- [Research Update]
Arias et al. Systematic Review of the Efficacy of Meditation Techniques as Treatments for Medical Illness. The Journal Of Alternative and Complementary Medicine. 12 (8), 2006, pp. 817832.
Background: Meditative techniques are sought frequently by patients coping with medical and psychological problems. Because of their increasingly widespread appeal and use, and the potential for use as medical therapies, a concise and thorough review of the current state of scientific knowledge of these practices as medical interventions was conducted. Purpose: To systematically review the evidence supporting efficacy and safety of meditative practices in treating illnesses, and examine areas warranting further study. Studies on normal healthy populations are not included. Methods: Searches were performed using PubMed, PsycInfo, and the Cochrane Database. Keywords were Meditation, Meditative Prayer, Yoga, Relaxation Response. Qualifying studies were reviewed and independently rated based on quality by two reviewers. Mid-to-highquality studies (those scoring above 0.65 or 65% on a validated research quality scale) were included. Results: From a total of 82 identified studies, 20 randomized controlled trials met our criteria. The studies included 958 subjects total (397 experimentally treated, 561 controls). No serious adverse events were reported in any of the included or excluded clinical trials. Serious adverse events are reported in the medical literature, though rare. The strongest evidence for efficacy was found for epilepsy, symptoms of the premenstrual syndrome and menopausal symptoms. Benefit was also demonstrated for mood and anxiety disorders, autoimmune illness, and emotional disturbance in neoplastic disease. Conclusions: The results support the safety and potential efficacy of meditative practices for treating certain illnesses, particularly in nonpsychotic mood and anxiety disorders. Clear and reproducible evidence supporting efficacy from large, methodologically sound studies is lacking.
Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, Schwartz GE A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive States of mind, rumination, and distraction. Annals of Behavioral Medicine. 2007 Feb; 33(1): 11-21.Background: Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. Purpose: This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress. Method: Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. Results: Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. Conclusions: The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.
Sephton SE, Salmon P, Weissbecker I, Ulmer C, Floyd A, Hoover K, Studts JL. Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial. Arthritis Rheum. 2007 Jan 31;57(1):77-85
Objective: Depressive symptoms are common among patients with fibromyalgia, and behavioral intervention has been recommended as a major treatment component for this illness. The objective of this study was to test the effects of the Mindfulness-Based Stress Reduction (MBSR) intervention on depressive symptoms in patients with fibromyalgia. Methods: This randomized controlled trial examined effects of the 8-week MBSR intervention on depressive symptoms in 91 women with fibromyalgia who were randomly assigned to treatment (n = 51) or a waiting-list control group (n = 40). Eligible patients were at least 18 years old, willing to participate in a weekly group, and able to provide physician verification of a fibromyalgia diagnosis. Of 166 eligible participants who responded to local television news publicizing, 49 did not appear for a scheduled intake, 24 enrolled but did not provide baseline data, and 2 were excluded due to severe mental illness, leaving 91 participants. The sample averaged 48 years of age and had 14.7 years of education. The typical participant was white, married, and employed. Patients randomly assigned to treatment received MBSR. Eight weekly 2.5-hour sessions were led by a licensed clinical psychologist with mindfulness training. Somatic and cognitive symptoms of depression were assessed using the Beck Depression Inventory administered at baseline, immediately post-program, and at follow-up 2 months after the conclusion of the intervention. Results: Change in depressive symptoms was assessed using slopes analyses of intervention effects over time. Depressive symptoms improved significantly in treatment versus control participants over the 3 assessments. Conclusion: This meditation-based intervention alleviated depressive symptoms among patients with fibromyalgia.
Lee SH, Ahn SC, Lee YJ, Choi TK, Yook KH, Suh SY, Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. Journal of Psychosomatic Research, 2007 Feb; 62(2): 189-195.Evidence indicates that low energy expenditure protocols derived from traditional Chinese medicine may benefit patients with cardiac impairment; therefore, the authors carried out a randomized controlled trial to test a 16-week medically assisted qi gong training program for the physical rehabilitation of patients with stable chronic atrial fibrillation and preserved left ventricular function. Functional capacity variation was evaluated using the 6-minute walk test, which was performed at baseline, at the end of the intervention, and after 16 weeks. Thirty men and 13 women (mean age, 68+/-8 years) were randomized to the intervention protocol or to a wait-list control group. Qi gong training was well tolerated and, compared with baseline, trained patients walked an average 114 meters more (27%) at the end of treatment (P<.001) and 57 meters more (13.7%) 16 weeks later (P=.008). Control subjects showed no variation in functional capacity. These results seem promising and deserve confirmation with further research.
