Integrating Mindfulness Training Research Articles

Effect of mindfulness training in adjunct to conventional physiotherapy on pain, function, and mindfulness attention awareness score in recreational long distance runners with patellofemoral pain syndrome: A randomized controlled trial protocol

Background The Patellofemoral Pain Syndrome (PFPS) poses a significant challenge in sports medicine due to its multifactorial etiology involving both physiological and psychological factors. Though widely used, conventional physiotherapy approaches often yield limited efficacy and high recurrence rates. Mindfulness-based interventions have emerged as promising adjuncts in managing various musculoskeletal conditions, offering potential benefits in pain management, coping strategies, and overall well-being. However, their efficacy in addressing PFPS remains underexplored, particularly in the context of recreational long-distance runners. This study investigates the effects of integrating mindfulness training as an adjunct to conventional physiotherapy on pain intensity, functional outcomes, and mindfulness awareness in recreational long-distance runners with PFPS. Methods Eligible individuals will be assigned randomly to either Group A (Mindfulness Training + Conventional Physiotherapy) or Group B (Conventional Physiotherapy). Outcome measures, such as the Numeric Pain Rating Scale (NPRS), Mindfulness Attention Awareness Scale (MAAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and knee joint position sense using a goniometer will be assessed at baseline and post-intervention. Mindfulness training will encompass a variety of techniques integrated with conventional physiotherapy sessions. Result This study has the potential to offer an enhanced treatment strategy that considers both the physical and psychological aspects of Patellofemoral Pain Syndrome (PFPS), potentially improving outcomes and well-being for recreational long-distance runners. CTRI Registration Number: CTRI/2024/03/064876

Stress and primary headaches – Mindfulness-Based Stress Reduction (MBSR) as a novel avenue for treatment

Introduction: In today's fast-paced life, an increasing number of people are experiencing chronic stress, which negatively impacts our mental and physical health, leading to troublesome conditions such as primary headaches. Faced with this challenge, more individuals are turning their attention to mindfulness techniques as an effective tool for stress management. In light of this, mindfulness, focusing on the awareness of the present moment, emerges as a promising method for preventing and alleviating stress-induced headaches and the resulting aftermath. 
 Purpose: Offer a comprehensive overview of the current understanding of the efficacy of mindfulness training, particularly Mindfulness-Based Stress Reduction (MBSR), in the prevention and relief of primary headaches and their associated consequences. 
 Description of the state of knowledge: MBSR demonstrates the potential for effectively coping with stress-induced headaches and their subsequent effects, including disability related to headaches. This category of pain includes conditions like migraine and tension-type headaches. In the clinical trials conducted thus far participants in the MBSR program show noticeable improvement in headache-related disability, self-efficacy, quality of life, catastrophic pain, and depression scores. 
 Summary: Studies suggest that integrating mindfulness training could present a promising strategy for preventing and reducing the severity of primary headaches and their consequences, by mitigating stress, a crucial factor influencing the onset of these headaches. To validate these promising findings, further randomized, large-scale, placebo-controlled studies are required.

Mindful Coping Power Effects on Children's Autonomic Nervous System Functioning and Long-Term Behavioral Outcomes.

Mindful Coping Power (MCP) was developed to enhance the effects of the Coping Power (CP) preventive intervention on children's reactive aggression by integrating mindfulness training into CP. In prior pre-post analyses in a randomized trial of 102 children, MCP improved children's self-reported anger modulation, self-regulation, and embodied awareness relative to CP but had fewer comparative effects on parent- and teacher-reported observable behavioral outcomes, including reactive aggression. It was hypothesized that MCP-produced improvements in children's internal awareness and self-regulation, if maintained or strengthened over time with ongoing mindfulness practice, would yield improvements in children's observable prosocial and reactive aggressive behavior at later time points. To appraise this hypothesis, the current study examined teacher-reported child behavioral outcomes at a one-year follow-up. In the current subsample of 80 children with one-year follow-up data, MCP produced a significant improvement in children's social skills and a statistical trend for a reduction in reactive aggression compared with CP. Further, MCP produced improvements in children's autonomic nervous system functioning compared with CP from pre- to post-intervention, with a significant effect on children's skin conductance reactivity during an arousal task. Mediation analyses found that MCP-produced improvements in inhibitory control at post-intervention mediated program effects on reactive aggression at the one-year follow-up. Within-person analyses with the full sample (MCP and CP) found that improvements in respiratory sinus arrhythmia reactivity were associated with improvements in reactive aggression at the one-year follow-up. Together, these findings indicate that MCP is an important new preventive tool to improve embodied awareness, self-regulation, stress physiology, and observable long-term behavioral outcomes in at-risk youth. Further, children's inhibitory control and autonomic nervous system functioning emerged as key targets for preventive intervention.

