Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness,anhedonia,guilt,fatigue,and impaired concentration.Although pharmacotherapy and psychotherapy can be effective,their utility is l...Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness,anhedonia,guilt,fatigue,and impaired concentration.Although pharmacotherapy and psychotherapy can be effective,their utility is limited by adverse effects and significant inter-individual variability.Non-pharmacological therapies from traditional medicine have emerged as promising adjuncts owing to their favorable safety profiles,minimal side effects,and high patient compliance.These therapies,including acupoint stimulation,meditation,and yoga,produce antidepressant effects by reducing neuroinflammation,modulating neurotransmitter release,enhancing neuroplasticity,and regulating the gut-brain axis.This review summarizes clinical applications and mechanistic insights of traditional medicine’s non-pharmacological therapies for depression,providing a scientific rationale for their integration into comprehensive management.展开更多
In recent years, cognitive difficulties associated with normal aging and dementia have been receiving increased attention from both public and scientific communities. With an increase in overall lifespan, promoting he...In recent years, cognitive difficulties associated with normal aging and dementia have been receiving increased attention from both public and scientific communities. With an increase in overall lifespan, promoting healthy cognition has become a priority and a necessity for minimizing and preventing individual and societal burdens associated with cognitive dysfunctions in the elderly. The general awareness concerning the efficacy of preventive(e.g., lifestyles) and palliative treatment strategies of cognitive impairments, related to either healthy or unhealthy trajectories in cognitive aging, is continuously rising. There are several therapeutic strategies which can be broadly classified as either pharmacological or non-pharmacological/psychosocial. In face of the modest evidence for success of pharmacological treatments, especially for dementia related impairments, psychosocial interventions are progressively considered as a complementary treatment. Despite the relative spread of psychosocial interventions in clinical settings, research in this area is rather scarce with evidence for success of these therapies remaining controversial. In this work we provide an evidence based perspective on cognitive intervention(s) for healthy aging, pre-dementia(mild cognitive impairment), and dementia populations. Current evidence and future directions for improving cognitive functions in the elderly are discussed as well.展开更多
Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hyp...Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs. Results Frail patients obtained low scores （4.1 ± 2.0） for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores （6.1 ± 2.1）. Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory （HBI）： positive mental attitudes （3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006） and health practices （3.6 ± 0.5 vs. 3.2 ± 0.5; P 〈 0.03）; as well as higher global scores （HBI raw score）： 83.3 ±10.6 vs. 77.3 ± 9.5; P 〈 0.03. Multiple regression analysis showed that frailty syndrome （FS） was a statistically significant independent determinant of worse adherence to pharmacological treatment （β= -0.27; P 〈 0.001） and health behaviors （β = -0.10; P = 0.036）. Education was a statistically significant independent determinant of better adherence to pharmacological treatment （β = 0.82; P = 0.012）, while net income positively affected health behaviors as measured by the HBI （β = 0.39; P = 0.046）. Conclusions FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients＇ adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.展开更多
BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medicati...BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.展开更多
Posterior cortical atrophy(PCA)is a rare neurodegene-rative condition characterized by progressive visual-perceptual deficits.Although the neurocognitive profile of PCA is a growing and relatively well-established fie...Posterior cortical atrophy(PCA)is a rare neurodegene-rative condition characterized by progressive visual-perceptual deficits.Although the neurocognitive profile of PCA is a growing and relatively well-established field,non-pharmacological care remains understudied and to be widely established in clinical practice.In the present work we review the available literature on non-pharmacological approaches for PCA,such as cognitive rehabilitation including individual cognitive exercises and compensatory techniques to improve autonomy in daily life,and psycho-education aiming to inform people with PCA about the nature of their visual deficits and limits of cognitive rehabilitation.The reviewed studies represented a total of 7 patients.There is a scarcity of the number of studies,and mostly consisting of case studies.Results suggest non-pharmacological intervention to be a potentially beneficial approach for the partial compensation of deficits,improvement of daily functionality and improvement of quality of life.Clinical implications and future directions are also highlighted for the advancement of the field,in order to clarify the possible role of non-pharmacological interventions,and its extent,in PCA.展开更多
