Pub Date : 2026-02-03DOI: 10.1016/j.ctim.2026.103325
Saleh A Alsanie, Fahad Saad Alhodieb, Moein Askarpour
Background: Ashwagandha (Withania somnifera), as an important herbal medicine, has been increasingly recognized for its role in mental health management, particularly in reducing stress and anxiety, and reflects the growing relevance of complementary and alternative medicine in addressing psychological well-being. The present study aims to investigate its effectiveness by pooling the evidence from existing randomized controlled trials (RCTs).
Methods: Major medical databases of PubMed, Scopus, and Web of Science Core Collection were searched. Eligible studies were included. Meta-analysis, meta-regression, non-linear dose-response analysis, and subgroup analyses were conducted. Standardized mean differences (SMDs) were calculated. P-values < 0.05 were considered as statistically significant. The study protocol was registered in the PROSPERO database (CRD420251073134).
Results: Twenty-two studies met the eligibility criteria and were included. Meta-analysis revealed that supplementation with ashwagandha significantly improves stress (SMD = -5.88; 95% CI: -8.15 to -3.60), depression (SMD = -5.68; 95% CI: -8.43 to -2.94), and anxiety (SMD = -6.87; 95% CI: -8.77 to -4.97). There was significant linear (coefficient = 0.005, P = 0.031) and non-linear (P-nonlinearity = 0.005) association between dosages of administered ashwagandha and stress levels.
Conclusion: Current evidence suggests that ashwagandha supplementation holds promising potential in alleviating symptoms of stress, anxiety, and depression. However, to strengthen these findings and translate them into clinical recommendations, well-designed, high-quality trials are still needed to address existing heterogeneity and to establish the most effective dosages and intervention durations.
{"title":"Effects of Ashwagandha (Withania somnifera) on Mental Health in Adults: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.","authors":"Saleh A Alsanie, Fahad Saad Alhodieb, Moein Askarpour","doi":"10.1016/j.ctim.2026.103325","DOIUrl":"https://doi.org/10.1016/j.ctim.2026.103325","url":null,"abstract":"<p><strong>Background: </strong>Ashwagandha (Withania somnifera), as an important herbal medicine, has been increasingly recognized for its role in mental health management, particularly in reducing stress and anxiety, and reflects the growing relevance of complementary and alternative medicine in addressing psychological well-being. The present study aims to investigate its effectiveness by pooling the evidence from existing randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>Major medical databases of PubMed, Scopus, and Web of Science Core Collection were searched. Eligible studies were included. Meta-analysis, meta-regression, non-linear dose-response analysis, and subgroup analyses were conducted. Standardized mean differences (SMDs) were calculated. P-values < 0.05 were considered as statistically significant. The study protocol was registered in the PROSPERO database (CRD420251073134).</p><p><strong>Results: </strong>Twenty-two studies met the eligibility criteria and were included. Meta-analysis revealed that supplementation with ashwagandha significantly improves stress (SMD = -5.88; 95% CI: -8.15 to -3.60), depression (SMD = -5.68; 95% CI: -8.43 to -2.94), and anxiety (SMD = -6.87; 95% CI: -8.77 to -4.97). There was significant linear (coefficient = 0.005, P = 0.031) and non-linear (P-nonlinearity = 0.005) association between dosages of administered ashwagandha and stress levels.</p><p><strong>Conclusion: </strong>Current evidence suggests that ashwagandha supplementation holds promising potential in alleviating symptoms of stress, anxiety, and depression. However, to strengthen these findings and translate them into clinical recommendations, well-designed, high-quality trials are still needed to address existing heterogeneity and to establish the most effective dosages and intervention durations.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103325"},"PeriodicalIF":3.5,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.1016/j.ctim.2026.103324
Larissa Régia da Fonsêca Marinho, Maria Eduarda de Araújo Ramos, Vinicius Dos Santos Lemos Pereira, Gabriel Pedro Duarte da Silva, Jucielly Ferreira da Fonseca, Silmara de Oliveira Silva, Kessya Dantas Diniz, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas
Objective: To map the scientific literature on the effects of auriculotherapy for managing anxiety in pregnant and postpartum women in health services.
Method: The review was conducted in June 2025 by two independent reviewers. A scope search was performed across the following databases: Scopus, LILACS (Latin American and Caribbean Health Sciences Literature), Web of Science, SciELO (Scientific Electronic Library Online), PubMed, Cochrane Library, the CAPES Catalog of Theses and Dissertations, SAGE Open, Wanfang Data, and the China National Knowledge Infrastructure. The review included full-text online manuscripts that addressed the research question, encompassing dissertations, theses, ministerial orders, guidelines, and scientific articles.
Results: The final sample consisted of 12 studies published between 2013 and 2025, with a peak in 2023 (25 %), originating from Brazil and Asia. The interventions predominantly used dark mustard seeds applied to the Shen Men and Anxiety acupoints. The State-Trait Anxiety Inventory (STAI) was the primary instrument for anxiety assessment. Most studies demonstrated a significant reduction in mean STAI scores and anxiety symptoms in pregnant and postpartum women following auriculotherapy. Key reported effects included decreased anxiety levels, reduced low back pain and fatigue, and improved sleep quality and energy levels.
