Journal of Integrative and Complementary Medicine最新文献

Background: We recently developed and established the feasibility of the first mind-body program aiming to prevent persistent concussion symptoms among young adults with anxiety - the Toolkit for Optimal Recovery after Concussion (TOR-C) and an active health education control (HE-C). Both interventions demonstrated preliminary improvements between baseline and post-intervention in outcomes including post-concussion symptoms, physical function, and anxiety. Here, we report on these outcomes 3 months post-intervention. Methods: Fifty young adults (ages 18-35) with a recent concussion (3-10 weeks) and anxiety (≥5 on GAD-7) were randomized to TOR-C (n = 25) or HE-C (n = 25). Participants completed measures of concussion symptoms (PCSS), anxiety (GAD-7), and physical function (WHODAS 2.0) at baseline (pre-randomization), post-intervention, and 3 months post-intervention. We used mixed-model ANOVA with a shared baseline to adjust for baseline differences and assessed within-group changes in these outcomes from baseline to 3 months. Results: Preliminary improvements in concussion symptoms from baseline to 3 months post-intervention were statistically significant in both groups, but clinically meaningful (i.e., exceeding the Minimal Clinically Important Difference) only for TOR-C. Baseline versus 3-month follow-up improvements in physical function and anxiety were statistically significant and clinically meaningful for both groups. Conclusions: Findings provide preliminary evidence that TOR-C may help improve post-concussion recovery, and support a future fully-powered trial to establish the efficacy and sustained effects of TOR-C versus HE-C.

Objective: To explore the acceptability of an 8-week, telehealth, group-based, mindful exercise intervention in individuals with knee osteoarthritis (OA). Methods: This qualitative study was nested within a randomized controlled trial (N = 40) comparing a mindful exercise intervention to an exercise-only control group. Thirteen participants from the mindful exercise arm were individually interviewed remotely using HIPAA-compliant Zoom. Interviews were guided by the Theoretical Framework of Acceptability (TFA). The transcripts were analyzed using an inductive thematic approach, and the identified themes were mapped onto TFA constructs to determine factors related to the intervention's acceptability. Results: Eight key themes were identified as follows: (1) Openness to Alternative Treatments for Knee Pain, (2) Challenges with Exercise and Equipment, (3) Varied Perceptions of Mindfulness, (4) Mindfulness was Enjoyable but Challenging, (5) Integration of Mindfulness with Exercise Varied by Exercise Type, (6) Perceived Impact of Intervention was Physical and Psychological, (7) Group Telehealth Format Enhanced Intervention Acceptability, and (8) 2-H Time Commitment was Challenging. Mapping these themes onto the constructs of the TFA highlighted factors that influenced the acceptability of the mindful exercise intervention. These included enjoyment in practicing mindfulness especially when integrated with familiar exercises, the 8-week intervention length, and convenience of the group and telehealth aspects of the intervention. Participants encountered challenges with the 2-h weekly time, exercise equipment, learning and practicing mindfulness independently, and absence of alternative formats (e.g., hybrid or self-guided options). Conclusion: The mindful exercise intervention was generally acceptable to people with knee OA. However, to enhance acceptability, modifications may be needed, such as adjusting the exercise types and equipment, providing additional support for learning and practicing mindfulness, and offering greater flexibility in session format, timing, and duration. These insights are valuable for developing more effective, patient-centered, mindfulness-based exercise interventions for individuals with knee OA.

Introduction: The use of traditional, complementary, and integrative medicine (TCIM) has grown rapidly worldwide. The aim of this umbrella review is to provide a comprehensive synthesis of the available evidence on factors associated with TCIM use to identify the most influential factor driving the use of TCIM. This review was guided by the following research question: What is the most influential factor driving TCIM use? Methods: This review was conducted in accordance with PRISMA guidelines. International literature was systematically searched using PubMed, Embase, and manual searching of reference lists. The search was limited to peer-reviewed systematic literature reviews published between January 2005 to March 2024, in Arabic and English languages, and reported empirical research findings on factors associated with TCIM use. Results: A total of 62 review articles were included. The following five prominent factors were identified and critically analyzed: Socioeconomic status; dissatisfaction with conventional medicine; internal locus of control; being holistic, natural, and safe; and perceived usefulness. Of these, perceived usefulness, defined as the perceived benefits of a TCIM modality in meeting specific health needs or goals, was the most influential factor driving TCIM use. Discussion: The findings of this umbrella review revealed that individuals would not use a specific type of TCIM unless they perceived some benefit from its use, even if the benefit lacked supporting scientific evidence. This insight provides a foundation for researchers, health practitioners, and policymakers to advance TCIM research, clinical practice, and policy by targeting its perceived benefits. Focusing on perceived benefits can help researchers prioritize areas that are most valued by patients, leading to more impactful studies and evidence-based recommendations for practice. Understanding perceived benefits can also lead to more informed discussions between patients and health practitioners, creating a more collaborative and culturally sensitive health care environment. Furthermore, addressing perceived benefits can guide regulations to ensure the safe, effective, and ethical use of TCIM practices, leading to more effective integration of TCIM into conventional medicine as the evidence of its usefulness accumulates.