Purpose: The purpose of this review is to systematically assess the potential effectiveness of targeted educational and other non-pharmacological interventions on diabetes control in populations of African descent in ...Purpose: The purpose of this review is to systematically assess the potential effectiveness of targeted educational and other non-pharmacological interventions on diabetes control in populations of African descent in developed countries. Such information can inform intervention strategies and highlight evidence-based approaches to deal with this significant problem in this population. Methods: A systematic review and a meta-analysis of random controlled trials and cohort studies evaluating the influence of education and other non-pharmacological interventions on HbA1Cconcentrations in patients of African descent with diabetes. A comprehensive search of PubMed, EMBASE, CINAHL, ZETOC, SIGLE databases was carried out. Results: Although nine studies (8 randomised controlled trials and 1 cohort study) met the inclusion criteria, relevant HbA1Cdata were available for 6 of the studies for the subsequent meta-analysis. Heterogeneity of meta-analysis was high (I2 = 92%), the random effects pooled standard mean difference favoured the intervention -0.66 (-1.15, -0.17), p = 0.009. After sensitivity analysis, I2 remained moderate to high at 69%. The random effects pooled standard mean difference continued to favour the intervention -0.48 (-0.81, -0.16), p = 0.009. Conclusion: There is evidence supporting the efficacy of educational and other non-pharmacological interventions in diabetes control in populations of African descent in English speaking developed countries. This conclusion is tempered by the significant heterogeneity of selected interventions and paucity of high quality research in the target population.展开更多
Background Supporting therapies that provide stress and pain control of preterm and term newborns infants contribute positively to the neuropsychomotor development.Non-pharmacological interventions that involve manual...Background Supporting therapies that provide stress and pain control of preterm and term newborns infants contribute positively to the neuropsychomotor development.Non-pharmacological interventions that involve manual techniques are described,considering protocols that can be reproduced by physical therapists,with positive and negative outcomes reports.Data sources Systematic review follows PRISMA 2020 statements guidelines.Primary and specific health sciences databases(Science Direct,Pubmed,Scielo,Embase and Scopus)were consulted between October 2021 and May 2022.Articles con-sidered were clinical trials,randomized or not,that included descriptions of the type of intervention as non-pharmacological and that studied the following outcomes:"pain"and"stress".Results Fifteen articles were selected for analysis,reaching a methodological quality of at least 3 on the Jadad Scale for the Quality of Researched Sources.The non-pharmacological therapies most applied in isolation were massage,swaddling or wrapping,gentle touch and kinesthetic stimulation,and the combined therapies were non-nutritive sucking and swad-dling,oral sucrose and swaddling,sensory stimulation and familiar odors,and sensory saturation.The outcomes found were relaxation,pain,and stress reduction after the application of painful procedures.The behavioral changes included crying,grimacing,yawning,sneezing,jerky arm or leg movements,startles,and finger flaring.The vital signs included heart rate,blood oxygen saturation level,and pulse respiration.Conclusions Combined techniques lead to better results in controlling neonatal pain when compared to isolated techniques.They can be applied both in preterm and term infants in a safe way and are reproducible in any health unit in a simple and economical way.展开更多
Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of dia...Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.展开更多
BACKGROUND Acupuncture is emerging as a promising treatment for insomnia.However,the determinants driving patients’decisions to pursue or adopt this treatment moda-lity remain underexplored.AIM To identify the key fa...BACKGROUND Acupuncture is emerging as a promising treatment for insomnia.However,the determinants driving patients’decisions to pursue or adopt this treatment moda-lity remain underexplored.AIM To identify the key factors shaping the willingness of patients with insomnia to seek and engage in acupuncture from a patient-centered perspective.METHODS A semi-structured focus group design was used,with a research framework integrating the capability,opportunity,motivation-behavior model,and theoretical domains framework.The results were mapped onto constructs of a behavioral wheel