Conclusion: Auriculotherapy shows beneficial effects for managing anxiety in pregnant and postpartum women, leading to enhanced well-being and reduced anxiety levels.
Implications: for the profession and/or patient care: Further research is necessary, particularly focusing on the postpartum period, to consolidate the evidence regarding the efficacy and safety of auriculotherapy in this population.
目的：整理有关卫生服务机构中听诊治疗妊娠和产后妇女焦虑效果的科学文献。方法：于2025年6月由两名独立评审员进行评审。在以下数据库中进行范围搜索：Scopus、LILACS（拉丁美洲和加勒比健康科学文献）、Web of Science、SciELO（科学电子图书馆在线）、PubMed、Cochrane图书馆、CAPES论文目录、SAGE Open、万方数据和中国国家知识基础设施。审查包括解决研究问题的全文在线手稿，包括学位论文，论文，部长命令，指导方针和科学文章。结果：最终样本包括2013年至2025年间发表的12项研究，2023年达到峰值（25%），来自巴西和亚洲。干预主要采用暗芥菜籽涂抹在沈门和焦虑穴。状态-特质焦虑量表（STAI）是评估焦虑的主要工具。大多数研究表明，在耳科治疗后，孕妇和产后妇女的平均STAI评分和焦虑症状显著降低。报告的主要效果包括降低焦虑水平，减轻腰痛和疲劳，改善睡眠质量和精力水平。结论：耳廓疗法对孕妇和产后妇女的焦虑有良好的控制作用，可以提高幸福感，降低焦虑水平。对专业和/或患者护理的启示：进一步的研究是必要的，特别是关注产后时期，以巩固关于耳穴治疗在这一人群中的有效性和安全性的证据。
{"title":"Effect of auriculotherapy on the management of anxiety in pregnant and postpartum women in health services: Scoping review.","authors":"Larissa Régia da Fonsêca Marinho, Maria Eduarda de Araújo Ramos, Vinicius Dos Santos Lemos Pereira, Gabriel Pedro Duarte da Silva, Jucielly Ferreira da Fonseca, Silmara de Oliveira Silva, Kessya Dantas Diniz, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas","doi":"10.1016/j.ctim.2026.103324","DOIUrl":"10.1016/j.ctim.2026.103324","url":null,"abstract":"<p><strong>Objective: </strong>To map the scientific literature on the effects of auriculotherapy for managing anxiety in pregnant and postpartum women in health services.</p><p><strong>Method: </strong>The review was conducted in June 2025 by two independent reviewers. A scope search was performed across the following databases: Scopus, LILACS (Latin American and Caribbean Health Sciences Literature), Web of Science, SciELO (Scientific Electronic Library Online), PubMed, Cochrane Library, the CAPES Catalog of Theses and Dissertations, SAGE Open, Wanfang Data, and the China National Knowledge Infrastructure. The review included full-text online manuscripts that addressed the research question, encompassing dissertations, theses, ministerial orders, guidelines, and scientific articles.</p><p><strong>Results: </strong>The final sample consisted of 12 studies published between 2013 and 2025, with a peak in 2023 (25 %), originating from Brazil and Asia. The interventions predominantly used dark mustard seeds applied to the Shen Men and Anxiety acupoints. The State-Trait Anxiety Inventory (STAI) was the primary instrument for anxiety assessment. Most studies demonstrated a significant reduction in mean STAI scores and anxiety symptoms in pregnant and postpartum women following auriculotherapy. Key reported effects included decreased anxiety levels, reduced low back pain and fatigue, and improved sleep quality and energy levels.</p><p><strong>Conclusion: </strong>Auriculotherapy shows beneficial effects for managing anxiety in pregnant and postpartum women, leading to enhanced well-being and reduced anxiety levels.</p><p><strong>Implications: </strong>for the profession and/or patient care: Further research is necessary, particularly focusing on the postpartum period, to consolidate the evidence regarding the efficacy and safety of auriculotherapy in this population.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103324"},"PeriodicalIF":3.5,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evidence suggests laser acupuncture (LA) may relieve pain and improve motor function in musculoskeletal disorders (MSDs), but the relationship between these outcomes is unclear.
Objectives
To (1) evaluate the effects of LA on pain and motor function outcomes in MSDs; (2) examine associations between pain modulation and motor function; and (3) explore the impact of treatment characteristics.
Methods
Ten databases were searched. Pooled effects were evaluated using Hedge’s g (g) through random-effects meta-analysis models, with subgroup analyses exploring heterogeneity (I2). Meta-regression was conducted to examine the influence of treatment characteristics and associations between pain and motor outcomes. GRADE approach assessed the certainty of evidence.
Results
Nineteen studies with 1816 participants were included. LA significantly reduced pain intensity (g = 0.59, I2 = 68 %, GRADE = low), improved physical function (g = 0.50, I2 = 67 %, GRADE = low), joint stiffness (g = −0.55, I2 = 31 %, GRADE = moderate) and increased range of motion (g = 0.76, I2 = 0 %, GRADE = moderate) but not walking speed (g = 0.38, I2 = 65 %, GRADE = low). Meta-regression showed that LA wavelength was significantly associated with pain relief (β = −3.77) and stiffness improvement (β = −3.07). However, pain relief was not associated with improvements in motor function.
