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Effectiveness of jyoti meditation for patients with chronic neck pain and psychological distress--a randomized controlled clinical trial.

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Journal The journal of pain
Year 2015
Links Pubmed DOI www.epistemonikos.org

This article is included in 1 Systematic review Systematic reviews (1 reference)

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UNLABELLED: Chronic neck pain is a common medical complaint partly mediated by psychosocial distress and having a high socioeconomic impact. There is preliminary evidence that stress reduction by meditation might be beneficial in chronic pain syndromes. We aimed to evaluate the effectiveness of an 8-week meditation program (jyoti meditation) in patients with chronic neck pain by means of a randomized clinical trial. Eighty-nine patients (aged 49.7 ± 10.5 years, 73 female) with chronic neck pain who scored >40 mm on a 100-mm visual analog scale and had concomitant increased perceived stress were randomized to an 8-week meditation program (jyoti meditation) with weekly 90-minute classes (n = 45) or to a home-based exercise program (n = 44) with a wait list offer for meditation. Both groups were instructed to practice at home. Outcomes were assessed at baseline and after 8 weeks. Primary outcome measure was change of mean pain at rest (visual analog scale score) from baseline to week 8. Secondary outcomes included pain at motion, functional disability, pain-related bothersomeness, perceived stress, quality of life, and psychological outcomes. Patients had neck pain for a mean of 11 years. Eighteen patients in the meditation group and 16 patients in the exercise group were lost to follow-up. Meditation training significantly reduced pain when compared to the exercise group after 8 weeks (reduction of 45.5 ± 23.3 mm to 21.6 ± 17.2 mm in the meditation group, and 43.8 ± 22.0 mm to 37.7 ± 21.5 mm in the exercise group; mean difference: 13.2 mm [95% confidence interval: 2.1, 24.4; P = .02]). Pain-related bothersomeness decreased more in the meditation group (group difference 11.0 mm [95% confidence interval: 1.0, 21.0; P = .03]). No significant treatment effects were found for pain at motion, psychological scores, and quality of life, although the meditation group showed nonsignificant greater improvements compared to the exercise group. In conclusion, meditation may support chronic pain patients in pain reduction and pain coping. Further well-designed studies including more active control comparisons and longer-term follow-up are warranted. PERSPECTIVE: This article presents the results of a randomized controlled trial on the clinical effects of an 8-week meditation program or self-care exercise in patients with chronic neck pain. Meditation reduced pain at rest but not disability and might be a useful treatment option for pain management of chronic neck pain.

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The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients.

Authors Hwang JA , Bae SH , Do Kim G , Kim KY
Journal Journal of physical therapy science
Year 2013
Links Pubmed DOI PubMed Central

This article is included in 1 Systematic review Systematic reviews (1 reference)

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[Purpose] This study aimed to examine the effects of sensorimotor training on the anticipatory postural adjustment (APA) of chronic low back pain (CLBP) patients. [Subjects and Methods] Fourteen CLBP patients were randomly assigned to Group II (ordinary physical therapy, n=7) and Group III (sensorimotor training, n=7). In addition, a normal group (Group I) consisting of seven subjects was chosen as the control group. The two CLBP groups received their own treatment five times per week, for four weeks, for 40 minutes each time. Changes in pain and functional performance evaluation were examined by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). In order to look at the change in APA, muscle onset time was examined using electromyography (EMG). [Results] Group III showed significant changes in both VAS and ODI. According to comparison of the results for muscle onset time, there were significant decreases in Group III's transversus abdominis muscle (TrA) and external oblique muscle (EO) in the standing and sitting positions. There were significant differences between Group II and III in terms of the TrA in the sitting position. [Conclusion] Sensorimotor training makes patients capable of learning how to adjust muscles, thereby alleviating pain and improving muscle performance.

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Effects of stabilization exercise using a ball on mutifidus cross-sectional area in patients with chronic low back pain.

