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Breathwork

Controlled breathing protocols — box breathing, 4-7-8, Wim Hof, and CO2 tolerance — for stress, HRV, and alertness.

Evidence is mixed

Acute effects of controlled breathing on HRV and stress are robust across dozens of RCTs. Long-term cognitive and mood benefits are less well-characterised. Wim Hof protocol claims outrun the controlled evidence; box breathing and slow breathing at ~6 breaths/min have the strongest mechanistic and RCT support.

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Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

A 10-week office-based hatha yoga program did not improve heart rate variability (a marker of physiological stress) for most participants, but those who consistently attended sessions saw improvements in flexibility, reduced state anxiety, and better upper-body muscular endurance, suggesting that high adherence is key to realizing benefits in fitness and psychological well-being.

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Evidence base

Min quality:

50 papers

RCTWikiHigh confidence

Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

Birinder S. Cheema, Angelique Houridis, Lisa Busch +8 more · BMC Complementary and Alternative Medicine · 2013 · 277 citations

A 10-week office-based hatha yoga program did not improve heart rate variability (a marker of physiological stress) for most participants, but those who consistently attended sessions saw improvements in flexibility, reduced state anxiety, and better upper-body muscular endurance, suggesting that high adherence is key to realizing benefits in fitness and psychological well-being.

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RCTWikiHigh evidence score

Stress Management and Resilience Training Among Department of Medicine Faculty: A Pilot Randomized Clinical Trial

Amit Sood, Kavita Prasad, Darrell R. Schroeder +1 more · Journal of General Internal Medicine · 2011 · 409 citations

A single 90-minute one-on-one training session in the SMART (Stress Management and Resiliency Training) program produced statistically significant improvements in resilience, perceived stress, anxiety, and overall quality of life at 8 weeks compared to a wait-list control group among 40 Department of Medicine physicians at Mayo Clinic.

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RCTWikiHigh evidence score

Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial

Wim Veling, Bart Lestestuiver, Marieke Jongma +2 more · Journal of Medical Internet Research · 2021 · 143 citations

A 10-day home-use VR nature relaxation app reduced momentary anxiety, sadness, and negative mood significantly more than standard audio relaxation exercises in 50 psychiatric outpatients, though both interventions improved mood and neither changed overall stress levels after 10 days.

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StudyModerate

Reporting animal research: Explanation and elaboration for the ARRIVE guidelines 2.0

Nathalie Percie du Sert, Amrita Ahluwalia, Sabina Alam +25 more · PLoS Biology · 2020 · 2,747 citations

Improving the reproducibility of biomedical research is a major challenge. Transparent and accurate reporting is vital to this process; it allows readers to assess the reliability of the findings and repeat or build upon the work of other researchers. The ARRIVE guidelines (Animal Research: Reporting In Vivo Experiments) were developed in 2010 to help authors and journals identify the minimum information necessary to report in publications describing in vivo experiments. Despite widespread endorsement by the scientific community, the impact of ARRIVE on the transparency of reporting in animal research publications has been limited. We have revised the ARRIVE guidelines to update them and facilitate their use in practice. The revised guidelines are published alongside this paper. This explanation and elaboration document was developed as part of the revision. It provides further information about each of the 21 items in ARRIVE 2.0, including the rationale and supporting evidence for their inclusion in the guidelines, elaboration of details to report, and examples of good reporting from the published literature. This document also covers advice and best practice in the design and conduct of animal studies to support researchers in improving standards from the start of the experimental design process through to publication.

StudyWikiModerate

2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee

Sharon L. Kolasinski, Tuhina Neogi, Marc C. Hochberg +29 more · Arthritis & Rheumatology · 2020 · 1,877 citations

This clinical practice guideline, based on a systematic review of the evidence, strongly recommends exercise, weight loss (for knee/hip OA), self-management programs, tai chi, cane use, and specific NSAID therapies for osteoarthritis, while conditionally recommending yoga, acupuncture, cognitive behavioral therapy, and several other interventions — providing a ranked, evidence-based toolkit for anyone managing OA symptoms.

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StudyTop journalWikiModerate

Management of post-acute covid-19 in primary care

Trisha Greenhalgh, Matthew Knight, Christine A’Court +2 more · BMJ · 2020 · 1,774 citations

Approximately 10% of people with COVID-19 experience prolonged symptoms lasting beyond three weeks, and this clinical review synthesises available evidence to guide primary care management, emphasising holistic support, symptom monitoring, and gradual return to activity rather than any single proven treatment.

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StudyWikiModerate

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

Hugh Calkins, Gerhard Hindricks, Riccardo Cappato +57 more · Heart Rhythm · 2017 · 2,701 citations

This expert consensus statement synthesises evidence from hundreds of studies to define when catheter or surgical ablation is appropriate for atrial fibrillation (AF), reporting that ablation is superior to antiarrhythmic drug therapy for maintaining sinus rhythm in paroxysmal AF (approximately 70–80% success at 1 year vs. 30–50% with drugs), but the statement is a clinical guideline, not a single experiment, so it cannot prove causation for any individual outcome.

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StudyLeading journalWikiModerate

2018 ESC Guidelines for the diagnosis and management of syncope

Michele Brignole, Angel Moya, Frederik J. de Lange +97 more · European Heart Journal · 2018 · 1,860 citations

This is not a single experiment but a clinical practice guideline synthesising hundreds of studies to define how doctors should diagnose, risk-stratify, and treat syncope (fainting); for someone running a self-experiment, the key takeaway is that most fainting is benign (reflex syncope) and can often be managed with physical counter-pressure manoeuvres, increased salt/fluid intake, and tilt-training, but that any unexplained fainting warrants medical evaluation first to rule out cardiac causes.