Conclusions
LA offers a non-invasive and effective approach for pain management and motor function performance, with wavelength as a key moderator. Functional benefits appear independent of analgesia, suggesting a feasible alternative for patients unable to tolerate exercise-based rehabilitation.
{"title":"Effects of laser acupuncture on pain and motor function in musculoskeletal disorders: A systematic review and meta-analysis","authors":"Renming Liu , Aung Aung Kywe Moe , Zhen Zheng , Hamed Alanazi , Maryam Zoghi , Shapour Jaberzadeh","doi":"10.1016/j.ctim.2026.103323","DOIUrl":"10.1016/j.ctim.2026.103323","url":null,"abstract":"<div><h3>Background</h3><div>Evidence suggests laser acupuncture (LA) may relieve pain and improve motor function in musculoskeletal disorders (MSDs), but the relationship between these outcomes is unclear.</div></div><div><h3>Objectives</h3><div>To (1) evaluate the effects of LA on pain and motor function outcomes in MSDs; (2) examine associations between pain modulation and motor function; and (3) explore the impact of treatment characteristics.</div></div><div><h3>Methods</h3><div>Ten databases were searched. Pooled effects were evaluated using Hedge’s g (<em>g</em>) through random-effects meta-analysis models, with subgroup analyses exploring heterogeneity (<em>I</em><sup><em>2</em></sup>). Meta-regression was conducted to examine the influence of treatment characteristics and associations between pain and motor outcomes. GRADE approach assessed the certainty of evidence.</div></div><div><h3>Results</h3><div>Nineteen studies with 1816 participants were included. LA significantly reduced pain intensity (<em>g</em> = 0.59, <em>I</em><sup><em>2</em></sup> = 68 %, GRADE = low), improved physical function (<em>g</em> = 0.50, <em>I</em><sup><em>2</em></sup> = 67 %, GRADE = low), joint stiffness (<em>g</em> = −0.55, <em>I</em><sup><em>2</em></sup> = 31 %, GRADE = moderate) and increased range of motion (<em>g</em> = 0.76, <em>I</em><sup><em>2</em></sup> = 0 %, GRADE = moderate) but not walking speed (<em>g</em> = 0.38, <em>I</em><sup><em>2</em></sup> = 65 %, GRADE = low). Meta-regression showed that LA wavelength was significantly associated with pain relief (<em>β</em> = −3.77) and stiffness improvement (<em>β</em> = −3.07). However, pain relief was not associated with improvements in motor function.</div></div><div><h3>Conclusions</h3><div>LA offers a non-invasive and effective approach for pain management and motor function performance, with wavelength as a key moderator. Functional benefits appear independent of analgesia, suggesting a feasible alternative for patients unable to tolerate exercise-based rehabilitation.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103323"},"PeriodicalIF":3.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.ctim.2026.103319
Emna Boulares , Nicola Luigi Bragazzi , Tan Sabrina Chen Yin , Soo Jeung Choi , Jung Hwan Park , Dongwoon Han
Background
Herbal medicines (HM) use among type 2 diabetes mellitus (T2DM) patients has grown tremendously despite the existence of conventional treatments. However, evidence on their safety, potential side effects, and interactions remains scarce. This systematic review and meta-analysis aim to determine the global prevalence of HM use among T2DM patients and assess the safety and potential interactions.
Methods
A systematic search of four electronic databases was conducted until March 2024. Data were extracted and then assessed through an adapted quality appraisal tool. A meta-analysis estimated the pooled prevalence of HM use among T2DM patients and examined predictors of use. Identified herbs were classified based on safety and potential interactions with pharmacological treatments. The study followed PRISMA guidelines.
Results
Twenty-two cross-sectional studies from 19 countries were included. The global prevalence of HM use among T2DM patients was 53%, with significant regional variations. The highest prevalence of HM use among T2DM patients is in the African region, accounting for 39.8% of global HM use. Among 49 identified herbs, Opuntia ficus-indica L., Trigonella foenum graecum L., Allium sativum L., and Cinnamomum verum J. were the most commonly used. The safety classification reported 7 contraindicated herbs and 19 requiring caution, and 23 considered safe for use. Additionally, 12 herbs reported potential pharmacological interactions.
Conclusions
Although the use of HM is widespread globally, multiple herbs pose safety concerns. Therefore, to preserve patients’ safety, it is essential to avoid using contraindicated herbs and to seek healthcare practitioner supervision.