Objective: The objective of this study was to examine the effectiveness of a meditation-based stress management program in patients with anxiety disorder. Methods: Patients with anxiety disorder were randomly assigned to an 8-week clinical trial of either a meditation-based stress management program or an anxiety disorder education program. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory, and the Symptom Checklist-90-Revised (SCL-90-R) were used to measure outcome at 0, 2, 4, and 8 weeks of the program. Results: Compared to the education group, the meditation-based stress management group showed significant improvement in scores on all anxiety scales (HAM-A, P=.00; STAI state, P=.00; STAI trait, P=.00; anxiety subscale of SCL-90-R, P=.00) and in the SCL-90-R hostility subscale (P=.01). Findings on depression measures were inconsistent, with no significant improvement shown by subjects in the meditation-based stress management group compared to those in the education group. The meditation-based stress management group did not show significant improvement in somatization, obsessive-compulsive symptoms, and interpersonal sensitivity scores, or in the SCL-90-R phobic anxiety subscale compared to the education group. Conclusions: A meditation-based stress management program can be effective in relieving anxiety symptoms in patients with anxiety disorder. However, well-designed, randomized, and controlled trials are needed to scientifically prove the worth of this intervention prior to treatment.
Poppa L. Manzoli L, Corti I, Congedo G, Romanazzi L, Parruti G. Functional capacity after traditional Chinese medicine (qi gong) training in patients with chronic atrial fibrillation: a randomized controlled trial. Preventive Cardiology. 2007 Winter; 10(1):22-25.
Effectiveness of a Tai chi Qigong program in promoting health-related quality of life and perceived social support in chronic obstructive pulmonary disease clients. Qual Life Res. 2010 Jun;19(5):653-64. by Chan AW, Lee A, Suen LK, Tam WW. The Nethersole School of Nursing, Chinese University of Hong Kong, Esther Lee Building, Shatin, New Territories, Hong Kong. aileenchan@...
ABSTRACT PURPOSE: This paper evaluates the effectiveness of a 3-month Tai chi Qigong (TCQ) program in promoting the psychosocial functional health of clients with chronic obstructive pulmonary disease (COPD) in Hong Kong . METHODS: This study employed a single-blind, randomized controlled trial. Two hundred and six COPD clients were randomly assigned into three groups, namely, TCQ group, exercise group, and control group. Subjects in the TCQ group received a TCQ program, consisting of two 60-min sessions each week for 3 months. Subjects in the exercise group were taught to practice breathing techniques combined with walking as an exercise. Subjects in the control group received their usual care. Data collections were performed at baseline, on the sixth week and on the third month. The primary outcomes were health-related quality of life using St. George Respiratory Questionnaire-Hong Kong Chinese version and perceived social support using the Multidimensional Scale of Perceived Social Support-Chinese version. RESULTS: The TCQ group showed greater improvements in the symptom (F4, 404=3.351, P=0.010) and activity domains (F4, 404=2.611, P=0.035). No differences were detected in perceived social support among the three groups. CONCLUSIONS: Tai chi Qigong promoted health outcomes with respect to clients' perception of their respiratory symptoms. Moreover, TCQ decreased disturbances to their physical activities.
Effects of yoga on the quality of life in cancer patients. Complement Ther Clin Pract. 2010 May;16(2):60-3.
By Ulger O, Yağli NV. Hacettepe University, Faculty of Medical Sciences, Department of Physical Therapy and Rehabilitation, Ankara, 06100 Samanpazari-Ankara, Turkey. ozlemulger@...
OBJECTIVE: This study sought to investigate the effects of yoga on the quality of life in patients with breast cancer. DESIGN: Twenty patients between 30 and 50 years of age presently under treatment for breast cancer were included in the study. The physical characteristics of the patients were recorded and general physiotherapy assessments performed. Eight sessions of a yoga program including warming and breathing exercises, asanas, relaxation in supine position, and meditation were applied to participants. MAIN OUTCOME MEASURES: The pre- and post-yoga quality of life assessments for the patients were conducted using the Nottingham Health Profile (NHP). Patients' stress levels were assessed using the STAI-I and STAI-II anxiety inventory. Their satisfaction levels about the yoga program was evaluated using the visual analog scale (VAS). RESULTS: It was found that patients' quality of life scores after the yoga program were better than scores obtained before the yoga program (p < 0.05). After sessions, there was a statistically significant decrease in their STAI-I (measuring the reactions of anxiety) scores and STAI-II (measuring the permanence of anxiety) scores (p < 0.05). It was found out that the satisfaction score concerning the yoga program was considerably increased after the yoga program (p < 0.05). CONCLUSIONS: It can be concluded that yoga is valuable in helping to achieve relaxation and diminish stress, helps cancer patients perform daily and routine activities, and increases the quality of life in cancer patients. This result was positively reflected in patients satisfaction with the yoga program. Copyright 2009 Elsevier Ltd. All rights reserved.
