An Individualized Yoga Intervention for People with Functional Neurological Disorder: Case Series.

Functional neurological disorder (FND) is a heterogeneous condition of neurological symptoms that cannot be linked to a specific neurological cause. Yoga combines movement, breathing, and meditation and has established mind-body effects for people who are managing both psychological and neurological conditions. This case series describes key components of a yoga program for people with FND, evaluating feasibility, acceptability, and efficacy via self-report surveys, clinical assessments, and postintervention interview. Four individuals with FND participated in 45-minute, one-to-one virtual yoga sessions, two times a week for 8 weeks. We measured outcomes in four domains (healthcare utilization, FND symptoms, quality of life and self-efficacy, and function and mobility) at baseline, week 4, and week 8. Assessments included the Psychogenic Movement Disorders Rating Scale, timed up-and-go test, Patient Health Questionnaire-15, Brief Illness Perceptions Questionnaire, 36-Item Short Form Health Survey, and University of Washington Self-Efficacy Scale. Four participants completed at least 8 sessions, and two completed the full intervention (16 sessions). There were no adverse events. Two participants reported positive changes after yoga and improved on all clinical assessments (timed up-and-go test and Psychogenic Movement Disorders Rating Scale). Postintervention interview analysis revealed three themes: negative diagnosis experience, perceived health effects of yoga, and session format preferences. This was an exploratory case series describing a yoga intervention that was associated with some benefits for people with FND (decreased FND symptom severity and increased function, perceived health, quality of life, and self-efficacy). A larger case series is warranted to understand how to best select individuals who would benefit from the program.

Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines.

Background: Clinical practice guidelines (CPGs) are used to guide decision-making, especially regarding complementary and alternative medicine (CAM) therapies that are unfamiliar to orthodox healthcare providers. This systematic review aimed to critically review and summarise CAM recommendations associated with anxiety management included in the existing CPGs. Methods: Seven databases, websites of six international guidelines developing institutions, and the National Centre for Complementary and Integrative Health website were systematically searched. Their reporting and methodological quality were evaluated using the Reporting Items for practice Guidelines in Healthcare checklist and the Appraisal of Guidelines for Research and Evaluation (2nd version) instrument, respectively. Results: Ten CPGs were included, with reporting rates between 51.4 and 88.6%. Seven of these were of moderate to high methodological quality. Seventeen CAM modalities were implicated, involving phytotherapeutics, mind-body practice, art therapy, and homeopathy. Applied relaxation was included in 70% CPGs, which varied in degree of support for its use in the treatment of generalised anxiety disorder. There were few recommendations for other therapies/products. Light therapy was not recommended for use in generalised anxiety disorder, and St John's wort and mindfulness were not recommended for use in social anxiety disorder in individual guidelines. Recommendations for the applicability of other therapies/products for treating a specific anxiety disorder were commonly graded as "unclear, unambiguous, or uncertain". No CAM recommendations were provided for separation anxiety disorder, specific phobia or selective mutism. Conclusion: Available guidelines are limited in providing logically explained graded CAM recommendations for anxiety treatment and care. A lack of high-quality evidence and multidisciplinary consultation during the guideline development are two major reasons. High quality and reliable clinical evidence and the engagement of a range of interdisciplinary stakeholders are needed for future CPG development and updating. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022373694, identifier CRD42022373694.

Mind-Body Practice and Family Caregivers' Subjective Well-Being: Findings From the Midlife in the United States (MIDUS) Study.

Objectives: Informal caregiving has been associated with higher stress and lower levels of subjective well-being. Mind-body practices including yoga, tai chi, and Pilates also incorporate stress reducing activities. The current study aimed to examine the association between mind-body practice and subjective well-being among informal family caregivers. Methods: A sample of informal caregivers were identified in the Midlife in the United States study (N = 506, M ± SDage = 56 ± 11, 67% women). We coded mind-body practice into three categories, including regular practice (participating in one or more of them "a lot" or "often"), irregular (participating "sometimes" and "rarely") and no practice ("never"). Subjective well-being was measured using the 5-item global life satisfaction scale and the 9-item mindfulness scale. We used multiple linear regression models to examine associations between mind-body practice and caregivers' subjective well-being, controlling for covariates of sociodemographic factors, health, functional status, and caregiving characteristics. Results: Regular practice was associated with both better mindfulness-related well-being (b = 2.26, p < .05) and better life satisfaction (b = 0.43, p < .05), after controlling for covariates. Discussion: Future research should examine whether there is a selection effect of caregivers with higher well-being being more likely to choose these activities, and/or if mind-body practices are effective non-pharmacological interventions to improve family caregivers' quality of life.

The Effectiveness of Complementary Therapy as Mind-Body Practice on Quality of Life among Cancer Survivors: A Quasi-Experimental Study.

OBJECTIVE: This study aimed to investigate quality of life (QOL) improvement in long-term cancer survivors using complementary therapy (CT) as mind-body practice. METHODS: A quasi-experimental study including intervention and control groups was conducted. Participants in the intervention group engaged in CTs, including music therapy, progressive muscle relaxation, and deep-breathing exercises for 8 weeks at home. QOL was evaluated in both the groups using Short Form-8 (SF-8) questionnaire before the experiment and at 4 and 8 weeks after starting the experiment. To examine QOL, we compared SF-8 subscale scores, the physical and mental component summaries of QOL. RESULTS: Cancer survivors were assigned to the intervention and control groups, comprising 69 and 59 individuals. There were no significant differences in QOL between the two groups with low scores, but there was a significant difference in the mental aspect of QOL in 4 weeks, indicating that the intervention group was lower than the control group. Meanwhile, the intervention group tended to experience increased changes in the mental aspect of QOL in 8 weeks compared to 4 weeks, although there was no significant difference. CONCLUSIONS: CT did not exhibit an effect on QOL among cancer survivors, especially in 4 weeks. This might have been due to sample size, participants' potential low compliance resulting in an inability to confirm whether the CTs were performed accurately and continuously, and consideration of what CT suited them. Meanwhile, CT may require a longer time to increase QOL. We recommend further studies to address these factors when conducting CT as mind-body practice.

Effects of mind-body practice on arterial stiffness, central hemodynamic parameters and cardiac autonomic function of college students.

A substantial number of studies have shown the beneficial effects of mind-body practice on physical fitness among both the healthy middle-aged and elderly adults and patients with chronic diseases. However, its positive effects on college students remain poorly understood. This study aimed to systematically investigate the potential efficiency of the Baduanjin exercise on the maintenance of the homeostasis of body composition and the improvement of the cardiovascular function of the college students. The study revealed a promising efficacy of the Baduanjin exercise in the prevention of the loss of water, inorganic salts, protein, and muscle contents and the accumulation of body fat. Furthermore, the present study also demonstrated the positive efficacy of Baduanjin exercise in decreasing of peripheral and central arterial blood pressure and carotid and femoral artery pulse wave velocity (cfPWV) of the college students. Moreover, the heart rate variability (HRV) analysis was also performed using the assessment of time and frequency domain indices. The data showed that all of the time-domain indices and the high-frequency (HF) band of the HRV relatively increased, whereas the low-frequency (LF) band of the HRV relatively decreased after the long-term Baduanjin exercise. Collectively, the present study suggested that a 12-week Baduanjin exercise could maintain the body composition in a relatively healthy and stable range and improve blood pressure, central hemodynamics, and the arterial stiffness of the college students. The underlying mechanism might be due to the improvement of parasympathetic activity and the suppression of sympathetic activity of college students via Baduanjin exercise.

Tai Chi practice and change in exercise habits in survivors of acute coronary syndromes: Is mindfulness a possible mechanism?

BACKGROUND: Mechanisms by which mind-body practice may improve exercise behaviors in patients with coronary heart disease (CHD) are unknown. PURPOSE: To identify predictors of exercise behaviors developed in response to a tai chi intervention. METHODS: We conducted an exploratory analysis using data from a pilot study of tai chi for physically inactive patients with CHD. We used Latent Class Analysis to identify patterns of moderate to vigorous physical activity (MVPA) (accelerometry-assessed, average min/week) over the 9-month study period. Logistic regression was used to evaluate associations between MVPA patterns and changes in exercise self-efficacy (Self-efficacy for exercise scale), social support (Multidimensional Scale of Perceived Social Support), resilience (Brief Resilience Survey), and mindfulness (Five Facets of Mindfulness) at 6 months. RESULTS: Data supported a 3-class model over time: 31% of participants were in class 1 (high and sustained MVPA, > 200 min/week), 21% were in class 2 (low and decreasing MVPA, < 100 > 50 min/week), and 48% in class 3 (low and stable MVPA, < 50 min/week). Higher mindfulness scores at 6 months were associated with a high and sustained MVPA pattern (b = 1.89, SE = 0.15, p = .01). Social support was inversely associated with low and decreasing MVPA (b = -0.72, SE = 0.34, p = .04). No associations were noted with the other factors. CONCLUSIONS: Improvements in mindfulness were associated with a distinct high and sustained MVPA pattern. Although only hypothesis-generating, these findings suggest that improvements in mindfulness skills could be a mechanism for the possible effect of Tai Chi in the promotion of MVPA.