背景：尽管存在传统治疗方法，但2型糖尿病（T2DM）患者中草药（HM）的使用仍大幅增长。然而，关于它们的安全性、潜在副作用和相互作用的证据仍然很少。本系统综述和荟萃分析旨在确定T2DM患者使用HM的全球患病率，并评估其安全性和潜在的相互作用。方法：系统检索5个电子数据库，检索截止至2024年3月。提取数据，然后通过适应的质量评估工具进行评估。一项荟萃分析估计了T2DM患者中HM使用的总流行率，并检查了使用的预测因素。确定的草药根据安全性和与药物治疗的潜在相互作用进行分类。该研究遵循PRISMA指南。结果：纳入了来自19个国家的22项横断面研究。T2DM患者中HM使用的全球患病率为53%，具有显著的地区差异。2型糖尿病患者中HM使用率最高的地区是非洲地区，占全球HM使用率的39.8%。经鉴定的49种草本植物中，最常用的是榕树油桐（Opuntia ficus-indica L.）、梧桐（Trigonella Foenum Graecum L.）、葱（Allium sativum L.）和肉桂（Cinnamomum verum J.）。安全分类报告了7种禁忌症草药，19种需要注意，23种被认为是安全的。此外，12种草药报告了潜在的药理相互作用。结论：虽然HM在全球广泛使用，但多种草药存在安全问题。因此，为了保护患者的安全，必须避免使用禁忌症草药，并寻求保健医生的监督。
{"title":"Assessing the safety of herbal medicine use among type 2 diabetes mellitus patients: A systematic review and meta-analysis","authors":"Emna Boulares , Nicola Luigi Bragazzi , Tan Sabrina Chen Yin , Soo Jeung Choi , Jung Hwan Park , Dongwoon Han","doi":"10.1016/j.ctim.2026.103319","DOIUrl":"10.1016/j.ctim.2026.103319","url":null,"abstract":"<div><h3>Background</h3><div>Herbal medicines (HM) use among type 2 diabetes mellitus (T2DM) patients has grown tremendously despite the existence of conventional treatments. However, evidence on their safety, potential side effects, and interactions remains scarce. This systematic review and meta-analysis aim to determine the global prevalence of HM use among T2DM patients and assess the safety and potential interactions.</div></div><div><h3>Methods</h3><div>A systematic search of four electronic databases was conducted until March 2024. Data were extracted and then assessed through an adapted quality appraisal tool. A meta-analysis estimated the pooled prevalence of HM use among T2DM patients and examined predictors of use. Identified herbs were classified based on safety and potential interactions with pharmacological treatments. The study followed PRISMA guidelines.</div></div><div><h3>Results</h3><div>Twenty-two cross-sectional studies from 19 countries were included. The global prevalence of HM use among T2DM patients was 53%, with significant regional variations. The highest prevalence of HM use among T2DM patients is in the African region, accounting for 39.8% of global HM use. Among 49 identified herbs, <em>Opuntia ficus-indica L., Trigonella foenum graecum L.</em>, <em>Allium sativum L.</em>, and <em>Cinnamomum verum J</em>. were the most commonly used. The safety classification reported 7 contraindicated herbs and 19 requiring caution, and 23 considered safe for use. Additionally, 12 herbs reported potential pharmacological interactions.</div></div><div><h3>Conclusions</h3><div>Although the use of HM is widespread globally, multiple herbs pose safety concerns. Therefore, to preserve patients’ safety, it is essential to avoid using contraindicated herbs and to seek healthcare practitioner supervision.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103319"},"PeriodicalIF":3.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.ctim.2026.103320
Tie-Chun Zhang , Zhao-Liang Luo , Jing Yuan , Yu-Sha Liao , Min-Min Ruan , Ting-Ting Yang , Hao-Run Wang , Zi-Han Yin , Ling Zhao
Objective
This study aimed to evaluate the clinical efficacy of acupuncture in the treatment of limb motor dysfunction following ischemic stroke, and to assess the influence of acupuncture intervention type and treatment dosage on therapeutic outcomes.
Methods
We conducted comprehensive searches multiple databases (e.g., PubMed, Embase, Cochrane, CNKI) and clinical trial registries for studies published up to 10 December 2024. Limb motor function, assessed using the Fugl-Meyer Assessment, was evaluated as the primary outcome. Data analysis was performed using RevMan, ADDIS, and STATA, with reviewer consistency evaluated by the intra-class correlation coefficient.
Results
A total of 71 trials were included. The risk of bias assessment indicated 91.5 % of studies had some concerns. The pairwise meta-analyses indicated that the combination of acupuncture and conventional treatment was more effective than conventional treatment alone in improving limb motor dysfunction. The network meta-analysis further indicated that manual acupuncture combined with conventional treatment was the most effective acupuncture-based intervention for improving limb motor dysfunction. Meanwhile, among all acupuncture dose regimens, high-dose acupuncture plus conventional treatment was associated with the greatest therapeutic benefit. However, the GRADE evaluation showed that the certainty of the evidence ranged from low to critically low.
Conclusion
Acupuncture combined with conventional therapy enhances limb motor function recovery in patients after ischemic stroke. Manual acupuncture combined with conventional treatment, especially when employing higher-dose acupuncture protocols, may represent one of the most effective therapeutic approaches. Although the low certainty of evidence warrants cautious interpretation, these findings indicate a promising treatment strategy and identify key areas that require verification through subsequent rigorous studies.
