-
The Journal of Orthopaedic and Sports... Aug 2023We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck... (Meta-Analysis)
Meta-Analysis
Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression.
We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. Intervention systematic review with meta-analysis. We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's , standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; | = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; | = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; | = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; | = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; | = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; | = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; | = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; | = 98%). There was no dose-response relationship for resistance exercise ( = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain ( = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability ( = 0.61). Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. .
Topics: Humans; Neck Pain; Mindfulness; Quality of Life; Exercise; Exercise Therapy; Chronic Pain
PubMed: 37339388
DOI: 10.2519/jospt.2023.11820 -
Obesity Reviews : An Official Journal... Nov 2019Common strategies for reducing body weight rely on limiting energy intake and restricting food choices. However, these strategies have often been proven ineffective in... (Meta-Analysis)
Meta-Analysis
Common strategies for reducing body weight rely on limiting energy intake and restricting food choices. However, these strategies have often been proven ineffective in achieving long-term and sustainable weight reduction. More recently, mindful eating as an alternative weight management strategy has gained increasing attention, yet systematic reviews on intuitive or mindful eating published so far present contradictory results. We performed a systematic review and meta-analysis on randomized controlled trials on weight loss programs based on mindful or intuitive eating. We analyzed results using meta-regressions. We included a total of 10 studies and found a significant weight loss effect of mindful/intuitive eating strategies compared with nonintervention controls (-0.348 kg, 95% CI: -0.591 to -0.105, P = 0.005). However, there was no difference compared with conventional diet programs (P = 0.99). Reduction of BMI (-0.137 kg/m , 95% CI: -0.365 to 0.091, P = 0.240) or waist circumference (-0.358 cm, 95% CI: -0.916 to 0.200, P = 0.209) were not statistically significant. Mindful/intuitive eating could be a practical approach to weight control. Limitations of this study include the unbalanced sex, origin, place of residence of the participants, and the short duration of interventions. Future research should aim at investigating long-term effects and include a more heterogeneous study population.
Topics: Analysis of Variance; Diet, Reducing; Energy Intake; Exercise; Feeding Behavior; Humans; Mindfulness; Obesity; Weight Loss; Weight Reduction Programs
PubMed: 31368631
DOI: 10.1111/obr.12918 -
PloS One 2022Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical well-being. This review aims to provide the most recent evaluation of Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Cancer Recovery (MBCR) treatments, in reducing symptoms of depression, anxiety and CRF in oncology populations.
METHODS
A search using the following search terms was conducted: (mindful* OR mindfulness* OR mindfulness-based* OR MBI* OR MBCT OR MBSR OR MBCR) AND (Oncol* OR cancer OR neoplasm OR lymphoma OR carcinoma OR sarcoma) to obtain relevant publications from five databases: PsycINFO, PubMed, Embase, and MEDLINE by EC, and ProQuest Dissertations & Theses Global from January 2000 to February 2022. 36 independent studies (n = 1677) were evaluated for their overall effect sizes (using random-effects models), subgroup analyses, and quality appraisals. Evaluations were performed separately for non-randomized (K = 20, n = 784) and randomized controlled trials (K = 16, n = 893).
RESULTS
The results showed that MBIs have significant medium effects in reducing symptoms of depression (Hedges' g = 0.43), anxiety (Hedges' g = 0.55) and CRF (Hedges' g = 0.43), which were maintained at least three months post-intervention. MBIs were also superior in reducing symptoms of anxiety (Hedges' g = 0.56), depression (Hedges' g = 0.43), and CRF (Hedges' g = 0.42) in oncology samples relative to control groups. The superiority of MBIs to control groups was also maintained at least three months post-intervention for anxiety and CRF symptoms, but not for depressive symptoms. The risk of bias of the included studies were low to moderate.
CONCLUSIONS
This review found that MBIs reduced symptoms of depression, anxiety and CRF in oncology populations.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO: International Prospective Register of Systematic Reviews: CRD42020143286.
Topics: Anxiety; Depression; Fatigue; Humans; Mindfulness; Neoplasms
PubMed: 35834503
DOI: 10.1371/journal.pone.0269519 -
International Journal of Nursing Studies Apr 2023Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of psychotherapy that are effective in improving physical and psychological symptoms, but no review has summarized their effectiveness on anxiety, depression, and fatigue in people with lung cancer.
