Dataset Information

Is less more? A randomized comparison of home practice time in a mind-body program.

ABSTRACT: Home practice is a major component of mind-body programs, yet little is known about how to optimize the amount of prescribed home practice in order to achieve an effective "dose" of practice while minimizing participant burden. This study tested how varying the amount of home practice in a mind-body program impacts compliance and stress reduction, and whether prescribing a flexible home practice schedule increases compliance. Eighty-four stressed participants undergoing a 12-week yoga program were randomized to low, medium, and high home practice conditions. The medium condition allowed participants the flexibility to choose one of two amounts of practice each day. The low practice group exhibited the highest compliance (91%) compared to the medium and low practice groups (?60%), but exhibited the lowest total practice time, and did not significantly reduce stress. The high practice group was the only group to achieve significant stress-reduction, which was maintained 12 weeks post program. Prescribing a flexible home practice schedule did not increase compliance. Results suggest that prescribing higher practice doses may maximize practice time and symptom reduction despite lower compliance.

SUBMITTER: Greenberg J

PROVIDER: S-EPMC6538938 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Is less more? A randomized comparison of home practice time in a mind-body program.

Greenberg Jonathan J Braun Tosca D TD Schneider Marissa L ML Finkelstein-Fox Lucy L Conboy Lisa A LA Schifano Elizabeth D ED Park Crystal C Lazar Sara W SW

Behaviour research and therapy 20181004

Home practice is a major component of mind-body programs, yet little is known about how to optimize the amount of prescribed home practice in order to achieve an effective "dose" of practice while minimizing participant burden. This study tested how varying the amount of home practice in a mind-body program impacts compliance and stress reduction, and whether prescribing a flexible home practice schedule increases compliance. Eighty-four stressed participants undergoing a 12-week yoga program we ...[more]

PMID: 30312895

Similar Datasets

Project description:IMPORTANCE:Treatment of chronic low back pain (LBP) in older adults is limited by the adverse effects of analgesics. Effective nonpharmacologic treatment options are needed. OBJECTIVE:To determine the effectiveness of a mind-body program at increasing function and reducing pain in older adults with chronic LBP. DESIGN, SETTING, AND PARTICIPANTS:This single-blind, randomized clinical trial compared a mind-body program (n = 140) with a health education program (n = 142). Community-dwelling older adults residing within the Pittsburgh metropolitan area were recruited from February 14, 2011, to June 30, 2014, with 6-month follow-up completed by April 9, 2015. Eligible participants were 65 years or older with functional limitations owing to their chronic LBP (?11 points on the Roland and Morris Disability Questionnaire) and chronic pain (duration ?3 months) of moderate intensity. Data were analyzed from March 1 to July 1, 2015. INTERVENTIONS:The intervention and control groups received an 8-week group program followed by 6 monthly sessions. The intervention was modeled on the Mindfulness-Based Stress Reduction program; the control program, on the "10 Keys" to Healthy Aging. MAIN OUTCOMES AND MEASURES:Follow-up occurred at program completion and 6 months later. The score on the Roland and Morris Disability Questionnaire was the primary outcome and measured functional limitations owing to LBP. Pain (current, mean, and most severe in the past week) was measured with the Numeric Pain Rating Scale. Secondary outcomes included quality of life, pain self-efficacy, and mindfulness. Intent-to-treat analyses were conducted. RESULTS:Of 1160 persons who underwent screening, 282 participants enrolled in the trial (95 men [33.7%] and 187 women [66.3%]; mean [SD] age,74.5 [6.6] years). The baseline mean (SD) Roland and Morris Disability Questionnaire scores for the intervention and control groups were 15.6 (3.0) and 15.4 (3.0), respectively. Compared with the control group, intervention participants improved an additional -1.1 (mean, 12.1 vs 13.1) points at 8 weeks and -0.04 (mean, 12.2 vs 12.6) points at 6 months (effect sizes, -0.23 and -0.08, respectively) on the Roland and Morris Disability Questionnaire. By 6 months, the intervention participants improved on the Numeric Pain Rating Scale current and most severe pain measures an additional -1.8 points (95% CI, -3.1 to -0.05 points; effect size, -0.33) and -1.0 points (95% CI, -2.1 to 0.2 points; effect size, -0.19), respectively. The changes in Numeric Pain Rating Scale mean pain measure after the intervention were not significant (-0.1 [95% CI, -1.1 to 1.0] at 8 weeks and -1.1 [95% CI, -2.2 to -0.01] at 6 months; effect size, -0.01 and -0.22, respectively). CONCLUSIONS AND RELEVANCE:A mind-body program for chronic LBP improved short-term function and long-term current and most severe pain. The functional improvement was not sustained, suggesting that future development of the intervention could focus on durability. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT01405716.