Intensive Meditation Training Improves Perceptual Discrimination and Sustained Attention. Psychol Sci. 2010 May 11. by Maclean KA, Ferrer E, Aichele SR, et al. Dept of Psychology, University of California , Davis .
Abstract: The ability to focus one's attention underlies success in many everyday tasks, but voluntary attention cannot be sustained for extended periods of time. In the laboratory, sustained-attention failure is manifest as a decline in perceptual sensitivity with increasing time on task, known as the vigilance decrement. We investigated improvements in sustained attention with training (~5 hr/day for 3 months), which consisted of meditation practice that involved sustained selective attention on a chosen stimulus (e.g., the participant's breath). Participants were randomly assigned either to receive training first (n = 30) or to serve as waiting-list controls and receive training second (n = 30). Training produced improvements in visual discrimination that were linked to increases in perceptual sensitivity and improved vigilance during sustained visual attention. Consistent with the resource model of vigilance, these results suggest that perceptual improvements can reduce the resource demand imposed by target discrimination and thus make it easier to sustain voluntary attention.
Long term tai chi exercise improves physical performance among people with peripheral neuropathy. Am J Chin Med. 2010;38(3):449-59. by Li L, Manor B. Department of Kinesiology, Louisiana State University , Baton Rouge , Louisiana , USA . lli3@...
Abstract: This study examined the effects of a 24-week Tai Chi intervention on physical function in individuals with peripheral neuropathy. Twenty-five women and men with peripheral neuropathy were recruited. Plantar pressure detection threshold was assessed with a 5.07 gauge monofilament. Functional gait was assessed by the 6-min walk and timed up-and-go tests. Isokinetic leg strength and standing balance was also assessed. Twenty-four consecutive weeks of modified, group-based Tai Chi practice was completed, with testing repeated every six weeks throughout. No adverse events were observed and attendance was 17 +/- 4 sessions per 6 weeks. After 6 weeks of Tai Chi, participants increased 6-min walk (P < 0.0001), timed up-and-go (P < 0.0001), and leg strength (P < 0.01) performance. Continued improvement was observed in the timed up-and-go. Plantar sensation improved (P = 0.003) following the Tai Chi intervention. Group-based Tai Chi is a safe, plausible, and effective intervention for those with PN.
ABSTRACT: BACKGROUND: Physical activity and exercise appear to improve psychological health. However, the quantitative effects of Tai Chi on psychological well-being have rarely been examined. We systematically reviewed the effects of Tai Chi on stress, anxiety, depression and mood disturbance in eastern and western populations. METHODS: Eight English and 3 Chinese databases were searched through March 2009. Randomized controlled trials, non-randomized controlled studies and observational studies reporting at least 1 psychological health outcome were examined. Data were extracted and verified by 3 reviewers. The randomized trials in each subcategory of health outcomes were meta-analyzed using a random-effects model. The quality of each study was assessed. RESULTS: Forty studies totaling 3817 subjects were identified. Approximately 29 psychological measurements were assessed. Twenty-three of 33 randomized and nonrandomized trials reported that 1 hour to 1 year of regular Tai Chi significantly increased psychological well-being including reduction of stress (effect size [ES], 0.66; 95% confidence interval [CI], 0.23 to 1.09), anxiety (ES, 0.66; CI, 0.29 to 1.03), and depression (ES, 0.56; CI, 0.31 to 0.80), and enhanced mood and emotion (ES, 0.45; CI, 0.20 to 0.69) in community-dwelling healthy participants and in patients with chronic conditions. Seven observational studies with relatively large sample sizes reinforced the beneficial association between Tai Chi practice and psychological health. CONCLUSIONS: Tai Chi appears to be associated with improvements in psychological well-being including reduced stress, anxiety, depression and mood disturbance, and increased self-esteem. Definitive conclusions were limited due to variation in designs, comparisons, heterogeneous outcomes and inadequate controls. High-quality, well-controlled, longer randomized trials are needed to better inform clinical decisions.
A qualitative study of mindfulness-based meditation therapy in Japanese cancer patients. Support Care Cancer. 2010 May 16. by Ando M, Morita T, Akechi T, Ifuku Y. Faculty of Nursing, St. Mary's College, Tsubukuhonmachi 422, Kurume City, Fukuoka, Japan, andou@....
