Changes in self-reported symptoms of depression and physical well-being in healthy individuals following a Taiji beginner course - Results of a randomized controlled trial.

BACKGROUND: Taiji is a mind-body practice being increasingly investigated for its therapeutic benefits in a broad range of mental and physical conditions. The aim of this study was to investigate the potential preventive effects of Taiji practice in healthy individuals with regard to their depressive symptomatology and physical well-being. METHODS: Seventy healthy Taiji novices were randomly assigned to a Taiji intervention group, that is, Taiji beginner course (Yang-Style Taiji, 2 h per week, 12 weeks) or a control group comprised of the waiting list for the course. Self-reported symptoms of depression (CES-D) and physical well-being (FEW-16) were assessed at baseline, at the end of the intervention, as well as 2 months later. RESULTS: The included participants had a mean age of 35.5 years. Physical well-being in the Taiji group significantly increased when comparing baseline to follow-up (FEW-16 sum score T(27) = 3.94, P = 0.001, 95% CI 0.17 to 0.55). Pearson's correlation coefficients displayed a strong negative relationship between self-reported symptoms of depression and physical well-being (P's < 0.001, r's ≥ -0.54). CONCLUSION: In this randomized controlled trial, we found significant evidence that a Taiji beginner course of 3 months duration elicits positive effects with respect to physical well-being in healthy individuals, with improvements pronouncing over time. Physical well-being was shown to have a strong relationship with depressive symptoms. Based on these results, the consideration of Taiji as one therapeutic option in the development of multimodal approaches in the prevention of depression seems justifiable.

Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women: results of a four-arm randomized controlled pilot trial.

OBJECTIVE: The aim of this study was to evaluate the feasibility of a clinical trial investigating the effects of acupuncture (AP) and Chinese herbal medicine (CHM) on hot flushes and quality of life in postmenopausal women. METHODS: Forty postmenopausal women reporting at least 20 hot flushes per week were enrolled in a randomized controlled trial. They were randomly allocated to receive traditional Chinese medicine (TCM) AP, sham AP, verum CHM, or placebo CHM for 12 weeks. Follow-up assessment was conducted 12 weeks after intervention. Primary outcome measures included hot flush frequency and severity. As a secondary outcome measure, the severity of menopausal symptoms was assessed using the Menopause Rating Scale (MRS) II. RESULTS: TCM AP induced a significant decline in all outcome measures from pretreatment to posttreatment compared with sham AP (hot flush frequency, P = 0.016; hot flush severity, P = 0.013; MRS, P < 0.001). In the TCM AP group, a larger decrease in MRS scores persisted from pretreatment to follow-up (P = 0.048). No significant differences were noted between the verum CHM group and the placebo CHM group. Compared with the verum CHM group, there was a significant decrease in MRS scores (P = 0.002) and a trend toward a stronger decrease in hot flush severity (P = 0.06) in the TCM AP group from pretreatment to posttreatment. CONCLUSIONS: TCM AP is superior to sham AP and verum CHM in reducing menopausal symptoms, whereas verum CHM shows no significant improvements when compared with placebo CHM.

Investigating short- and long-term transfer effects of a Taiji beginner course in participants' daily life.

OBJECTIVE: In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants' everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants' daily lives. METHODS: We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course (tp1) and at two months (tp2) as well as one year after course completion (tp3). Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tp1 and tp3. RESULTS: Transfer effects were reported by 91.1% of all respondents after course completion (tp1) and persisted in 73.3% at the one-year follow-up assessment (tp3), counting "increase of self-efficacy", "improvement of stress management", and "increase of body awareness" as the most frequently mentioned effects. Transfer effects predominantly occurred in participants' work and social environments, as well as during everyday activities in public areas. While self-reliant Taiji practice frequency significantly decreased from 82.2% at tp1 to 55.6% at tp3 (P < 0.001), the magnitude of self-reported transfer effects did not (P = 0.35). As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tp1 (r = 0.51; P < 0.001) and tp3 (r = 0.35; P = 0.020). Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 (r = 0.42; P < 0.004), whereas self-reliant practice frequency and transfer effects at tp1 were positively correlated with self-reliant practice frequency at tp3 on a trend level (r < 0.27; P > 0.08). CONCLUSION: Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants' everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.

