Mind-body Program Research Articles

A randomized controlled trial of two simple mind-body programs, Kirtan Kriya meditation and music listening, for adults with subjective cognitive decline: Feasibility and acceptability

Purpose of the studyIn this randomized controlled trial (RCT), we assessed the feasibility and acceptability of two simple home-based relaxation programs in adults experiencing subjective cognitive decline, a strong predictor of Alzheimer's disease. Design and methodsSixty participants were randomized to a beginner Kirtan Kriya meditation (KK) program or a music listening (ML) program. Participants were asked to practice 12min daily for the first 12 weeks, then as often as they liked for the following 3 months. Participants underwent assessments at baseline, 12 weeks, and 6 months to evaluate changes in key outcomes. Feasibility and acceptability were evaluated by measuring recruitment and retention rates, assessment visit attendance, practice adherence, and treatment expectancy; exit questionnaires completed at 12 weeks and 6 months provided additional data regarding participant experience with the study, perceived barriers to and facilitators of practice, reasons for drop-out, and views regarding the assigned intervention. ResultsFifty-three participants (88%) completed the 6 month study. Adherence in both groups was excellent, with participants completing 93% (91% KK, 94% ML) of sessions on average in the first 12 weeks, and 71% (68% KK, 74% ML) during the 3 month, practice-optional, follow-up period. At week 12, over 80% of participants indicated they were likely to continue practicing following study completion. Responses to both structured and open-ended exit questionnaire items also suggested high satisfaction with both programs. ConclusionsFindings of this RCT of a beginner meditation practice and a simple ML program suggest that both programs were well accepted and the practices are feasible in adults with early memory loss.

Guidelines for Creating, Implementing, and Evaluating Mind–Body Programs in a Military Healthcare Setting

Research suggests that the development of mind-body skills can improve individual and family resilience, particularly related to the stresses of illness, trauma, and caregiving. To operationalize the research evidence that mind-body skills help with health and recovery, Samueli Institute, in partnership with experts in mind-body programming, created a set of guidelines for developing and evaluating mind-body programs for service members, veterans, and their families. The Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting outline key strategies and issues to consider when developing, implementing, and evaluating a mind-body focused family empowerment approach in a military healthcare setting. Although these guidelines were developed specifically for a military setting, most of the same principles can be applied to the development of programs in the civilian setting as well. The guidelines particularly address issues unique to mind-body programs, such as choosing evidence-based modalities, licensure and credentialing, safety and contraindications, and choosing evaluation measures that capture the holistic nature of these types of programs. The guidelines are practical, practice-based guidelines, developed by experts in the fields of program development and evaluation, mind-body therapies, patient- and family-centered care, as well as, experts in military and veteran's health systems. They provide a flexible framework to create mind-body family empowerment programs and describe important issues that program developers and evaluators are encouraged to address to ensure the development of the most impactful, successful, evidence-supported programs possible.

An exploratory study of an online mind–body program for poor sleepers in a community sample

IntroductionDelivering mind–body interventions using the Internet may be an effective way to provide evidence-based treatments to help reduce sleep disturbance. A sleep-focused mind–body intervention, mind–body bridging (MBB), showing promise in improving sleep was adapted for Internet use as SleepSTAR program. The aim of this observational study was to evaluate the feasibility and acceptability, and potential sleep health benefits, of SleepSTAR. MethodsThirty-seven participants with self-reported sleep disturbance were recruited into the study. They viewed online SleepSTAR content for 3 consecutive daily sessions (20min each for a total of 60min). Participants provided feedback about the SleepSTAR website and contents, and responded to a validated sleep scale to indicate how they slept, after applying SleepSTAR techniques. Assessments were conducted at pre-intervention, post-intervention (after 3 nights of SleepSTAR), and 1 week, 1-month and 3-month follow-ups. ResultsMost participants responded favorably to SleepSTAR, and reported frequently viewing the website and using the techniques throughout the assessment period. Based on the validated sleep scale, participants’ sleep disturbance declined significantly at post-assessment, and further at the 1-week assessment. These improvements were maintained at all three follow-ups. ConclusionsThis study provides preliminary support for SleepSTAR as a promising online mind–body intervention to help individuals manage their sleep. The study also supports the great potential of implementing this promising self-help program on the Internet to increase accessibility and promote better health through the use of novel, evidence-based mind–body interventions.