derived from the capability,opportunity,motivation-behavior/theoretical domains framework matrix.Data analyses employed abductive thematic analysis.RESULTS Data saturation was achieved after ten focus group sessions,involving a total of 45 participants.Key facilitators for patients with insomnia seeking acupuncture included:(1)Cultural beliefs in ethnic medicine;(2)Concerns about the adverse effects of,and dependence on,hypnotics;(3)Expectations of improvement in comorbid symptoms;(4)Desire for more communication with the clinician;and(5)Incentives from peers and online key opinion leaders.Barriers were:(1)Limited knowledge of acupuncture indications;(2)Accessibility burden;(3)Needle-phobia;and(4)Safety concerns.Additionally,prior acupuncture experiences,family/friend attitudes,and treatment costs(reimbursement rate in health insurance)served as both facilitators and barriers.CONCLUSION The interrelated facilitators and barriers underscore that the decision to use acupuncture for insomnia is a complex issue involving efficacy/safety,culture,economics,information dissemination,and communication factors.Expanding patient education on acupuncture,increasing media exposure,and improving governmental oversight of this process are essential.Investing in high-quality acupuncture services in public hospital nighttime clinics and community health centers is expected to address accessibility challenges.Acupuncturists need to improve doctor-patient communication,including guiding patients to set treatment expectations that are grounded in reality to enhance service quality.For patients with significant needle-phobia,cognitive manipulation or hypnosis te-chniques may be employed to improve treatment compliance.展开更多
Clinical hypnosis has been proposed as a non-pharmacological intervention in pediatric healthcare,drawing on children’s natural capacity for imagination and focused attention.It has been applied across a broad spectr...Clinical hypnosis has been proposed as a non-pharmacological intervention in pediatric healthcare,drawing on children’s natural capacity for imagination and focused attention.It has been applied across a broad spectrum of medical and psychological conditions,yet its true clinical value remains a matter of debate.This narrative review synthesizes findings from randomized controlled trials,cohort studies,systematic reviews,and clinical case series on pediatric hypnotherapy.Literature was selected based on relevance,methodological quality,and diversity of application.Evidence suggests that pediatric hypnosis may reduce acute and chronic pain,support management of functional gastrointestinal disorders,alleviate anxiety and habit disorders,improve sleep,and provide symptom relief in chronic diseases such as cancer and cystic fibrosis.Techniques are individualized and developmentally tailored,often using guided imagery,storytelling,and self-hypnosis.Reported benefits include reduced symptom burden,decreased reliance on medications,and improved quality of life.However,the strength of evidence varies considerably across conditions.Limitations include a shortage of large-scale trials,variability in individual responsiveness,limited availability of trained clinicians,and ongoing skepticism from healthcare providers and caregivers.While pediatric hypnosis may show promise as a safe and empowering adjunctive therapy,its clinical efficacy remains to be firmly established across all conditions.Further large-scale,methodologically rigorous research is required to clarify its actual benefits,cost-effectiveness,and role within integrative,evidence-based pediatric care.展开更多
BACKGROUND Intensive care units(ICUs)are stressful milieus for patients,particularly when under mechanical ventilation.Music is a non-pharmacological intervention that has shown a positive impact on physiological and ...BACKGROUND Intensive care units(ICUs)are stressful milieus for patients,particularly when under mechanical ventilation.Music is a non-pharmacological intervention that has shown a positive impact on physiological and psychological parameters in patients on mechanical ventilation.AIM To evaluate outcome of music therapy on patients who are critically ill to note the effect on ICU stays.METHODS One-hundred-and-thirty-six adult patients with acute respiratory failure requiring mechanical ventilation for 48 hours or more were randomized into the music therapy or routine care(control)groups.Patients were assessed for weaning criteria before music therapy was given.If eligible,a 30-minute music therapy was given prior to the extubation.Vital parameters were recorded at 5-minute intervals of therapy.Visual Analog Scale(VAS)-Dyspnea and VAS-Anxiety(VASA)were assessed before and after therapy.Richmond Agitation-Sedation Scale and Numerical Rating Scale scoring were conducted.RESULTS The difference in times of ventilator support in the music therapy intervention group(58.22±14.90 hours)and the control group(56.88±13.10 hours)was not statistically significant.ICU length of stay was significantly lower in the music therapy group(4.97±1.70 days vs control group:5.70±1.74 days).ICU mortality was significantly lower in the music therapy group as compared with the control group(7.4%vs 19.1%;P=0.043).At 0 minute the VAS-A scores of the music therapy(6.82±1.36)and control group(7.07±1.07)were comparable.During the remainder of the observation period,the VAS score of the music therapy group was significantly lower than that of the control group.CONCLUSION Music therapy is an inexpensive non-pharmacological intervention for patients in the ICU.However,future multicenter studies are warranted before routinely using music therapy in patients in the ICU.展开更多
