Journal of Integrative and Complementary Medicine最新文献

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: A reliable manual examination has not been validated as a diagnostic tool for nociplastic visceral pain. Aims: To establish the interrater reliability of a manual examination protocol for functional pancreatic visceral dysfunction and the clinical criteria for a manual palpatory diagnosis based on the clinical features of the nociplastic visceral pain. Methods: This double-blind cross-sectional study involved 60 participants assessed by three raters using a manual protocol for diagnosing functional pancreatic visceral dysfunction. Five palpation-based criteria were evaluated: (1) local pain, (2) referred pain, (3) neurovegetative symptoms, (4) hyperalgesia or allodynia, and (5) tissue resistance/density. Interrater agreement was measured using percentage agreement and Fleiss' kappa. The reliability of the Verbal Numerical Rating Scale (vNRS) was assessed using the intraclass correlation coefficient (ICC). Repeated measures analysis of variance and Cochran's Q test (with Bonferroni correction) were used to analyze vNRS scores and categorical outcomes, respectively. Significance was set at p < 0.05. Results: Criteria 1, 3, and 4 showed particularly high levels of agreement, with overall agreement percentages of 93.3%, 95.6%, and 95.6%, respectively. The corresponding Fleiss' kappa values were 0.863, 0.880, and 0.908, indicating almost perfect agreement. In contrast, Criteria 2 and 5 demonstrated substantial, but comparatively lower, agreement, with overall percentages of 86.7% and 87.8% and Fleiss' kappa values of 0.679 and 0.755. The vNRS demonstrated excellent reliability across all three pancreas regions, with ICC values well >0.90: head (ICC = 0.943, 95% confidence interval [CI] = 0.913-0.964), body (ICC = 0.950, 95% CI = 0.923-0.968), and tail (ICC = 0.963, 95% CI = 0.944-0.977). Conclusions: Three blinded raters reached an almost perfect pair-wise interrater agreement on the presence or absence of functional visceral dysfunction in the topographic projection of the pancreas. This study provides preliminary evidence that a manual diagnostic protocol is a reliable and potentially useful diagnostic tool in diagnosing nociplastic pain in the topographic projection of the pancreas. Future research should prioritize evaluating the validity of the nociplastic visceral pain diagnosis.

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.

Objective: Capoeira is an Afro-Brasilian martial art as well as a music- and dance-based cultural practice. This article aims to establish a foundational framework for future research endeavors in the domain of Capoeira by conducting a comprehensive review of existing literature focused on the relationship between Capoeira and physical as well as mental health aspects. Methods: PubMed, PsychArticle, and Google Scholar were searched from January 01, 2012, until July 15, 2022. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study selection and risk-of-bias judgments were performed by two authors independently. Only articles written in German or English language were eligible for this review. Geographical restrictions with regard to social status or gender were not made. Results: A total of 19 relevant studies meeting predetermined inclusion and exclusion criteria were identified for analysis. While robust studies specifically addressing the intersection of Capoeira and physical and mental health are currently lacking, this review reveals mixed findings. The impact of Capoeira on physical health (cardiovascular variables, flexibility, balance, bone density) appears inconclusive, contrasting with the more discernible positive effects observed on mental health outcomes (general health behavior/lifestyle, executive functions, conscious attention control, social skills, prosocial behavior, self-efficacy, self-confidence, resilience, anger, and aggressive behavior/aggression). Discussion: The concentration of studies within the Portuguese-speaking region raises the possibility of a geographic bias. Despite this limitation, this review suggests that Capoeira holds promise as a psychotherapeutic intervention. However, the need for further studies to establish its solid effectiveness is underscored. Conclusion: This review provides a synthesis of existing literature on Capoeira and its effects on physical and mental health. The observed trends warrant additional research, particularly in diverse geographic settings, to validate and extend our understanding of Capoeira's potential as a psychotherapeutic intervention.

Background: The minimally invasive repair of pectus excavatum (MIRPE), a surgical procedure done primarily in adolescence to correct pectus excavatum (PE), a congenital chest wall deformity, is associated with significant postoperative pain and opioid consumption. The use of an integrative medicine (IM) approach-combining complementary therapies with conventional treatments-can support postoperative pain management and potentially reduce opioid consumption in adolescent patients undergoing this procedure. This scoping review examines the published literature addressing the use of IM modalities in adolescent patients undergoing MIRPE. Methods: A comprehensive search of MEDLINE, EMBASE, Web of Science Core Collection, and Google Scholar was conducted from inception through January 2024. Studies were included if they addressed the inclusion of at least one IM modality during the MIRPE perioperative to support pain management. These modalities could be delivered at any time during that period and used alongside any conventional analgesic methods. Results: Eleven studies met the inclusion criteria. Eight of these (72.7%) implemented an integrative modality in this population. Of these eight, the most common integrative modalities were mindfulness/purposeful relaxation (n = 5), self-hypnosis (n = 3), cognitive-behavioral therapy (CBT) (n = 2), music/music therapy (n = 2), aromatherapy (n = 1), and massage (n = 1). Only six studies described the use of an integrative modality as an experimental condition. Still, self-hypnosis (n = 3), CBT (n = 2), and virtual reality-guided relaxation (n = 1) all augment postoperative pain management. While these studies have low levels of evidence and/or small sample sizes, they still demonstrated reduced pain scores (n = 4) and opioid consumption (n = 2) without appreciable adverse effects. Conclusion: There is a paucity of literature examining the use of integrative modalities in adolescent patients undergoing MIRPE. The included studies demonstrate preliminary evidence of the positive outcomes associated with IM modalities overall and a low-risk profile. However, the small number of studies, observational and retrospective designs, limited sample sizes, and large heterogeneity across the studies demonstrate limited, low-level evidence, highlighting a need for further rigorous research to determine the efficacy of these modalities. Further investigation, especially in specific promising modalities such as hypnosis and guided relaxation, is warranted. Incorporating IM modalities into perioperative care for this population should be further explored.

Objectives: This study was conducted to bring psychedelic and biofield science into interdisciplinary dialogue and encourage scientific investigations of psychedelic therapy as a form of energy medicine. In thinking these two sites together, important resonances between both forms of therapy were highlighted which can help elucidate clearer therapeutic mechanisms across both therapies. Methods/Design: Comparative ethnographic methods and a repeated measures design were used to conduct this research over a period of 2 years. A total of 150 qualitative interviews with 135 participants present at psychedelic-assisted therapy retreats and 15 at biofield settings were conducted. All the participants belonged to different ethnic, racial, and religious backgrounds; age groups; and reported differing levels of illness and health. The data (ethnographer's field notes, audio and video archives, as well as background research conducted on each of the field sites) was then transcribed and collated, and resonant themes were highlighted. Interventions: The research was conducted at wellness retreat spaces in the Netherlands and in Mexico; across entheogenic substances such as ayahuasca/yage, psilocybin-containing mushrooms, as well as psilocybin-containing truffles; and in biofield settings in the United States and Europe that included practices such as Reiki. Results/Findings: Based on 2 years of ethnographic research at psychedelic-assisted therapy retreats and in biofield settings, this article proffers that interdisciplinary dialogue between both forms of therapy is vital in understanding intention and attention as temporally and conceptually distinct categories with divergent healing effects. The research also demonstrates intention and attention as embodied phenomenon as opposed to mental acts. Conclusions: Intention and attention are conceptually and temporally distinct embodied phenomenon, and these differences can be best understood through an interdisciplinary study across psychedelic and biofield therapies. Scientists studying these topics should take these distinctions into account to be able to more accurately understand healing mechanisms across both forms of therapy.