Background: Green Care therapies were developed in the late 20th century as nature-based interventions aimed at supporting recovery for individuals with mental and physical health challenges. Animal-assisted therapy with farm animals (AATF), a branch of Green Care, involves engaging individuals with farm animals in natural settings to promote healing. Previous studies have shown the benefits of animal-assisted therapies (AAT) for individuals with traumatic brain injury (TBI), suggesting AATF could offer similar advantages. This study aimed to examine the impact of an AATF program using domesticated ducks as therapeutic companions for individuals with TBI. Objective: The primary objective was to explore how individuals with TBI perceive their participation in an AATF-based therapeutic intervention. Methods: The study involved a 12-week AATF program, with semi-structured interviews conducted postintervention to capture participants' experiences. A qualitative descriptive approach with atheoretical thematic analysis was employed to identify key themes from the data. Results: Four key themes were developed from the analysis: Emotional Wellbeing, Attachment, Care, and Nature and Environment. These themes reflected participants' shared experiences and highlighted the perceived benefits of AATF in TBI rehabilitation. Conclusion: This study presents AATF, specifically involving domesticated ducks, as an innovative therapeutic intervention for individuals with TBI. The findings suggest that fostering meaningful connections with animals significantly enhances emotional well-being and provides a promising approach to improving rehabilitation outcomes for individuals living with TBI.
Background: Opioid use disorder (OUD) remains a global crisis, with chronic pain (CP), anxiety, and opioid cravings contributing to treatment discontinuation and return to opioid use. Despite the effectiveness of medications for OUD (MOUD) such as buprenorphine and methadone, they are underutilized, with nearly 50% of individuals discontinuing prematurely or returning to opioid use. Mind-body therapies (e.g., mindfulness, acupuncture, Tai Chi) have shown promise in reducing stress, drug cravings, and pain while improving well-being. However, Tai Chi has not been systematically tested for individuals with OUD and co-occurring CP and anxiety. The authors aimed to evaluate the feasibility of a virtual Tai Chi Easy (vTCE) intervention as an adjunct therapy for adults with OUD and co-occurring CP, and/or anxiety. Methods: A theory-driven, pre-post, single-group quasi-experimental design was used to evaluate intervention feasibility benchmarks and conduct baseline comparisons between inpatient and outpatient participants. The 8-week vTCE intervention consisted of gentle movements, breathing exercises, self-massage, and mindfulness practices, integrating these components into a holistic mind-body approach. Results: Of 32 screened individuals, 19 enrolled and 15 participated. Recruitment goals were partially met after expanding to outpatient settings (65% of the target). Retention was low, with only 3 participants (15.8%) completing the final assessment. Presurvey completion was high (95%), but postsurvey completion was limited (15.7%). Adherence was low, with only 20% attending more than one session. Acceptability and appropriateness averaged 3.5/5, and feasibility reached 4/5. No injuries were reported, supporting intervention safety. Conclusion: The vTCE intervention was not feasible in the inpatient setting. Outpatient settings showed greater feasibility, with notable differences in baseline characteristics, including self-reported opioid cravings. Lessons learned from this pilot study highlight the need to tailor recruitment, retention, and intervention strategies for future research testing vTCE as an adjunct therapy for individuals with OUD and co-occurring symptoms receiving outpatient MOUD. Trial Registration: ClinicalTrials.gov (Identifier: NCT05850533). Registered: 04/25/2023.
Background: There is currently no generally accepted theory able to explain the observed clinical efficacy of homeopathy. The aim of this scoping review is to identify all theoretical approaches that have been used to explain homeopathy, with the objective of establishing a basis for identifying promising hypotheses and theories for future elaboration. Methods: Medline, Embase, Scopus, Web of Science, PhilPapers, several online library catalogs, and personal libraries were searched for original studies up to July 12, 2024. Screening and data extraction were performed independently by two reviewers. Publications were included if they developed or advanced theories or models related to homeopathy. The aspect of homeopathy addressed by each study was extracted: the Principle of Similars and/or Potentisation. The theories identified in this review could be grouped into 14 overarching theoretical frameworks. Results: In total, 2118 records were screened, 500 full texts were assessed for eligibility, and 216 studies were included in this review. Starting in 1832 until the late 20th century, only sporadic contributions were found. From the 1990s, a marked increase in scholarly output was recorded. Most first authors were established in Germany, the United States, the United Kingdom, or India. The frameworks with the highest number of contributions were humanities, complex systems, water structures, and weak quantum theory. Overall, 22% of included publications described theoretical approaches that tried to cover both main aspects of homeopathy, 46% only Potentisation, 20% only the Principle of Similars (and 11% were unspecific). The theories within the humanities framework focused more on the Principle of Similars, complex systems theories on both principles, and the theories within the water structures, nanostructures, and mathematical models frameworks focused mostly on the Potentisation aspect. Conclusions: This scoping review offers an overview of theories and models on the mode of action of homeopathy. These could be classified into 14 largely nonoverlapping frameworks. Unexpectedly, the placebo did not emerge as such a framework. In the next step, these theories would be assessed in terms of their quality, plausibility, compatibility with modern science, and experimental falsifiability.