Authors Chung S , Lee J , Yoon J
Journal Journal of sports science & medicine
Year 2013
Links Pubmed

This article is included in 1 Systematic review Systematic reviews (1 reference)

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The purpose of this study was to compare the effects of lumbar stabilization exercises using balls to the effects of general lumbar stabilization exercises with respect to changes in the cross section of the multifidus (MF), weight bearing, pain, and functional disorders in patients with non-specific chronic low back pain. Twelve patients participated in either a 8 week (3 days per week) stabilization exercise program using balls and control group (n = 12). The computer tomography (CT) was used to analyze MF cross-sectional areas (CSA) and Tetrax balancing scale was used to analyze left and right weight bearing differences. Both groups had significant changes in the CSA of the MF by segment after training (p < 0.05) and the experimental group showed greater increases at the L4 (F = 9.854, p = 0.005) and L5 (F = 39. 266, p = 0.000). Both groups showed significant decreases in weight bearing, from 9.25% to 5.83% in the experimental group and from 9.33% to 4.25% in the control group (p < 0.05), but did not differ significantly between the two groups. These results suggests that stabilization exercises using ball can increases in the CSA of the MF segments, improvement in weight bearing, pain relief, and recovery from functional disorders, and the increases in the CSA of the MF of the L4 and L5 segments for patients with low back pain. Key PointsCompared with the stabilization exercise using a ball and general stabilization exercise increased the CSA of the MF, weight bearing, pain, and functional ability in patients with low back pain.We verified that increases in the CSA of the MF of the L4 and L5 segments and functional ability during the stabilization exercise using a ball.The stabilization exercise using a ball was shown to be an effective exercise method for patients with low back pain in a rehabilitation program by increasing functional ability and the CSA of the MF.

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The effect of balance training on cervical sensorimotor function and neck pain.

Authors Beinert K , Taube W
Journal Journal of motor behavior
Year 2013
Links Pubmed DOI

This article is included in 1 Systematic review Systematic reviews (1 reference)

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The authors' aim was to evaluate the effect of balance training on cervical joint position sense in people with subclinical neck pain. Thirty-four participants were randomly assigned to balance training or to stay active. Sensorimotor function was determined before and after 5 weeks of training by assessing the ability to reproduce the neutral head position and a predefined rotated head position. After balance training, the intervention group showed improved joint repositioning accuracy and decreased pain whereas no effects were observed in the control group. A weak correlation was identified between reduced neck pain intensity and improved joint repositioning. The present data demonstrate that balance training can effectively improve cervical sensorimotor function and decrease neck pain intensity.

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Does acupuncture activate endogenous analgesia in chronic whiplash-associated disorders? A randomized crossover trial.

Journal European journal of pain (London, England)
Year 2013
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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BACKGROUND: Many patients with chronic pain, including those with chronic whiplash-associated disorders (WAD), show features of central sensitization. Randomized trials examining whether treatments are able to influence the process of central sensitization in patients with chronic WAD are emerging. Therefore, the present study aimed at examining whether acupuncture results in activation of endogenous analgesia and relief in symptoms in patients with chronic WAD. METHODS: In this randomized crossover pilot trial with blinded assessors, each patient (n = 39) received two treatment sessions of identical duration, with acupuncture and relaxation therapy randomly crossed over in visit 2. Primary outcome measurement included immediate activation of endogenous analgesia i.e., pressure pain sensitivity and conditioned pain modulation. Secondary outcome measurements included pain relief and reduced disability level. RESULTS: Local pressure pain sensitivity at baseline and during conditioned pain modulation decreased significantly more following acupuncture compared with relaxation (time x group interactions: p &lt; 0.001), both in the neck and at a site distinct from the painful region. When comparing the effects of acupuncture versus relaxation, no differences were observed on conditioned pain modulation, temporal summation of pressure pain, neck disability or symptom severity (all p-values &gt;0.05). CONCLUSION: It was shown that one session of acupuncture treatment results in acute improvements in pressure pain sensitivity in the neck and calf of patients with chronic WAD. Acupuncture had no effect on conditioned pain modulation or temporal summation of pressure pain. Both acupuncture and relaxation appear to be well-tolerated treatments for people with chronic WAD. These findings suggest that acupuncture treatment activates endogenous analgesia in patients with chronic WAD.

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Effectiveness of home-based cupping massage compared to progressive muscle relaxation in patients with chronic neck pain--a randomized controlled trial.

