Complementary Therapies in Clinical Practice最新文献

This study examined the usefulness of drama and music therapies as communication strategies for reducing symptoms of post-traumatic stress disorder (PTSD) and generalised anxiety disorder (GAD) among school children (aged 10–16) who were victims of the 2022 floods in Nigeria. The researchers randomly assigned the children to control (n = 122) drama therapy (n = 120) and music therapy (n = 120) groups. The result of the study revealed that after the intervention, school children in the drama and music therapies (unlike those in the control group) reported a significant reduction in their PTSD and GAD symptoms; the reduction achieved statistical significance (p = 0.001, η_p² = 0.48). Further results revealed a significant interactive effect of gender (p = 0.001) with boys reporting a significant reduction more than girls. The results showed that drama therapy contributed more to reducing PTSD symptoms, while music therapy contributed more to reducing GAD symptoms. The difference did not achieve statistical significance (p = 0.23). The researchers conclude that both drama and music therapies were associated with reduced symptoms, indicating the interventions may be beneficial therapies.

Background and purpose

A growing number of studies have investigated the efficacy of acupuncture in the treatment of painful diabetic peripheral neuropathy (PDPN), but the findings of these studies have generated conflicting results. This study therefore aimed to assess the efficacy of acupuncture for treating PDPN so as to offer more conclusive results.

Methods

Seven databases were systematically searched for studies published up until December 1, 2023. All randomized controlled trials (RCTs) of acupuncture for PDPN with visual analog scale (VAS) for pain score were included. Study selection, data extraction, and evaluation were conducted independently by researchers. The Risk of Bias 2 (RoB2) tool was employed to assess the risk of bias. From this sample, the mean difference (MD), 95 % confidence intervals (CI), publication bias, and heterogeneity were then computed.

Results

The manual acupuncture group exhibited a significant decrease in the VAS for pain score compared with the routine care group (p < 0.0001; MD = −1.45 [95 % CI, −1.97 to −0.93], I² = 84 %). The real acupuncture group demonstrated a greater reduction in VAS scores than the sham acupuncture group (p = 0.004; MD = −0.97 [95 % CI, −1.63 to −0.31], I² = 65 %). Additionally, the acupuncture group showed improvements in sensory nerve conduction velocity (SNCV, p < 0.0001; MD = 2.29 [95 % CI, 1.79 to 2.78], I² = 14 %) as well as motor nerve conduction velocity (MNCV, p < 0.0001; MD = 2.87 [95 % CI, 2.46 to 3.27], I² = 0). Different durations of acupuncture treatment, including 6–10 weeks and 3–4 weeks, demonstrated a significant reduction in VAS scores compared with the routine care group.

Conclusion

This meta-analysis provides preliminary evidence for the claim that acupuncture has the potential to alleviate PDPN symptoms and improve SNCV and MNCV. However, high-quality RCTs are needed to offer further evidence and thus better substantiate such a contention.

Objective

This study aims to ascertain the effectiveness of creative art therapy (CAT) in alleviating symptoms of postpartum depression (PPD).

Methods

A systematic review of all randomized controlled trials of CAT for PPD was conducted. Eight bibliographic databases, namely, PubMed, The Cochrane Library, Embase, Web of Science, CNKI, Wanfang Database, VIP Database, and China Biomedical Literature Database were searched digitally, while Google Scholar database was searched manually for a comprehensive literature search. The search period is from the establishment of the database to May 2024. Literature screening and data extraction were conducted independently by two researchers, and the risk of bias in the included studies was evaluated. Finally, RevMan5.3 software and STATA 15.1 software were used for meta-analysis.

