Lee SW, et al.
BACKGROUND: Mind-body practices such as yoga are widely popular,
but little is known about how such exercises impact health-related quality of
OBJECTIVE: To measure changes in health-related quality of life
associated with 3 months of mind-body training as practiced in community-based
DESIGN: Prospective cohort study.
SETTING: Eight centers for practice of mind-body training.
PARTICIPANTS: One hundred ninety-four English-speaking adults
who had taken no more than 10 classes at the centers prior to enrollment in the
study. One hundred seventy-one (88%) returned the 3-month follow-up
INTERVENTION: Administration of the SF-36 questionnaire at the
start of training and after 3 months.
MEASUREMENTS AND MAIN RESULTS: At baseline, new participants in
mind-body training reported lower scores than U.S. norms for 7 of 8 domains of
the SF-36: mental health, role emotional, social, vitality, general health,
body pain, and role physical (P < .002 for all comparisons). After 3 months
of training, withinpatient change scores improved in all domains (P < .0001), including a change of +15.5
(standard deviation. 21) in the
mental health domain. In hierarchical regression analysis,
younger age (P = .0003), baseline level of depressive symptoms (P = .01), and reporting
a history of hypertension (P = .0054) were independent predictors of greater
improvement in the SF-36 mental health score. Five participants (2.9%) reported
a musculoskeletal injury.
CONCLUSIONS: New participants in a community-based mindbody training
program reported poor health-related quality of life at baseline and moderate
improvements after 3 months of
practice. Randomized trials are needed to determine whether benefits
may be generalizable to physician-referred populations.
Yeh GY, et al.
PURPOSE: To examine the effects of a 12-week tai chi
program on quality of life and exercise capacity in patients with heart
METHODS: Thirty patients with chronic stable heart
failure and left ventricular ejection fraction < or =40% (mean [+/- SD] age, 64 +/- 13
years; mean baseline ejection fraction, 23% +/- 7%; median New York Heart
Association class, 2 [range, 1 to 4]) were randomly assigned to receive usual
care (n = 15), which included pharmacologic therapy and dietary and exercise
counseling, or 12 weeks of tai chi training (n = 15) in addition to usual care.
Tai chi training consisted of a 1-hour class held twice weekly. Primary
outcomes included quality of life and exercise capacity. Secondary outcomes
included serum B-type natriuretic peptide and plasma catecholamine levels. For
3 control patients with missing data items at 12 weeks, previous values were
carried forward. RESULTS: At 12 weeks, patients in the tai chi group showed
improved quality-of-life scores (mean between-group difference in change, -25
points, P = 0.001), increased distance walked in 6 minutes (135 meters, P =
0.001), and decreased serum B-type natriuretic peptide levels (-138 pg/mL, P =
0.03) compared with patients in the control group. A trend towards improvement
was seen in peak oxygen uptake. No differences were detected in catecholamine
levels. CONCLUSION: Tai chi may be a beneficial adjunctive treatment that
enhances quality of life and functional capacity in patients with chronic heart
failure who are already receiving standard medical therapy.
analysis of the underlying similarities between the Eastern meditation
tradition and attention restoration theory (ART) provides a basis
for an expanded framework for studying directed attention. The focus
of the analysis is the active role the individual can play in the
preservation and recovery of the directed attention capacity. Two
complementary strategies are presented that can help individuals
more effectively manage their attentional resource. One strategy
involves avoiding unnecessary costs in terms of expenditure of
directed attention. The other involves enhancing the effect of
restorative opportunities. Both strategies are hypothesized to be
more effective if one gains generic knowledge, self-knowledge, and
specific skills. The interplay between a more active form of mental
involvement and the more passive approach of meditation appears to
have far-reaching ramifications for managing directed attention.
John A. Astin, et al.
Background: Although emerging evidence
during the past several decades suggests that psychosocial factors can directly
influence both physiologic function and health outcomes, medicine had failed to
move beyond the biomedical model, in part because of lack of exposure to the
evidence base supporting the biopsychosocial model. The literature was reviewed
to examine the efficacy of representative psychosocial–mind-body interventions,
including relaxation, (cognitive) behavioral therapies, meditation, imagery,
biofeedback, and hypnosis for several common clinical conditions.
Methods: An electronic search was
undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a
manual search of the reference sections of relevant articles for related
clinical trials and reviews of the literature. Studies examining mind-body
interventions for psychological disorders were excluded. Owing to space
limitations, studies examining more body-based therapies, such as yoga and tai
chi chuan, were also not included. Data were extracted from relevant systematic
reviews, metaanalyses, and randomized controlled trials.
Results: Drawing principally from
systematic reviews and meta-analyses, there is considerable evidence of
efficacy for several mind-body therapies in the treatment of coronary artery
disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence,
chronic low back pain, disease and treatment related symptoms of cancer, and
improving postsurgical outcomes. We found moderate evidence of efficacy for
mind-body therapies in the areas of hypertension and arthritis. Additional
research is required to clarify the relative efficacy of different mind-body
therapies, factors (such as specific patient characteristics) that might
predict more or less successful outcomes, and mechanisms of action. Research is
also necessary to examine the cost offsets associated with mind-body therapies.
Conclusions: There is now considerable
evidence that an array of mind-body therapies can be used as effective adjuncts
to conventional medical treatment for a number of common clinical conditions.