Background: Evidence regarding the optimal dosage of forest therapy is limited. The aim of this study was to compare the effects of two dosages of standardized forest therapy sessions on participant-reported outcomes in the general population. This study also explored whether these effects depended on a specific forest location. Methods: In this randomized controlled multisite trial taking place in three different German forests, participants of the general population were assigned to either a two-session group (2SG) of forest therapy of 2 h each with a break-day in between or three consecutive sessions (3SG) of forest therapy of 2 h each. The primary outcome was the between-group difference of 2SG versus 3SG of forest therapy on Total Mood Disturbance (TMD) using the Profile of Mood States (POMS) at day 3, immediately postintervention. Secondary outcomes were vitality (SVS-G), self-efficacy (GSE), physical/mental health (PH/MH), anxiety (STAI), physical symptoms (BLR/BLR'), perceived stress (PSQ), and perceived benefits of nature (PBNQ). A subset of questionnaires was used before and after each session (POMS, STAI, SVS-G, and PSQ). Pre- and postintervention differences were computed for comparisons within each group and between them using t test statistics, while analysis of variance (ANOVA) tested for differences between forests. Results: One hundred and seventy-one participants (91 in 2SG and 80 in 3SG; 56.1 ± 14.5 years) were included in the intention-to-treat analysis. No significant group differences were found for the TMD (p = 0.99), although there was an overall improvement in both groups (TMD: within-group p < 0.001 for both, 2SG: d = 0.95, 3SG: d = 0.81). No significant group differences were found for any secondary outcomes, although significant improvements were seen within groups for most outcomes. The ANOVA revealed neither statistically significant interactions between the three forests nor statistically significant interactions between the factors "group" and "location" for TMD. Conclusions: Participation in two versus three sessions of standardized forest therapy sessions with 2 h each may have similar beneficial effects on physical/mental health parameters in the general population. A low-dose approach may already achieve beneficial effects on mental health. These findings can provide evidence for the possible implementation of forest therapy as a therapy form in Germany.

Aim: This study was conducted to evaluate the effect of laughter yoga on blood glucose levels, disease perception, and perceived stress levels in patients with type 2 diabetes. Methods: The research is a randomized controlled trial with pretest-post-test control group. The population of the study was followed up with the diagnosis of type 2 diabetes mellitus (T2DM) in the endocrine outpatient clinics of a hospital in the western region of Turkey. The sample consisted of 100 patients (laughter yoga group = 50, control group = 50) determined by power analysis. Participants were assigned to each group through a process of simple randomization. Those in the laughter yoga group (LYG) participated in online eight laughter yoga sessions together with a diet program. The following statistical methods were used to evaluate data: percentage, mean and standard deviation, chi-square, independent-sample t test, and paired sample t test. Data collection was facilitated using a "Patient Identification Form," "The Brief Disease Perception Scale," and "The Perceived Stress Scale." Results: It was determined that the descriptive characteristics of the patients in the experimental and control groups were similar. According to the primary outcome, the postprandial blood glucose level of the patients in the LYG was (mean ± standard deviation [SD]: 98.17 ± 18.71) in the pretest; it decreased to (mean ± SD: 75.15 ± 9.65) in the post-test, and this difference was statistically significant (p < 0.001, effect size d: 1.628). While the mean blood glucose level of the patients in the control group was (mean ± SD: 102.17 ± 16.50) in the pretest, it increased to (Mean ± SD: 139.08 ± 15.65) in the post-test and this difference was statistically significant (p < 0.001, effect size d: 2.295). While the mean score of the Brief Disease Perception Scale post-test was (mean ± SD: 33.50 ± 4.51) points in the experimental group, it was (mean ± SD: 53.70 ± 4.15) points in the control group and the difference between them was statistically significant (p < 0.001). It was determined that the Perceived Stress Scale post-test mean score was (mean ± SD: 21.50 ± 4.54) points in the experimental group and (mean ± SD: 32.70 ± 4.15) points in the control group, and the difference between the groups was statistically significant (p < 0.001). It was determined that the negative illness perceptions and stress levels of the patients who applied laughter yoga were significantly reduced. Conclusion: Laughter yoga was found to reduce postprandial blood glucose levels, improve disease perception, and reduce stress levels in patients with T2DM.