Dementia: Treating Patients and Caregivers with Complementary and Alternative Medicine - Results of a Clinical Expert Conference Using the World Café Method

Background: In Germany the number of inhabitants with dementia is expected to increase from 1.2 million at present to 2.3 million in 2050. Our aim was to investigate which treatments complementary and alternative medicine (CAM) experts consider to be of therapeutic use in developing treatment strategies and hypotheses for further clinical studies. Methods: In a participatory group workshop the ‘World Café' method was used. As questions we asked: 1) ‘Based on your clinical experience, which CAM therapies are effective in the treatment of patients with dementia? 2) Based on your clinical experience, which CAM therapies are effective in the treatment of lay and professional caregivers of patients with dementia?, and 3) How should a CAM treatment program look like?' Further Delphi rounds were used to reach consensus and summarize the results. Results: The 2-day workshop took place in January 2012 in Berlin. A total of 17 experts participated. The most important subject in the treatment was the need to understand patients' biographies in order to individualize the therapy. Therapy itself consists of the therapeutic relationship, nonmedical therapies such as sports, massage, music and arts therapy as well as medical treatment such as herbal or homeopathic medicines. With regard to caregivers the most important aim is to prevent or reduce psychological distress, e.g., by mind-body programs. Instead of single treatments, more general elements such as understanding the patients' biographies, therapeutic relationships, individualizing, networking, and self-care emerged as main results. Discussion: An integrative treatment program should connect outpatient and inpatient care as well as all experts. CAM training courses should be offered to doctors, nurses, and caregivers. Future clinical studies should focus on complex intervention programs integrating these key elements.

Can a Multimodal Mind–Body Program Enhance the Treatment Effects of Physical Activity in Breast Cancer Survivors With Chronic Tumor-Associated Fatigue? A Randomized Controlled Trial

Background. Chronic fatigue is one of the most restricting symptoms following primary breast cancer treatment, but clinical studies on symptom management are rare. The objective was to evaluate the impact of a multimodal mind-body program (MMMT), including moderate physical activity as compared with a walking intervention alone, on chronic fatigue symptoms of women with stage I to IIIA breast cancer. Sixty-four women (mean age = 56.7 years) suffering from chronic fatigue after active tumor treatment were randomly assigned to either an experimental or a control (n = 32 each) intervention (10 weeks). Fatigue, quality of life (QoL), functional well-being, anxiety, and depression were measured with standard questionnaires at baseline, after 10 weeks, and after 3 months. Compared with baseline, both groups had reduced fatigue scores after treatment without any significant difference between groups (posttreatment, Δ = -0.3, confidence interval = -1.6 to 1.0, P = .678; follow-up, Δ = -0.4, confidence interval = -1.8 to 0.9, P = .510). All patients also improved regarding QoL and general functional well-being. Since both interventions reduced fatigue symptoms and enhanced QoL to a similar extent, we observed no verifiable add-on effect of the MMMT regarding fatigue symptoms. Considering the higher costs with additional expenditure related to MMMT, home-based walking intervention is recommended.

P02.121. Psychological outcomes of a mind body program for successful aging

Purpose The biopsychosocial model of successful aging is aimed at developing a sense of well-being, high self-assessed quality of life, and a sense of personal fulfillment even in the context of illness and disability. The purpose of this study was to explore key outcomes of a new Successful Aging Mind Body program. We hypothesized the program would increase self-efficacy, which would lead to improved feelings of well-being.

