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The Cochrane Database of Systematic... Dec 2021Autogenic drainage is an airway clearance technique that was developed by Jean Chevaillier in 1967. The technique is characterised by breathing control using expiratory... (Review)
Review
BACKGROUND
Autogenic drainage is an airway clearance technique that was developed by Jean Chevaillier in 1967. The technique is characterised by breathing control using expiratory airflow to mobilise secretions from smaller to larger airways. Secretions are cleared independently by adjusting the depth and speed of respiration in a sequence of controlled breathing techniques during exhalation. The technique requires training, concentration and effort from the individual but it has previously been shown to be an effective treatment option for those who are seeking techniques to support and promote independence. However, at a time where the trajectory and demographics of the disease are changing, it is important to systematically review the evidence demonstrating that autogenic drainage is an effective intervention for people with cystic fibrosis.
OBJECTIVES
To compare the clinical effectiveness of autogenic drainage in people with cystic fibrosis with other physiotherapy airway clearance techniques.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles and reviews, as well as two ongoing trials registers (02 February 2021). Date of most recent search of the Cochrane Cystic Fibrosis Trials Register: 06 July 2021.
SELECTION CRITERIA
We identified randomised and quasi-randomised controlled studies comparing autogenic drainage to another airway clearance technique or no therapy in people with cystic fibrosis for at least two treatment sessions.
DATA COLLECTION AND ANALYSIS
Data extraction and assessments of risk of bias were independently performed by three authors. The authors assessed the quality of the evidence using the GRADE system. The authors contacted seven teams of investigators for further information pertinent to their published studies.
MAIN RESULTS
Searches retrieved 64 references to 37 individual studies, of which eight (n = 212) were eligible for inclusion. One study was of parallel design with the remaining seven being cross-over in design; participant numbers ranged from 4 to 75. The total study duration varied between four days and two years. The age of participants ranged between seven and 63 years with a wide range of disease severity reported. Six studies enrolled participants who were clinically stable, whilst participants in two studies received treatment whilst hospitalised with an infective exacerbation. All studies compared autogenic drainage to one (or more) other recognised airway clearance technique. Exercise is commonly used as an alternative therapy by people with cystic fibrosis; however, there were no studies identified comparing exercise with autogenic drainage. The certainty of the evidence was generally low or very low. The main reasons for downgrading the level of evidence were the frequent use of a cross-over design, outcome reporting bias and the inability to blind participants. The review's primary outcome, forced expiratory volume in one second, was the most common outcome measured and was reported by all eight studies; only three studies reported on quality of life (also a primary outcome of the review). One study reported on adverse events and described a decrease in oxygen saturation levels whilst performing active cycle of breathing techniques, but not with autogenic drainage. Seven of the eight included studies measured forced vital capacity and three of the studies used mid peak expiratory flow (per cent predicted) as an outcome. Six studies reported sputum weight. Less commonly used outcomes included oxygen saturation levels, personal preference, hospital admissions, intravenous antibiotics and pseudomonas gene expression. There were no statistically significant differences found between any of the techniques used with respect to the outcomes measured except when autogenic drainage was described as being the preferred technique of the participants in one study over postural drainage and percussion.
AUTHORS' CONCLUSIONS
Autogenic drainage is a challenging technique that requires commitment from the individual. As such, this intervention merits systematic review to ensure its effectiveness for people with cystic fibrosis, particularly in an era where treatment options are changing rapidly. From the studies assessed, autogenic drainage was not found to be superior to any other form of airway clearance technique. Larger studies are required to better evaluate autogenic drainage in comparison to other airway clearance techniques in view of the relatively small number of participants in this review and the complex study designs. The studies recruited a range of participants and were not powered to assess non-inferiority. The varied length and design of the studies made the analysis of pooled data challenging.