Abstract: PURPOSE: The primary objective of the study was to examine mindfulness-based meditation therapy qualitatively. A secondary goal was to examine the differences in themes selected by Japanese and Western patients receiving this therapy. METHODS: The subjects were 28 patients who were undergoing anti-cancer treatment. The subjects participated in two sessions of mindfulness-based meditation therapy, including breathing, yoga movement, and meditation. Each patient was taught the program in the first session, then exercised at home with a CD, and subsequently met the interviewer in a second session after 2 weeks. Primary physicians recruited the patients and interviews were conducted individually by nurses or psychologists with training in the program. Patients provided answers to pre- and post-intervention interviews about the meaning of their illness. RESULTS: Narrative data from the semi-structured interview were analyzed qualitatively. Pre-intervention, themes such as "Effort to cope," "Looking back," "Spirituality," "Personal growth," and "Suffering" were often chosen. Post-intervention, themes such as "Adapted coping," "Personal growth," "Positive meaning," "Spirituality," and "Negative recognition" were more commonly chosen. CONCLUSIONS: Mindfulness-based meditation therapy may be effective for producing adapted coping, including positive recognition and changes for an adapted lifestyle. There were some common aspects and some differences in the themes selected by patients in this study and Western patients received mindfulness therapy in other studies.
The contribution of mindfulness practice to a multicomponent behavioral sleep intervention following substance abuse treatment in adolescents: a treatment-development study. Subst Abus. 2010 Apr;31(2):86-97. by Britton WB, Bootzin RR, Cousins JC, et al. Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island 02906, USA. Willoughby_Britton@...
Abstract: Poor sleep is common in substance use disorders (SUDs) and is a risk factor for relapse. Within the context of a multicomponent, mindfulness-based sleep intervention that included mindfulness meditation (MM) for adolescent outpatients with SUDs (n = 55), this analysis assessed the contributions of MM practice intensity to gains in sleep quality and self-efficacy related to SUDs. Eighteen adolescents completed a 6-session study intervention and questionnaires on psychological distress, sleep quality, mindfulness practice, and substance use at baseline, 8, 20, and 60 weeks postentry. Program participation was associated with improvements in sleep and emotional distress, and reduced substance use. MM practice frequency correlated with increased sleep duration and improvement in self-efficacy about substance use. Increased sleep duration was associated with improvements in psychological distress, relapse resistance, and substance use-related problems. These findings suggest that sleep is an important therapeutic target in substance abusing adolescents and that MM may be a useful component to promote improved sleep.
Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway . A six-month follow-up study. Rasmussen Clin Exp Rheumatol. 2009 Sep-Oct;27(5 Suppl 56):S46-50. by LB, Mikkelsen K, Haugen M, Pripp AH, Førre ØT. Maharishi Ayurveda Health Centre, Mesnali, Lillehammer , Norway . lars.rasmussen@...
Abstract: BACKGROUND: Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic medicine, which is also known as Maharishi Ayurveda. It is a consciousness based revival of the ancient Ayurvedic medicine tradition in India and is established by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) technique. OBJECTIVE: To conduct a pilot study of the effect of the treatment program at the Health Centre on fibromyalgia patients. METHODS: Thirty-one women with diagnosed fibromyalgia received an individually designed Maharishi Vedic physiological purification therapy. All subjects received personal advice on diet based on Ayurvedic principles, including a novel approach to food into-lerance, and daily routines. In addition they were offered instruction in TM (for stress and pain management and personal development) (four subjects started), and recommended Ayurvedic herbal food products for home treatment. MAIN OUTCOME MEASURES: A modified Fibromyalgia Impact Questionnaire included a visual analogue scale for each of the seven outcomes: working ability, generalised pain, tiredness, stiffness, tiredness on arising, anxiety and depression. Pre-treatment scores were compared with scores at six-month follow-up for levels of statistical significance. RESULTS: Twenty-eight subjects (90%) completed the follow-up. The outcome measures were reduced by 25 to 46% by the study's endpoint: working ability (p<0.002), pain (p<0.001), tiredness (p<0.001), morning tiredness (p<0.001), stiffness (p<0.005), anxiety (p<0.136), and depression (p<0.001). A group of five excellent responders including all four participants who started to practise TM, had almost no symptoms by the endpoint. Compared to the non-meditating control group the TM-subgroup showed statistically significant improvements for all outcome measures except depression. CONCLUSIONS: In this pilot study fibromyalgia patients undergoing treatment at Maharishi Ayurveda Health Centre in Norway showed significant improvements six months post treatment. Because fibromyalgia is considered a treatment-resistant condition, these encouraging results warrant further research.