P04.28. Implementing a mind-body medicine relaxation training program in an urban high school: changes in health behaviors, perceived stress, and anxiety

Purpose The negative impact of excessive stress on adolescents is linked to increased substance abuse, violence, and depression. The Relaxation Response (RR), a physiologic response opposite to the fight-or-flight response, has been shown to be effective in treating anxiety/depression and reducing stress in high school students. Several studies have demonstrated that RR-based interventions that involve psychoeducation and teaching relaxation strategies are related to decreased anxiety and perceived stress in high school students. These interventions have previously been led by study staff. This study’s objective was to assess the feasibility of having high school teachers implement an RR curriculum with their own students.

P02.173. Objective and subjective adherence in mindfulness meditation trials

Purpose Home practice is frequently prescribed as part of mindbody medicine interventions although rarely objectively measured. As part of our ongoing mind-body medicine research program, we created iMINDr, a custom monitoring software program to collect objective adherence data. The goals for these analyses were to assess: 1) any differences in objective versus subjective adherence, and 2) which baseline measures predict adherence in ongoing mindfulness meditation randomized clinical trials being conducted at our lab.

A brief report of depressive symptoms and health promoting behaviors among women with infertility attending a clinical mind-body program

Diagnosis of infertility or treatment for infertility can result in distress, including for some women, depressive symptoms. Integrative infertility treatment programs are gaining recognition and popularity, and many women may seek this kind of care. However, depressive symptoms may be a barrier to fully engaging in and benefiting from mind-body infertility programs. The aim of this retrospective, cross-sectional chart review, was to describe the baseline level of depressive symptoms and differences in baseline health promoting behaviors by level of depressive symptoms among women (n = 104) presenting to a mind-body infertility program in the clinical setting. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II), and health promoting behaviors were assessed using the Health Promoting Lifestyle Profile-II (HPLP-II). The mean BDI-II score for the sample was 16.3 (±8.5). Participants scoring in the moderate–severe range on the BDI-II had significantly lower scores on Spiritual Growth, Interpersonal Relations, Stress Management and Nutrition subscales of the HPLP-II. There were no significant differences on the Physical Activity or Health Responsibility subscales. These findings may have implications for the treatment of women with infertility, particularly those who seek an integrative approach to treatment.

The design and methods of the aging successfully with pain study

Chronic low back pain (CLBP) is widespread among older adults (≥65years) and is often treated inadequately. With a rapidly growing aging population, CLBP will increase and so will the demand for treatment. We believe that mind-body therapies can help to meet this demand. We present the methodology of a randomized, controlled clinical trial of 300 individuals with CLBP aged 65years or older. The specific aims are, 1) to determine the effectiveness of a mindfulness meditation program in increasing function and reducing pain among older adults with CLBP, and 2) to evaluate the impact of mindfulness meditation on neuropsychological performance in older adults with CLBP. The intervention program is modeled on the Mindfulness-Based Stress Reduction Program (MBSR) and the control is adapted from the 10 Keys™ to Healthy Aging. We will measure self-reported and objectively measured physical function and include a variety of measures to assess pain intensity and pain interference and psychological function. Our primary hypothesis is that the MBSR program will be more effective than the 10 Keys™ program in increasing function and decreasing pain. The proposed study represents the first large, well-controlled, comprehensive examination of the effects of a mind-body program on older adults with chronic pain.

Mass Disasters and Mind-Body Solutions: Evidence and Field Insights

Treatment for the psychological consequences of mass disasters is essential to the recovery of individuals and communities. Little is known about how to provide effective mental health interventions when there are thousands of victims and little, if any, access to care. Post-disaster research and program evaluations suggest that mind-body practices can provide significant relief of anxiety, depression, posttraumatic stress, and physical ailments. Mind-body programs are inexpensive, adaptable to different cultures and conditions, and can be taught rapidly to large numbers of people, including community leaders, to create a sustainable resource for local mental health needs. The challenges of doing research in disaster areas are illustrated using examples from field studies. Potential risks of administering programs to vulnerable populations are discussed, with program design recommendations. The development of safe, effective, trauma-sensitive, culturally appropriate, sustainable programs requires research and collaboration among healthcare professionals, mind-body trainers, researchers, academic institutions, government agencies, and non-governmental humanitarian organizations.