Aim: To systematically assess the therapeutic impact of music interventions on hypertensive disorders of pregnancy (HDP). Design: Systematic review and meta-analysis. Methods: A comprehensive search of various databases, such as PubMed, Embase, Cochrane Library, Web of Science, Scopus, CINAHL, EBSCO, Chinese National Knowledge Infrastructure, China Biomedical Literature Database, and Foreign Medical Literature Retrieval Service, was conducted to identify randomized controlled trials (RCTs) investigating the impact of music therapy on HDP from their inception through March 2024. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment using RoB 2. Statistical analyses were conducted in STATA 17, with evidence certainty graded using Grading of Recommendations Assessment, Development, and Evaluation. The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered in PROSPERO. Results: The meta-analysis included 14 RCTs comprising 1,477 participants. Five separate meta-analyses were conducted to compare the efficacy of music therapy versus standard care. Moderate-quality evidence from randomized trials demonstrated significant reductions associated with music therapy in systolic blood pressure (mean difference [MD] = -10.55 mmHg, 95% confidence interval [CI]: -13.86 to -7.24, p < 0.05), diastolic blood pressure (MD = -8.14 mmHg, 95% CI: -10.59 to -5.58, p < 0.05), sleep quality in patients with hypertension (MD = -1.95 points, 95% CI: -2.41 to -1.49, p < 0.05), and depression (MD = -7.80 points, 95% CI: -9.97 to -5.64, p < 0.001). Low-quality evidence suggested a modest improvement in anxiety (MD = -7.24 points, 95% CI: -8.84 to -5.64, p < 0.05). No publication bias was found in the comprehensive analysis results (all p > 0.1). Conclusion: Our systematic review suggests that adjunctive music therapy provides clinically relevant benefits for controlling systolic and diastolic blood pressure and improving psychological outcomes including anxiety, depression, and sleep quality in patients with HDP when compared with standard care alone.
Introduction: Noninvasive, nonablative capacitive and resistive radiofrequency has emerged as a therapeutic tool for managing pelvic pain. However, research on its efficacy in pelvic floor dysfunctions is limited. This study aimed to evaluate the effectiveness of capacitive and resistive radiofrequency therapy for primary dysmenorrhea. Methods: A randomized, single-blind, controlled trial was conducted. Forty-five nulliparous women with a medical diagnosis of primary dysmenorrhea were included. Participants were randomly assigned to one of three groups: transabdominal radiofrequency, intracavitary radiofrequency, or control. The intervention groups received nine 20-min sessions, with 3 sessions per week over 3 weeks between menstrual cycles. Pain intensity, menstrual quality of life, general quality of life, and pain pressure thresholds were assessed at baseline, postintervention, and at 1-month follow-up. Results: Both transabdominal and intracavitary radiofrequency significantly reduced pain intensity compared with the control group (p < 0.001). Intracavitary radiofrequency achieved a greater reduction than transabdominal, although this difference was not statistically significant (p = 0.311). No significant between-group differences were observed in mechanical sensitivity (p > 0.05) across all pressure points. Menstrual quality of life significantly improved in the intracavitary group compared with the control (p = 0.023), whereas the transabdominal group showed no significant improvement (p = 0.176). Changes in general quality of life were not statistically significant in any group (p > 0.05). Conclusion: Both transabdominal and intracavitary radiofrequency therapies produced short-term reduction in pain intensity in women with primary dysmenorrhea. As the efficacy between modalities did not differ significantly, treatment could be tailored to patient preference and tolerability.