Results

Twelve studies, including 1633 patients, were included in this review. The results of our meta-analysis revealed that the intervention group was significantly better than the control group in depression [SMD = −0.882, 95 % CI: −1.256 to −0.508, P ＜ 0.001][WMD = 0.680, 95 % CI: 0.407–0.953, P ＜ 0.001], anxiety [SMD = −0.712, 95 % CI: −1.405 to −0.019, P = 0.044], and personal state [WMD = −5.180, 95 % CI: −5.869 to −4.491, P ＜ 0.001][SMD = 0.388, 95 % CI: 0.132–0.643, P = 0.003], and the difference was statistically significant. Sensitivity analysis revealed that the above results were stable.

Conclusion

CAT (music and creative games) was found to be effective in relieving depression, anxiety, and personal state in patients with PPD. Though CAT appears to be worthy of clinical application, more high-quality and large-sample studies are required to explore various aspects in the current context.

Background

and Purpose: Pilates exercises have been recommended to improve postural balance and reduce the risk of falls in older adults. However, the certainty of these recommendations remains unclear. In this sense, our objective was to update the literature and verify the effects of Pilates on postural balance and the risk of falls in this population.

Methods

A systematic search was conducted across multiple databases, including PubMed, EMBASE, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS, and PEDro, on April 17, 2023. The methodological quality of the studies was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE system. Meta-analysis calculations were performed by standardized mean difference (SMD).

Results

A total of 39 studies, involving 1770 participants, were included in the systematic review. Only 14 studies exhibited satisfactory methodological quality. Evidence with very low to moderate certainty showed that Pilates was significantly superior to control groups on indicators of dynamic postural balance (SMD = 1.60 to 0.72), static postural balance (SMD = 0.37 to 0.25), and general state of balance (SMD = 0.76), but not to reduce the number and fear of falls. Furthermore, Pilates was comparable to other forms of exercise for these outcomes.

Conclusions

Pilates can be recommended to enhance static and dynamic postural balance in older adults, but not to reduce the number of falls or the fear of falling. Given that no outcomes showed high certainty of evidence, future studies may alter these findings.

Objective

To diminish the negative influence of sarcopenia on senior adults, the study aimed to investigate the association between adherence to 24-h movement behavior guidelines (physical activity, sedentary behavior, sleep duration) and the risk of sarcopenia among individuals aged ≥55 years in five low- and middle-income countries (LMICs).

Methods

A total of 16,503 adults aged ≥55 years were included in this cross-sectional study. The study utilized data from Global Aging and Adult Health Survey (SAGE). Participants reported their information about physical activity, sedentary behavior, and sleep duration using the questionnaire. Sarcopenia was identified as low skeletal muscle mass with a diminished gait speed or weakened handgrip strength. Multiple logistic regression models were used to investigate the association between adherence to 24-h movement behavior guidelines and the risk of sarcopenia.

Results

Merely 32.73 % of participants met all three 24-h movement behavior guidelines (physical activity, less sedentary behavior, sleep). Meeting all three guidelines (p < 0.01) was significantly associated with a lower risk of sarcopenia. Meeting physical activity only (p < 0.05), or meeting both physical activity and sedentary behaivor (p < 0.05), or meeting both physical activity and sleep duration (p < 0.01) guidelines were also associated with a reduced risk of sarcopenia. Moreover, adults aged 65+ years who adhered to 24-h movement behavior guidelines exhibited a significantly reduced risk of developing sarcopenia.

Conclusion

The findings suggest that the adherence to 24-h movement behavior guidelines for regular physical activity, limited sedentary behavior, and sufficient sleep duration was associated with a reduced risk of sarcopenia in adults aged ≥55 years in five LMICs.

Background and purpose

Previous studies have suggested that music listening has the potential to positively affect cognitive functions and mood in individuals with post-stroke cognitive impairment (PSCI), with a preference for self-selected music likely to yield better outcomes. However, there is insufficient clinical evidence to suggest the use of music listening in routine rehabilitation care to treat PSCI. This randomized control trial (RCT) aims to investigate the effects of personalized music listening on mood improvement, activities of daily living (ADLs), and cognitive functions in individuals with PSCI.