Abstract A63: Effectiveness of a holistic mind-body intervention to treat fatigue in breast cancer survivors: Does race make a difference?

Abstract Introduction: Persistent fatigue affects up to 40% of breast cancer survivors and has multiple contributing factors including pain, sleep disturbance, depression, anxiety, decreased physical activity, weight gain, and treatment-induced menopausal symptoms. A holistic mind-body medicine intervention was developed by the Mercy Medical Center Prevention and Research Center team to address fatigue and its many contributing factors among breast cancer survivors. Overall, the intervention was shown to effectively decrease levels of self-reported fatigue among breast cancer survivors. The purpose of this analysis was to examine whether the effectiveness of the group-based mind-body medicine program differed by race, as little research has assessed the role of race in fatigue improvement among breast cancer survivors. Design: Quasi-experimental design using a before/after evaluation to assess change in fatigue scores. Population: 206 breast cancer survivors (154 Caucasians; 52 African-Americans) with a chief complaint of fatigue. Outcome Measures: Change in severity of fatigue as measured by a 10 cm visual analog scale (0=no fatigue; 10=most fatigue). Fatigue was measured at baseline, end-of-program, two and six months post-program completion. Results: African-Americans reported higher levels of fatigue than Caucasians at baseline and at the three follow-up time points; however, these differences were not statistically significant. African-Americans’ mean score from the visual analog scale showed improvement from 6.3 (SD 1.8) at baseline to 4.4 (SD 2.5) at end-of-program (p<0.001). Results were similar for Caucasians who scored 5.5 (SD 2.2) at baseline compared to 3.6 (2.2) after the intervention (p<0.001). Fatigue improvement was maintained for both groups at two and six month follow up evaluations. Conclusion: A group-based holistic mind-body medicine intervention effectively improved fatigue across both African-American and Caucasian breast cancer survivors. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A63.

A Mind–Body Program for Older Adults with Chronic Low Back Pain: Results of a Pilot Study

Determine the impact of an 8-week mindfulness meditation program on disability, psychological function, and pain severity in community-dwelling older adults with chronic low back pain, and to test the education control program for feasibility. Randomized controlled trial. Participants. Forty community-dwelling older adults with moderate low back pain or greater for at least the previous 3 months. Intervention. Participants were randomized to an 8-week meditation program or an 8-week education control program. Disability, psychological function, and pain severity were assessed. The same measures were obtained for both groups at baseline, at the end of the program, and 4 months after program completion. Sixteen participants (80%) completed the meditation program and 19 (95%) completed the education program. Both the meditation and control group improved on measures of disability, pain, and psychological function, both at program completion and 4-month follow-up. The differences between the two groups did not reach statistical significance. The meditation group practiced mindfulness meditation a mean of 5 days/week (range 1-7) and mean of 31 minutes/session (range 22-48). At 4 months follow-up 14/16 (88%) participants continued to meditate. Both the intervention group and the education control group improved on outcome measures suggesting both programs had a beneficial effect. Participants continued to meditate on 4-month follow-up. The control program was feasible but not inert. Piloting the control program in mind-body research can inform the design of larger clinical trials.

A Randomized Controlled Trial on Effects of the Transcendental Meditation Program on Blood Pressure, Psychological Distress, and Coping in Young Adults