Introduction: This study aimed to determine the effect of listening to music during the postoperative period on pain and anxiety levels in women who underwent cesarean delivery. Methods: This randomized controlled trial included 110 women who had undergone cesarean section between February and July 2024. Beginning at the 24th postpartum hour, women in the intervention group listened to relaxing classical music for 15 min every hour, while no intervention was applied to the control group. A standardized playlist of instrumental classical music (e.g., works by Mozart, Vivaldi, and Debussy) was created to induce relaxation and ensure consistency across participants. At the 48th postpartum hour, both groups were assessed using the Descriptive Characteristics Form, the Postpartum-Specific Anxiety Scale (PSAS), and the Pain Catastrophizing Scale (PCS). Results: Women in the intervention group listened to an average of 72.02 ± 3.14 min of music. The mean scores on the PSAS and PCS were significantly higher in the control group than in the intervention group (p < 0.001). Discussion: The findings indicate that listening to relaxing classical music significantly reduces postpartum anxiety and perceived pain. These results support the incorporation of culturally appropriate, music-based non-pharmacological strategies into routine postpartum care following cesarean delivery. This trial is registered at ClinicalTrials.gov under the title "The Effect of Music Postoperative Period (EMPP)" (Registration No: NCT07164521, https://clinicaltrials.gov/study/NCT07164521).
Background: Sleep disorders are increasingly prevalent and significantly impact physical and mental health. Yoga Nidra, a guided meditative practice, has been proposed as a non-pharmacological intervention to enhance sleep quality. This systematic review evaluates the efficacy of Yoga Nidra in managing sleep disorders across diverse populations. Methods: A systematic search of PubMed, Cochrane Library, PsycINFO, and Scopus databases was conducted to identify randomized controlled trials (RCTs) evaluating Yoga Nidra for sleep-related outcomes, published up to March 31, 2025. The primary objective was to assess the efficacy of Yoga Nidra on sleep quality and related psychological outcomes. Risk of bias (RoB) was assessed using the Cochrane RoB tool (in seven domains). Results: Six RCTs (n = 244) were included, involving participants with chronic insomnia, hypertension, acute insomnia, COVID-19 health care workers, and sportspersons. Most studies reported significant improvements in key sleep parameters such as sleep onset latency, total sleep time, and sleep efficiency among participants practicing Yoga Nidra. Improvements were observed compared to various control interventions, including cognitive behavioral therapy for insomnia, progressive muscle relaxation, and music-based relaxation. However, heterogeneity was noted in intervention protocols, outcome measures, and duration. Most studies had moderate to high RoB, primarily due to lack of blinding and incomplete outcome reporting. Moreover, there was a lack of accurate reporting of adverse events and safety data across the studies. Conclusion: Yoga Nidra appears to show promise as a therapeutic intervention for improving sleep and related mental health outcomes. Nevertheless, high-quality, methodologically robust RCTs are needed to confirm its efficacy and support its integration into evidence-based clinical practice.
Objective: Aiming at evaluating the effectiveness and safety of Guizhi Fuling Wan or Keishibukuryogan (GZFL) on prostate diseases, to provide available synthesized evidence for clinical application. Methods: Randomized controlled trials (RCTs) were identified from English, Chinese, Japanese, and Korean electronic databases, the search date ranged from the inception of databases to July 2024. Rev-Man 5.4.1 software was applied in the analysis of extracted data. Results: 23 studies were included in the meta-analysis, 12 studies on chronic prostatitis(CP) and 11 studies on benign prostatic hyperplasia (BPH). The synthesized results showed that GZFL had a significantly higher effective rate compared to the control group both in BPH (risk difference [RD] = 0.14, 95% confidence interval [CI] [0.10, 0.18], p < 0.00001) and CP (RD = 0.19, 95% CI [0.14, 0.23], p < 0.00001). It reduced the International Prostate Symptom score (mean difference [MD] = -3.19, 95% CI [-5.35, -1.02], p = 0.004) and NIH Chronic Prostatitis Symptom Index score (MD = -4.09, 95% CI [-5.04, -3.15], p < 0.00001), It also had a significant effect on reducing postvoid residual urine (MD = -6.73, 95% CI [-10.12, -3.33], p = 0.0001), prostate volume (MD = -2.59, 95% CI [-4.39, -0.80], p = 0.005), and increasing maximum urinary flow rate (MD = 1.61, 95% CI [1.11, 2.10], P < 0.00001). A few studies have also reported its therapeutic effects on prostate cancer. No severe adverse effects were reported. Conclusion: GZFL is effective and safe for BPH and CP in alleviating symptoms, improving scale scores. Rigorously designed clinical trials are necessary for further clinical application.
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