{"title":"Clinical effect and contributing factors of acupuncture for limb motor dysfunction after ischemic stroke: A systematic review and exploratory network meta-analysis","authors":"Tie-Chun Zhang , Zhao-Liang Luo , Jing Yuan , Yu-Sha Liao , Min-Min Ruan , Ting-Ting Yang , Hao-Run Wang , Zi-Han Yin , Ling Zhao","doi":"10.1016/j.ctim.2026.103320","DOIUrl":"10.1016/j.ctim.2026.103320","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the clinical efficacy of acupuncture in the treatment of limb motor dysfunction following ischemic stroke, and to assess the influence of acupuncture intervention type and treatment dosage on therapeutic outcomes.</div></div><div><h3>Methods</h3><div>We conducted comprehensive searches multiple databases (e.g., PubMed, Embase, Cochrane, CNKI) and clinical trial registries for studies published up to 10 December 2024. Limb motor function, assessed using the Fugl-Meyer Assessment, was evaluated as the primary outcome. Data analysis was performed using RevMan, ADDIS, and STATA, with reviewer consistency evaluated by the intra-class correlation coefficient.</div></div><div><h3>Results</h3><div>A total of 71 trials were included. The risk of bias assessment indicated 91.5 % of studies had some concerns. The pairwise meta-analyses indicated that the combination of acupuncture and conventional treatment was more effective than conventional treatment alone in improving limb motor dysfunction. The network meta-analysis further indicated that manual acupuncture combined with conventional treatment was the most effective acupuncture-based intervention for improving limb motor dysfunction. Meanwhile, among all acupuncture dose regimens, high-dose acupuncture plus conventional treatment was associated with the greatest therapeutic benefit. However, the GRADE evaluation showed that the certainty of the evidence ranged from low to critically low.</div></div><div><h3>Conclusion</h3><div>Acupuncture combined with conventional therapy enhances limb motor function recovery in patients after ischemic stroke. Manual acupuncture combined with conventional treatment, especially when employing higher-dose acupuncture protocols, may represent one of the most effective therapeutic approaches. Although the low certainty of evidence warrants cautious interpretation, these findings indicate a promising treatment strategy and identify key areas that require verification through subsequent rigorous studies.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103320"},"PeriodicalIF":3.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.ctim.2026.103321
Nemanja Lakicevic , Marko Manojlovic , Elena Chichinina , Apollinaria Chursina , Kristina Tarasova , Ewan Thomas , Yuming Zhong , Antonino Bianco , Patrik Drid
Background
Optimizing physical fitness (PF) and developing executive functions (EFs) is of great importance in preschool children. The link between PF, obtained through repetitive physical activity, and EFs is gaining increasing attention in recent years and we sought to systematically search the literature on the relationship between PF and EFs in preschool children published in the last five years.
Methods
Web of Science, Scopus, and PubMed were databases searched for the relevant literature. Original studies written in English and published in peer-reviewed journals including healthy children aged 3–6 years who were simultaneously tested for PF and EFs were considered eligible. To ensure transparent and accurate reporting we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Investigation was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD420251072802).
Results
A total of 20 studies (n = 3117, age=4.9 ± 2.5 years) were included in the final analysis. Aerobic fitness was consistently associated with better EF outcomes. Body composition, muscle strength, and flexibility were not associated with aspects of EF. Agility, speed, and power were positively associated with the parameters of working memory. The dynamic component of balance was correlated with enhanced inhibitory control. The link between agility, speed, power, and the static component of balance with inhibitory control was quite inconsistent. Similarly, conflicting evidence was observed regarding the association between dynamic and static balance with working memory aspects.
Conclusion
Aerobic fitness appears to play a significant role in enhancing EF development while the relationship between other components of PF and EFs seems less clear. Kindergartens are uniquely positioned to nurture children, making them ideal for promoting the development PF and EF through intentional, play-based, and developmentally aligned experiences.
背景优化身体素质和发展执行功能在学龄前儿童中具有重要意义。近年来，通过重复体育活动获得的PF和ef之间的联系越来越受到关注，我们试图系统地检索近五年来发表的关于学龄前儿童PF和ef之间关系的文献。方法检索web of Science、Scopus、PubMed等数据库，检索相关文献。用英文撰写并发表在同行评议期刊上的原始研究，包括同时接受PF和EFs测试的3-6岁健康儿童，被认为符合条件。为了确保报告透明和准确，我们遵循了系统评价和荟萃分析（PRISMA）指南的首选报告项目。该研究已在国际前瞻性系统评价注册（PROSPERO）数据库（CRD420251072802）中前瞻性注册。结果共纳入20项研究（n = 3117，年龄=4.9 ± 2.5岁）。有氧适能始终与更好的EF结果相关。身体组成、肌肉力量和柔韧性与EF各方面无关。敏捷性、速度和力量与工作记忆参数呈正相关。平衡的动态成分与抑制控制增强相关。敏捷性、速度、力量和静态平衡与抑制控制之间的联系是不一致的。同样，关于动态和静态平衡与工作记忆方面的关系，也观察到相互矛盾的证据。结论有氧适能在促进EF发育中起重要作用，而其他成分与EF之间的关系尚不清楚。幼儿园在培养孩子方面具有独特的地位，通过有意的、以游戏为基础的、与发展相一致的体验，使幼儿园成为促进PF和EF发展的理想场所。
{"title":"Physical fitness and executive functions in early childhood: A systematic review of recent evidence","authors":"Nemanja Lakicevic , Marko Manojlovic , Elena Chichinina , Apollinaria Chursina , Kristina Tarasova , Ewan Thomas , Yuming Zhong , Antonino Bianco , Patrik Drid","doi":"10.1016/j.ctim.2026.103321","DOIUrl":"10.1016/j.ctim.2026.103321","url":null,"abstract":"<div><h3>Background</h3><div>Optimizing physical fitness (PF) and developing executive functions (EFs) is of great importance in preschool children. The link between PF, obtained through repetitive physical activity, and EFs is gaining increasing attention in recent years and we sought to systematically search the literature on the relationship between PF and EFs in preschool children published in the last five years.</div></div><div><h3>Methods</h3><div>Web of Science, Scopus, and PubMed were databases searched for the relevant literature. Original studies written in English and published in peer-reviewed journals including healthy children aged 3–6 years who were simultaneously tested for PF and EFs were considered eligible. To ensure transparent and accurate reporting we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Investigation was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD420251072802).