Mindfulness meditation improves cognition: evidence of brief mental training. Conscious Cogn. 2010 Jun;19(2):597-605. by Zeidan F, Johnson SK, Diamond BJ, et al. Department of Neurobiology and Anatomy, Wake Forest University School of Medicine, Winston-Salem , NC 27157 , USA . fzeidan@...
Abstract: Although research has found that long-term mindfulness meditation practice promotes executive functioning and the ability to sustain attention, the effects of brief mindfulness meditation training have not been fully explored. We examined whether brief meditation training affects cognition and mood when compared to an active control group. After four sessions of either meditation training or listening to a recorded book, participants with no prior meditation experience were assessed with measures of mood, verbal fluency, visual coding, and working memory. Both interventions were effective at improving mood but only brief meditation training reduced fatigue, anxiety, and increased mindfulness. Moreover, brief mindfulness training significantly improved visuo-spatial processing, working memory, and executive functioning. Our findings suggest that 4days of meditation training can enhance the ability to sustain attention; benefits that have previously been reported with long-term meditators. 2010 Elsevier Inc. All rights reserved.
From alpha to gamma: Electrophysiological correlates of meditation-related states of consciousness. Med Hypotheses. 2010 Mar 11. by Fell J, Axmacher N, Haupt S. Department of Epileptology, University of Bonn , Sigmund-Freud Str. 25, D-53105 Bonn , Germany .
Abstract: Meditation practice is difficult to access because of its countless forms of appearances originating from the complexity of cultures it has to serve. This makes a suitable categorization for scientific use almost impossible. However, empirical data suggest that different forms of meditation show similar steps of development in terms of their neurophysiological correlates. Some electrophysiological alterations can be observed on the beginner/student level, which are closely related to non-meditative processes. Others seem to correspond to an advanced/expert level, and seem to be unique for meditation-related states of consciousness. Meditation is one possibility to specialize brain/mind functions using the brain's immanent neural plasticity. This plasticity is probably recruited by certain EEG patterns observed during or as a result of meditation, for instance, synchronized gamma oscillations. While meditation formerly has been understood to comprise mainly passive relaxation states, recent EEG findings suggest that meditation is associated with active states which involve cognitive restructuring and learning. Copyright © 2010. Published by Elsevier Ltd.
Meditation in medical practice: a review of the evidence and practice. Prim Care. 2010 Mar;37(1):81-90. by
Meditation practice in the medical setting is proving to be an excellent adjunctive therapy for many illnesses and an essential and primary means of maintaining holistic health and wellness. Rather than being a fringe or marginal concept, meditation is now widely known and accepted as a beneficial mind-body practice by the general public and in the scientific community. Extensive research shows and continues to show the benefits of meditation practice for a wide range of medical conditions. Further efforts are required to operationalize and apply meditation practice in clinical and medical educational settings in ways that are practical, effective, and meaningful. .
Meditation effects on cognitive function and cerebral blood flow in subjects with memory loss: a preliminary study. J Alzheimers Dis. 2010 Jan; 20(2):517-26. by Newberg AB, Wintering N, Khalsa DS, Roggenkamp H, Waldman MR. Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania , Philadelphia , PA , USA Center for Spirituality and the Mind, University of Pennsylvania , Philadelphia , PA , USA .
This preliminary study determined if subjects with memory loss problems demonstrate changes in memory and cerebral blood flow (CBF) after a simple 8-week meditation program. Fourteen subjects with memory problems had an IV inserted and were injected with 250MBq of Tc-99m ECD while listening to a neutral stimulus CD. They then underwent a pre-program baseline SPECT scan. Then subjects were guided through their first meditation session with a CD, during which they received an injection of 925MBq ECD, and underwent a pre-program meditation scan. Subjects completed an 8-week meditation program and underwent the same scanning protocol resulting in a post-program baseline and meditation scan. A region of interest (ROI) template obtained counts in each ROI normalized to whole brain to provide a CBF ratio. Baseline and meditation scans and neuropsychological testing were compared before and after the program. The meditation program resulted in significant increases (p< 0.05) in baseline CBF ratios in the prefrontal, superior frontal, and superior parietal cortices. Scores on neuropsychological tests of verbal fluency, Trails B, and logical memory showed improvements after training. This preliminary study evaluated whether an 8-week meditation program resulted in improvements in neuropsychological function and differences in CBF in subjects with memory loss. While the findings are encouraging, there are a number of limitations that can be addressed in future studies with more participants and more detailed analyses.
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