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StudyModerate

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Robert A. Swarm, Judith A. Paice, Doralina L. Anghelescu +27 more · Journal of the National Comprehensive Cancer Network · 2019 · 597 citations

In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

StudyModerate

Weaning from mechanical ventilation

J-M. Boles, Julian Bion, Alfred F. Connors +8 more · European Respiratory Journal · 2007 · 2,092 citations

Weaning covers the entire process of liberating the patient from mechanical support and from the endotracheal tube. Many controversial questions remain concerning the best methods for conducting this process. An International Consensus Conference was held in April 2005 to provide recommendations regarding the management of this process. An 11-member international jury answered five pre-defined questions. 1) What is known about the epidemiology of weaning problems? 2) What is the pathophysiology of weaning failure? 3) What is the usual process of initial weaning from the ventilator? 4) Is there a role for different ventilator modes in more difficult weaning? 5) How should patients with prolonged weaning failure be managed? The main recommendations were as follows. 1) Patients should be categorised into three groups based on the difficulty and duration of the weaning process. 2) Weaning should be considered as early as possible. 3) A spontaneous breathing trial is the major diagnostic test to determine whether patients can be successfully extubated. 4) The initial trial should last 30 min and consist of either T-tube breathing or low levels of pressure support. 5) Pressure support or assist-control ventilation modes should be favoured in patients failing an initial trial/trials. 6) Noninvasive ventilation techniques should be considered in selected patients to shorten the duration of intubation but should not be routinely used as a tool for extubation failure.

StudyModerate

Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force

NM Siafakas, P. Vermeire, N.B. Pride +8 more · European Respiratory Journal · 1995 · 1,592 citations

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. In the European Union, COPD and asthma, together with pneumonia, are the third most common cause of death. In North America, COPD is the fourth leading cause of death, and mortality rates and prevalence are increasing. The major characteristic of COPD is the presence of chronic airflow limitation that progresses slowly over a period of years and is, by definition, largely irreversible. Most patients with COPD are, or were, cigarette smokers. Prevention by reducing the prevalence of smoking remains a priority. Although much of the damage is irreversible at the time of clinical presentation, treatments are available to improve the quality of life, the life expectancy, and perhaps the functional ability of patients with COPD. Several national and international consensus statements on optimal assessment and management of asthma have been published in recent years. These consensus statements have led to international standardization of diagnosis and management and to better care. They also form a basis for clinical audits and suggest areas of future research. However, there have been few attempts to develop consensus guidelines on management of COPD [1, 2]. The European Respiratory Society (ERS) has taken the initiative of producing a consensus statement on COPD. A Task Force of scientists and clinicians was invited to provide this European consensus. The guidelines are intended for use by physicians involved in the care of patients with COPD, and their main goals are to inform health professionals and to reverse a widespread nihilistic approach to the management of these patients. This Task Force firmly believes that treatment can significantly improve the quality and length of life of patients suffering from this chronic, progressive condition. Subcommittees of the Task Force focused on the five main sections of this project: Pathology/Pathophysiology, Epidemiology, Assessment, Treatment, and Management. Experts produced papers within each section, and these papers were brought together by the subcommittee heads. At a plenary meeting held in Wiesbaden, Germany on November 11–13, 1993, all contributions were extensively discussed, and additional working group meetings were arranged. Flowcharts for management in common clinical situations were produced. However, at all stages, members of the Task Force found themselves confronted by unresolved questions and regional differences in management across Europe. A practical approach was adopted, combining established scientific evidence and a consensus view when current data were inadequate. This approach identified more clearly those areas where further research is needed. Comments on drafts of the consensus statement were invited from participants of the original meeting, which included colleagues from North America. The edited document was sent to independent experts for external review. All members had an opportunity to comment on the document at the ERS meeting in Nice on October 2, 1994. As chairmen of the Task Force, we hope that the final document will promote better management of COPD in Europe. We would like to thank all who contributed to it. On behalf of the ERS, we also gratefully acknowledge a generous educational grant from Boehringer Ingelheim and the organizational assistance provided by M.T. Lopez-Vidriero.

StudyLeading journalModerate

Interoception, contemplative practice, and health

Norman A. S. Farb, Jennifer Daubenmier, Cynthia Price +6 more · Frontiers in Psychology · 2015 · 613 citations

Interoception can be broadly defined as the sense of signals originating within the body. As such, interoception is critical for our sense of embodiment, motivation, and well-being. And yet, despite its importance, interoception remains poorly understood within modern science. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It is hoped that this integrative effort will advance our understanding of how interoception determines well-being, and identify the central challenges to such understanding. To this end, we introduce an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind-body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a person's sense of presence and agency in the world.

StudyModerate

Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 4th Edition

R. Norman Harden, Ann Louise Oaklander, Allen W. Burton +7 more · Pain Medicine · 2013 · 527 citations

OBJECTIVE: This is the fourth edition of diagnostic and treatment guidelines for complex regional pain syndrome (CRPS; aka reflex sympathetic dystrophy). METHODS: Expert practitioners in each discipline traditionally utilized in the treatment of CRPS systematically reviewed the available and relevant literature; due to the paucity of levels 1 and 2 studies, less rigorous, preliminary research reports were included. The literature review was supplemented with knowledge gained from extensive empirical clinical experience, particularly in areas where high-quality evidence to guide therapy is lacking. RESULTS: The research quality, clinical relevance, and "state of the art" of diagnostic criteria or treatment modalities are discussed, sometimes in considerable detail with an eye to the expert practitioner in each therapeutic area. Levels of evidence are mentioned when available, so that the practitioner can better assess and analyze the modality under discussion, and if desired, to personally consider the citations. Tables provide details on characteristics of studies in different subject domains described in the literature. CONCLUSIONS: In the humanitarian spirit of making the most of all current thinking in the area, balanced by a careful case-by-case analysis of the risk/cost vs benefit analysis, the authors offer these "practical" guidelines.