Topics: Adolescent; Adult; Child; Cystic Fibrosis; Drainage, Postural; Humans; Middle Aged; Oxygen Saturation; Physical Therapy Modalities; Quality of Life; Young Adult
PubMed: 34910295
DOI: 10.1002/14651858.CD009595.pub3 -
Nature Reviews. Neurology Mar 2014Chronic pain is common, and the available treatments do not provide adequate relief for most patients. Neuromodulatory interventions that modify brain processes... (Review)
Review
Chronic pain is common, and the available treatments do not provide adequate relief for most patients. Neuromodulatory interventions that modify brain processes underlying the experience of pain have the potential to provide substantial relief for some of these patients. The purpose of this Review is to summarize the state of knowledge regarding the efficacy and mechanisms of noninvasive neuromodulatory treatments for chronic pain. The findings provide support for the efficacy and positive side-effect profile of hypnosis, and limited evidence for the potential efficacy of meditation training, noninvasive electrical stimulation procedures, and neurofeedback procedures. Mechanisms research indicates that hypnosis influences multiple neurophysiological processes involved in the experience of pain. Evidence also indicates that mindfulness meditation has both immediate and long-term effects on cortical structures and activity involved in attention, emotional responding and pain. Less is known about the mechanisms of other neuromodulatory treatments. On the basis of the data discussed in this Review, training in the use of self-hypnosis might be considered a viable 'first-line' approach to treat chronic pain. More-definitive research regarding the benefits and costs of meditation training, noninvasive brain stimulation and neurofeedback is needed before these treatments can be recommended for the treatment of chronic pain.
Topics: Autogenic Training; Brain; Chronic Pain; Electric Stimulation Therapy; Humans; Meditation; Neurotransmitter Agents; Pain Management
PubMed: 24535464
DOI: 10.1038/nrneurol.2014.12 -
The Effect of Stress Management Techniques on Persons with Addictive Behaviors: a Systematic Review.Materia Socio-medica Sep 2021According to the current state of knowledge, addictions are often developed as a maladaptive coping response to elevated stress levels. Stress management has a... (Review)
Review
BACKGROUND
According to the current state of knowledge, addictions are often developed as a maladaptive coping response to elevated stress levels. Stress management has a beneficial effect on various mental health problems. Yet, there is no strong evidence concerning the effect of stress management on stress levels of individuals with addictive behaviors, although such an effect might benefit their addictive symptoms.
OBJECTIVE
To investigate the effect of stress management on stress levels of persons with addictive behaviors.
METHODS
A systematic review of the literature was carried out on Biomed Central, PubMed, Scopus and Web of Science searching for relevant trials investigating the effect of stress management techniques, specifically of Progressive Muscle Relaxation (PMR), Autogenic Training (AT) and Guided Imagery (GI), on stress levels of individuals with addictive behaviors. In order to be included, the studies had to be randomized trials using an intervention and a non-intervention or a placebo control group, to apply PMR, GI or AT, to include a sample with addictive behaviors, to be published in English, to involve a baseline and at least one subsequent measurement, to be published in peer-review journals and to measure stress through instruments or biochemical assessments. The trials' quality was assessed by the use of the Jadad Scale.
RESULTS
A total of four studies met the inclusion criteria and were further analyzed. The findings indicated that PMR might lead to a reduction of stress levels, while no such evidence is found concerning GI and AT. The quality of all trials was low.
CONCLUSION
Progressive Muscle Relaxation and GI might have a divergent effect on persons with addictive behaviors. Yet, the low number of the studies and their poor quality debars drawing reliable conclusions for potential beneficial effects.
PubMed: 34759780
DOI: 10.5455/msm.2021.33.213-218 -
Journal of Exercise Rehabilitation Feb 2019Preeclampsia (PE) is the most common medical complication of pregnancy characterized by hypertension and significant proteinuria after the 20th week of gestation, its...
Preeclampsia (PE) is the most common medical complication of pregnancy characterized by hypertension and significant proteinuria after the 20th week of gestation, its prevalence is about 2%-8% of pregnancies. Antihypertensive drugs were found to have an adverse effect to both the mother and the fetus so interest is increased in nonchemical treatment. This study was conducted to compare between the effects of stretching exercises versus autogenic training (AT) on PE. This study was carried out on 40 preeclamptic primiparous women, their gestational age was exceeding 20 weeks. They were randomly divided into two equal groups; group A consisted of 20 women received stretching exercises and group B consisted of 20 women received relaxation training in the form of AT. All patients in both groups A and B received (3 sessions per week for 6 weeks) and received methyldopa as the antihypertensive drug. Evaluation of all patients in both groups A and B was done before and after the treatment program by assessing arterial blood pressure and proteinuria. Results of this study revealed that there is a significant decrease in systolic blood pressure, diastolic blood pressure and proteinuria in both groups A and B after 6 weeks of treatment. There was no significant difference between both groups post-treatment in systolic blood pressure, diastolic blood pressure, and proteinuria. It can be concluded that both stretching exercise and AT were found to be effective nonchemical methods which control the symptoms of PE.