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Journal PloS one
Year 2013
Links Pubmed DOI PubMed Central

This article is included in 3 Systematic reviews Systematic reviews (3 references)

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UNLABELLED: Chronic neck pain is a major public health problem with very few evidence-based complementary treatment options. This study aimed to test the efficacy of 12 weeks of a partner-delivered home-based cupping massage, compared to the same period of progressive muscle relaxation in patients with chronic non-specific neck pain. Patients were randomly assigned to self-directed cupping massage or progressive muscle relaxation. They were trained and asked to undertake the assigned treatment twice weekly for 12 weeks. Primary outcome measure was the current neck pain intensity (0-100 mm visual analog scale; VAS) after 12 weeks. Secondary outcome measures included pain on motion, affective pain perception, functional disability, psychological distress, wellbeing, health-related quality of life, pressure pain thresholds and adverse events. Sixty one patients (54.1±12.7 years; 73.8%female) were randomized to cupping massage (n = 30) or progressive muscle relaxation (n = 31). After treatment, both groups showed significantly less pain compared to baseline however without significant group differences. Significant effects in favor of cupping massage were only found for wellbeing and pressure pain thresholds. In conclusion, cupping massage is no more effective than progressive muscle relaxation in reducing chronic non-specific neck pain. Both therapies can be easily used at home and can reduce pain to a minimal clinically relevant extent. Cupping massage may however be better than PMR in improving well-being and decreasing pressure pain sensitivity but more studies with larger samples and longer follow-up periods are needed to confirm these results. TRIAL REGISTRATION: ClinicalTrials.gov NCT01500330.

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The role of fear of movement in subacute whiplash-associated disorders grades I and II.

Journal Pain
Year 2013
Links Pubmed DOI PubMed Central

This article is included in 1 Systematic review Systematic reviews (1 reference)

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Fear and avoidance of activity may play a role in fostering disability in whiplash-associated disorders (WAD). This study examined the role of fear after WAD and assessed the effectiveness of 3 treatments targeting fear. People still symptomatic from WAD grade I-II injuries approximately 3months previously (n=191) completed questionnaires (eg, Neck Disability Index [NDI]) and were randomized to 1 of the treatments: (1) informational booklet (IB) describing WAD and the importance of resuming activities, (2) IB+didactic discussions (DD) with clinicians reinforcing the booklet, and (3) IB+imaginal and direct exposure desensitization (ET) to feared activities. DD and ET participants received three 2-hour treatment sessions. Absolute improvements in NDI were in predicted direction (ET=14.7, DD=11.9, IB=9.9). ETs reported significantly less posttreatment pain severity compared with the IB (Mean=1.5 vs 2.3, P<.001, d=0.6) and DD (M=1.5 vs 2.0, P=.039, d=0.6) groups. Reduction in fear was the most important predictor of improvement in NDI (β=0.30, P<.001), followed by reductions in pain (β=0.20, P=.003) and depression (β=0.18, P=.004). The mediational analysis confirmed that fear reduction significantly mediated the effect of treatment group on outcome. Results highlight the importance of fear in individuals with subacute WAD and suggest the importance of addressing fear via exposure therapy and/or educational interventions to improve function.

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Chronic neck pain and treatment of cognitive and behavioural factors: results of a randomised controlled clinical trial.

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Journal European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Year 2012
Links Pubmed DOI PubMed Central