Mind-body practices in U.S. adults: Prevalence and correlates.

OBJECTIVES: Mind-body practices (MBP), such as Yoga or Tai-Chi, have increased in popularity in the past 25 years in the US. These activities may help promote a less sedentary lifestyle and may have positive effects on health. The objective of the present study is to understand the prevalence and trends of MBP in US adults and the factors associated with their use in a population-based adult lifespan sample. METHODS: We used data from three waves of the Midlife in the United States (MIDUS) survey (1995, 2005, and 2015), a population-based longitudinal study of community-dwelling adults. Only data from participants with valid observations across three waves (N = 2262) aged 24-74 years at baseline (M = 46; SD = 11) were used. We examined the prevalence of MBP, longitudinal patterns, and correlates of MBP use over 20 years. RESULTS: Rates of MBP use were relatively stable over time in this sample, with 20%, 17%, and 18% of participants using MBP at wave 1, 2, and 3, respectively. A number of sociodemographic and health variables were independently related to frequency of MBP use over 20 years: Women, participants with higher levels of education, never married participants, and participants who suffered from multiple chronic health conditions were more likely to use MBP. DISCUSSION: Our findings suggest that MBP may provide an opportunity for physical activity for individuals suffering from chronic health conditions. More research is needed to understand whether this, in turn, results in better health outcomes for these individuals.

Characteristics of Yoga Practice and Predictors of Practice Frequency.

Yoga is a globally popular mind-body practice used for health. The objective of this study was to characterize yoga practice and factors associated with frequency of practice. Yoga practitioners were sent invitations via email to participate in an online survey. Yoga characteristics and other sociodemographics were collected. Data from 309 consenting respondents were analyzed for patterns in practice characteristics (yoga techniques, location of practice, method of instruction, teacher status, and yoga type). Associations between characteristics of practice and yoga practice frequency were computed. The following characteristics were then analyzed as predictors of practice frequency in a regression model: location of practice, method of instruction, teacher status, yoga type, and techniques. Most respondents reported use of all three yoga techniques (movements, breathing, and meditation) and practiced an average of 4.5 ± 1.9 days a week. Key characteristics such as location of practice, method of instruction, and frequency significantly differed by teacher status and by yoga type (Viniyoga practitioners vs. other yoga styles). In our regression model, being a yoga teacher, being taught a one-on-one yoga practice by someone else, and regular use of movement were positively associated with increased practice frequency. Our analyses provide insight into how yoga factors such as teacher status, method of instruction, and use of tools relate to practice frequency. Understanding the relationships between practice characteristics and practice frequency may allow for the improved implementation of yoga for health.

Mind-Body Practice Changes Fractional Amplitude of Low Frequency Fluctuations in Intrinsic Control Networks.

Cognitive control impairment is a typical symptom largely reported in populations with neurological disorders. Previous studies have provided evidence about the changes in cognitive control induced by mind-body training. However, the neural correlates underlying the effect of extensive mind-body practice on cognitive control remain largely unknown. Using resting-state functional magnetic resonance imaging, we characterized dynamic fluctuations in large-scale intrinsic connectivity networks associated with mind-body practice, and examined their differences between healthy controls and Tai Chi Chuan (TCC) practitioners. Compared with a control group, the TCC group revealed significantly decreased fractional Amplitude of Low Frequency Fluctuations (fALFF) in the bilateral frontoparietal network, default mode network and dorsal prefrontal-angular gyri network. Furthermore, we detected a significant association between mind-body practice experience and fALFF in the default mode network, as well as an association between cognitive control performance and fALFF of the frontoparietal network. This provides the first evidence of large-scale functional connectivity in brain networks associated with mind-body practice, shedding light on the neural network changes that accompany intensive mind-body training. It also highlights the functionally plastic role of the frontoparietal network in the context of the "immune system" of mental health recently developed in relation to flexible hub theory.

The interrelationship between sleep and depression: a secondary analysis of a randomized controlled trial on mind-body-spirit intervention.