Psychological distress contributes to the development of hypertension in young adults. This trial assessed the effects of a mind-body intervention on blood pressure (BP), psychological distress, and coping in college students. This was a randomized controlled trial (RCT) of 298 university students randomly allocated to either the Transcendental Meditation (TM) program or wait-list control. At baseline and after 3 months, BP, psychological distress, and coping ability were assessed. A subgroup of 159 subjects at risk for hypertension was analyzed similarly. Changes in systolic BP (SBP)/diastolic BP (DBP) for the overall sample were -2.0/-1.2 mm Hg for the TM group compared to +0.4/+0.5 mm Hg for controls (P = 0.15, P = 0.15, respectively). Changes in SBP/DBP for the hypertension risk subgroup were -5.0/-2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05). Changes in psychological distress and coping correlated with changes in SBP (P values < 0.05) and DBP (P values < 0.08). This is the first RCT to demonstrate that a selected mind-body intervention, the TM program, decreased BP in association with decreased psychological distress, and increased coping in young adults at risk for hypertension. This mind-body program may reduce the risk for future development of hypertension in young adults.

Evolving Conceptions of Mindfulness in Clinical Settings

A number of issues important to the clinical utility of mindfulness require systematic study. These include the most parsimonious definition of mindfulness for clinical purposes, how mindfulness is best described to be most approachable to patients, and the extent to which mindfulness shares common mechanisms with other mind–body programs. The discussion includes a brief review of the transition of mindfulness from traditional into clinical settings as well as the components commonly contained within clinical descriptions of mindfulness. A model based on facility in the use of attention is proposed, and a description of mechanisms by which attentional skill may lead to the recognition of internal associational processes and account for psychological outcomes is given. Using constructs already familiar to patients, an attention-based conception may also be more accessible to patients than more elaborate descriptions and have greater utility in identifying commonalities that mindfulness training may have with other mind–body programs.

Abstract B22: Effectivness of a family-focused intervention to treat persistent fatigue in breast cancer surivivors: A pilot randomized trial

Abstract B22 Background Thirty to forty percent of breast cancer survivors suffer from persistent fatigue lingering months to years after adjuvant therapy is completed. This persistent fatigue affects family dynamics feeding a continuing cycle of additional stress and resultant fatigue. We developed a mind-body medicine group intervention and demonstrated a forty percent reduction in fatigue with benefits persisting six months post intervention. A pilot randomized trial was conducted to test if combining the mind-body medicine group intervention with a family-focused intervention is more effective in reducing fatigue for breast cancer survivors than the group intervention only. For the family intervention, family members attended two of the eight weekly sessions and had two family-based counseling sessions with the clinical research therapist. Methodology Subjects who were at least three months post-completion of adjuvant chemotherapy and/or radiation therapy for breast cancer with a baseline fatigue score of &amp;lt;50 as measured by the vitality subscale of the SF-36 Health Survey were randomized to either the group mind-body medicine program or the group program with the integrated family intervention. Thirty-six women entered the pilot study but three dropped out after attending less than two of the eight weekly sessions and were not able to be evaluated. The primary outcome assessed was change in severity of fatigue as measured by the Piper Fatigue Scale. Results Seventeen women were randomized to the family intervention and nineteen to the comparison group intervention. There was no statistically significant difference between the groups by age, martial status or years of education. Those randomized to the family group were on average 4.8 years from the diagnosis of breast cancer compared to 2.8 for the comparison group intervention. Participants in both groups had a statistically significant improvement in fatigue scores at end-of-program with further improvement at two-month follow-up compared to baseline. Mean fatigue scores for the family intervention arm: (baseline-5.7; end -of-program-3.1; two-month-1.4; p&amp;lt;0.001). Fatigue scores for comparison group (baseline-6.5; end-of-program-3.4; two-month-2.7; p&amp;lt;0.001). Comparing the two intervention arms, there were no statistically significant differences at end-of-program (p=0.71) or at two-month follow-up (p=0.14). Recruitment for the trial was challenging, primarily due to the time commitment required from both the survivors and family members. Conclusions A holistic mind-body medicine intervention significantly improved fatigue but augmenting the program with an additional family component did not result in significant incremental improvement in fatigue. Qualitative data from interviews with participants noted that both family members and survivors found benefit in shared learning about fatigue and effective interventions and in discussing their feelings and concerns during counseling sessions. Although this pilot study had limited power to detect a difference between the two arms, the challenges in recruitment for the study suggest that future interventions require a more efficient method to incorporate family members into the program. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B22.

