The journal of alternative and complementary medicine : research on paradigm, practice, and policy
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J Altern Complement Med · Apr 2020
Randomized Controlled TrialEffects of Short Wave Diathermy Added on Dextrose Prolotherapy Injections in Osteoarthritis of the Knee.
Objective: To show the effects of short wave diathermy (SWD) added on prolotherapy injections in osteoarthritis (OA) of the knee on pain, physical functioning, and quality of life. Design: This is a single-blinded randomized controlled study. Setting: Physical Medicine and Rehabilitation Department of a university hospital. ⋯ Conclusions: This study shows that prolotherapy is effective for pain, functionality, and quality of life in patients with OA of the knee. The effects of additional SWD require more evidence. More studies of higher quality are required to make a statement.
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J Altern Complement Med · Apr 2020
Randomized Controlled TrialPreliminary Efficacy of a Brief Mindfulness Intervention for Procedural Stress in Medical Intern Simulated Performance: A Randomized Controlled Pilot Trial.
Objectives: Simulation-based mastery learning (SBML) programs have been shown to be beneficial to improve procedural skill acquisition. However, simulated procedure performance can be affected by a host of factors, including stress. This investigation examined the preliminary efficacy of bolstering an established SBML program for medical residents with a brief mindfulness intervention (called a PITSTOP) to reduce procedural stress and improve simulator performance. Design: The study employed a partially blinded, parallel-group, randomized, repeated-measures intention-to-treat design. ⋯ PGY 1 participants were randomly assigned to the PITSTOP intervention (12-min PITSTOP mindfulness training video) or control group (12-min control video on ways to increase physical activity) before the SBML pretest. Outcome measures: The primary outcome was a comparison of each group's simulator performance during pre- and post-tests. Secondary outcomes were changes in groups' procedural stress during these tests (assessed using self-reported, instructor-rated, and physiologic indicators), and self-reported self-regulation outcomes. Results: Residents who watched the PITSTOP video before their SBML training made fewer procedural errors relative to controls during their pretest for intrajugular CVC insertion (p = 0.03). PITSTOP participants also had lower heart rate (p = 0.03) and less visible trembling (p = 0.003) relative to controls at the post-test. Conclusions: This study provides preliminary evidence that a brief, mindfulness intervention may reduce stress during SBML training.
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J Altern Complement Med · Mar 2020
Randomized Controlled TrialThalamic Gamma Aminobutyric Acid Level Changes in Major Depressive Disorder After a 12-Week Iyengar Yoga and Coherent Breathing Intervention.
Objective: To determine if a 12-week yoga intervention (YI) was associated with increased gamma aminobutyric acid (GABA) levels and decreased depressive symptoms in participants with major depressive disorder (MDD). Methods : Subjects were randomized to a high-dose group (HDG) of three YIs a week and a low-dose group (LDG) of two YIs a week. Thalamic GABA levels were obtained using magnetic resonance spectroscopy at Scan-1 before randomization. After the assigned 12-week intervention, Scan-2 was obtained, immediately followed by a YI and Scan-3. ⋯ Post hoc, participants were divided into two groups based on having an increase in GABA levels at Scan-2. Increases in Scan-2 GABA levels were observed in participants whose mean time between their last YI and Scan-2 was 3.93 ± 2.92 standard deviation (SD) days, but not in those whose mean time between their last YI and Scan-2 was 7.83 ± 6.88 SD. Conclusions: This study tentatively supports the hypothesis that one of the mechanisms through which yoga improves mood is by increasing the activity of the GABA system. The observed increase in GABA levels following a YI that was no longer observed 8 days after a YI suggests that the associated increase in GABA after a YI is time limited such that at least one YI a week may be necessary to maintain the elevated GABA levels.
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J Altern Complement Med · Oct 2019
Observational StudyPrevalence and Characteristics of Chronic Spinal Pain Patients with Different Hopes (Treatment Goals) for Ongoing Chiropractic Care.
Objectives: The treatment goals of patients successfully using ongoing provider-based care for chronic spinal pain can help inform health policy related to this care. Design: Multinomial logistical hierarchical linear models were used to examine the characteristics of patients with different treatment goals for their ongoing care. Settings/Location: Observational data from a large national sample of patients from 125 chiropractic clinics clustered in 6 U. S. regions. Subjects: Patients with nonwork-injury-related nonspecific chronic low-back pain (CLBP) and chronic neck pain (CNP). Interventions: All were receiving ongoing chiropractic care. Outcome measures: Primary outcomes were patient endorsement of one of four goals for their treatment. Explanatory variables included pain characteristics, pain beliefs, goals for mobility/flexibility, demographics, and other psychological variables. Results: Across our sample of 1614 patients (885 with CLBP and 729 with CNP) just under one-third endorsed a treatment goal of having their pain go away permanently (cure). ⋯ In univariate analysis across these goals, patients differed significantly on almost all variables. In the multinomial logistic models, a goal of cure was associated with shorter pain duration and more belief in a medical cure; a goal of preventing pain from coming back was associated with lower pain levels; and those with goals of preventing their pain from getting worse or temporarily relieving pain were similar, including in having their pain longer. Conclusions: Although much of health policy follows a curative model, the majority of these CLBP and CNP patients have goals of pain management (using ongoing care) rather than "cure" (care with a specific end) for their chiropractic care. This information could be useful in crafting policy for patients facing provider-based nonpharmacologic care for chronic pain.