This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with...This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with sleep disturbances recruited from Zouping County Traditional Chinese Medicine Hospital.Participants were divided into control and experimental groups,and sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before and after the intervention.The experimental group received Chinese herbal foot bath therapy,while the control group did not.Post-intervention results showed a significant improvement in sleep quality for the experimental group,with a mean PSQI score of 7.79(SD=2.90),compared to 13.45(SD=2.57)in the control group,indicating continued poor sleep.Statistical analysis confirmed that the therapy led to significant improvements across overall and component PSQI scores.The study concludes that Chinese herbal foot bath therapy is a safe,non-invasive,and cost-effective method to enhance sleep quality among postpartum women,especially those of advanced maternal age.It holds promise as a complementary treatment option and could be integrated into standard postpartum care practices to address sleep disturbances without relying on pharmacological interventions.展开更多
Objective:Breast cancer in India is growing at an alarming rate,and the fact that it is currently being detected more frequently in the younger age groups is even more concerning.In India,a woman dies of breast cancer...Objective:Breast cancer in India is growing at an alarming rate,and the fact that it is currently being detected more frequently in the younger age groups is even more concerning.In India,a woman dies of breast cancer every 8 min,which is a terrible situation.Breast cancer claims one life for every two women who are diagnosed with it.However,the morbidity level is gradually increasing due to advanced medical treatment,but we need to be aware and alert.Methods:The research has been structured as a randomized controlled trial.A total of 180 breast cancer patients were taken from Acharya Vinoba Bhave Rural Hospital(AVBRH),Cancer Center Sawangi Meghe for the study as per inclusion and exclusion criteria.With intervention,the period of the study was 11 months.A signed consent form was taken from each participant and based on the answers before,during,and after the trial the data were analyzed using IBM SPSS v29.Results:The investigator believes that the Buerger-Allen exercise and Epsom salt foot bath will improve the symptoms in the symptomatic group of breast cancer patients and will prevent or delay the occurrence of peripheral neuropathy symptoms among the asymptomatic group as well as improve the overall quality of life(QoL).However,during the trial,if any of the study participants developed any side effects,they would be identified early and prompt treatment would be initiated.Conclusions:This study protocol aims to evaluate and compare the non-pharmacological treatment options for chemotherapy-induced peripheral neuropathy(CIPN)and to develop a new treatment option that will pave the way to lead a new non-pharmacological cost-effective treatment option for breast cancer patients which also could improve the QoL.展开更多
Hypertension is a very prevalent risk factor for cardiovascular disease. The prevalence of resistant hypertension, i.e., uncontrolled hypertension with 3 or more antihypertensive agents including 1 diuretic, is betwee...Hypertension is a very prevalent risk factor for cardiovascular disease. The prevalence of resistant hypertension, i.e., uncontrolled hypertension with 3 or more antihypertensive agents including 1 diuretic, is between 5% and 30% in the hypertensive population. The causes of resistant hypertension are multifactorial and include behavioral and biological factors, such as nonadherence to pharmacological treatment. All current treatment guidelines highlight the positive role of physical exercise as a non-pharmacological tool in the treatment of hypertension. This paper draws attention to the possible role of physical exercise as an adjunct non-pharmacological tool in the management of resistant hypertension. A few studies have investigated it, employing different methodologies, and taken together they have shown promising results. In summary, the available evidence suggests that aerobic physical exercise could be a valuable addition to the optimal pharmacological treatment of patients with resistant hypertension.展开更多