Project description:The self-reported health and functional status of persons with back pain in the United States have declined in recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts and coping behaviors have been demonstrated to affect how well patients respond to treatments for back pain, few patients receive treatments that address these factors. Cognitive-behavioral therapy (CBT), which addresses psychosocial factors, has been found to be effective for back pain, but access to qualified therapists is limited. Another treatment option with potential for addressing psychosocial issues, mindfulness-based stress reduction (MBSR), is increasingly available. MBSR has been found to be helpful for various mental and physical conditions, but it has not been well-studied for application with chronic back pain patients. In this trial, we will seek to determine whether MBSR is an effective and cost-effective treatment option for persons with chronic back pain, compare its effectiveness and cost-effectiveness compared with CBT and explore the psychosocial variables that may mediate the effects of MBSR and CBT on patient outcomes.In this trial, we will randomize 397 adults with nonspecific chronic back pain to CBT, MBSR or usual care arms (99 per group). Both interventions will consist of eight weekly 2-hour group sessions supplemented by home practice. The MBSR protocol also includes an optional 6-hour retreat. Interviewers masked to treatment assignments will assess outcomes 5, 10, 26 and 52 weeks postrandomization. The primary outcomes will be pain-related functional limitations (based on the Roland Disability Questionnaire) and symptom bothersomeness (rated on a 0 to 10 numerical rating scale) at 26 weeks.If MBSR is found to be an effective and cost-effective treatment option for patients with chronic back pain, it will become a valuable addition to the limited treatment options available to patients with significant psychosocial contributors to their pain.Clinicaltrials.gov Identifier: NCT01467843.

Project description:This study was the first randomized controlled trial to test if mind-body interventions can improve self-regulation in prisoners with different personality disorders, using a combination of gene expression, neural, and behavioral measures.Thirty prisoners with personality disorders who score high on psychopathy were assigned to a mindfulness intervention (n=10), a yoga intervention (n=10), or a wait-list control group (n=10) using stratified random sampling. Both mindfulness and yoga interventions were held at the same time and lasted three hours per day on five consecutive days. At baseline and after the intervention, we measured inflammation-related gene expression; resting state brain activit with electroencephalography (EEG); risk-taking and attention with cognitive tasks; event-related potentials (ERPs) related to the attention task; and stress, emotion regulation and mindfulness with questionnaires. We expected that both yoga and mindfulness would improve self-regulation (i.e., executive attention, emotion regulation and self-awareness), reduce stress and risk-taking behavior, downregulate inflammatory-related gene expression and increase alpha and theta power. Blood was collected for the analysis of changes in gene expression of 38 genes related to inflammation and the immune system (IL-1 signaling pathway). Venipuncture samples were collected into 10ml EDTA tubes, lysed and frozen at -80°C. Peripheral blood mononuclear cells were isolated by density gradient centrifugation. Ribonucleic acid (RNA) was extracted (QiaAmp RNA Blood Mini kit; Qiagen) and tested for suitable mass and integrity (NanoDrop One, Acclaro Sample Intelligence; Thermo Scientific). RNA was then converted to fluorescent cRNA for hybridization to IL-1 signaling pathway plate H96 (Bio-Rad Labs Ltd, UK). Gene expression data were expressed as cycle threshold (CT) values by calculating 2−ΔΔCT, and referencing to the geomean of all genes because endogenous control genes that are supposed to have constant levels of expression were not stable in this case. After normalizing 2−ΔΔCT to the wait-list control group median, the data were imported into SPSS and analyzed by group allocation based on change scores of each normalized 2−ΔΔCT. Intent-to-treat (ITT) principles were used for all the analyses. Post-intervention missing data was handled by running multiple imputations. A p-value of <0.05 was considered significant and Bonferroni correction was implemented to adjust for multiple comparisons (i.e., <.02 was considered significant in individual 2-group comparisons). The data were analyzed with the IBM SPSS 24.0 software (Statistical Package for Social Sciences, SPSS Inc., 237 Chicago, IL). The effectiveness of interventions was tested by calculating changes scores and running non-parametric Kruskal-Wallis test for K independent samples because the assumptions for ANOVA were not met. If there was a significant difference detected, it was followed with Mann-Whitney U test 240 and Kolmogorov-Smirnov Z test to determine specific group differences. Additionally, eta squared was used as a measure of effect size to determine the proportion of variability in outcomes that can be explained by group membership.We found no significant changes in gene expression or any other measures.

Dataset Information

Is less more? A randomized comparison of home practice time in a mind-body program.

Publications

Is less more? A randomized comparison of home practice time in a mind-body program.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets