complementary Medicine, Western Sydney University, Penrith, New South Wales, 2751, Australia.
| | - Paul P Fahey
- School of Science and Health, Western Sydney University, Penrith, New South Wales, 2751, Australia.
| | - Birinder S Cheema
- School of Science and Health, Western Sydney University, Penrith, New South Wales, 2751, Australia; National Institute of Complementary Medicine, Western Sydney University, Penrith, New South Wales, 2751, Australia.
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Assessing the Functional Status of Older Cancer Patients in an Ambulatory Care Visit. Healthcare (Basel) 2015; 3:846-59. [PMID: 27417801 PMCID: PMC4939579 DOI: 10.3390/healthcare3030846] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/26/2015] [Accepted: 09/10/2015] [Indexed: 01/22/2023] Open
Abstract
Functional status assessment is a useful and essential component of the complete history and physical exam of the older patient diagnosed with cancer. Functional status is the ability to conduct activities that are necessary for independence and more executive activities, such as money management, cooking, and transportation. Assessment of functional status creates a portal into interpreting the health of in older persons. Understanding limitations and physical abilities can help in developing cancer treatment strategies, patient/family teaching needs, and in-home services that enhance patient/family care. This article will review the benefits of functional assessment, instruments that can be used during an ambulatory care visit, and interventions that can address potential limitations.
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Saper RB. Minding the Mat: Moving the Yoga Field Forward. Glob Adv Health Med 2015; 4:5-6. [PMID: 25984410 PMCID: PMC4424940 DOI: 10.7453/gahmj.2015.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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