[Modalities of acupuncture treatments in assisted reproductive technology--a comparison of treatment practice in Swiss, German, and Austrian fertility centers with findings from randomized controlled trials]. / Akupunkturbehandlungsmodalitäten bei künstlicher Befruchtung--ein Vergleich der Behandlungspraxis in schweizerischen, deutschen und österreichischen Kinderwunschzentren mit Erhebungen in randomisierten kontrollierten Studien.

BACKGROUND: One in 5 couples is affected by infertility. To increase the effectiveness of assisted reproductive technology (ART) adjuvant acupuncture treatments are frequently administered. However, little is known about acupuncture treatment modalities employed in fertility centers. The aim of our study was to assess modalities of acupuncture treatments in fertility centers and compare them with investigated acupuncture treatments in randomized controlled trials (RCTs) related to ART. METHODS: Referring to fertility centers listed on the websites of the Swiss, German, and Austrian national fertility associations, 180 centers were invited to participate in an online survey assessing the provision of acupuncture in ART. Survey results were compared with data from 17 RCTs. RESULTS: Acupuncture was offered by 33 (38.4%) of all responding fertility centers (n = 86; responder rate = 47.8%). In 39.4% the selection of acupuncture points is standardized or semi-standardized (24.2%) and in 27.3% based on individual TCM-diagnosis. Body acupuncture using needle stimulation was mentioned most frequently (84.8%). Some clinics reported additional use of auricular acupuncture (24.2%) and moxibustion (21.2%). Treatment providers were mainly physician-acupuncturists (84.8%). Compared to the RCTs, we found strong differences in point selection, mode of stimulation, and professional background of treatment providers. CONCLUSIONS: Less than 40% of all fertility centres in Switzerland, Germany, and Austria offering acupuncture employ standardized acupuncture treatment protocols. To increase external validity of acupuncture research in ART, and to investigate clinical effectiveness of this adjuvant intervention, semi-standardized and individualized point selection should be considered, and treatment provision by non-acupuncturists should be omitted in future trials.

Investigating short- and long-term transfer effects of a Taiji beginner course in participants' daily life / 中西医结合学报

In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants' everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants' daily lives.

Getting started with taiji: investigating students expectations and teachers appraisals of taiji beginners courses.

In recent years, Taiji has been frequently investigated and considered as a stress management intervention. Although health care providers' appraisals and consumers' expectations are regarded as essential for treatment outcome, little attention has been drawn to this issue in Taiji research. In our study we have conducted two surveys to explore beginners' (n = 74) expectations and teachers' (n = 136) appraisals of their Taiji courses in general as well as more particularly related to stress management. Qualitative data analysis revealed that beginners mainly expected to learn a new method that is applicable in their daily life to foster peace of mind and to enhance their stress management. Congruently moderate-to-high improvements in stress management have also been found in quantitative analysis, whereby a lower educational level predicted higher expectations (P = 0.016). Taiji-teachers stated body- and mind-related benefits most frequently and appraised moderate-to-high improvements in stress management. Higher appraisals were predicted by a shorter teaching experience (P = 0.024). Our results inform about beginners' expectations and teachers' appraisals related to a Taiji-beginners course and highlight the role of educational background and teaching experience in shaping stress-management-related beginners' expectations and teachers' appraisals.

Taiji practice attenuates psychobiological stress reactivity--a randomized controlled trial in healthy subjects.