OBJECTIVES: To conduct a secondary analysis of a randomized controlled trial (RCT) that aims to understand the mediating effects embedded in a mind-body-spirit intervention for sleep and mood disturbances. METHODS: 126 adults with mild to moderate depression and subjective sleep disturbance, defined as Center for Epidemiologic Studies Depression Scale (CESD) scores from 10 to 34 and Pittsburgh Sleep Quality Index (PSQI) score > 5, participated in a waitlist-controlled RCT of an integrative mind-body-spirit intervention (I-BMS). Holistic well-being scale (HWS), a measure of the state of affliction and equanimity in mind, body and spirit, was included as a possible mediator. Data was collected at baseline and three-month follow-up. Mediation analyses were adopted to examine the pathways leading to sleep and mood improvements. RESULTS: After adjustments of baseline severities, changes in depressive symptoms partially mediated the effect of I-BMS on nighttime symptoms of insomnia (95% CI: 0.12-0.96), while exerting a full mediating effect on daytime symptoms of insomnia (95% CI: 0.14-0.64). The effect of I-BMS on mood was mediated by daytime symptoms of insomnia and spiritual orientation, but not by nighttime symptoms of insomnia (95% CI: 0.93-4.62). CONCLUSION: A bidirectional relationship was found between sleep disturbances and depressive symptoms following a mind-body-spirit intervention. The relationship between daytime symptoms and depressive symptoms was especially strong. Of the HWS variables, spiritual orientation was the only significant mediator of mood improvement following I-BMS. Our findings suggest that efforts to optimize the treatment of comorbid sleep disturbances and depression are needed, especially the treatment of daytime impairments along with sleep and mood disruptions.

[Discussion around the use of yoga in psychiatry]. / Réflexion sur l'usage du yoga en psychiatrie.

Many mind-body practices have recently been introduced into psychiatric care including yoga. An experiment in the field addresses the issue of the organisation and applications of this discipline, and envisages the possibility of extending the scope of indications.

Long-term meditation training induced changes in the operational synchrony of default mode network modules during a resting state.

Using theoretical analysis of self-consciousness concept and experimental evidence on the brain default mode network (DMN) that constitutes the neural signature of self-referential processes, we hypothesized that the anterior and posterior subnets comprising the DMN should show differences in their integrity as a function of meditation training. Functional connectivity within DMN and its subnets (measured by operational synchrony) has been measured in ten novice meditators using an electroencephalogram (EEG) recording in a pre-/post-meditation intervention design. We have found that while the whole DMN was clearly suppressed, different subnets of DMN responded differently after 4 months of meditation training: The strength of EEG operational synchrony in the right and left posterior modules of the DMN decreased in resting post-meditation condition compared to a pre-meditation condition, whereas the frontal DMN module on the contrary exhibited an increase in the strength of EEG operational synchrony. These findings combined with published data on functional-anatomic heterogeneity within the DMN and on trait subjective experiences commonly found following meditation allow us to propose that the first-person perspective and the sense of agency (the witnessing observer) are presented by the frontal DMN module, while the posterior modules of the DMN are generally responsible for the experience of the continuity of 'I' as embodied and localized within bodily space. Significance of these findings is discussed.

EEG-guided meditation: A personalized approach.

The therapeutic potential of meditation for physical and mental well-being is well documented, however the possibility of adverse effects warrants further discussion of the suitability of any particular meditation practice for every given participant. This concern highlights the need for a personalized approach in the meditation practice adjusted for a concrete individual. This can be done by using an objective screening procedure that detects the weak and strong cognitive skills in brain function, thus helping design a tailored meditation training protocol. Quantitative electroencephalogram (qEEG) is a suitable tool that allows identification of individual neurophysiological types. Using qEEG screening can aid developing a meditation training program that maximizes results and minimizes risk of potential negative effects. This brief theoretical-conceptual review provides a discussion of the problem and presents some illustrative results on the usage of qEEG screening for the guidance of mediation personalization.

Kouksundo, a traditional Korean mind-body practice, regulates oxidative stress profiles and stress hormones.

BACKGROUND: Kouksundo is a traditional Korean mind-body practice that has been practiced for thousands of years. We investigated the effects of Kouksundo on oxidative stress-related biomarkers and stress hormones. METHODS: A single-arm observational study was conducted on 57 Kouksundo trainees (34 males and 23 females). Blood samples were collected 30 min before and after Kouksundo practice (25 min for warm-up, 45 min for breathing meditation, and 20 min for cool-down). RESULTS: Kouksundo significantly reduced serum levels of oxidant markers, including reactive oxygen species (p<0.01), nitric oxide (p<0.01), and malondialdehyde (p<0.05), induced elevation of superoxide dismutase (p<0.01), and reduction of catalase (p<0.001). No significant changes were observed in total antioxidant capacity or total glutathione content levels (p>0.05). Kouksundo practice also significantly reduced the serum level of cortisol (p<0.001), norepinephrine (p<0.001), and dopamine (p<0.05), and significantly increased serum epinephrine concentrations (p<0.05). CONCLUSION: The traditional Korean mind-body practice Kouksundo provided health benefits by regulating oxidative stress and levels of stress hormones. This study is the first investigation of the changes in oxidative stress and stress hormones induced by mind-body therapy, producing reference data for mechanistic studies on these practices.