AIM:To investigate the effect of lifestyle interventions in the non-pharmacological management of type 2 diabetes via a mechanistic approach.METHODS:A randomized controlled trial was carried out on 60 type 2 diabetic ...AIM:To investigate the effect of lifestyle interventions in the non-pharmacological management of type 2 diabetes via a mechanistic approach.METHODS:A randomized controlled trial was carried out on 60 type 2 diabetic male and female volunteers that fulfilled the inclusion criteria,with their proper consent and permission of the International Electrotechnical Commission for 1 year.30 patients were included in the test group and 30 patients in the control group.Demographic details,anthropometrical status,physical activity,food habits and blood glucose lipid profile of the volunteers were recorded at baseline,the test group was directed for lifestyle intervention and final blood glucose lipid data were collected at the end of one year of patient follow-up.RESULTS:After 1 year,the test group who had a lifestyle intervention was found to show a significant improvement in blood glucose lipid profile.The fasting plasma glucose level(FPG),postprandial plasma glucose level(PPG),glycosylated hemoglobin(HbA1c) and body mass index(BMI) values of the test group were reduced significantly,up to 145 ± 2.52,174 ± 2.59,6.3 ± 0.32 and 25 ± 0.41 respectively at the end of the study period,in comparison to the control group whereFPG,PPG,HbA1c and BMI values were 193 ± 3.36,249 ± 4.24,7.2 ± 0.42 and 26 ± 0.65 respectively.Improvement in the total cholesterol(TC),triglyceride(TG),high-density lipoproteins(HDL) and low-density lipoproteins(LDL) values of the test group was also remarkable in comparison to the control group.The TC,TG,HDL and LDL values of the test group were reduced significantly,up to 149 ± 3.32,124 ± 2.16,58 ± 0.62 and 118 ± 2.31,respectively.CONCLUSION:The significant improvement in the blood glucose lipid profile of the test group after 1 year signifies the value of non-pharmacological management of type 2 diabetes via lifestyle intervention strategies.展开更多
Osteoporosis in men is a heterogeneous disease that has received little attention.However,one third of worldwide hip fractures occur in the male population.This problem is more prevalent in people over70 years of age....Osteoporosis in men is a heterogeneous disease that has received little attention.However,one third of worldwide hip fractures occur in the male population.This problem is more prevalent in people over70 years of age.The etiology can be idiopathic or secondary to hypogonadism,vitamin D deficiency and inadequate calcium intake,hormonal treatments for prostate cancer,use of toxic and every disease or drug use that alters bone metabolism.Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis.However,risk factors in men are very heterogeneous.There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment.New treatments will offer new therapeutic prospects.The goal of this work is a revision of the present status knowledge about male osteoporosis.展开更多
Purpose： The purpose of this study was to evaluate whether and to what extent the observed effects on self-rated sleep in a previous study using a combined treatment program with physical exercise and sleep education...Purpose： The purpose of this study was to evaluate whether and to what extent the observed effects on self-rated sleep in a previous study using a combined treatment program with physical exercise and sleep education can be attributed by the physical activity （PA） component. Methods： The present study reports supplementary analysis of an already described and published study. Data were provided by a nonclinical sample of 98 normal-active adults with chronic initiating and the maintaining of sleep complaints. The additional analysis included sleep log, exercise log, and daily pedometer data which were collected during a baseline week and 6-week of a combined intervention. Results： The results indicate that the number of steps （p -- 0.02） and the duration of PA （p = 0.01） is significantly related to the improvement in subjective sleep measures and therefore reveal an independent effect within this combined sleep program. Sleep diary data （recuperation of sleep, number of awakenings after sleep onset, and wake time after sleep onset time） improved significant （all p 〈 0.01） over the intervention program. About 50% of the participants stated that the PA had an effect on their improvement. Conclusion： Improvements on subjective sleep quality after a combined intervention cannot be attributed to the cognitive component alone, but PA has an independent effect. Adults with chronic sleep complaints benefit from exercise. Therefore structured PA should be implemented in any sleep management programs.展开更多