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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<b>PURPOSE: </b>Although there is growing evidence in favour of the bio-psychosocial approach to the treatment of persistent neck pain, it is questioned whether treating psychological factors can improve patient perceptions of disability, pain and quality of life. This randomised, controlled study with 12 months' follow-up was conducted to evaluate the efficacy of adding cognitive-behavioural principles to exercises for chronic neck pain.<b>METHODS: </b>Eighty patients were randomly assigned to the usual neck exercises plus cognitive-behavioural treatment (PTcb group, 40 subjects) or to treatment based on neck exercises alone (PT group, 40 subjects). Before treatment (T1), at the end of treatment (T2) and 12 months later (T3), all of the patients completed a booklet including the Neck Pain and Disability Scale, a numerical rating scale, and the Short-Form Health Survey Questionnaire (SF-36).<b>RESULTS: </b>The present trial failed to demonstrate its primary end point: the pre- and post-treatment difference in total NPDS scores was not statistically different between groups. Disability improved similarly in both groups over time, remaining stable until T3 in the PTcb group and slightly increasing at the same time in the PT group. Pain trends were comparable, with both groups showing an improvement between T1 and T2, and a slight worsening between T2 and T3. There were significant increases in all of the SF-36 domains except for health in general, and vitality in both groups by the end of treatment. SF-36 showed a between-group difference only for the physical activity domain (10.4; 95% CI 2.4-18.5).<b>CONCLUSION: </b>Disability, pain and quality of life improved at the end of treatment in both groups, without differences between them.

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Efficacy of perceptive rehabilitation in the treatment of chronic nonspecific low back pain through a new tool: a randomized clinical study.

Journal Clinical rehabilitation
Year 2012
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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OBJECTIVE: To evaluate the efficacy of a perceptive rehabilitative approach, based on a new device, with regard to pain and disability in patients with chronic nonspecific low back pain. DESIGN: Single blind, randomized, controlled trial. SETTING: An outpatient academic hospital. PATIENTS: Seventy-five patients with chronic low back pain. INTERVENTIONS: Patients were randomized into three groups. Twenty-five subjects received 10 sessions in one month, based on specific perceptive exercises that were performed on a suitably developed device. Twenty-five patients entered a Back School programme. Twenty-five patients comprised a control group that received the same medical and pharmacological assistance as the other groups. MAIN OUTCOME MEASURES: Pain was assessed using the Visual Analogue Scale and McGill Pain Questionnaire. Disability was evaluated using the Oswestry Disability Index and Waddell Disability Index. All measurements were recorded before treatment, at the end of the study, and at 12 and 24 weeks. RESULTS: General pain relief was recorded in all the groups, which was elicited more quickly in the perceptive treatment group; significant differences in pain scores were observed at the end of treatment (P < 0.001 for visual analogue scale and P = 0.001 for Questionnaire) versus the other groups. Disability scores in the perceptive group did not differ significantly from those in the other group, whereas these scores significantly differed between Back School and control groups at the follow-ups (P < 0.01 for both scales). CONCLUSION: Perceptive rehabilitation has immediate positive effects on pain. Back School reduces disabilities at follow-up.

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The efficacy of a perceptive rehabilitation on postural control in patients with chronic nonspecific low back pain.

Journal International journal of rehabilitation research. Internationale Zeitschrift für Rehabilitationsforschung. Revue internationale de recherches de réadaptation
Year 2012
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This article is included in 1 Systematic review Systematic reviews (1 reference)

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Patients with chronic low back pain have a worse posture, probably related to poor control of the back muscles and altered perception of the trunk midline. The aim of this study was to evaluate the efficacy of a perceptive rehabilitation in terms of stability and pain relief in patients with chronic nonspecific low back pain. Thirty patients were enrolled and randomized into two groups: 15 patients received rehabilitation, on the basis of a specific tool to perform perceptive exercises [perceptive group (PG)], and 15 patients received a back school programme [back school group (BG)]. Both groups were assessed using stabilometry and the McGill Pain Questionnaire before and at the end of treatment. For the reference values of stabilometric parameters, 15 healthy individuals were enrolled. Significant reductions in sway length (P=0.019) and laterolateral sway velocity (P=0.038) were observed in the PG. The anteroposterior sway velocity was reduced in both the groups, but significantly only for BG (P=0.048). The percentage of sway length reduction was inversely and significantly correlated with the initial sway length value for PG (R=-0.708, P=0.003), but not for BG (R=-0.321, P=0.243). In the PG, the sagittal arrows and bi-acromial and bi-spinoiliac lines' angles were all significantly reduced. General pain relief was reported after treatment, without a significant difference (P=0.436). Our results suggest that a perceptive rehabilitation can improve the postural stability for the realignment of the trunk, controlling the back pain. The use of cognitive exercises may strengthen the usual rehabilitation of low back pain, avoiding the recurrence of symptoms.