Background: Although concussion symptoms often resolve within 4-6 weeks, for a minority of patients, persistent postconcussion symptoms (PPCS), such as headaches, fatigue, and mood disturbances, may continue for months or years following a head injury. Rehabilitation of this group-often female-is crucial for reducing health and gender disparities in concussion recovery. A recent report by the National Center for Complementary and Integrative Health showed that the use of complementary health approaches, such as yoga and meditation, has substantially increased in the last two decades. Little is known, however, about the acceptability of these approaches among female patients with concussion, who are most vulnerable to PPCS. This study evaluates the acceptability of a brain-injury-tailored yoga and meditation program for female patients with concussion. Methods: We conducted a cross-sectional survey of women in PINK Concussions, a social media support network for female patients with concussion. Along with demographic and concussion-related questions, participants were asked to elaborate on their interest/lack of interest. Data were analyzed subjectively using thematic analysis of open-text responses and objectively by text network analysis. Results: A total of 434 PINK Concussion members responded to the survey conducted from November 10 to 13, 2023, with 117 (27%) completing all questions. A majority (n = 97; 83%) expressed interest in the program, for reasons including prior yoga experience (n = 30), health/well-being benefits (n = 27), and balance/healing/mindfulness (n = 23). For participants who were not interested (n = 14; 12%), reasons included physical disabilities (n = 6), time constraints (n = 3), and enrollment in similar programs (n = 5). The text network analysis showed the central reason for participants' interest was "help," with connections to "exercise," "physical health," "mental health," "improving balance," and "feeling great." Conclusions: Most female patients with concussion in the PINK Concussion group were interested in a brain-injury-tailored yoga and meditation program, suggesting high acceptability for this group of patients with chronic concussion sequelae.

Objectives: This scoping review provides an overview of the current evidence base for trauma-informed yoga (TIY) for survivors of sexual, domestic, and interpersonal violence to document the spectrum of study designs, population and intervention characteristics, and associated results of TIY for trauma survivors. Methods: Authors utilized the scoping review methodology outlined by Arksey and O'Malley (2005). Pubmed and Scopus were searched initially conducted on August 16, 2022, and updated to include any new studies on March 25, 2025. Data extracted included study design, population characteristics, intervention specifics, and results. Authors devexbvgloped an innovative mnemonic to inform discussion of results: WELLNESS: Well-being; Empathy; Longevity (durability of therapeutic effect); Lessen trauma symptoms; Nurturing (self-compassion), Ease stress, Security, and Self-awareness). Results: The combined initial and updated literature searches yielded 4167 studies. Title and abstract screening netted 35 studies meeting review criteria. Full-text review netted 18 studies meeting criteria. Sexual, interpersonal, and domestic violence survivors who participated in TIY reported enhancement of physical and psychological function and well-being. Effects included increased sense of safety, self-compassion, personal growth, and self-regulation. Studies reported reduced depression, anxiety, negative thoughts, stress and trauma symptoms, and increased self-esteem; positive coping; improved relationships, better sleep and enhanced mindfulness; and sense of peace. Conclusion: TIY is beneficial to survivors of sexual, domestic, and interpersonal violence by promoting peaceful embodiment without retraumatization and enhancing affect regulation to decrease reactivity and agitation. The constellation of effects can improve the sequelae of trauma, and survivors may benefit from long-term TIY programming to ensure more robust improvement.

Purpose: This study evaluates the performance of large language models (LLMs) in the context of the Chinese National Traditional Chinese Medicine Licensing Examination (TCMLE). Materials and Methods: We compared the performances of different versions of Generative Pre-trained Transformer (GPT) and Enhanced Representation through Knowledge Integration (ERNIE) using historical TCMLE questions. Results: ERNIE-4.0 outperformed all other models with an accuracy of 81.7%, followed by ERNIE-3.5 (75.2%), GPT-4o (74.8%), and GPT-4 turbo (50.7%). For questions related to Western internal medicine, all models showed high accuracy above 86.7%. Conclusion: The study highlights the significance of cultural context in training data, influencing the performance of LLMs in specific medical examinations.