BACKGROUND: Stress reducing effects of Taiji, a mindful and gentle form of body movement, have been reported in previous studies, but standardized and controlled experimental studies are scarce. The present study investigates the effect of regular Taiji practice on psychobiological stress response in healthy men and women. METHODS: 70 participants were randomly assigned to either Taiji classes or a waiting list. After 3 months, 26 (8 men, 18 women) persons in the Taiji group and 23 (9 men, 14 women) in the waiting control group underwent a standardized psychosocial stress test combining public speaking and mental arithmetic in front of an audience. Salivary cortisol and α-amylase, heart rate, and psychological responses to psychosocial stress were compared between the study groups. (ClinicalTrials.gov number, NCT01122706.) RESULTS: Stress induced characteristic changes in all psychological and physiological measures. Compared to controls, Taiji participants exhibited a significantly lower stress reactivity of cortisol (p = .028) and heart rate (p = .028), as well as lower α-amylase levels (p = .049). They reported a lower increase in perceived stressfulness (p = .006) and maintained a higher level of calmness (p = .019) in response to psychosocial stress. CONCLUSION: Our results consistently suggest that practicing Taiji attenuates psychobiological stress reactivity in healthy subjects. This may underline the role of Taiji as a useful mind-body practice for stress prevention.

Laser acupuncture for myofascial pain of the masticatory muscles. A controlled pilot study.

PURPOSE: The purpose of this investigation was to evaluate the effectiveness of laser acupuncture within the scope of a pilot study. METHODS: 108 adult patients were examined and of those eleven patients were included in the prospective pilot study. These patients took part voluntarily and were diagnosed with tendomyopathy of the masticatory musculature with maximum face and jaw pain on a visual analogous scale VAS > or = 30 in the last 14 days. Four patients wanted to be sure not to be assigned to the placebo group and were treated with the laser (group1, verum open, N = 4). The remaining seven were split by means of block randomisation into groups 2 (verum blind, N = 3) and 3 (placebo blind, N = 4). Two local points (ST 6, SI 18) and two distant points (SI 3, LI 4) on both sides of the body were stimulated (groups 1 and 2) or placebo-stimulated (group 3) with the LASERneedle machine for 15 minutes twice a week for three weeks (6 sessions). After three months a clinical follow-up was carried out, which included a standardised questionnaire as to the maximum pain intensity (VAS and verbal scale) and on the need for further treatment. A pain reduction (VAS) of about 50% was evaluated as a success. RESULTS: Pain decreased on average 40 VAS points for ten of eleven patients. The pain reduction on the VAS in group 1 (verum open) was more than 50% for all four patients, in group 3 (placebo blind) for three of four patients, and in group 2 (verum blind) all remained under 50%. The evaluation on the verbal scale showed a pain reduction from moderate to very strong pains initially, to moderate, light and no pain after three months for all three groups. DISCUSSION: The range of application of the laser was limited by the narrow inclusion criteria of the pilot study. The laser acupuncture (open and blinded) did not show a negative effect in any group. The pain reduction was strongest with the blinded patients of the placebo group. The worst performance was in the blinded group with laser acupuncture. CONCLUSION: Due to the low number of participants, no clear conclusion can be drawn. Laser needle acupuncture may be a treatment option for patients with an interest in a noninvasive, complementary therapy. But clarification and treatment planning on an individual basis must take place first.

[Complementary and alternative medicine in primary care in Switzerland]. / Komplementarmedizin in Schweizer praxen der grundversorgung.

OBJECTIVE: This study investigated the current supply of complementary and alternative medicine (CAM) in Swiss primary care. Information was collected on physicians' qualifications in CAM, frequency of patients' demand for CAM, physicians' supply and temporal resources for CAM as well as physicians' referrals to CAM. MATERIAL AND METHODS: 750 (500 German-speaking and 250 French-speaking) randomly selected Swiss female and male primary care physicians were asked to complete a questionnaire (response rate 50.4%). Sociodemographic data on professional training, place of residence, and sex were used to calculate a weighting factor to correct the responders' data in the analysis accordingly. RESULTS: 14.2% of the physicians were qualified in at least one CAM discipline. Around 30% (95% confidence interval 25.4-34.6%) of the physicians were asked for CAM by their patients more than once a week. Homeopathy and phytotherapy were the most frequently offered therapies, followed by traditional Chinese medicine (TCM)/acupuncture. 62.5% (57.6-67.4%) of the physicians refer their patients to CAM. Most patients were referred to TCM/acupuncture. Of the 37.2% (32.6-42.4%) of the physicians who do not refer their patients to CAM, around 40% (35.1-44.9%) offer it themselves. CONCLUSION: About three quarters of the physicians offer CAM themselves or refer their patients to CAM treatments. CAM is very important in primary medical care in Switzerland. Clear regulations for CAM are required in order to ensure a high quality in care.