OBJECTIVES
To evaluate the effectiveness of mindfulness-based interventions in reducing anxiety, depression, and fatigue in people with lung cancer.
DESIGN
Systematic review and meta-analysis.
METHODS
We searched the PubMed, Web of Science, Embase, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, and China Science and Technology Journal databases from inception to 13 April 2022. Eligible studies included randomized controlled trials of people with lung cancer receiving mindfulness-based interventions reporting on the outcomes of anxiety, depression, and fatigue. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. The meta-analysis was performed by using Review Manager 5.4, and the effect size was calculated by the standardized mean difference and its 95% confidence interval.
RESULTS
The systematic review included 25 studies (2420 participants), whereas the meta-analysis included 18 studies (1731 participants). Mindfulness-based interventions significantly decreased levels of anxiety [standardized mean difference = -1.15, 95% confidence interval (-1.36, -0.94), Z = 10.75, P < 0.001], depression [standardized mean difference = -1.04, 95% confidence interval (-1.60, -0.48), Z = 3.66, P < 0.001], and fatigue [standardized mean difference = -1.29, 95% confidence interval (-1.66, -0.91), Z = 6.79, P < 0.001]. The subgroup analysis indicated that programs lasting less than eight weeks in length with structured intervention components (e.g., mindfulness-based stress reduction and mindfulness-based cognitive therapy) and 45 min of daily home practice implemented in patients with advanced stage lung cancer showed better effects than programs lasting more than eight weeks in length with less structured components and more than 45 min of daily home practice implemented in patients with mixed stage lung cancer. The overall quality of the evidence was low due to the lack of allocation concealment and blinding and the high risk of bias in most studies (80%).
CONCLUSIONS
Mindfulness-based interventions might be effective in reducing anxiety, depression, and fatigue in people with lung cancer. However, we cannot draw definitive conclusions because the overall quality of the evidence was low. More rigorous studies are needed to confirm the effectiveness and examine which intervention components may be most effective for improved outcomes.
Topics: Humans; Anxiety; Depression; Fatigue; Lung Neoplasms; Mindfulness; Quality of Life
PubMed: 36796118
DOI: 10.1016/j.ijnurstu.2023.104447 -
BMC Neurology Jan 2020Populations with reduced sensory and motor function, such as spinal cord injury (SCI) are at increased risk of depression, anxiety, pain, and poorer quality of life...
BACKGROUND
Populations with reduced sensory and motor function, such as spinal cord injury (SCI) are at increased risk of depression, anxiety, pain, and poorer quality of life (QoL). Mindfulness-Based Interventions (MBIs) have been developed with the aim of improving outcomes for people with SCI. To understand the value of MBIs, a systematic review was conducted pertaining to the use of MBIs, and interventions including elements of mindfulness, with people with SCI.
METHODS
Databases were reviewed from 1996 to October 2018 (updated January 2020). Eligibility criteria included the assessment of at least one of the common secondary consequences of SCI (i.e. risk of depression, anxiety, pain, and QoL), describe the use of mindfulness training as a component part of an intervention, or as the whole intervention. The Cochrane Collaboration Risk of Bias and The Effective Public Health Practice Project Quality Assessment Tools were utilised for quality appraisals. Two assessors appraised the studies and demonstrated good agreement (Cohen's k = .848, p < .001).
RESULTS
Five papers met the inclusion criteria, and demonstrated a range of results of interventions delivered individually, in a group format, in person, and online. Only one study reported significant reductions in pain-related outcomes (with moderate effect sizes), with the remaining studies (n = 4) demonstrating no change. Four studies described reductions in depressive symptoms and three reported reductions in anxiety. Despite the importance of good QoL as a goal for people with SCI, few studies (n = 2) assessed this as an outcome with no improvements reported. Study quality ranged from high to low/weak.
CONCLUSIONS
The findings in this review provide mixed support for the use of mindfulness to improve outcomes after SCI. In particular, findings indicate that mindfulness may be particularly effective for improving symptoms of depression and anxiety. This review highlights the requirement for more rigorous, high-quality research, particularly larger randomised-controlled trials with long-term follow-up, in this area. The small number of studies included in the present review mean that conclusions drawn are preliminary and thus reflects the paucity of the research in the area to date.