PubMed: 30899745
DOI: 10.12965/jer.1836524.262 -
The Cochrane Database of Systematic... Oct 2017Autogenic drainage is an airway clearance technique that was developed by Jean Chevaillier in 1967. The technique is characterised by breathing control using expiratory... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Autogenic drainage is an airway clearance technique that was developed by Jean Chevaillier in 1967. The technique is characterised by breathing control using expiratory airflow to mobilise secretions from smaller to larger airways. Secretions are cleared independently by adjusting the depth and speed of respiration in a sequence of controlled breathing techniques during exhalation. The technique requires training, concentration and effort from the individual. It is important to systematically review the evidence demonstrating that autogenic drainage is an effective intervention for people with cystic fibrosis.
OBJECTIVES
To compare the clinical effectiveness of autogenic drainage in people with cystic fibrosis with other physiotherapy airway clearance techniques.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles and reviews, as well as two trials registers (31 August 2017).Dtae of most recent search of the Cochrane Cystic Fibrosis Trials Register: 25 September 2017.
SELECTION CRITERIA
We identified randomised and quasi-randomised controlled studies comparing autogenic drainage to another airway clearance technique or no therapy in people with cystic fibrosis for at least two treatment sessions.
DATA COLLECTION AND ANALYSIS
Data extraction and assessments of risk of bias were independently performed by two authors. The authors assessed the quality of the evidence using the GRADE system. The authors contacted two investigators for further information pertinent to their published studies.
MAIN RESULTS
Searches retrieved 35 references to 21 individual studies, of which seven (n = 208) were eligible for inclusion. One study was of parallel design with the remaining six being cross-over in design; participant numbers ranged from 17 to 75. The total study duration varied between four days and two years. The age of participants ranged between seven and 63 years with a wide range of disease severity reported. Six studies enrolled participants who were clinically stable, whilst participants in one study had been hospitalised with an infective exacerbation. All studies compared autogenic drainage to one (or more) other recognised airway clearance technique. Exercise is commonly used as an alternative therapy by people with cystic fibrosis; however, there were no studies identified comparing exercise with autogenic drainage.The quality of the evidence was generally low or very low. The main reasons for downgrading the level of evidence were the frequent use of a cross-over design, outcome reporting bias and the inability to blind participants.The review's primary outcome, forced expiratory volume in one second, was the most common outcome measured and was reported by all seven studies; only three studies reported on quality of life (also a primary outcome of the review). One study reported on adverse events and described a decrease in oxygen saturation levels whilst performing active cycle of breathing techniques, but not with autogenic drainage. Six of the seven included studies measured forced vital capacity and three of the studies used mid peak expiratory flow (per cent predicted) as an outcome. Six studies reported sputum weight. Less commonly used outcomes included oxygen saturation levels, personal preference, hospital admissions or intravenous antibiotics. There were no statistically significant differences found between any of the techniques used with respect to the outcomes measured except when autogenic drainage was described as being the preferred technique of the participants in one study over postural drainage and percussion.
AUTHORS' CONCLUSIONS
Autogenic drainage is a challenging technique that requires commitment from the individual. As such, this intervention merits systematic review to ensure its effectiveness for people with cystic fibrosis. From the studies assessed, autogenic drainage was not found to be superior to any other form of airway clearance technique. Larger studies are required to better evaluate autogenic drainage in comparison to other airway clearance techniques in view of the relatively small number of participants in this review and the complex study designs. The studies recruited a range of participants and were not powered to assess non-inferiority. The varied length and design of the studies made the analysis of pooled data challenging.
Topics: Adolescent; Adult; Aged; Child; Cystic Fibrosis; Drainage, Postural; Exhalation; Forced Expiratory Volume; Humans; Middle Aged; Mucus; Quality of Life; Randomized Controlled Trials as Topic; Respiratory Therapy
PubMed: 28984368
DOI: 10.1002/14651858.CD009595.pub2 -
International Journal of Environmental... Mar 2018The aim of this work was to evaluate a course to reduce distress in an Italian police force. Based on the findings from the first investigations on this population,... (Review)
Review
BACKGROUND
The aim of this work was to evaluate a course to reduce distress in an Italian police force. Based on the findings from the first investigations on this population, courses to improve the ability to manage distress were tailored by management. Several free courses were proposed, including physical efficiency (e.g., total body conditioning) and wellness (e.g., autogenic training) classes. The goal of this research was to evaluate the courses and their impact on the perceived distress and general health of the participants, as well as the effectiveness in increasing the use of adaptive coping strategies.
METHODS
A descriptive investigation was conducted involving a sample of 105 police officers before (time 1) and after (time 2) they had participated in the courses.
RESULTS
Findings confirmed both physical and wellness courses affected, in participants, the perceived distress, thereby increasing the perception of wellbeing. The participants expressed having mental health benefits, the use of adaptive coping strategies increased, while the maladaptive coping strategies decreased.
CONCLUSION
This study confirms that these courses could effectively reduce the risk of chronic disease, a consequence of persistent exposure to distress.
Topics: Adaptation, Psychological; Adult; Female; Humans; Italy; Male; Middle Aged; Occupational Stress; Patient Education as Topic; Police; Stress, Psychological; Surveys and Questionnaires
PubMed: 29570662
DOI: 10.3390/ijerph15040578 -
International Journal of Environmental... May 2022Introduction: People with depression often complain of dysfunction in cognitive processes, particularly attention. Pharmacotherapy is one of the most commonly used...
Introduction: People with depression often complain of dysfunction in cognitive processes, particularly attention. Pharmacotherapy is one of the most commonly used methods of treating depressive disorders and related attention difficulties. Patients also benefit from various forms of psychotherapy and frequently support themselves with alternative therapeutic methods. The purpose of this study was to examine whether a 15-min-long relaxation training session could improve the efficiency of attention and perceptiveness in individuals diagnosed with depressive disorders. Methods: Forty-two individuals participated in the study, including 20 individuals diagnosed with recurrent depressive disorder (rDD) and 22 healthy subjects (comparison group, CG). The so-called continuous performance test in the Polish version (Attention and Perceptiveness Test, APT) was applied in the study. In the first stage, the participants completed the 6/9 version of the APT test and then took part in a 15-min relaxation training session (autogenic training developed by the German psychiatrist Johannes Heinrich Schultz). The next step of the study was to perform APT again (parallel version—3/8). Results: The analyses showed statistically significant differences (p < 0.001) in the results obtained in the two versions of APT between the studied groups (rDD versus CG) in terms of the perceptual speed index. These differences were seen both before and after the introduction of the relaxation training. There was a statistically significant difference in the value of the perceptual speed index before and after the applied relaxation training for the subjects with depression (p = 0.004) and for the whole study group (p = 0.008). A significant correlation of illness symptom severity with decreased attentional efficiency was observed in the rDD group (perceptual speed index)—both before (r = −0.864; p < 0.001) and after the relaxation training (r = −0.785; p < 0.001). Conclusions: The continuous performance test (APT) is a reliable indicator of impaired attention efficiency among patients with depressive symptoms compared to healthy subjects. 15-min-long one-time relaxation exercise has a beneficial effect on attention efficiency measured by APT in people with depression.
Topics: Attention; Depression; Depressive Disorder; Humans; Neuropsychological Tests; Relaxation Therapy
PubMed: 35682056
DOI: 10.3390/ijerph19116473 -
Journal of Korean Medical Science Oct 2009Biofeedback with or without combined autogenic training is known to be effective for the treatment of migraine. This study aimed to examine the effect of biofeedback... (Randomized Controlled Trial)
Randomized Controlled Trial
Biofeedback with or without combined autogenic training is known to be effective for the treatment of migraine. This study aimed to examine the effect of biofeedback treatment on headache activity, anxiety, and depression in Korean female patients with migraine headache. Patients were randomized into the treatment group (n=17) and monitoring group (n=15). Mood states including anxiety and depression, and psychophysiological variables such as mean skin temperature of the patients were compared with those of the normal controls (n=21). We found greater treatment response rate (defined as > or =50% reduction in headache index) in patients with biofeedback-assisted autogenic training than in monitoring group. The scores on the anxiety and depression scales in the patients receiving biofeedback-assisted autogenic training decreased after the biofeedback treatment. Moreover, the decrease in their anxiety levels was significantly related to the treatment outcome. This result suggests that the biofeedback-assisted autogenic training is effective for the treatment of migraine and its therapeutic effect is closely related to the improvement of the anxiety level.
Topics: Adult; Affect; Analysis of Variance; Anxiety; Autogenic Training; Biofeedback, Psychology; Body Temperature; Depression; Female; Humans; Migraine Disorders; Republic of Korea; Severity of Illness Index
PubMed: 19794995
DOI: 10.3346/jkms.2009.24.5.936 -
Medicine Aug 2021The occurrence of post-stroke emotional problems is significant during the early post-stroke stage and affects the recovery of functionality among the survivors. Because...
INTRODUCTION
The occurrence of post-stroke emotional problems is significant during the early post-stroke stage and affects the recovery of functionality among the survivors. Because stroke survivors require active engagement in rehabilitation to optimize the process of neuroplasticity in the initial stage of stroke, there is a need to integrate an intervention, preferably therapists-mediated during rehabilitation, which reduce emotional problems thus improve motivation level among the survivors. One such technique is autogenic relaxation training (ART). ART has been found to reduce anxiety and depression among patients with several medical conditions. However, its usage in stroke survivors during rehabilitation has been limited to date. Therefore, this study is intended to evaluate the effectiveness of ART in addition to usual physiotherapy in improving emotional state and functional level of stroke survivors during rehabilitation.
METHODS
This is an assessor blinded randomized controlled trial comparing 2 intervention approaches namely ART-added physiotherapy (experimental group) and usual physiotherapy (control group). A total of 70 post-stroke patients will be recruited and allocated into either the ART-added physiotherapy or the usual physiotherapy group. The ART-added physiotherapy group will undergo a 20-minute ART session followed by 40 minutes of usual physiotherapy. While the usual physiotherapy group will receive usual physiotherapy alone for 60 minutes. All participants will be treated once a week and are required to carry out a set of home exercises for 2 times per week during the 12-week intervention. Assessment of emotional status and functional independence will be carried out at pre-intervention and week 13 of the intervention with the use of Hospital anxiety and depression scale, Barthel index, and EuroQol-5 dimensions-5 levels. All data will be analyzed using descriptive and inferential statistics.
DISCUSSION
The expected main study outcome is an enhanced evidence-based physiotherapy program that may be used by physiotherapists in the rehabilitation of stroke patients with emotional disturbances.
TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry, ACTRN12619001664134 (last updated on 28/11/2019).
Topics: Autogenic Training; Emotions; Functional Status; Humans; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Single-Blind Method; Stroke Rehabilitation
PubMed: 34414949
DOI: 10.1097/MD.0000000000026924 -
Journal of Health Psychology Mar 2022Many people find it difficult to practice progressive muscle relaxation (PMR) regularly. We attempted to improve relaxation quantity (i.e. adherence), and relaxation... (Randomized Controlled Trial)
Randomized Controlled Trial
Many people find it difficult to practice progressive muscle relaxation (PMR) regularly. We attempted to improve relaxation quantity (i.e. adherence), and relaxation quality via placebo. A total of 100 women were randomly assigned to a standard group, which practiced PMR at home every day for two weeks, or a placebo group, which practiced PMR for two weeks with additional daily placebo treatment. To monitor adherence to relaxation practice, we used a smartphone app. The placebo group practiced more often than the standard group. Both groups did not differ in their reported relaxation level after the daily exercises.
Topics: Autogenic Training; Exercise; Female; Humans; Mobile Applications; Placebo Effect; Relaxation Therapy
PubMed: 32873114
DOI: 10.1177/1359105320954238