Integrated Meditation and Exercise Therapy: A Randomized Controlled Pilot of a Combined Nonpharmacological Intervention Focused on Reducing Disability and Pain in Patients with Chronic Low Back Pain

Abstract

Objective This pilot trial examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise compared with a control condition in chronic low back pain patients. We hypothesized that meditation before exercise would reduce disability, pain, and anxiety by increasing mindfulness prior to physical activity compared with an audiobook control group. Participants Thirty-eight adults completed either meditation and exercise treatment (MedExT) (n=18) or an audiobook control condition (n=20). Setting Duquesne University Exercise Physiology Laboratory. Design A pilot, assessor-blinded, randomized controlled trial. Methods Over a 4-week period, participants in the MedExT group performed 12–17 minutes of guided meditation followed by 30 minutes of moderate-intensity walking exercise 5 days per week. Measures of disability, pain, mindfulness, and anxiety were taken at baseline and postintervention. Pain perception measurements were taken daily. Results Compared with the control group, we observed larger improvements in disability in the MedExT intervention, although the changes were modest and not statistically significant (mean between-group difference, –1.24; 95% confidence interval [CI], –3.1 to 0.6). For secondary outcome measures, MedExT increased mindfulness (within-group) from pre-intervention to postintervention (P=0.0141). Additionally, mean ratings of low back pain intensity and unpleasantness significantly improved with time for the MedExT group compared with that of the control group, respectively (intensity P=0.0008; unpleasantness P=0.0022). Conclusion . Overall, 4 weeks of MedExT produced suggestive between-group trends for disability, significant between-group differences for measures of pain, and significant within-group increases in mindfulness.

Kinesiophobia and physical activity: A systematic review and meta-analysis

“…Fifty-one studies assessed physical activity using a self-reported measure (Table 1). Most of these questionnaire-based studies used the short form of the International Physical Activity Questionnaire (IPAQ-SF; n = 20) 29,73,76,78,79,82,85,86,112,114,116,130,131,133,138–141,146,147 which consists of 6 items assessing time spent in light (i.e., walking), moderate (e.g., carrying light loads, cycling at moderate speed, doubles tennis), and vigorous physical activity (e.g., digging, fast cycling, heavy lifting, aerobics) over the last 7 days 159 . Other questionnaires were used to assess physical activity, such as the Baecke Habitual Physical Activity Questionnaire 160 (BHPAQ; n = 5) 64,89,90,107,113 , Saltin-Grimby Physical Activity Level Scale 161 (SGPALS; n = 5) 80,104,115,125,135 , Godin-Shephard Leisure-Time Exercise Questionnaire 162 (GLTEQ; n = 2) 121,134 , Minnesota Leisure Time Physical Activity Questionnaire 163 (MLTPAQ; n = 1) 136 , Physical Activity Scale for the Elderly 164 (PASE; n = 2) 123,149 , Physical Activity Questionnaire for the Elderly 164 (PAQE; n = 1) 72 , Short Questionnaire to Assess Health Enhancing Physical Activity 165 (SQUASH; n = 1) 142 , the Tegner Assessment Scale 166 (TAS; n = 1) 63 , University of California Los Angeles (UCLA) activity score 167 (n = 1) 84 , Leisure Time Physical Activity Index 168 (LTPAI; n = 1) 67 , Global Physical Activity Questionnaire 169 (GPAQ; n = 2) 77,83 , Freiburger Questionnaire on Physical Activity 170 (FQPA; n = 1) 127 , Jurka Physical Activity Scale 171 (JPAS; n = 1) 81 , Rapid Assessment of Physical Activity questionnaire 172 (RAPAQ; n = 1) 68 , Tecumseh Occupational Activity Questionnaire 173 (TOAQ; n = 1) 136 , and Australian Health Survey-derived questions (AHS; n = 1) …”

“…Physical activity was also assessed with devices such as accelerometers measuring accelerations in 3 dimensions (n = 23) 65,66,74,75,78,91,110,113,117,118,120,122,124,126,129,132,137,143–145,148,150,151 and pedometers measuring the number of steps (n = 3) 63,88,128 (Table 1). In most studies, the device was worn at the hip (n = 10) 63,91,113,117,124,129,137,148,150,151 .…”

“…Mean pain intensity at rest was reported in 45 out of the 74 articles included in the systematic review. Most studies used the Visual Analog Scale 174 (VAS; n = 21) 65,69–71,76,78,82,85,89,90,112,114,117,119,120,122,124,126,138,139,141 or the Numeric Rating Scale 175 (NRS; n = 15) 29,62,66,68,75,79,80,83,88,111,113,116,127,128,137 . Other studies used the Knee Injury Osteoarthritis Outcome Score pain subscale 176 (KOOS-P; n = 3) 63,84,134 , Brief Pain Inventory 177 (n = 1) 64 , Oxford Knee Score 178 (OKS; n = 1) 140 , the Quality of Well-Being Scale – Self-administered Pain Scale 179 (QWBS-P; n = 1) 150 , the Short Form 36 bodily pain 180 (SF-36; n = 1) 130 , the Graphic Rating Scale 181 (GRS; n = 1) 133 , Fibromyalgia Impact Questionnaire-Pain 182 (FIQ-Pain, n = 1) 67 and the Verbal Rating Scale 183 (VRS; n = 1) 104 .…”

Self-Healing: A Concept for Musculoskeletal Body Pain Management – Scientific Evidence and Mode of Action

“…100 Mindfulness is a mediation practice associated with changes in cognitive, sensorial experience and brain activity that has been shown to reduce levels of pain across a wide range of pain-related disorders including fibromyalgia. [101][102][103] After a four-session meditation intervention, during a noxious heat stimulus, there was a mean 40% reduction in pain intensity and 57% reduction in pain unpleasantness ratings. 103 In a small trial in Scotland of 34 patients, mindfulness meditation as a sole therapy for some involved a period of change which may help with painful and chronic conditions.…”

Effects of Pulsed-Wave Chromotherapy and Guided Relaxation on the Theta-Alpha Oscillation During Arrest Reaction

“…The combination of different wellness practices ( Zgierska et al, 2016 ; Hanley et al, 2021 ; Liu et al, 2021 ; Polaski et al, 2021 ) has demonstrated an increased efficiency promoting the development of devices, such as chromotherapy room. Chromotherapy is an ancient alternative medicine, often considered as a pseudoscience, planning to use the energy of electromagnetic radiations in the visible light spectrum to produce physiological and or psychological effects in humans.…”