The Impact of Mindfulness on Stress and Burnout of New Graduate Nurses as a Component of a Nurse Residency Program.

This evidence-based practice project assessed the impact of integrating mindfulness training into an existing nurse residency program. Stress and burnout are endemic in healthcare. The transition to practice is associated with stress and anxiety for newly graduated nurses. Evidence supports mindfulness-based interventions to mitigate stress and burnout and improve the workplace environment and patient outcomes. This project employed a pre/post design to measure burnout, stress, and mindfulness, comparing means and standard deviations between intervention and comparison nurse residency cohorts. Mindfulness training was integrated at 4 points within the 1st 6 months of the residency program. The intervention cohort reported significantly less burnout and stress and more mindfulness at 6 months than the comparison group. Mindfulness training can be feasibly integrated into an existing nurse residency program to decrease stress and burnout for new graduate nurses during the transition to practice.

Special Issue: Integrating Mindfulness Training with Clinical Biofeedback: Practical Applications

This special issue continues the focus of the spring and summer 2018 issues (Volume 46, Issues 1 and 2) on the benefits of integrating mindfulness and biofeedback approaches and identifies several new areas of application in pediatric biofeedback, the treatment of adults with intellectual disabilities, care for persons with respiratory illness and mechanical ventilation, and the management of chronic multiple sclerosis.The issue opens with an article by two leaders in biofeedback, who argue that mindfulness is as a natural extension of the awareness training inherent in biofeedback and other self-regulation approaches. Eric Peper and Richard Harvey compare mindfulness with other self-regulation strategies, such as progressive muscle relaxation, autogenic training, and transcendental meditation. They identify common elements shared by mindfulness with other self-regulation strategies. They also argue that most of the commonly used self-regulation strategies have comparable efficacy. They suggest mechanisms making many such self-regulation skills effective, including effects on the gamma aminobutyric acid neurotransmitter system. Finally, they call for further research to explore dropout rates, adverse effects, and other dimensions of mindfulness training.Next, Jonathan Sikorski and Olivia Hernandez-Gonzalez address the challenges in applying mindfulness-based interventions with two special populations. They point out that young children often struggle with communicating their needs, feelings, and desires with others. Adults with intellectual disabilities face similar challenges. The authors introduce practical strategies they have developed to introduce mindfulness skills for these two groups. They also use biofeedback as a tool to assist both groups in enhancing internal awareness of the link between emotions and physiological sensations. To illustrate their approach, they present two case narratives, the first a 10-year-old boy with generalized anxiety disorder, and the second a 28-year-old adult with Prader-Willi syndrome and intellectual disabilities.Urszula Klich presents a case study illustrating her clinical approach, which emphasizes teaching self-regulation and compassion. The case example in her article presents a patient with a tracheostomy who is experiencing anxiety related to pain and anxiety about eventual removal of her vent. Mechanical ventilation for acute respiratory insufficiency accounts for approximately 800,000 hospitalizations each year, and discontinuation of mechanical ventilation is challenging for patients and care teams alike. Klich combined compassion-based strategies with biofeedback to reduce anxiety about decannulation (removal of the tracheostomy tube). Her interventions included mindfulness meditation, breath training, heart rate variability training, loving kindness meditation, and the use of mindfulness strategies to ameliorate anxiety.In the final article, Donald Moss discusses the integration of mindfulness training, clinical biofeedback, and lifestyle change in the management of multiple sclerosis (MS). Moss provides a discussion of the medical diagnosis and treatment of MS, a review of the epidemiology and genetics of the condition, and a case narrative describing a 36-year-old woman with a pattern of chronic relapsing MS. This chapter also shows the use of the Pathways Model to organize treatment. The Pathways Model is an overall self-directed program of acquiring self-regulation skills and implementing lifestyle changes as a supplement to professional intervention.

Beneficial Effects of School-based Mindfulness Training On Impulsivity in Healthy Adolescents: Results From a Pilot Randomized Controlled Trial

Since impulsivity is associated with unhealthy behaviors in adolescents, interventions targeting impulsivity could positively affect such behaviors. Whether integrating mindfulness training (MT) into standard school-based health education could improve impulsivity is unknown. To obtain preliminary estimates of effect of MT integrated in standard high school health education on impulsivity. Two high schools in Massachusetts were randomized to school-based health education plus MT (HE-MT) or to health education plus attention control (HE-AC). The outcome was change in impulsivity at end of treatment (EOT) and 6 months after EOT. Students (n=53; 30 HE-MT, 23 HE-AC) were on average 14.5 years old and 40% belonged to ethnic minorities. Compared to the control condition, HE-MT had significant effects on impulsivity at EOT (beta = -9.7; SE = 3.8, p = 0.01), while smaller, non-significant differences were seen 6 months after EOT. This rigorous pilot study suggests that MT could have a beneficial effect on impulsivity in adolescents. Improvements in impulsivity could have important implications should future larger studies show that such improvements result in healthier behaviors.