Physiological and psychological responses to a 12-week BodyBalance training programme

BodyBalance is a popular mind-body program practised at numerous leisure centres throughout the western world that makes many unsubstantiated claims as to the benefits of participation. This study examines physiological and psychological responses in adults, aged (mean+/-S.D.) 43.9+/-10.9 years, to a 12-week 'BodyBalance' exercise program. An exercise intervention group (n=17) undertook three 1-h classes, each week for 12 consecutive weeks while the control group (n=17) attended three 90-min 'health lectures'. ANCOVA demonstrated significant differences between the control and exercise groups in body mass, skinfold measures, total girth circumference from six sites, maximal isometric back strength, five measures of flexibility and state anxiety. Post-hoc tests on the experimental group data showed body fat decreased significantly by 1.10+/-1.02% (t=4.44; P<0.01), girth by 4.40+/-5.80cm (t=3.13; P<0.01) and back strength increased by 17.12+/-15.39kgf (t=-4.59; P<0.01). Flexibility was also significantly enhanced with performance of the modified sit-and-reach test increasing by 5.90+/-2.56cm (t=-9.50; P<0.01), hip flexion by 9.84+/-8.41 degrees (t=-4.82; P<0.01), hip extension by 7.65+/-4.48 degrees (t=-7.04; P<0.01), hip abduction by 10.00+/-4.91 degrees (t=-8.40; P<0.01) and lateral trunk flexion by 3.06+/-5.72 degrees (t=-2.21; P<0.05). Finally, state-anxiety (STAI) was significantly reduced intra-class at weeks 1, 6 and 12 by 9.24+/-9.46 (t=4.02; P<0.01), 6.59+/-6.26 (t=4.34; P<0.01) and 7.18+/-5.50 (t=5.38; P<0.01), respectively. The findings of this study suggest mind-body exercise programs like BodyBalance could significantly benefit state-anxiety as well as strength, flexibility, and anthropometry around the trunk.

Preparing for Successful Surgery: An Implementation Study

To evaluate the implementation of a mind-body program for surgical patients in a community hospital, assessing patient participation, patient perception, and program impact on anxiety, pain, and quality of sleep during the perioperative period. Two hundred thirty patients having total hip replacement, total knee replacement, hysterectomy, or colectomy participated in this investigation. One hundred fifteen patients were assigned to the control group before the start of the mind-body program and received routine care. The subsequent 115 patients were assigned to the intervention group and were given an audio CD (containing guided imagery, affirmations, and relaxation music) and a brochure three to seven days before surgery. The brochure recommended that patients listen to the CD twice a day before and after surgery. Anxiety, pain at rest, pain with movement, quality of sleep, and program participation were assessed for the first two postoperative days, and patient perception of the program was assessed at the end of the two days. Anxiety scores were lower in the intervention group on the evening of surgery. Despite a trend toward lower pain scores in the intervention group, no difference between the intervention and control groups reached statistical significance, including quality of sleep. Of patients in the intervention group, 74% listened to the CD at least once after surgery, and 37% listened to the program three or more times. Most patients who used the CD at least once rated it as helpful, and 87% said they would use it for future operations. Patient response to a perioperative mind-body program was favorable. Most patients listened to the program CD at least once, and a third used the CD repeatedly, as recommended. The majority of patients who used the CD felt it had been helpful and would use it again. Program participants experienced less anxiety on the night of surgery.

Healing Back Pain Naturally: The Mind–Body Program Proven to Work

Healing Back Pain Naturally: The Mind–Body Program Proven to Work

Healing Back Pain Naturally: The Mind–Body Program Proven to Work

From Thomason Hospital, El Paso, Tex; Louisiana State University Health Sciences Center, School of Nursing, New Orleans, La; Sharon Regional Health System, Sharon, Pa; Christiana Care Health Services, Newark, Del; University of Colorado Hospital, Denver, Colo.