Lifestyle News and Research

Tai Chi is effective in treating knee osteoarthritis: A randomized controlled trial.

Arthritis Rheum. 2009 Oct 29;61(11):1545-1553

Authors: Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, McAlindon T

OBJECTIVE: To evaluate the effectiveness of Tai Chi in the treatment of knee osteoarthritis (OA) symptoms. METHODS: We conducted a prospective, single-blind, randomized controlled trial of 40 individuals with symptomatic tibiofemoral OA. Patients were randomly assigned to 60 minutes of Tai Chi (10 modified forms from classic Yang style) or attention control (wellness education and stretching) twice weekly for 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score at 12 weeks. Secondary outcomes included WOMAC function, patient and physician global assessments, timed chair stand, depression index, self-efficacy scale, and quality of life. We repeated these assessments at 24 and 48 weeks. Analyses were compared by intent-to-treat principles. RESULTS: The 40 patients had a mean age of 65 years and a mean body mass index of 30.0 kg/m(2). Compared with the controls, patients assigned to Tai Chi exhibited significantly greater improvement in WOMAC pain (mean difference at 12 weeks -118.80 mm [95% confidence interval (95% CI) -183.66, -53.94; P = 0.0005]), WOMAC physical function (-324.60 mm [95% CI -513.98, -135.22; P = 0.001]), patient global visual analog scale (VAS; -2.15 cm [95% CI -3.82, -0.49; P = 0.01]), physician global VAS (-1.71 cm [95% CI -2.75, -0.66; P = 0.002]), chair stand time (-10.88 seconds [95% CI -15.91, -5.84; P = 0.00005]), Center for Epidemiologic Studies Depression Scale (-6.70 [95% CI -11.63, -1.77; P = 0.009]), self-efficacy score (0.71 [95% CI 0.03, 1.39; P = 0.04]), and Short Form 36 physical component summary (7.43 [95% CI 2.50, 12.36; P = 0.004]). No severe adverse events were observed. CONCLUSION: Tai Chi reduces pain and improves physical function, self-efficacy, depression, and health-related quality of life for knee OA.

PMID: 19877092 [PubMed - as supplied by publisher]

An investigation of brain processes supporting meditation.

Cogn Process. 2009 Oct 31;

Authors: Bærentsen KB, Stødkilde-Jørgensen H, Sommerlund B, Hartmann T, Damsgaard-Madsen J, Fosnæs M, Green AC

Meditation is an ancient spiritual practice, which aims to still the fluctuations of the mind. We investigated meditation with fMRI in order to identify and characterise both the "neural switch" mechanism used in the voluntary shift from normal consciousness to meditation and the "threshold regulation mechanism" sustaining the meditative state. Thirty-one individuals with 1.5-25 years experience in meditation were scanned using a blocked on-off design with 45 s alternating epochs during the onset of respectively meditation and normal relaxation. Additionally, 21 subjects were scanned during 14.5 min of sustained meditation. The data were analysed with SPM and ICA. During the onset of meditation, activations were found bilaterally in the putamen and the supplementary motor cortex, while deactivations were found predominately in the right hemisphere, the precuneus, the posterior cingulum and the parieto-temporal area. During sustained meditation, SPM analysis revealed activation in the head of nucleus caudatus. Extensive deactivations were observed in white matter in the right hemisphere, i.e. mainly in the posterior occipito-parieto-temporal area and in the frontal lobes. ICA identified 38 components including known baseline-resting state components, one of which not only overlaps with the activated area revealed in the SPM analysis but extends further into frontal, temporal, parietal and limbic areas, and might presumably constitute a combination of frontoparietal and cinguloopercular task control systems. The identified component processes display varying degrees of correlation. We hypothesise that a proper characterisation of brain processes during meditation will require an operational definition of brain dynamics matching a stable state of mind.

PMID: 19876663 [PubMed - as supplied by publisher]

Diaphragmatic Breathing Reduces Exercise-induced Oxidative Stress.