Happier Healers: Randomized Controlled Trial of Mobile Mindfulness for Stress Management.

Medical students have higher rates of depression and psychologic distress than the general population, which may negatively impact academic performance and professional conduct. This study assessed whether 10-20 min of daily mindfulness meditation for 30 days, using a mobile phone application, could decrease perceived stress and improve well-being for medical students. Eighty-eight medical students were stratified by class year and randomized to either intervention or control groups to use the mobile application Headspace, an audio-guided mindfulness meditation program, for 30 days. All participants completed the Perceived Stress Scale (PSS), Five-Facet Mindfulness Questionnaire (FFMQ), and General Well-Being Schedule (GWBS) at baseline (T1), 30 days (T2), and 60 days (T3). Repeated measures analysis of variance (rANOVA) was conducted for intervention versus control groups across T1, T2, and T3 to examine differences in stress, mindfulness, and well-being. There was a significant interaction between time and treatment group for perceived stress and well-being. Perceived stress significantly decreased for the intervention group from T1 to T3 (F[2,142] = 3.98, p < 0.05). General well-being significantly increased for the intervention group compared to the control group from T1 to T2, and the increase was sustained through T3 (F[2,144] = 3.36, p < 0.05). These results highlight that a mobile audio-guided mindfulness meditation program is an effective means to decrease perceived stress in medical students, which may have implications on patient care. Integrating mindfulness training into medical school curricula for management of school- and work-related stress may lead to fewer negative physician outcomes (e.g., burnout, anxiety, and depression) and improved physician and patient outcomes. This has implications for a broad group of therapists and healthcare providers, ultimately improving quality of healing and patient care.

Integrating mindfulness training in school health education to promote healthy behaviors in adolescents: Feasibility and preliminary effects on exercise and dietary habits.

Whether mindfulness training (MT) could improve healthy behaviors is unknown. This study sought to determine feasibility and acceptability of integrating MT into school-based health education (primary outcomes) and to explore its possible effects on healthy behaviors (exploratory outcomes). Two high schools in Massachusetts (2014–2015) were randomized to health education plus MT (HE-MT) (one session/week for 8 weeks) or to health education plus attention control (HE-AC). Dietary habits (24-h dietary recalls) and moderate-to-vigorous physical activity (MVPA/7-day recalls) were assessed at baseline, end of treatment (EOT), and 6 months thereafter. Quantile regression and linear mixed models were used, respectively, to estimate effects on MVPA and dietary outcomes adjusting for confounders. We recruited 53 9th graders (30 HEM, 23 HEAC; average age 14.5, 60% white, 59% female). Retention was 100% (EOT) and 96% (6 months); attendance was 96% (both conditions), with moderate-to-high satisfaction ratings. Among students with higher MVPA at baseline, MVPA was higher in HE-MT vs. HE-AC at both EOT (median difference = 81 min/week, p = 0.005) and at 6 months (p = 0.004). Among males, median MVPA was higher (median difference = 99 min/week) in HE-MT vs. HEAC at both EOT (p = 0.056) and at 6 months (p = 0.04). No differences were noted in dietary habits. In sum, integrating school-based MT into health education was feasible and acceptable and had promising effects on MVPA among male and more active adolescents. These findings suggest that MT may improve healthy behaviors in adolescents and deserve to be reproduced in larger, rigorous studies.

A Randomized Pilot Study of a Phone-Based Mindfulness and Weight Loss Program

ABSTRACTThis study evaluated the feasibility and efficacy of integrating mindfulness training into a phone-based weight loss program to improve outcomes in those with high levels of emotional eating. Participants were 75 enrollees into an employer-sponsored weight loss program who reported high levels of overeating in response to thoughts and feelings. Seventy-five overweight and obese participants (92% female, 65% Caucasian, aged 26 to 68 years) were randomized to the new mindfulness weight loss program (n = 50) or the standard behavioral weight loss program (n = 25). Both programs consisted of 11 coaching calls with health coaches and registered dietitians with supplemental online materials. Satisfaction, engagement, and percent weight lost did not significantly differ for intervention vs. control at six months. Intervention participants had significantly better scores at six-month follow-up on mindful eating, binge eating, experiential avoidance, and one mindfulness subscale. Exploratory analyses showed that improvements on several measures predicted more weight loss in the intervention group. This pilot study found that integrating mindfulness into a brief phone-based behavioral weight loss program was feasible and acceptable to participants, but did not produce greater weight loss on average, despite hypothesized changes in mindful eating. Only one third of intervention participants reported participating in mindfulness exercises regularly. Mechanisms of change observed within the intervention group suggest that for adults with high levels of emotional eating those who embrace mindful eating and meditation may lose more weight with a mindfulness intervention.

