Complementary therapies in medicine最新文献

Background: Dyadic Tai Chi interventions are increasingly employed for care recipient-caregiver dyads, improving safety, benefits, and interpersonal connections. However, research shows considerable heterogeneity in defining and implementing caregiver roles and engagement, highlighting the need for clearer standards to support evidence-based practice.

Objective: To review and clarify the roles and engagement levels of caregivers during dyadic Tai Chi interventions.

Methods: A scoping review was conducted following the methodological framework and reported per PRISMA-ScR guidelines. Systematic search was performed across nine databases (PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, Embase, PsycINFO, Google Scholar, CNKI, and WanFang).

Results: Of the 20 articles included, more than one third (35%, n = 7) failed to define caregivers or specify inclusion criteria. Where specified, criteria commonly included age restrictions, active caregiving roles, cognitive competence, cohabitation/frequent contact, and primary family caregiver status. Family caregivers were the most common type (70%, n = 14), followed by unpaid (20%, n = 4) and paid caregivers (10%, n = 2). Their roles varied substantially, including active co-designing practice regimens, monitoring adherence and ensuring safety, and assisting with data collection. Key attributes of dyadic Tai Chi interventions included the mode of task execution (dyadic co-execution), varying caregiver engagement (passive presence, parallel engagement, and interactive engagement), and target populations: care recipients (55%, n = 11), dyads (40%, n = 8), and caregivers only (5%, n = 1).

Conclusion: The findings clarify caregivers' roles and engagement levels during dyadic Tai Chi interventions. The observed heterogeneity highlights the complexity and dynamic attributes, indicating a greater standardization in future research.

Background: Adolescents and young adults (AYA) with diabetes experience significant biopsychosocial burden linked to hormonal shifts, HPA‑axis dysregulation, autonomic imbalance, metainflammation, and socio‑emotional stress, with heightened challenges among marginalized populations and those with "double diabetes." This pilot evaluated the feasibility of an eight‑week integrative, chakra‑informed yoga program for AYA with type 1 or type 2 diabetes and included caregiver assessments to explore preliminary multidomain outcomes.

Objective: To assess feasibility and explore preliminary psychological, physiological, relational, and biomarker changes following a developmentally attuned Kundalini yoga program for AYA with diabetes and their caregivers.

Methods: A prospective, single‑arm pilot delivered weekly 90‑minute sessions integrating chakra‑aligned movement, breathwork, mantra, mudras, meditation, journaling, and peer dialogue. Psychological indicators, stress‑regulation markers, relational measures, inflammatory and cardiometabolic biomarkers, glycemic indices, and anthropometrics were collected pre‑intervention, post‑intervention, and three‑month follow‑up. Within‑subject changes were assessed using Wilcoxon signed‑rank tests and Friedman tests.

Results: Thirteen AYA (mean age 17.9 ± 1.8 years; 77% Black/African American; 92% type 1 diabetes) and 12 caregivers completed all assessments. Feasibility was high (attendance 84%; retention 100%). Adolescent diabetes distress decreased pre‑to‑post (p < 0.05); caregiver distress decreased pre‑to‑post and at follow‑up (p < 0.01). Adolescent perceived stress (p = 0.03) and serum cortisol (p = 0.02) declined across timepoints. Total cholesterol (p = 0.01) and LDL (p = 0.01) also decreased.

Conclusions: This single‑group pilot supports feasibility and was associated with improvements in psychological distress, stress‑regulation markers, and cardiometabolic indices. Larger controlled trials are warranted to evaluate potential additive benefits alongside standard diabetes care.

Background: Baduanjin exercise has shown promise in improving symptoms in patients with fibromyalgia syndrome (FMS), though existing studies are often limited by small sample sizes and a reliance on subjective measures. More robust evidence is needed to further establish its clinical benefits.

Objectives: To evaluate the effects of Baduanjin exercise on disease impact, pain, sleep quality, fatigue, and muscle activation in patients with FMS, using both subjective and objective measures.

Methods: This assessor-blinded, two-arm randomized controlled trial was conducted at a university-affiliated hospital in Changchun. Adults with a formal diagnosis of FMS were randomly assigned (1:1) to Baduanjin group or control group. The Baduanjin group engaged in 30 min of supervised Baduanjin exercise daily for 4 weeks, while the control group received standard therapy for the same duration. Assessments were conducted at baseline, week 4, and week 8. The primary outcome was the change in Fibromyalgia Impact Questionnaire (FIQR) score. Secondary outcomes included Visual Analog Scale (VAS), Widespread Pain Index (WPI), Pittsburgh Sleep Quality Index (PSQI), and Multidimensional Fatigue Inventory (MFI-20). Surface electromyography (sEMG) was used as an exploratory measure of muscle activation, quantified by the root mean square (RMS) of the signal. Analyses followed the intention-to-treat principle.

Results: Seventy-four participants (mean [SD] age, 47.96 [9.54] years; 41 [55.41%] female) were randomized to the Baduanjin (n = 37) and control (n = 37) groups. At week 4, the Baduanjin group showed a significant improvement in disease impact (FIQR; MD, -4.49 points; P = 0.005), muscle activation (sEMG RMS; MD, +24.9 μV left, +26.4 μV right; P = 0.014 and P = 0.038), pain intensity (VAS; MD, -0.78 points; P = 0.037), pain extent (WPI; MD, -1.91 points; P < 0.001), sleep quality (PSQI; MD, -1.65 points; P = 0.001), and fatigue (MFI-20; MD, -4.74 points; P = 0.001) compared with the control group. At week 8, between-group differences in pain intensity and disease impact were no longer significant, but improvements in pain extent, sleep quality and fatigue persisted in the Baduanjin group. Mild adverse events were reported in both groups, with no serious adverse events.

Conclusions: Baduanjin exercise is a safe and effective non-pharmacological intervention that provides short-term improvements in overall disease burden and multidimensional symptoms in FMS, supporting its use as a complementary mind-body strategy in clinical management.

Trial registration: ITMCTR2025001832.

Background: Dementia is a multi-domain disorder syndrome characterized by progressive cognitive decline. At present, there is insufficient evidence regarding the efficacy and safety of animal-assisted therapy for dementia. This study aims to identify, describe, evaluate, and summarize the currently available controlled trial evidence on animal-assisted therapy for dementia, using an evidence map to identify evidence gaps.

Methods: The system searched 9 databases (PubMed, EMBASE, Cochrane Library, Clinical Key, Web of Science, CNKI, Wanfang, CQVIP, and SinoMed) from the time of inception to December 18, 2024. Randomized controlled trials (RCTs) on animal-assisted therapy for dementia or its complications were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool. A bubble plot evidence map was developed to visually summarize evidence across predefined dimensions (e.g., intervention type, outcome domain, effect direction, and study quality). Existing systematic reviews were consulted for background/context only.

Results: A total of 36 RCTs met the inclusion criteria. Many published RCTs had limitations such as suboptimal study design and small sample sizes, resulting in concerns about risk of bias and heterogeneity. The evidence map suggests that AAT may improve neuropsychiatric symptoms and selected patient-centered outcomes (e.g., quality of life and functional independence); however, findings varied across outcomes.

Conclusion: Evidence suggests Animal-assisted therapy may improve neuropsychiatric symptoms and some patient-centered outcomes in dementia, but study quality is low and heterogeneity high; findings should be interpreted cautiously and confirmed in well-designed, adequately powered trials.