StudyModerate

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Elaine Miller, Laura L. Murray, Lorie Richards +4 more · Stroke · 2010 · 761 citations

Certified rehabilitation counselors www.crccertification.com Assist individuals with disabilities to maximize their vocational and avocational living goals in the most integrated setting possible through the application of the counseling process, including vocational and counseling, case management, referral, and service coordination; identifying and addressing employment and attitudinal barriers; and job analysis, development, and placement services. Neuropsychologists www.apa.org Specialize in brain-behavior relationships and have extensive training in anatomy, physiology, and neuropathology. They identify and treat cognitive and neurobehavioral dysfunction, and through assessment also monitor recovery and thereby enhance community reintegration. Occupational therapists www.aota.org Focus on the "skills of living" necessary for independent and satisfying living. OT services include customized treatment programs to perform daily activities, comprehensive home and job site evaluations and adaptation recommendations, performance skills assessment and interventions, adaptive equipment recommendations and training, and family and caregiver education. Rehabilitation nurses (RNs) www.rehabnurse.org Manage complex medical issues, provide ongoing patient and caregiver education, and establish care plans to maintain optimal wellness. RNs use a holistic approach to fulfill patients' medical, environmental, spiritual, vocational, and educational needs via principles from other disciplines and their own unique medical expertise (bowel, bladder, and skin management). In all care settings, RNs function as coordinators/case managers, collaborators, and counselors. A registered nurse with at least 2 years of practice in rehabilitation who passes the Association of Rehabilitation Nurses examination can earn the Certified Rehabilitation Nurse distinction. Physical therapists www.apta.org Experts in examining and treating neuromuscular problems that affect the abilities of individuals to move. PTs practice in many settings and with all age groups. Physicians www.aapmr.org Usually coordinate the rehabilitation team and manage medical conditions pertaining to stroke and comorbidities. A physician may be a physiatrist (ie, specializing in physical medicine and rehabilitation and thus restoration of function in individuals with problems that range from simple physical mobility to more complex cognitive issues). Recreational therapists www.atra-online.com Provide treatment services and recreation activities to individuals with disabilities to facilitate independent physical, cognitive, emotional, and social functioning by enhancing individuals' current skills and assisting new skill development for daily living and community function. Besides discharge planning for community reintegration, they help individuals develop or redevelop social, discretionary time, decision-making, coping, self-advocacy, and basic skills to enhance overall quality of life. Social workers www.naswdc.org Assist individuals, groups, or communities restore or enhance their capacity for social functioning, while creating societal conditions favorable to their goals. Requires knowledge of human development and behavior; social, economic, and cultural institutions; and interactions among these factors. Social workers help prevent crises; counsel individuals, families, and communities to facilitate coping with everyday stresses; and identify resources to allow individuals with disabilities to remain in the community. SLPs www.asha.org Assess speech, language and other cognitive functions, as well as swallowing, and provide interventions and counseling/education to address language and speech disorders (eg, aphasia, apraxia of speech, dysarthria, and cognitive-communication impairment). SLPs also intervene when swallowing and cognitive disorders exist. They provide services to all age groups and in all care settings. RN indicates rehabilitation nurse. Downloaded from http://ahajournals.org by on August 11, 2023

RCTHigh evidence score

A RCT Comparing Daily Mindfulness Meditations, Biofeedback Exercises, and Daily Physical Exercise on Attention Control, Executive Functioning, Mindful Awareness, Self-Compassion, and Worrying in Stressed Young Adults

Esther I. de Bruin, Judith Esi van der Zwan, Susan M. Bögels · Mindfulness · 2016 · 133 citations

Our Western society is characterized by multitasking, competition, and constant time pressure. Negative effects of stress for the individual (anxiety, depression, somatic complaints) and for organizations and society (costs due to work absence) are very high. Thus, time-efficient self-help interventions to address these issues are necessary. This study assessed the effects of daily mindfulness meditations (MM) versus daily heart rate variability biofeedback (HRV-BF) and daily physical exercise (PE) on attention control, executive functioning, mindful awareness, self-compassion, and worrying. Young adults (n = 75, age range 18 to 40) with elevated stress levels were randomized to MM, HRV-BF, or PE, and measurements were taken at pre-test, post-test, and follow-up. Interventions in all three groups were self-guided and lasted for 5 weeks. Generalized estimating equation analyses showed that overall, all three interventions were effective and did not differ from each other. However, practice time differed between groups, with participants in the PE group practicing much more than participants in the other two groups. Therefore, additional analyses were carried out in two subsamples. The optimal dose sample included only those participants who practiced for at least 70 % of the total prescribed time. In the equal dose sample, home practice intensity was equal for all three groups. Again, the effects of the three interventions did not differ. In conclusion, MM, HRV-BF, and PE are all effective self-help methods to improve attention control, executive functioning, mindful awareness, self-compassion, and worrying, and mindfulness meditation was not found to be more effective than HRV-biofeedback or physical exercise for these cognitive processes.

StudyTop journalModerate

Thinking through other minds: A variational approach to cognition and culture

Samuel P. L. Veissière, Axel Constant, Maxwell J. D. Ramstead +2 more · Behavioral and Brain Sciences · 2019 · 358 citations

The processes underwriting the acquisition of culture remain unclear. How are shared habits, norms, and expectations learned and maintained with precision and reliability across large-scale sociocultural ensembles? Is there a unifying account of the mechanisms involved in the acquisition of culture? Notions such as "shared expectations," the "selective patterning of attention and behaviour," "cultural evolution," "cultural inheritance," and "implicit learning" are the main candidates to underpin a unifying account of cognition and the acquisition of culture; however, their interactions require greater specification and clarification. In this article, we integrate these candidates using the variational (free-energy) approach to human cognition and culture in theoretical neuroscience. We describe the construction by humans of social niches that afford epistemic resources called cultural affordances. We argue that human agents learn the shared habits, norms, and expectations of their culture through immersive participation in patterned cultural practices that selectively pattern attention and behaviour. We call this process "thinking through other minds" (TTOM) - in effect, the process of inferring other agents' expectations about the world and how to behave in social context. We argue that for humans, information from and about other people's expectations constitutes the primary domain of statistical regularities that humans leverage to predict and organize behaviour. The integrative model we offer has implications that can advance theories of cognition, enculturation, adaptation, and psychopathology. Crucially, this formal (variational) treatment seeks to resolve key debates in current cognitive science, such as the distinction between internalist and externalist accounts of theory of mind abilities and the more fundamental distinction between dynamical and representational accounts of enactivism.