Materials and methods

A total of 34 patients with PSCI were randomly assigned to either the music group or the control group. Patients in the music group underwent a three-month personalized music-listening intervention. The intervention involved listening to a personalized playlist tailored to each individual's cultural, ethnic, and social background, life experiences, and personal music preferences. In contrast, the control group patients listened to white noise as a placebo. Cognitive function, neurological function, mood, and ADLs were assessed.

Results

After three months of treatment, the music group showed significantly higher Montreal Cognitive Assessment (MoCA) scores compared to the control group (p=0.027), particularly in the domains of delayed recall (p=0.019) and orientation (p=0.023). Moreover, the music group demonstrated significantly better scores in National Institutes of Health Stroke Scale (NIHSS) (p=0.008), Barthel Index (BI) (p=0.019), and Zarit Caregiver Burden Interview (ZBI) (p=0.008) compared to the control group. No effects were found on mood as measured by the Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Rating Scale (HAMD).

Conclusion

Personalized music listening promotes the recovery of cognitive and neurological functions, improves ADLs, and reduces caregiver burden in patients with PSCI.

Background and purpose

WATSU (Water-Shiatsu) is a body-oriented therapy in warm-water pool with passive movements, massage and breathing techniques. The present study investigated the short-term effect of a single session of WATSU on body awareness.

Materials and methods

In a randomized-controlled study 60 volunteers (18–65 years) were assigned to a 20-min intervention of WATSU or to a 20-min lecture on WATSU. Immediately before and after the intervention they had to answer questionnaires. Primary endpoint of the investigation was the change of the total score of the non-verbal Awareness Body Chart (ABC). Secondary endpoints were the changes of the scores of the 14 single body parts of the ABC, of the Visual Analogue Pain Scale, of a German self-perception questionnaire (KEKS) and changes in mood scored with a German questionnaire on mood (Bf-SR). To compare groups, Mann-Whitney U tests were used.

Results

The WATSU group had a significantly higher increase in the ABC total score in comparison to the lecture group (WATSU: 0.3 (IQR 0 – 0.8), lecture: 0.1 (IQR -0.2 – 0.2), p = 0.014). In the KEKS no group differences were seen. In WATSU a significantly stronger improvement of pain (Visual Analogue Pain Scale: WATSU: −15 (IQR -29 to −8), lecture: −4 (IQR -9 – 2), p < 0.001) and of mood (Bf-SR: WATSU: −6 (IQR -14 to −2), lecture: −1 (IQR -5 – 1), p = 0.003) could be observed.

Conclusion

This study showed that WATSU immediately increases body awareness and improves pain and mood.

Objective

To systematically investigate the efficacy of aromatherapy in patients with acute coronary syndrome (ACS).

Methods

We conducted a comprehensive search for papers published until November 2023 using the following databases: PubMed, Embase, and Cochrane Library. This study was conducted following the PRISMA and Cochrane Guidelines. The inclusion criteria were randomized controlled trials (RCTs) performed to assess the comparative effectiveness of inhalation aromatherapy versus controls in individuals diagnosed with ACS. The Jadad rating method was used to assess the quality of the included studies, and a meta-analysis was performed using the RevMan 5.4 software. Heterogeneity was quantified using the Higgins I2 (%) test.

Results

A total of 12 RCTs with 476 patients with ACS were included. Aromatherapy has been shown to reduce anxiety scores significantly (standard mean difference [SMD]: −1.18, 95 % confidence interval [CI]: −1.33 to −1.03; P < 0.00001) along with reduction in systolic blood pressure (MD = -8.78, 95 % CI [-13.92, −3.65], P = 0.008); diastolic blood pressure (MD = −7.76, 95 % CI [-11.39, −4.12], P < 0.001); mean artery pressure MD = −9.68, 95 % CI [-13.93.-5.44]; P < 0.0001). However, no significant effects were reported on the heart rate (MD = −6.98, 95 % CI [-15.46, 1.50], P = 0.11) and respiratory rate (MD = −0.67, 95 % CI [-2.52, 1.19], P = 0.48). A greater frequency of aromatherapy was associated greater anxiety −1.80 incidence, with 95 % CI [-2.04, −1.56]. Citrus essential oils exhibited the strongest effect (SMD = −1.97, 95 % CI [-3.34, −0.60], P = 0.005) in reducing anxiety levels.