[Laser needle acupuncture in women with dysmenorrhoea: a randomised controlled double blind pilot trial]. / Lasernadel-Akupunktur bei Frauen mit Dysmenorrhoe: Eine randomisierte kontrollierte doppelblinde Pilotstudie.

BACKGROUND: Dysmenorrhoea is a common gynaecological disorder.It is treated symptomatically if it is not caused by any underlying disease. Acupuncture is successfully used for menstrual disorders but is associated with certain side effects such as pain. Laser needle acupuncture is a new, non-invasive procedure that might mimic the effects of acupuncture. OBJECTIVE: The aim of this study is to investigate whether the effect of active laser needle acupuncture is superior to the effect of placebo laser needle acupuncture in women with dysmenorrhoea. PATIENTS AND METHODS: Women aged 18-50 years and with a minimum menstrual pain of 4 out of 10 points on a visual analogue scale (VAS) were included in this randomised double blind trial and treated with laser needle acupuncture (Laserneedle Computer-System). Every woman was treated with the same 8 acupuncture points (SP6, LV3 and LI4 bilateral; CV3 and ST36 on the right) in 8 sessions of 20 min each, over a period of 3 menstrual cycles. The primary endpoint was successful pain reduction, defined as a 50% reduction of the mean menstrual pain between baseline and end of the study (calculated from those 2 menstrual days with the worst pain levels on the VAS). We compared real laser acupuncture with placebo laser acupuncture (no laser activity). RESULTS: 48 women, mean age 29.6 +/- 7.5 years, were included in the study (30 women in the placebo group, 18 in the verum group). In the real acupuncture group, the success rate was 16.7% (3/18), in the placebo group 20% (6/30). CONCLUSIONS: We could not find a significant advantage of laser needle acupuncture compared to placebo laser needle acupuncture treatment. Further investigations are recommended because laser needle treatment is non-invasive and allows double blind acupuncture studies.

[Status of alternative medicine in Crohn disease and ulcerative colitis patents: a questionnaire survey]. / Stellenwert der Komplementärmedizin bei M.-Crohn- und Colitis-ulcerosa-Patienten: Eine Fragebogenerhebung.

BACKGROUND: Patients with M. Crohn or colitis ulcerosa live with a chronic disease. Pharmaceuticals used in convention-al medicine have been proven to be effective but can have strong side-effects. Thus, it is no surprise that affected patients are very interested in complementary and alternative medicine (CAM). OBJECTIVE: The aim of our survey was to investigate the use and the application of CAM by patients with M. Crohn and colitis ulcerosa in Switzerland. PATIENTS AND METHODS: Out-patients of the gastroenterological centre at the University Hospital Bern and of two gastroenterological private practices in a medium-sized city completed a self-administered questionnaire on CAM. Demographic variables, disease-related data, use of different approaches of complementary medicine, attitudes towards and the use of CAM were asked for. RESULTS: Out of 204 mailed questionnaires 71% (144) could be evaluated, 44% from patients of the University Hospital, 56% from patients of the gastroenterological private practices. CAM was used by 47% of the patients. The most commonly used methods of CAM were: homeopathy, traditional Chinese medicine and acupuncture. 67% of the patients benefitted by CAM in the long run, whereas 10.5% suffered a relapse of their disease during CAM therapies. The main reason for the patients to apply to CAM was to complement conventional treatment. CONCLUSION: Our survey points out that the studied out-patients have a strong interest in CAM. It is therefore important that clinical research in the various unconventional therapies will be further promoted.