</div></div><div><h3>Results</h3><div>A total of 20 studies (n = 3117, age=4.9 ± 2.5 years) were included in the final analysis. Aerobic fitness was consistently associated with better EF outcomes. Body composition, muscle strength, and flexibility were not associated with aspects of EF. Agility, speed, and power were positively associated with the parameters of working memory. The dynamic component of balance was correlated with enhanced inhibitory control. The link between agility, speed, power, and the static component of balance with inhibitory control was quite inconsistent. Similarly, conflicting evidence was observed regarding the association between dynamic and static balance with working memory aspects.</div></div><div><h3>Conclusion</h3><div>Aerobic fitness appears to play a significant role in enhancing EF development while the relationship between other components of PF and EFs seems less clear. Kindergartens are uniquely positioned to nurture children, making them ideal for promoting the development PF and EF through intentional, play-based, and developmentally aligned experiences.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103321"},"PeriodicalIF":3.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12DOI: 10.1016/j.ctim.2026.103322
Ana María Peraile-Huerta , Estela Jiménez-López , Valentina Díaz-Goñi , Tomás Olivo Martins-de-Passos , Fernando Peral-Martínez , Sandra Herráiz-Garrote , Ana Pérez-Moreno , Arthur Eumann Mesas , Bruno Bizzozero-Peroni
Objectives
To synthesize the available evidence on the effects of animal-assisted therapy on core symptom dimensions (including positive, negative, and general symptoms), specific symptom domains (including depression, anhedonia, anxiety, stress) and cognitive functioning in patients with psychotic spectrum disorders.
Methods
A systematic review and meta-analysis were conducted in accordance with the PRISMA and Cochrane Handbook for Systematic Reviews of Interventions guidelines. The PubMed, Cochrane Library, Web of Science and PsycINFO databases were searched from inception to June 2025 with no language restrictions. Experimental follow-up studies implementing animal-assisted therapy in patients with psychotic disorders were included. Pooled standardized mean differences (SMDs) with 95 % confidence intervals (CIs) were estimated using a random effects model. Heterogeneity was assessed with the I² statistic.
Results
A total of 12 studies (10 randomized controlled trials, a quasi-experimental controlled trial and a pre-post study) involving 408 patients (mean age range: 37.0–55.3 years; 32.6 % women) were included. Compared with control conditions, patients receiving animal-assisted therapy (predominantly dog-assisted) showed significantly greater pre-post improvements in negative symptoms (SMD = −0.51, 95 % CI: −0.95, −0.07; I2 = 45.2 %; n = 6). No significant effects were found for positive symptoms (SMD = −0.68, 95 % CI: −1.68, 0.32; I2 = 83.8 %; n = 6) or general symptoms (SMD = −0.08, 95 % CI: −0.86, 0.69; I2 = 72.5 %; n = 4). Sensitivity analyses restricted to dog-assisted interventions yielded similar effect estimates. Anxiety symptoms showed reductions but could not be synthesized quantitatively.
Conclusion
Animal-assisted therapy may help alleviate symptoms in patients with psychotic disorders, particularly by reducing negative symptoms. Further randomized controlled trials are needed to confirm these findings and clarify their clinical significance.
{"title":"Animal-assisted therapy in patients with psychotic disorders: A systematic review and meta-analysis","authors":"Ana María Peraile-Huerta , Estela Jiménez-López , Valentina Díaz-Goñi , Tomás Olivo Martins-de-Passos , Fernando Peral-Martínez , Sandra Herráiz-Garrote , Ana Pérez-Moreno , Arthur Eumann Mesas , Bruno Bizzozero-Peroni","doi":"10.1016/j.ctim.2026.103322","DOIUrl":"10.1016/j.ctim.2026.103322","url":null,"abstract":"<div><h3>Objectives</h3><div>To synthesize the available evidence on the effects of animal-assisted therapy on core symptom dimensions (including positive, negative, and general symptoms), specific symptom domains (including depression, anhedonia, anxiety, stress) and cognitive functioning in patients with psychotic spectrum disorders.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted in accordance with the PRISMA and Cochrane Handbook for Systematic Reviews of Interventions guidelines. The PubMed, Cochrane Library, Web of Science and PsycINFO databases were searched from inception to June 2025 with no language restrictions. Experimental follow-up studies implementing animal-assisted therapy in patients with psychotic disorders were included. Pooled standardized mean differences (SMDs) with 95 % confidence intervals (CIs) were estimated using a random effects model. Heterogeneity was assessed with the I² statistic.</div></div><div><h3>Results</h3><div>A total of 12 studies (10 randomized controlled trials, a quasi-experimental controlled trial and a pre-post study) involving 408 patients (mean age range: 37.0–55.3 years; 32.6 % women) were included. Compared with control conditions, patients receiving animal-assisted therapy (predominantly dog-assisted) showed significantly greater pre-post improvements in negative symptoms (SMD = −0.51, 95 % CI: −0.95, −0.07; I<sup>2</sup> = 45.2 %; n = 6). No significant effects were found for positive symptoms (SMD = −0.68, 95 % CI: −1.68, 0.32; I<sup>2</sup> = 83.8 %; n = 6) or general symptoms (SMD = −0.08, 95 % CI: −0.86, 0.69; I<sup>2</sup> = 72.5 %; n = 4). Sensitivity analyses restricted to dog-assisted interventions yielded similar effect estimates. Anxiety symptoms showed reductions but could not be synthesized quantitatively.</div></div><div><h3>Conclusion</h3><div>Animal-assisted therapy may help alleviate symptoms in patients with psychotic disorders, particularly by reducing negative symptoms. Further randomized controlled trials are needed to confirm these findings and clarify their clinical significance.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103322"},"PeriodicalIF":3.5,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.ctim.2026.103318
Maoqing Fu , Yifeng Zhang , Xiansheng Zhao , Shuai Wang , Zhongyang Xu , Kang Li , Chaoliang Lv
Background
Chronic nonspecific low back pain (NSLBP) imposes a substantial burden on individuals and healthcare systems globally. Although exercise therapy is a recommended first-line intervention, its implementation faces significant challenges. This study employed the Consolidated Framework for Implementation Research (CFIR) to systematically identify multi-level factors influencing the implementation of exercise interventions for NSLBP patients within the Chinese healthcare context.