Conclusion

Aromatherapy appears to be an effective non-pharmacological intervention for reducing blood pressure and anxiety in individuals with ACS. This suggests that aromatherapy more than twice a day is effective in reducing anxiety levels. However, aromatherapy had no statistically significant impact on the heart or respiratory rates. Moreover, additional high-quality RCTs should be conducted to verify these results and explore the efficacy and mechanism of aromatherapy in patients with ACS.

Background and purpose

Electroacupuncture (EA) is one of the non-pharmacological therapies in traditional Chinese medicine to treat urinary retention. The objective of this meta-analysis is to assess the efficacy of electroacupuncture in the treatment of urinary retention after stroke.

Methods

Overall, seven electronic databases were searched until December 31, 2023, and randomized control trials about EA for urinary retention after stroke were reviewed. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias for included studies. The meta-analysis was conducted by RevMan 5.4 and Stata/MP 17.0 software.

Results

Eleven studies with a total of 856 participants were included in this meta-analysis. EA treatment yielded an improved reduction in the post-void residual (PVR) (mean difference [MD]: 37.85, 95 % confidence interval [CI]: 55.09 to −20.61 p < 0.0001) and the weight of diaper pads (MD: 38.87, 95 % CI: 42.68 to −335.06). Further analysis indicated that EA improved the effectiveness ratio (risk ratio [RR]: 1.36, 95 % CI: 1.20 to 1.53, p < 0.00001), the function of the bladder (MD: 0.45, 95 % CI: 0.61 to −0.30), and the quality of life (MD: 1.15, 95 %: CI: 2.10 to −0.20) in comparison to normal treatment and simple acupuncture.

Conclusion

EA may be an effective way and reasonable modality to incorporate into the multiple prevention and therapy for urinary retention after stroke. The wide application of EA could be associated with the improvement of bladder and life quality and decline in the PVR for patients after stroke with urinary retention.

Background

Engaging in clinical research includes confronting challenges about the uncertainty around outcomes and ramifications the results may have on practice. This is pertinent for osteopathy where little is known about the experiences of osteopaths involved in clinical trials. The aim of this study was to explore the lived experience of osteopaths who participated in a randomised controlled trial for infantile colic. The study was informed by a principles-based approach to clinical ethics and their application to practice.

Design

Qualitative study using semi-structured interviews and reflexive thematic analysis.

Setting

An international two-arm pragmatic randomised controlled trial (the CUTIES trial) to evaluate the effectiveness of osteopathic care for infantile colic.

Methods

A principles-based approach to clinical ethics and their application to practice for osteopaths asked to make decisions about participating in a clinical trial was used. Osteopaths from the UK and Australia who completed the CUTIES trial training were invited to be interviewed about their experiences, regardless of whether they went on to recruit infants in the trial. Interviewees were asked about their reasons for wanting to participate in the CUTIES trial, why they decided to continue or not to continue in the trial and, for those who completed the trial, their personal experiences as participants in the trial. Data were analysed using reflexive thematic analysis.

Results

Nine osteopaths were interviewed. Three themes were identified from the data: Paradigm dilemma - observed clinical outcomes vs scientific evidence for mechanism of effects; trial-related ethical dilemmas; and trial outcome dilemmas.

Conclusion

Participating in the CUTIES trial required osteopaths to overcome clinical ethical dilemmas for the benefit of patients, the research, and the profession.