Topics: Anxiety; Chronic Pain; Depression; Female; Humans; Male; Mindfulness; Quality of Life; Spinal Cord Injuries
PubMed: 31964353
DOI: 10.1186/s12883-020-1619-5 -
Psycho-oncology Dec 2019Mindfulness-based interventions (MBIs) are increasingly used within psycho-oncology. Since the publication of the most recent comprehensive meta-analysis on MBIs in... (Meta-Analysis)
Meta-Analysis
Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
Mindfulness-based interventions (MBIs) are increasingly used within psycho-oncology. Since the publication of the most recent comprehensive meta-analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.
METHODS
Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta-analysis, and evaluated risk of bias.
RESULTS
Twenty-nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post-intervention (Hedges's g = 0.32; 95%CI: 0.22-0.41; P < .001) and follow-up (g = 0.19; 95%CI: 0.07-0.30; P < .002). Statistically significant effects were also found at either post-intervention or follow-up for a range of self-reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow-up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post-intervention.
CONCLUSIONS
MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.
Topics: Cancer Survivors; Humans; Mindfulness; Neoplasms; Outcome and Process Assessment, Health Care; Psychological Distress; Randomized Controlled Trials as Topic
PubMed: 31464026
DOI: 10.1002/pon.5214 -
Complementary Therapies in Clinical... Nov 2020Many people with chronic medical conditions experience symptoms that are complex and negatively impact their quality of life (QOL). This review and meta-analysis... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND PURPOSE
Many people with chronic medical conditions experience symptoms that are complex and negatively impact their quality of life (QOL). This review and meta-analysis examined the benefits of mindfulness based art therapy (MBAT) to relieve symptoms.
METHODS
Included were studies that (a) evaluated an MBAT intervention in adults, (b) included a sufficient effect size and control group, and (c) assessed symptoms and QOL outcomes.
RESULTS
Fourteen studies sampling adolescents and adults met inclusion criteria. Participants who received MBAT interventions reported significant improvements in psychological and physical symptoms indices compared to controls; the meta-analysis MBAT interventions revealed a medium effect size whereas that for controls the effect size was equivalent to zero.
CONCLUSION
MBAT is a promising intervention for symptom relief. However, the literature is limited by the small number of studies. Randomized controlled trials with larger samples are needed to validate findings.
Topics: Adolescent; Adult; Anxiety; Art Therapy; Depression; Fatigue; Humans; Mindfulness; Quality of Life
PubMed: 33075726
DOI: 10.1016/j.ctcp.2020.101246 -
Scientific Reports Jul 2023Sporadic evidence exists for burnout interventions in terms of types, dosage, duration, and assessment of burnout among clinical nurses. This study aimed to evaluate... (Meta-Analysis)
Meta-Analysis
Sporadic evidence exists for burnout interventions in terms of types, dosage, duration, and assessment of burnout among clinical nurses. This study aimed to evaluate burnout interventions for clinical nurses. Seven English databases and two Korean databases were searched to retrieve intervention studies on burnout and its dimensions between 2011 and 2020.check Thirty articles were included in the systematic review, 24 of them for meta-analysis. Face-to-face mindfulness group intervention was the most common intervention approach. When burnout was measured as a single concept, interventions were found to alleviate burnout when measured by the ProQoL (n = 8, standardized mean difference [SMD] = - 0.654, confidence interval [CI] = - 1.584, 0.277, p < 0.01, I = 94.8%) and the MBI (n = 5, SMD = - 0.707, CI = - 1.829, 0.414, p < 0.01, I = 87.5%). The meta-analysis of 11 articles that viewed burnout as three dimensions revealed that interventions could reduce emotional exhaustion (SMD = - 0.752, CI = - 1.044, - 0.460, p < 0.01, I = 68.3%) and depersonalization (SMD = - 0.822, CI = - 1.088, - 0.557, p < 0.01, I = 60.0%) but could not improve low personal accomplishment. Clinical nurses' burnout can be alleviated through interventions. Evidence supported reducing emotional exhaustion and depersonalization but did not support low personal accomplishment.