StudyTop journalModerate

Potential self-regulatory mechanisms of yoga for psychological health

Tim Gard, Jessica J. Noggle, Crystal L. Park +2 more · Frontiers in Human Neuroscience · 2014 · 464 citations

Research suggesting the beneficial effects of yoga on myriad aspects of psychological health has proliferated in recent years, yet there is currently no overarching framework by which to understand yoga's potential beneficial effects. Here we provide a theoretical framework and systems-based network model of yoga that focuses on integration of top-down and bottom-up forms of self-regulation. We begin by contextualizing yoga in historical and contemporary settings, and then detail how specific components of yoga practice may affect cognitive, emotional, behavioral, and autonomic output under stress through an emphasis on interoception and bottom-up input, resulting in physical and psychological health. The model describes yoga practice as a comprehensive skillset of synergistic process tools that facilitate bidirectional feedback and integration between high- and low-level brain networks, and afferent and re-afferent input from interoceptive processes (somatosensory, viscerosensory, chemosensory). From a predictive coding perspective we propose a shift to perceptual inference for stress modulation and optimal self-regulation. We describe how the processes that sub-serve self-regulation become more automatized and efficient over time and practice, requiring less effort to initiate when necessary and terminate more rapidly when no longer needed. To support our proposed model, we present the available evidence for yoga affecting self-regulatory pathways, integrating existing constructs from behavior theory and cognitive neuroscience with emerging yoga and meditation research. This paper is intended to guide future basic and clinical research, specifically targeting areas of development in the treatment of stress-mediated psychological disorders.

StudyModerate

Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain

Peter O’Sullivan, J.P. Cañeiro, Mary O’Keeffe +4 more · Physical Therapy · 2018 · 410 citations

Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes. Cognitive functional therapy was developed as a flexible integrated behavioral approach for individualizing the management of disabling LBP. This approach has evolved from an integration of foundational behavioral psychology and neuroscience within physical therapist practice. It is underpinned by a multidimensional clinical reasoning framework in order to identify the modifiable and nonmodifiable factors associated with an individual's disabling LBP. This article illustrates the application of cognitive functional therapy to provide care that can be adapted to an individual with disabling LBP.

StudyLeading journalModerate

State of the science and recommendations for using wearable technology in sleep and circadian research

Massimiliano de Zambotti, Cathy Goldstein, Jesse D. Cook +4 more · SLEEP · 2023 · 193 citations

Wearable sleep-tracking technology is of growing use in the sleep and circadian fields, including for applications across other disciplines, inclusive of a variety of disease states. Patients increasingly present sleep data derived from their wearable devices to their providers and the ever-increasing availability of commercial devices and new-generation research/clinical tools has led to the wide adoption of wearables in research, which has become even more relevant given the discontinuation of the Philips Respironics Actiwatch. Standards for evaluating the performance of wearable sleep-tracking devices have been introduced and the available evidence suggests that consumer-grade devices exceed the performance of traditional actigraphy in assessing sleep as defined by polysomnogram. However, clear limitations exist, for example, the misclassification of wakefulness during the sleep period, problems with sleep tracking outside of the main sleep bout or nighttime period, artifacts, and unclear translation of performance to individuals with certain characteristics or comorbidities. This is of particular relevance when person-specific factors (like skin color or obesity) negatively impact sensor performance with the potential downstream impact of augmenting already existing healthcare disparities. However, wearable sleep-tracking technology holds great promise for our field, given features distinct from traditional actigraphy such as measurement of autonomic parameters, estimation of circadian features, and the potential to integrate other self-reported, objective, and passively recorded health indicators. Scientists face numerous decision points and barriers when incorporating traditional actigraphy, consumer-grade multi-sensor devices, or contemporary research/clinical-grade sleep trackers into their research. Considerations include wearable device capabilities and performance, target population and goals of the study, wearable device outputs and availability of raw and aggregate data, and data extraction, processing, and analysis. Given the difficulties in the implementation and utilization of wearable sleep-tracking technology in real-world research and clinical settings, the following State of the Science review requested by the Sleep Research Society aims to address the following questions. What data can wearable sleep-tracking devices provide? How accurate are these data? What should be taken into account when incorporating wearable sleep-tracking devices into research? These outstanding questions and surrounding considerations motivated this work, outlining practical recommendations for using wearable technology in sleep and circadian research.

StudyModerate

Microbiome and tryptophan metabolomics analysis in adolescent depression: roles of the gut microbiota in the regulation of tryptophan-derived neurotransmitters and behaviors in human and mice

Manfei Zhou, Yichun Fan, Liuting Xu +11 more · Microbiome · 2023 · 209 citations

BACKGROUND: Adolescent depression is becoming one of the major public health concerns, because of its increased prevalence and risk of significant functional impairment and suicidality. Clinical depression commonly emerges in adolescence; therefore, the prevention and intervention of depression at this stage is crucial. Recent evidence supports the importance of the gut microbiota (GM) in the modulation of multiple functions associated with depression through the gut-brain axis (GBA). However, the underlying mechanisms remain poorly understood. Therefore, in the current study, we aimed to screen the microbiota out from healthy and depressive adolescents, delineate the association of the targeted microbiota and the adolescent depression, address the salutary effects of the targeted microbiota on anti-depressive behaviors in mice involving the metabolism of the tryptophan (Trp)-derived neurotransmitters along the GBA. RESULTS: Here, we found the gut microbiota from healthy adolescent volunteers, first diagnosis patients of adolescent depression, and sertraline interveners after first diagnosis displayed significant difference, the relative abundance of Faecalibacterium, Roseburia, Collinsella, Blautia, Phascolarctobacterium, Lachnospiraceae-unclassified decreased in adolescent depressive patients, while restored after sertraline treatment. Of note, the Roseburia abundance exhibited a high efficiency in predicting adolescent depression. Intriguingly, transplantation of the fecal microbiota from healthy adolescent volunteers to the chronic restraint stress (CRS)-induced adolescent depressed mice significantly ameliorated mouse depressive behaviors, in which the Roseburia exerted critical roles, since its effective colonization in the mouse colon resulted in remarkably increased 5-HT level and reciprocally decreased kynurenine (Kyn) toxic metabolites quinolinic acid (Quin) and 3-hydroxykynurenine (3-HK) levels in both the mouse brain and colon. The specific roles of the Roseburia were further validated by the target bacteria transplantation mouse model, Roseburia intestinalis (Ri.) was gavaged to mice and importantly, it dramatically ameliorated CRS-induced mouse depressive behaviors, increased 5-HT levels in the brain and colon via promoting tryptophan hydroxylase-2 (TPH2) or -1 (TPH1) expression. Reciprocally, Ri. markedly restrained the limit-step enzyme responsible for kynurenine (indoleamine2,3-dioxygenase 1, IDO1) and quinolinic acid (3-hydroxyanthranilic acid 3,4-dioxygenase, 3HAO) generation, thereby decreased Kyn and Quin levels. Additionally, Ri. administration exerted a pivotal role in the protection of CRS-induced synaptic loss, microglial activation, and astrocyte maintenance. CONCLUSIONS: This study is the first to delineate the beneficial effects of Ri. on adolescent depression by balancing Trp-derived neurotransmitter metabolism and improving synaptogenesis and glial maintenance, which may yield novel insights into the microbial markers and therapeutic strategies of GBA in adolescent depression. Video Abstract.

StudyModerate

Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient

J. Bott, Sidney Blumenthal, Martin Buxton +15 more · Thorax · 2009 · 448 citations

Physiotherapy should be offered to patients with a variety of medical respiratory conditions, with the aim of breathlessness management and symptom control, mobility and function improvement or maintenance, and airway clearance and cough enhancement or support. Strategies and techniques include: rehabilitation, exercise testing (including for ambulatory oxygen assessment), exercise prescription, airway clearance, and positioning and breathing techniques. Physiotherapy may be helpful for postural and/or musculoskeletal dysfunction and pain, and provide help in improving continence, especially during coughing and forced expiratory manoeuvres. Physiotherapists are usually central to the delivery of pulmonary rehabilitation and may be instrumental in the non-invasive ventilation service. Physiotherapists are frequently involved in the delivery of oxygen and some nebulised substances, as well as providing vital monitoring of, for example, ventilatory function and cough effectiveness. Some complementary therapies may be appropriate in some situations (Web Appendix 1).

StudyModerate

The Effect of Deep and Slow Breathing on Pain Perception, Autonomic Activity, and Mood Processing—An Experimental Study

Volker Busch, Walter Magerl, Uwe Kern +3 more · Pain Medicine · 2011 · 243 citations

OBJECTIVE: Deep and slow breathing (DSB) techniques, as a component of various relaxation techniques, have been reported as complementary approaches in the treatment of chronic pain syndromes, but the relevance of relaxation for alleviating pain during a breathing intervention was not evaluated so far. METHODS: In order to disentangle the effects of relaxation and respiration, we investigated two different DSB techniques at the same respiration rates and depths on pain perception, autonomic activity, and mood in 16 healthy subjects. In the attentive DSB intervention, subjects were asked to breathe guided by a respiratory feedback task requiring a high degree of concentration and constant attention. In the relaxing DSB intervention, the subjects relaxed during the breathing training. The skin conductance levels, indicating sympathetic tone, were measured during the breathing maneuvers. Thermal detection and pain thresholds for cold and hot stimuli and profile of mood states were examined before and after the breathing sessions. RESULTS: The mean detection and pain thresholds showed a significant increase resulting from the relaxing DSB, whereas no significant changes of these thresholds were found associated with the attentive DSB. The mean skin conductance levels indicating sympathetic activity decreased significantly during the relaxing DSB intervention but not during the attentive DSB. Both breathing interventions showed similar reductions in negative feelings (tension, anger, and depression). CONCLUSION: Our results suggest that the way of breathing decisively influences autonomic and pain processing, thereby identifying DSB in concert with relaxation as the essential feature in the modulation of sympathetic arousal and pain perception.

RCTLeading journalHigh evidence score

Naturopathic Care for Anxiety: A Randomized Controlled Trial ISRCTN78958974

Kieran Cooley, Orest Szczurko, Dan Perri +4 more · PLoS ONE · 2009 · 112 citations

BACKGROUND: Anxiety is a serious personal health condition and represents a substantial burden to overall quality of life. Additionally anxiety disorders represent a significant cost to the health care system as well as employers through benefits coverage and days missed due to incapacity. This study sought to explore the effectiveness of naturopathic care on anxiety symptoms using a randomized trial. METHODS: Employees with moderate to severe anxiety of longer than 6 weeks duration were randomized based on age and gender to receive naturopathic care (NC) (n = 41) or standardized psychotherapy intervention (PT) (n = 40) over a period of 12 weeks. Blinding of investigators and participants during randomization and allocation was maintained. Participants in the NC group received dietary counseling, deep breathing relaxation techniques, a standard multi-vitamin, and the herbal medicine, ashwagandha (Withania somnifera) (300 mg b.i.d. standardized to 1.5% with anolides, prepared from root). The PT intervention received psychotherapy, and matched deep breathing relaxation techniques, and placebo. The primary outcome measure was the Beck Anxiety Inventory (BAI) and secondary outcome measures included the Short Form 36 (SF-36), Fatigue Symptom Inventory (FSI), and Measure Yourself Medical Outcomes Profile (MY-MOP) to measure anxiety, mental health, and quality of life respectively. Participants were blinded to the placebo-controlled intervention. RESULTS: Seventy-five participants (93%) were followed for 8 or more weeks on the trial. Final BAI scores decreased by 56.5% (p<0.0001) in the NC group and 30.5% (p<0.0001) in the PT group. BAI group scores were significantly decreased in the NC group compared to PT group (p = 0.003). Significant differences between groups were also observed in mental health, concentration, fatigue, social functioning, vitality, and overall quality of life with the NC group exhibiting greater clinical benefit. No serious adverse reactions were observed in either group. RELEVANCE: Many patients seek alternatives and/or complementary care to conventional anxiety treatments. To date, no study has evaluated the potential of a naturopathic treatment protocol to effectively treat anxiety. Knowledge of the efficacy, safety or risk of natural health products, and naturopathic treatments is important for physicians and the public in order to make informed decisions. INTERPRETATION: Both NC and PT led to significant improvements in patients' anxiety. Group comparison demonstrated a significant decrease in anxiety levels in the NC group over the PT group. Significant improvements in secondary quality of life measures were also observed in the NC group as compared to PT. The whole system of naturopathic care for anxiety needs to be investigated further including a closer examination of the individual components within the context of their additive effect. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN78958974.

StudyLeading journalModerate

Inflammation–Nature's Way to Efficiently Respond to All Types of Challenges: Implications for Understanding and Managing “the Epidemic” of Chronic Diseases

Jeanette M. Bennett, Glenn Reeves, George E. Billman +1 more · Frontiers in Medicine · 2018 · 518 citations

; the pathways of several common conditions are described in detail. The final part of the paper considers the implications of these understandings for clinical care and explore how this lens could shape the physician-patient encounter and health system redesign. We conclude that healthcare professionals must advocate for an anti-inflammatory lifestyle at the patient level as well as at the local and national levels to enhance population health and well-being.

StudyTop journalModerate

Vagal Tank Theory: The Three Rs of Cardiac Vagal Control Functioning – Resting, Reactivity, and Recovery

Sylvain Laborde, Emma Mosley, Alina Mertgen · Frontiers in Neuroscience · 2018 · 292 citations

The aim of this paper is to set the stage for the vagal tank theory, showcasing a functional resource account for self-regulation. The vagal tank theory, building on neurophysiological, cognitive and social psychology approaches, will introduce a physiological indicator for self-regulation that has mainly been ignored from cognitive and social psychology, cardiac vagal control (also referred to as cardiac vagal activity). Cardiac vagal control reflects the contribution of the vagus nerve, the main nerve of the parasympathetic nervous system, to cardiac regulation. We propose cardiac vagal control to be an indicator of how efficiently self-regulatory resources are mobilized and used. Three systematic levels of cardiac vagal control analysis are suggested: resting, reactivity, and recovery. Based on this physiological indicator we derive the metaphor of the vagal tank, which can get depleted and replenished. Overall, the vagal tank theory will enable to integrate previous findings from different disciplines and to stimulate new research questions, predictions, and designs regarding self-regulation.

StudyLeading journalModerate

Matter Over Mind: A Randomised-Controlled Trial of Single-Session Biofeedback Training on Performance Anxiety and Heart Rate Variability in Musicians

Ruth Wells, Tim Outhred, James Heathers +2 more · PLoS ONE · 2012 · 181 citations

BACKGROUND: Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity. OBJECTIVE: This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance. METHODS: A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV. RESULTS: Slow breathing groups (n=30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n=15) during 5 minute recordings of performance anticipation following the intervention (effect size: η(2) =0.122 and η(2) =0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n=15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n=7) (r=0.379). CONCLUSIONS: These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety.

StudyModerate

All around suboptimal health — a joint position paper of the Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine

Wei Wang, Yuxiang Yan, Zheng Guo +12 more · The EPMA Journal · 2021 · 162 citations

First two decades of the twenty-first century are characterised by epidemics of non-communicable diseases such as many hundreds of millions of patients diagnosed with cardiovascular diseases and the type 2 diabetes mellitus, breast, lung, liver and prostate malignancies, neurological, sleep, mood and eye disorders, amongst others. Consequent socio-economic burden is tremendous. Unprecedented decrease in age of maladaptive individuals has been reported. The absolute majority of expanding non-communicable disorders carry a chronic character, over a couple of years progressing from reversible suboptimal health conditions to irreversible severe pathologies and cascading collateral complications. The time-frame between onset of SHS and clinical manifestation of associated disorders is the operational area for an application of reliable risk assessment tools and predictive diagnostics followed by the cost-effective targeted prevention and treatments tailored to the person. This article demonstrates advanced strategies in bio/medical sciences and healthcare focused on suboptimal health conditions in the frame-work of Predictive, Preventive and Personalised Medicine (3PM/PPPM). Potential benefits in healthcare systems and for society at large include but are not restricted to an improved life-quality of major populations and socio-economical groups, advanced professionalism of healthcare-givers and sustainable healthcare economy. Amongst others, following medical areas are proposed to strongly benefit from PPPM strategies applied to the identification and treatment of suboptimal health conditions:Stress overload associated pathologiesMale and female healthPlanned pregnanciesPeriodontal healthEye disordersInflammatory disorders, wound healing and pain management with associated complicationsMetabolic disorders and suboptimal body weightCardiovascular pathologiesCancersStroke, particularly of unknown aetiology and in young individualsSleep medicineSports medicineImproved individual outcomes under pandemic conditions such as COVID-19.

StudyModerate

The role of heart rate variability in sports physiology

JIN-GUO DONG · Experimental and Therapeutic Medicine · 2016 · 316 citations

Heart rate variability (HRV) is a relevant marker reflecting cardiac modulation by sympathetic and vagal components of the autonomic nervous system (ANS). Although the clinical application of HRV is mainly associated with the prediction of sudden cardiac death and assessing cardiovascular and metabolic illness progression, recent observations have suggested its applicability to physical exercise training. HRV is becoming one of the most useful tools for tracking the time course of training adaptation/maladaptation of athletes and in setting the optimal training loads leading to improved performances. However, little is known regarding the role of HRV and the internal effects of physical exercise on an athlete, which may be useful in designing fitness programs ensuring sufficient training load that may correspond with the specific ability of the athlete. In this review, we offer a comprehensive assessment of investigations concerning the interrelation between HRV and ANS, and examine how the application of HRV to physical exercise may play a role in sports physiology.

