Digital Delivery of Meditative Movement Training Improved Health of Cigarette-Smoke-Exposed Subjects.

Peter Payne,Steven Fiering,Mardi Crane-Godreau,David Zava,Paul Hage,Anthony Brown,Carole Gaudet,Thomas J Gould

doi:10.3389/fpubh.2018.00282

Abstract

Many FA who flew prior to the ban on smoking in commercial aircraft exhibit an unusual pattern of long-term pulmonary dysfunction. This randomized controlled study tested the hypothesis that digitally delivered meditative movement (MM) training improves chronic obstructive pulmonary disease (COPD)-related symptoms in flight attendants (FA) who were exposed to second-hand cigarette smoke (SHCS) while flying. Phase I of this two-phase clinical trial was a single-arm non-randomized pilot study that developed and tested methods for MM intervention; we now report on Phase II, a randomized controlled trial comparing MM to a control group of similar FA receiving health education (HE) videos. Primary outcomes were the 6-min walk test and blood levels of high sensitivity C-reactive protein (hs-CRP). Pulmonary, cardiovascular, autonomic and affective measures were also taken. There were significant improvements in the 6-min walk test, the Multidimensional Assessment of Interoceptive Awareness (MAIA) score, and the COPD Assessment Test. Non-significant trends were observed for increased dehydroepiandrosterone sulfate (DHEAS) levels, decreased anxiety scores and reduced blood hs-CRP levels, and increased peak expiratory flow (PEF). In a Survey Monkey questionnaire, 81% of participants who completed pre and post-testing expressed mild to strong positive opinions of the study contents, delivery, or impact, while 16% expressed mild negative opinions. Over the course of the year including the study, participant adoption of the MM practices showed a significant and moderately large correlation with overall health improvement; Pearson's R = 0.62, p < 0.005. These results support the hypothesized benefits of video-based MM training for this population. No adverse effects were reported.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02612389

Highlights

AND BACKGROUNDMorbidities in Flight Attendants Exposed to Second-Hand Cigarette SmokeFlight attendants (FA) who flew before the ban on smoking in commercial aircraft present with many of the co-morbidities of chronic obstructive pulmonary disease (COPD) but their pulmonary dysfunction differs from the standard definition of this disorder
We suggest that in future similar studies DHEAS should be considered as a useful objective marker of improved health in this kind of intervention
This study addressed a specific population, flight attendants with workplace-related second-hand cigarette smoke exposure for more than 5 years

Summary

Introduction

Flight attendants (FA) who flew before the ban on smoking in commercial aircraft (implemented progressively from 1988 to 2000) present with many of the co-morbidities of chronic obstructive pulmonary disease (COPD) but their pulmonary dysfunction differs from the standard definition of this disorder These FA, in good health at the time that they were hired, were exposed to second-hand cigarette smoke (SHCS) in the course of their often vigorous work activities, as well as to a wide range of other stressors [including interpersonal stress, aviation-associated threats and emergencies, disrupted diurnal rhythms and polluted air [1,2,3,4]]. Research into the effects of stress and trauma on pulmonary health, including insights into the embedding of fear responses by nicotine exposure, are changing the overarching paradigms about the nature of the lasting respiratory effects of tobacco smoke exposure [15,16,17,18]

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