Topics: Humans; Burnout, Professional; Emotions; Mindfulness; Achievement; Nurses
PubMed: 37414811
DOI: 10.1038/s41598-023-38169-8 -
Annals of Palliative Medicine Jul 2021Mindfulness-based interventions (MBIs) and cognitive behavioral therapy (CBT) have both been shown to be effective treatment approaches for anxiety. The purpose of this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mindfulness-based interventions (MBIs) and cognitive behavioral therapy (CBT) have both been shown to be effective treatment approaches for anxiety. The purpose of this paper was to directly investigate the ability of MBIs and CBT to improve anxiety symptoms (primary outcome), as well as depression symptoms and sleep quality (second outcome).
METHODS
We searched the following electronic databases from 1st December, 2019 to 14th January 2021: English databases including PubMed, PsycINFO, Web of Science, the Cochrane Library, Elsevier, Springer Link, Wiley Online Library, ClinicalTrails, and Embase, and Chinese database including CNKI, WANFANG, and CQVIP. The eligibility criteria included the following: (I) patients with anxiety disorders or symptoms of anxiety; and those with physical or mental disorders with comorbid anxiety symptoms; (II) randomized controlled trial (RCT) design; (III) the treatment group received MBIs; (IV) the control group received CBT; and (V) the treatment outcomes were anxiety, depression, and sleep quality.
RESULTS
In total, 4,095 abstracts were reviewed. Of these, the full-texts of 45 articles were read in detail; and 11 RCTs were finally included in the analysis. Upon completion of MBIs and CBT group sessions, the study outcomes (mean anxiety, depression, and sleep quality scores) revealed no difference between MBIs and CBT with regards to anxiety, depression, and sleep quality post-intervention. Subgroup analysis was also performed, and the results indicated that MBIs may provide a small advantage for people with anxiety symptoms compared to CBT [standard mean difference (SMD): -0.36, 95% confidence interval (CI): -0.66 to -0.06], while the CBT group demonstrated a small comparative advantage for anxiety in the Liebowitz Social Anxiety Scale (LSAS) and Social Phobia Inventory (SPIN) scales, as well as mindfulness-based stress reduction (MBSR) in the types of MBIs (LSAS: SMD: 0.35, 95% CI: 0.08 to 0.63; SPIN: SMD: 0.51, 95% CI: 0.11 to 0.92; MBSR: SMD: 0.41, 95% CI: 0.07 to 0.74).
DISCUSSION
There was no significant difference between MBIs and CBT in terms of the treatment outcomes of anxiety, depression, and sleep quality. MBIs could be used as an alternative intervention to CBT for anxiety symptoms.
TRIAL REGISTRATION
This meta-analysis was conducted in line with the PRISMA guideline and was registered at PROSPERO https://www.crd.york.ac.uk/PROSPERO/ (CRD42021219822).
Topics: Anxiety; Anxiety Disorders; Cognitive Behavioral Therapy; Humans; Mindfulness; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 34353047
DOI: 10.21037/apm-21-1212 -
International Journal of Mental Health... Jun 2019Mindfulness-based stress reduction (MBSR) has been widely used to improve various physical and mental conditions. Studies show the intervention is particularly effective... (Meta-Analysis)
Meta-Analysis
Mindfulness-based stress reduction (MBSR) has been widely used to improve various physical and mental conditions. Studies show the intervention is particularly effective in alleviating depression, anxiety, and stress in working-aged adults. No recent systematic review has focused on the use of MBSR in older adults. This study aims to examine the effects of MBSR intervention on depression, anxiety, and stress symptoms of older adults. Five electronic databases were searched for relevant randomized controlled trials (RCTs) published between 1990 and 2017. Six eligible studies were included and computed for meta-analysis. The methodological quality and risk of biases across the included RCTs were assessed using the Cochrane risk of bias assessment tool. Overall, the amount of evidence is limited and of relatively low quality. The results of this review provide evidence that the MBSR is more effective than wait-list-control group to reduce depression in older adults with clinically significant symptoms immediately following the intervention. However, there is no clear evidence that the intervention reduced the perception of stress and anxiety, or that positive effects are maintained over the longer term. More robust studies involving larger sample sizes and using longer follow-up measurements are required.
Topics: Aged; Anxiety; Depression; Humans; Mindfulness; Relaxation Therapy; Stress, Psychological
PubMed: 30656813
DOI: 10.1111/inm.12568