StudyTop journalModerate

Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity

Roderik J. S. Gerritsen, Guido P. H. Band · Frontiers in Human Neuroscience · 2018 · 277 citations

Contemplative practices, such as meditation and yoga, are increasingly popular among the general public and as topics of research. Beneficial effects associated with these practices have been found on physical health, mental health and cognitive performance. However, studies and theories that clarify the underlying mechanisms are lacking or scarce. This theoretical review aims to address and compensate this scarcity. We will show that various contemplative activities have in common that breathing is regulated or attentively guided. This respiratory discipline in turn could parsimoniously explain the physical and mental benefits of contemplative activities through changes in autonomic balance. We propose a neurophysiological model that explains how these specific respiration styles could operate, by phasically and tonically stimulating the vagal nerve: respiratory vagal nerve stimulation (rVNS). The vagal nerve, as a proponent of the parasympathetic nervous system (PNS), is the prime candidate in explaining the effects of contemplative practices on health, mental health and cognition. We will discuss implications and limitations of our model.

RCTWikiHigh evidence score

Conscious connected breathing with breath retention intervention in adults with chronic low back pain: protocol for a randomized controlled pilot study

Steven D. Pratscher, Kimberly T. Sibille, Roger B. Fillingim · Pilot and Feasibility Studies · 2023 · 8 citations

This document describes the planned design for a pilot study, not its results, aiming to determine if a specific breathing technique (conscious connected breathing with breath retention) is feasible and acceptable for adults with chronic low back pain, which is a crucial first step before testing if it actually reduces pain.

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StudyModerate

Reduction in perceived stress as a migraine trigger

Richard B. Lipton, Dawn C. Buse, Charles B. Hall +5 more · Neurology · 2014 · 143 citations

OBJECTIVE: To test whether level of perceived stress and reductions in levels of perceived stress (i.e., "let-down") are associated with the onset of migraine attacks in persons with migraine. METHODS: Patients with migraine from a tertiary headache center were invited to participate in a 3-month electronic diary study. Participants entered data daily regarding migraine attack experience, subjective stress ratings, and other data. Stress was assessed using 2 measures: the Perceived Stress Scale and the Self-Reported Stress Scale. Logit-normal, random-effects models were used to estimate the odds ratio for migraine occurrence as a function of level of stress over several time frames. RESULTS: Of 22 enrolled participants, 17 (median age 43.8 years) completed >30 days of diaries, yielding 2,011 diary entries including 110 eligible migraine attacks (median 5 attacks per person). Level of stress was not generally associated with migraine occurrence. However, decline in stress from one evening diary to the next was associated with increased migraine onset over the subsequent 6, 12, and 18 hours, with odds ratios ranging from 1.5 to 1.9 (all p values < 0.05) for the Perceived Stress Scale. Decline in stress was associated with migraine onset after controlling for level of stress for all time points. Findings were similar using the Self-Reported Stress Scale. CONCLUSIONS: Reduction in stress from one day to the next is associated with migraine onset the next day. Decline in stress may be a marker for an impending migraine attack and may create opportunities for preemptive pharmacologic or behavioral interventions.

StudyModerate

Review of Stress Detection Methods Using Wearable Sensors

Georgios V. Taskasaplidis, Dimitris A. Fotiadis, Panagiotis D. Bamidis · IEEE Access · 2024 · 80 citations

Stress is a significant factor that affects well-being and health. Factors that trigger stress include work, social interactions, and economic and environmental factors. Stress may cause lower labor productivity, physical and mental health problems, and malfunctions in all social aspects of life. Psychosomatic health can be improved if proper stress detection mechanisms are present in daily life and stress reduction methods can occur. Wearable sensors are currently used in many commercial and scientific applications in a non-destructive or annoying manner. These devices are used in daily routines. In this paper, a comprehensive review of the latest literature and developments in stress detection methods is presented through extensive and holistic research on stress response, both at the level of the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal axis (HPA). This study focused on the exploitation of various methods, technologies, and data analysis systems to understand stress in a multifaceted and comprehensive manner. Various stress-related factors are presented along with biological signal measurements, and physical secretions or biomarkers are primarily used for stress detection. Furthermore, the manner in which body movement and posture measurements may be related to stress was investigated, together with speech and hand tremors. Various stress-detection technologies have been analyzed, and existing data analysis methods that can be applied to stress-detection systems have been highlighted. This review serves as a reference and guideline for exploring this area of interest, identifying research opportunities, and offering ideas, options, and suggestions for optimized solutions regarding future applications and research.

StudyModerate

COHERENCE: BRIDGING PERSONAL, SOCIAL AND GLOBAL HEALTH

Rollin McCraty · Journal of Nursing Social Studies Public Health and Rehabilitation · 2012 · 181 citations

All nature is a continuum.The endless complexity of life is organized into patterns which repeat themselves -theme and variations -at each level of system.These similarities and differences are proper concerns for science.From the ceaseless streaming of protoplasm to the many-vectored activities of supranational systems, there are continuous flows through living systems as they maintain their highly organized steady states.""Even more basic to this presentation than the concept of 'system' are the concepts of 'space', 'time', 'matter', 'energy', and information, because the living systems exist in space and are made of matter and energy organized by information" (James Grier Miller, Living Systems, 1978).

StudyModerate

Health 2050: The Realization of Personalized Medicine through Crowdsourcing, the Quantified Self, and the Participatory Biocitizen

Melanie Swan · Journal of Personalized Medicine · 2012 · 403 citations

The concepts of health and health care are moving towards the notion of personalized preventive health maintenance and away from an exclusive focus on the cure of disease. This is against the backdrop of contemporary public health challenges that include increasing costs, worsening outcomes, 'diabesity' epidemics, and anticipated physician shortages. Personalized preventive medicine could be critical to solving public health challenges at their causal root. This paper sets forth a vision and plan for the realization of preventive medicine by 2050 and examines efforts already underway such as participatory health initiatives, the era of big health data, and qualitative shifts in mindset.