Sleep is a critical part of our daily routine.It impacts every organ and system of our body,from the brain to the heart and from cellular metabolism to immune function.A consistent daily schedule of quality of sleep m...Sleep is a critical part of our daily routine.It impacts every organ and system of our body,from the brain to the heart and from cellular metabolism to immune function.A consistent daily schedule of quality of sleep makes a world of difference to our health and well-being.Despite its importance,so many individuals have trouble sleeping well.Poor quality sleep has such a detrimental impact on many aspects of our lives;it affects our thinking,learning,memory,and movements.Further,and most poignantly,poor quality sleep over time increases the risk of developing a serious medical condition,including neurodegenerative disease.In this review,we focus on a potentially new non-pharmacological treatment that improves the quality of sleep.This treatment,called photobiomodulation,involves the application of very specific wavelengths of light to body tissues.In animal models,these wavelengths,when applied at night,have been reported to stimulate the removal of fluid and toxic waste-products from the brain;that is,they improve the brain’s inbuilt house-keeping function.We suggest that transcranial nocturnal photobiomodulation,by improving brain function at night,will help improve the health and well-being of many individuals,by enhancing the quality of their sleep.展开更多
BACKGROUND Syncope presents with diagnostic challenges and is associated with high healthcare costs.Neurogenic orthostatic hypotension(nOH)as one cause of syncope is not well established.We review a case of syncope ca...BACKGROUND Syncope presents with diagnostic challenges and is associated with high healthcare costs.Neurogenic orthostatic hypotension(nOH)as one cause of syncope is not well established.We review a case of syncope caused by nOH in a patient with Parkinson's disease.CASE SUMMARY We describe a case of syncope caused by nOH in Parkinson's disease and review the literature.A 70-year-old man with Parkinson's disease had uncontrolled blood pressure for 1 mo,with blood pressure ranging from 70/40 to 220/112 mmHg,and once lost consciousness lasting for several minutes after getting up.Ambulatory blood pressure monitoring indicated nocturnal hypertension(up to 217/110 mmHg)and morning orthostatic hypotension(as low as 73/45 mmHg).Seated-to-standing blood pressure measurement showed that the blood pressure dropped from 173/96 mmHg to 95/68 mmHg after standing for 3 min from supine position.A diagnosis of nOH with supine hypertension was made.During the course of treatment,Midodrine could not improve the symptoms.Finally,the patient's blood pressure stabilized with simple strategies by strengthening exercises,reducing the duration of lying in bed in the daytime,and consuming water intake before getting up.CONCLUSION nOH is one of the causes of syncope.Ambulatory blood pressure monitoring is a cost-effective method for its diagnosis,and non-pharmacological measures are still the primary management methods.展开更多
Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (C...Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (CBT I) combined with light therapy and physical activity can be effective in the treatment of comorbid insomnia in older adults. Methods: Sixty-three (63) insomnia patients (47 female, 16 male) with an average age of 66.6 years participated in the program. Before and after the treatment, the participants completed questionnaires to assess their sleep quality (PSQI), day-time sleepiness (ESS), mood (BDI) and well-being (WHO-5-Index). In addition, they kept sleep diaries for six weeks. Results: Pre-post comparisons revealed a significant improvement in sleep latency and sleep quality, as well as a significant reduction of day-time sleepiness. In patients with both insomnia and depression, all depression scores improved slightly but significantly. Conclusions: Non-pharmacological combination treatment using CBT I, light therapy and physical activity seemed to be effective in older adults with comorbid insomnia and improve additionaly depressive symptoms.展开更多
基金supported by the Beijing Natural Science Foundation(7244491)Beijing TCM Science and Technology Development Fund Project(BJZYON-2023-05)+2 种基金Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ15-YQ-048,ZZ-YQ2023006)Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-D-202409)Science and Technology Innovation Project of the Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences(CIZJS2025023).
文摘Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness,anhedonia,guilt,fatigue,and impaired concentration.Although pharmacotherapy and psychotherapy can be effective,their utility is limited by adverse effects and significant inter-individual variability.Non-pharmacological therapies from traditional medicine have emerged as promising adjuncts owing to their favorable safety profiles,minimal side effects,and high patient compliance.These therapies,including acupoint stimulation,meditation,and yoga,produce antidepressant effects by reducing neuroinflammation,modulating neurotransmitter release,enhancing neuroplasticity,and regulating the gut-brain axis.This review summarizes clinical applications and mechanistic insights of traditional medicine’s non-pharmacological therapies for depression,providing a scientific rationale for their integration into comprehensive management.