Evid Based Complement Alternat Med. 2009 Oct 29;

Authors: Martarelli D, Cocchioni M, Scuri S, Pompei P

Diaphragmatic breathing is relaxing and therapeutic, reduces stress, and is a fundamental procedure of Pranayama Yoga, Zen, transcendental meditation and other meditation practices. Analysis of oxidative stress levels in people who meditate indicated that meditation correlates with lower oxidative stress levels, lower cortisol levels and higher melatonin levels. It is known that cortisol inhibits enzymes responsible for the antioxidant activity of cells and that melatonin is a strong antioxidant; therefore, in this study, we investigated the effects of diaphragmatic breathing on exercise-induced oxidative stress and the putative role of cortisol and melatonin hormones in this stress pathway. We monitored 16 athletes during an exhaustive training session. After the exercise, athletes were divided in two equivalent groups of eight subjects. Subjects of the studied group spent 1 h relaxing performing diaphragmatic breathing and concentrating on their breath in a quiet place. The other eight subjects, representing the control group, spent the same time sitting in an equivalent quite place. Results demonstrate that relaxation induced by diaphragmatic breathing increases the antioxidant defense status in athletes after exhaustive exercise. These effects correlate with the concomitant decrease in cortisol and the increase in melatonin. The consequence is a lower level of oxidative stress, which suggests that an appropriate diaphragmatic breathing could protect athletes from long-term adverse effects of free radicals.

PMID: 19875429 [PubMed - as supplied by publisher]

Effect of tailored practice and patient care plans on secondary prevention of heart disease in general practice: cluster randomised controlled trial.

BMJ. 2009;339:b4220

Authors: Murphy AW, Cupples ME, Smith SM, Byrne M, Byrne MC, Newell J,

OBJECTIVE: To test the effectiveness of a complex intervention designed, within a theoretical framework, to improve outcomes for patients with coronary heart disease. DESIGN: Cluster randomised controlled multicentre trial. SETTING: General practices in Northern Ireland and the Republic of Ireland, regions with different healthcare systems. PARTICIPANTS: 903 patients with established coronary heart disease registered with one of 48 practices. INTERVENTION: Tailored care plans for practices (practice based training in prescribing and behaviour change, administrative support, quarterly newsletter), and tailored care plans for patients (motivational interviewing, goal identification, and target setting for lifestyle change) with reviews every four months at the practices. Control practices provided usual care. MAIN OUTCOME MEASURES: The proportion of patients at 18 month follow-up above target levels for blood pressure and total cholesterol concentration, and those admitted to hospital, and changes in physical and mental health status (SF-12). RESULTS: At baseline the numbers (proportions) of patients above the recommended limits were: systolic blood pressure greater than 140 mm Hg (305/899; 33.9%, 95% confidence interval 30.8% to 33.9%), diastolic blood pressure greater than 90 mm Hg (111/901; 12.3%, 10.2% to 14.5%), and total cholesterol concentration greater than 5 mmol/l (188/860; 20.8%, 19.1% to 24.6%). At the 18 month follow-up there were no significant differences between intervention and control groups in the numbers (proportions) of patients above the recommended limits: systolic blood pressure, intervention 98/360 (27.2%) v control, 133/405 (32.8%), odds ratio 1.51 (95% confidence interval 0.99 to 2.30; P=0.06); diastolic blood pressure, intervention 32/360 (8.9%) v control, 40/405 (9.9%), 1.40 (0.75 to 2.64; P=0.29); and total cholesterol concentration, intervention 52/342 (15.2%) v control, 64/391 (16.4%), 1.13 (0.63 to 2.03; P=0.65). The number of patients admitted to hospital over the 18 month study period significantly decreased in the intervention group compared with the control group: 107/415 (25.8%) v 148/435 (34.0%), 1.56 (1.53 to 2.60; P=0.03). CONCLUSIONS: Admissions to hospital were significantly reduced after an intensive 18 month intervention to improve outcomes for patients with coronary heart disease, but no other clinical benefits were shown, possibly because of a ceiling effect related to improved management of the disease. TRIAL REGISTRATION: Current Controlled Trials ISRCTN24081411.

PMID: 19875426 [PubMed - in process]