StudyLeading journalModerate

A calming hug: Design and validation of a tactile aid to ease anxiety

Alice Haynes, Annie Lywood, Emily M. Crowe +3 more · PLoS ONE · 2022 · 60 citations

Anxiety disorders affect approximately one third of people during their lifetimes and are the ninth leading cause of global disability. Current treatments focus on therapy and pharmacological interventions. However, therapy is costly and pharmacological interventions often have undesirable side-effects. Healthy people also regularly suffer periods of anxiety. Therefore, a non-pharmacological, intuitive, home intervention would be complementary to other treatments and beneficial for non-clinical groups. Existing at-home anxiety aids, such as guided meditations, typically employ visual and/or audio stimuli to guide the user into a calmer state. However, the tactile sense has the potential to be a more natural modality to target in an anxiety-calming device. The tactile domain is relatively under-explored, but we suggest that there are manifold physiological and affective qualities of touch that lend it to the task. In this study we demonstrate that haptic technology can offer an enjoyable, effective and widely accessible alternative for easing state anxiety. We describe a novel huggable haptic interface that pneumatically simulates slow breathing. We discuss the development of this interface through a focus group evaluating five prototypes with embedded behaviours ('breathing', 'purring', 'heartbeat' and 'illumination'). Ratings indicated that the 'breathing' prototype was most pleasant to interact with and participants described this prototype as 'calming' and 'soothing', reminding them of a person breathing. This prototype was developed into an ergonomic huggable cushion containing a pneumatic chamber powered by an external pump allowing the cushion to 'breathe'. A mixed-design experiment (n = 129) inducing anxiety through a group mathematics test found that the device was effective at reducing pre-test anxiety compared to a control (no intervention) condition and that this reduction in anxiety was indistinguishable from that of a guided meditation. Our findings highlight the efficacy of this interface, demonstrating that haptic technologies can be effective at easing anxiety. We suggest that the field should be explored in more depth to capture the nuances of different modalities in relation to specific situations and trait characteristics.

StudyModerate

The mindful moms training: development of a mindfulness-based intervention to reduce stress and overeating during pregnancy

Cassandra Vieten, Barbara Laraia, Jean L. Kristeller +6 more · BMC Pregnancy and Childbirth · 2018 · 78 citations

BACKGROUND: Pregnancy is a time of high risk for excessive weight gain, leading to health-related consequences for mothers and offspring. Theory-based obesity interventions that target proposed mechanisms of biobehavioral change are needed, in addition to simply providing nutritional and weight gain directives. Mindfulness training is hypothesized to reduce stress and non-homeostatic eating behaviors - or eating for reasons other than hunger or caloric need. We developed a mindfulness-based intervention for high-risk, low-income overweight pregnant women over a series of iterative waves using the Obesity-Related Behavioral Intervention Trials (ORBIT) model of intervention development, and tested its effects on stress and eating behaviors. METHODS: Overweight pregnant women (n = 110) in their second trimester were enrolled in an 8-week group intervention. Feasibility, acceptability, and facilitator fidelity were assessed, as well as stress, depression and eating behaviors before and after the intervention. We also examined whether pre-to-post intervention changes in outcomes of well-being and eating behaviors were associated with changes in proposed mechanisms of mindfulness, acceptance, and emotion regulation. RESULTS: Participants attended a mean of 5.7 sessions (median = 7) out of 8 sessions total, and facilitator fidelity was very good. Of the women who completed class evaluations, at least half reported that each of the three class components (mindful breathing, mindful eating, and mindful movement) were "very useful," and that they used them on most days at least once a day or more. Women improved in reported levels of mindfulness, acceptance, and emotion regulation, and these increases were correlated with reductions in stress, depression, and overeating. CONCLUSIONS: These findings suggest that in pregnant women at high risk for excessive weight gain, it is both feasible and effective to use mindfulness strategies taught in a group format. Further, increases in certain mindfulness skills may help with better management of stress and overeating during pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov NCT01307683 , March 8, 2011.

StudyLeading journalModerate

Cardiac coherence, self-regulation, autonomic stability, and psychosocial well-being

Rollin McCraty, Maria A. Zayas · Frontiers in Psychology · 2014 · 288 citations

The ability to alter one's emotional responses is central to overall well-being and to effectively meeting the demands of life. One of the chief symptoms of events such as trauma, that overwhelm our capacities to successfully handle and adapt to them, is a shift in our internal baseline reference such that there ensues a repetitive activation of the traumatic event. This can result in high vigilance and over-sensitivity to environmental signals which are reflected in inappropriate emotional responses and autonomic nervous system dynamics. In this article we discuss the perspective that one's ability to self-regulate the quality of feeling and emotion of one's moment-to-moment experience is intimately tied to our physiology, and the reciprocal interactions among physiological, cognitive, and emotional systems. These interactions form the basis of information processing networks in which communication between systems occurs through the generation and transmission of rhythms and patterns of activity. Our discussion emphasizes the communication pathways between the heart and brain, as well as how these are related to cognitive and emotional function and self-regulatory capacity. We discuss the hypothesis that self-induced positive emotions increase the coherence in bodily processes, which is reflected in the pattern of the heart's rhythm. This shift in the heart rhythm in turn plays an important role in facilitating higher cognitive functions, creating emotional stability and facilitating states of calm. Over time, this establishes a new inner-baseline reference, a type of implicit memory that organizes perception, feelings, and behavior. Without establishing a new baseline reference, people are at risk of getting "stuck" in familiar, yet unhealthy emotional and behavioral patterns and living their lives through the automatic filters of past familiar or traumatic experience.

StudyTop journalModerate

Breathing: a Powerfull Tool for Physical &amp; Neuropsychological Regulation. The role of Mobile Apps

Athanasios Drigas, Eleni Mitsea · Technium Social Sciences Journal · 2022 · 79 citations

Breathing, although unconscious and often overlooked, is a central aspect of our whole being and one of our most vital functions. This review paper aims at investigating the physiological as well as the neuropsychological benefits of breathing training techniques. In addition, we examine the effectiveness of mobile breathing applications in upgrading human health and wellness. Finally, we discuss the role of metacognition in breathing, as the only means people have to gain awareness of the profound powers of breath and take conscious control of their health.