Methods
A qualitative study design was utilized. Participants (n = 25) included spine surgeons, rehabilitation physicians, and patients with chronic NSLBP recruited from multiple hospitals in Jining, Shandong Province. A semi-structured interview guide, developed based on the CFIR framework, was used for data collection via face-to-face or telephone interviews. The CFIR comprises five overarching domains; however, the 'Process' domain was excluded from this study as it focused on pre-implementation factors. Data were analyzed using directed content analysis.
Results
The study identified 37 factors influencing implementation, mapped onto four CFIR domains. From the physician perspective (n = 18), 14 facilitators and 15 barriers were identified. Patient perspectives (n = 7) revealed 4 facilitators and 4 barriers across the same domains. Physicians acknowledged the cost-effectiveness and benefits of exercise therapy but highlighted challenges including the need for professional patient evaluation, lack of standardized protocols, insufficient insurance coverage, and limited surgeon engagement. Primary healthcare institutions expressed willingness to promote exercise therapy. Rehabilitation departments possessed advantages in facilities and expertise, while spine surgery departments faced shortages in resources, personnel, and training. At the individual level, perceptions, habits, and knowledge gaps among both physicians and patients significantly impacted implementation.
Conclusions
This CFIR-guided qualitative study elucidated salient barriers and facilitators influencing exercise therapy implementation for NSLBP in China. Consequently, healthcare policymakers and managers should prioritize revising relevant policies to mitigate identified barriers and amplify facilitators. Enhanced implementation is expected to improve quality of life for chronic back pain patients and lessen the societal burden.
{"title":"Barriers and facilitators to implementing exercise therapy for nonspecific low back pain in China: A qualitative study using the consolidated framework for implementation research (CFIR)","authors":"Maoqing Fu , Yifeng Zhang , Xiansheng Zhao , Shuai Wang , Zhongyang Xu , Kang Li , Chaoliang Lv","doi":"10.1016/j.ctim.2026.103318","DOIUrl":"10.1016/j.ctim.2026.103318","url":null,"abstract":"<div><h3>Background</h3><div>Chronic nonspecific low back pain (NSLBP) imposes a substantial burden on individuals and healthcare systems globally. Although exercise therapy is a recommended first-line intervention, its implementation faces significant challenges. This study employed the Consolidated Framework for Implementation Research (CFIR) to systematically identify multi-level factors influencing the implementation of exercise interventions for NSLBP patients within the Chinese healthcare context.</div></div><div><h3>Methods</h3><div>A qualitative study design was utilized. Participants (n = 25) included spine surgeons, rehabilitation physicians, and patients with chronic NSLBP recruited from multiple hospitals in Jining, Shandong Province. A semi-structured interview guide, developed based on the CFIR framework, was used for data collection via face-to-face or telephone interviews. The CFIR comprises five overarching domains; however, the 'Process' domain was excluded from this study as it focused on pre-implementation factors. Data were analyzed using directed content analysis.</div></div><div><h3>Results</h3><div>The study identified 37 factors influencing implementation, mapped onto four CFIR domains. From the physician perspective (n = 18), 14 facilitators and 15 barriers were identified. Patient perspectives (n = 7) revealed 4 facilitators and 4 barriers across the same domains. Physicians acknowledged the cost-effectiveness and benefits of exercise therapy but highlighted challenges including the need for professional patient evaluation, lack of standardized protocols, insufficient insurance coverage, and limited surgeon engagement. Primary healthcare institutions expressed willingness to promote exercise therapy. Rehabilitation departments possessed advantages in facilities and expertise, while spine surgery departments faced shortages in resources, personnel, and training. At the individual level, perceptions, habits, and knowledge gaps among both physicians and patients significantly impacted implementation.</div></div><div><h3>Conclusions</h3><div>This CFIR-guided qualitative study elucidated salient barriers and facilitators influencing exercise therapy implementation for NSLBP in China. Consequently, healthcare policymakers and managers should prioritize revising relevant policies to mitigate identified barriers and amplify facilitators. Enhanced implementation is expected to improve quality of life for chronic back pain patients and lessen the societal burden.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103318"},"PeriodicalIF":3.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.ctim.2025.103317
Chan-Young Kwon , Jiyoon Won , Boram Lee
Background
Diaphragmatic breathing (DB) is widely used clinically, but a comprehensive synthesis of randomized controlled trial (RCT) evidence on its health effects is lacking. This systematic review evaluated the health effects of DB interventions in adults based on RCT evidence.