A Mindfulness-Based Lifestyle Intervention for Obese, Inactive Endometrial Cancer Survivors: A Feasibility Study.

Background: Mindfulness-based interventions (MBIs) to address self-regulation and lifestyle behaviors (diet, physical activity) may benefit endometrial cancer survivors (ECS), who are at increased risk for morbidity and mortality associated with obesity. However, the acceptability of mindfulness training and whether it can augment behavior change in ECS is unknown. We aimed to examine; 1) the feasibility of the Mindfulness in Motion + Diet (MIM+D) intervention and 2) the preliminary efficacy of MIM+D for improving mindfulness, diet, PA and health-related quality of life (HRQL). Methods: ECS (Mage=62.4, ±5yrs from diagnosis) completed assessments at baseline, 8 and 14 weeks. Feasibility was determined by intervention completion surveys, attendance and adherence data. We used repeated measures ANOVA’s (SPSS 22.0) and effect size estimates (Cohen’s d) to examine changes in mindfulness, diet, PA, and HRQL over time. Results: Thirteen ECS (76%) completed the MIM+D program and attendance (≥6/8 sessions) was 90%. Women reported favorably on the overall quality (mean of 4.75/5) and benefits of the MIM+D program; however, would have preferred receiving MIM+D closer to diagnosis. Intention to treat analyses found MIM+D did not significantly improve any outcomes. However, an intervention completers analysis showed significant change in mindfulness (p=.0039) and small to moderate estimates for change in fruits and vegetable intake (d=.23), MVPA (d=.45), RAND SF-36: MCS (d=.46), and sleep quality (d=.68). Conclusions: Integrating mindfulness training into behavioral interventions is feasible and ECS that adhere to these lifestyle programs may benefit. However, to future research should examine the-long term effects of mindfulness-based behavioral lifestyle interventions.

Mindfulness Training as an Adjunct to Evidence-Based Treatment for ADHD Within Families

Objective: Individuals with ADHD face significant neurodevelopmental hurdles with inattention and/or hyperactive/impulsive behavior through their life span. Mindfulness training may be one self-regulatory method for strengthening attentional processes (orienting, alerting, and executive attention). This review’s goals are to (a) argue for the use of mindfulness training as an adjunct to evidence-based treatment for ADHD and (b) call for improving psychosocial intervention for ADHD within families by integrating mindfulness training with behavioral parent training. Method: EBSCOhost was utilized to search 29 psychology-related research databases through Athabasca University. Results: Mindfulness training should be incorporated into current treatment guidelines as a psychosocial option for families with ADHD. Conclusion: Preliminary findings suggest significant improvements in attentional processes, and prominent mindfulness-based approaches have been successfully adapted for ADHD.

Implementation of mindfulness training for adolescent residential clients

Purpose – Interest in using mindfulness as a clinical intervention technique has increased, with evidence suggesting that it can be successfully integrated both into treatment for adolescents and for people with substance use disorders. The purpose of this paper is to explore the degree to which mindfulness training can be implemented among adolescents undergoing residential substance abuse treatment. Design/methodology/approach – Nine adolescent males in a residential therapeutic community (TC) substance use treatment center enrolled in a voluntary mindfulness training program consisting of eight 90 minute sessions, each led by a clinical psychologist trained in mindfulness-based stress reduction. After the training program concluded, a brief participant survey and participant and staff focus groups were conducted. Findings – Both survey and focus group discussions indicate that the mindfulness training program was perceived as helpful, acceptable, and feasible. Suggestions for integrating mindfulness training into residential treatment facilities for adolescents are discussed. Originality/value – This study highlights the potential of mindfulness training to augment traditional TC treatment for adolescents, and provides enough information for practitioners to implement mindfulness training in their treatment settings.

Integrating Mindfulness Training into K-12 Education: Fostering the Resilience of Teachers and Students

Over the past decade, training in mindfulness—the intentional cultivation of moment-by-moment non-judgmental focused attention and awareness—has spread from its initial western applications in medicine to other fields, including education.Thispaperreviewsresearchandcurriculapertaining to the integration of mindfulness training into K-12 education, both indirectly bytraining teachers andthrough direct teaching of students. Research on the neurobiology of mindfulness in adults suggests that sustained mindfulness practice can enhance attentional and emotional self-regulation and promote flexibility, pointing toward significant potential benefits for both teachers and students. Early research results on three illustrative mindfulness-based teacher training initiatives sug- gest that personal training in mindfulness skills can increase teachers' sense of well-being and teaching self-efficacy, as well as their ability to manage classroom behavior and establish and maintain supportive relationships with stu- dents. Since 2005, 14 studies of programs that directly train