Methods
Six electronic databases were searched through January 2025 for RCTs comparing DB to control conditions in adults. Two reviewers independently selected studies, extracted data, and assessed risk of bias (Cochrane RoB 2). A narrative synthesis was performed due to substantial heterogeneity across studies.
Results
We included 48 RCTs. DB protocols were highly heterogeneous, with parameters varying widely in breathing frequency (2–10 breaths/min), session duration (3–45 min), and total duration (single session to 12 weeks). Methodological quality was a significant concern (only 2.12 % of outcomes low risk of bias). Consistent benefits were found for gastroesophageal reflux disease (GERD) (including reduced medication use), anxiety, post-COVID-19 syndrome, and gestational diabetes). In healthy adults, DB showed acute cardiovascular benefits. However, evidence was inconsistent for chronic obstructive pulmonary disease, and DB was less effective than standard care after cardiac surgery. Safety was underreported (18.75 % of studies), but no serious adverse events were noted.
Conclusions
DB is a promising complementary therapy for specific conditions, including GERD, but the evidence base is constrained by methodologically weak and heterogeneous primary studies. Future research requires rigorous, standardized trial designs to establish its clinical value. Despite these limitations, DB is a low-cost, accessible, and apparently safe intervention for select conditions.
背景：横膈膜呼吸法（膈肌呼吸法）在临床上被广泛应用，但缺乏对其健康影响的综合随机对照试验（RCT）证据。本系统综述基于RCT证据评估了DB干预对成人健康的影响。方法：检索了截至2025年1月的6个电子数据库，以比较成人DB和对照条件的rct。两位审稿人独立选择研究、提取数据并评估偏倚风险（Cochrane RoB 2）。由于研究的异质性，我们进行了叙事综合。结果：我们纳入了48项随机对照试验。DB协议是高度异质性的，其参数在呼吸频率（2-10次/分钟）、疗程持续时间（3-45分钟）和总持续时间（单疗程至12周）方面变化很大。方法学质量值得关注（只有2.12%的结果存在低偏倚风险）。对胃食管反流病（GERD）（包括减少药物使用）、焦虑、covid -19后综合征和妊娠糖尿病)均有一致的益处。在健康成人中，DB显示急性心血管益处。然而，慢性阻塞性肺疾病的证据不一致，心脏手术后DB不如标准护理有效。安全性报告不足（18.75%的研究），但未发现严重不良事件。结论：DB是包括胃食管反流在内的特殊疾病的一种有希望的补充疗法，但证据基础受到方法学薄弱和异质性初步研究的限制。未来的研究需要严格、标准化的试验设计来确定其临床价值。尽管存在这些限制，但对于某些条件，DB是一种低成本、可访问且显然安全的干预方法。
{"title":"The health effects of diaphragmatic breathing: A systematic review","authors":"Chan-Young Kwon , Jiyoon Won , Boram Lee","doi":"10.1016/j.ctim.2025.103317","DOIUrl":"10.1016/j.ctim.2025.103317","url":null,"abstract":"<div><h3>Background</h3><div>Diaphragmatic breathing (DB) is widely used clinically, but a comprehensive synthesis of randomized controlled trial (RCT) evidence on its health effects is lacking. This systematic review evaluated the health effects of DB interventions in adults based on RCT evidence.</div></div><div><h3>Methods</h3><div>Six electronic databases were searched through January 2025 for RCTs comparing DB to control conditions in adults. Two reviewers independently selected studies, extracted data, and assessed risk of bias (Cochrane RoB 2). A narrative synthesis was performed due to substantial heterogeneity across studies.</div></div><div><h3>Results</h3><div>We included 48 RCTs. DB protocols were highly heterogeneous, with parameters varying widely in breathing frequency (2–10 breaths/min), session duration (3–45 min), and total duration (single session to 12 weeks). Methodological quality was a significant concern (only 2.12 % of outcomes low risk of bias). Consistent benefits were found for gastroesophageal reflux disease (GERD) (including reduced medication use), anxiety, post-COVID-19 syndrome, and gestational diabetes). In healthy adults, DB showed acute cardiovascular benefits. However, evidence was inconsistent for chronic obstructive pulmonary disease, and DB was less effective than standard care after cardiac surgery. Safety was underreported (18.75 % of studies), but no serious adverse events were noted.</div></div><div><h3>Conclusions</h3><div>DB is a promising complementary therapy for specific conditions, including GERD, but the evidence base is constrained by methodologically weak and heterogeneous primary studies. Future research requires rigorous, standardized trial designs to establish its clinical value. Despite these limitations, DB is a low-cost, accessible, and apparently safe intervention for select conditions.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103317"},"PeriodicalIF":3.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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