基金Supported by The Foundation for Science and Technology,FCT(SFRH/BD/64457/2009 and SFRH/BD/65213/2009,co-funded by FSE/POPH)project PIC/IC/83290/2007,which is supported by FEDER(POFC-COMPETE) and FCT
文摘In recent years, cognitive difficulties associated with normal aging and dementia have been receiving increased attention from both public and scientific communities. With an increase in overall lifespan, promoting healthy cognition has become a priority and a necessity for minimizing and preventing individual and societal burdens associated with cognitive dysfunctions in the elderly. The general awareness concerning the efficacy of preventive(e.g., lifestyles) and palliative treatment strategies of cognitive impairments, related to either healthy or unhealthy trajectories in cognitive aging, is continuously rising. There are several therapeutic strategies which can be broadly classified as either pharmacological or non-pharmacological/psychosocial. In face of the modest evidence for success of pharmacological treatments, especially for dementia related impairments, psychosocial interventions are progressively considered as a complementary treatment. Despite the relative spread of psychosocial interventions in clinical settings, research in this area is rather scarce with evidence for success of these therapies remaining controversial. In this work we provide an evidence based perspective on cognitive intervention(s) for healthy aging, pre-dementia(mild cognitive impairment), and dementia populations. Current evidence and future directions for improving cognitive functions in the elderly are discussed as well.
文摘Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs. Results Frail patients obtained low scores （4.1 ± 2.0） for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores （6.1 ± 2.1）. Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory （HBI）： positive mental attitudes （3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006） and health practices （3.6 ± 0.5 vs. 3.2 ± 0.5; P 〈 0.03）; as well as higher global scores （HBI raw score）： 83.3 ±10.6 vs. 77.3 ± 9.5; P 〈 0.03. Multiple regression analysis showed that frailty syndrome （FS） was a statistically significant independent determinant of worse adherence to pharmacological treatment （β= -0.27; P 〈 0.001） and health behaviors （β = -0.10; P = 0.036）. Education was a statistically significant independent determinant of better adherence to pharmacological treatment （β = 0.82; P = 0.012）, while net income positively affected health behaviors as measured by the HBI （β = 0.39; P = 0.046）. Conclusions FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients＇ adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.
基金Supported by Ningbo Science and Technology Plan Project Public Welfare Plan(Municipal Level),No:2019C50099Ningbo Medical Key Supporting Discipline Child Health Science,No:2022-F26。
文摘BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.
文摘Posterior cortical atrophy(PCA)is a rare neurodegene-rative condition characterized by progressive visual-perceptual deficits.Although the neurocognitive profile of PCA is a growing and relatively well-established field,non-pharmacological care remains understudied and to be widely established in clinical practice.In the present work we review the available literature on non-pharmacological approaches for PCA,such as cognitive rehabilitation including individual cognitive exercises and compensatory techniques to improve autonomy in daily life,and psycho-education aiming to inform people with PCA about the nature of their visual deficits and limits of cognitive rehabilitation.The reviewed studies represented a total of 7 patients.There is a scarcity of the number of studies,and mostly consisting of case studies.Results suggest non-pharmacological intervention to be a potentially beneficial approach for the partial compensation of deficits,improvement of daily functionality and improvement of quality of life.Clinical implications and future directions are also highlighted for the advancement of the field,in order to clarify the possible role of non-pharmacological interventions,and its extent,in PCA.
文摘Purpose: The purpose of this review is to systematically assess the potential effectiveness of targeted educational and other non-pharmacological interventions on diabetes control in populations of African descent in developed countries. Such information can inform intervention strategies and highlight evidence-based approaches to deal with this significant problem in this population. Methods: A systematic review and a meta-analysis of random controlled trials and cohort studies evaluating the influence of education and other non-pharmacological interventions on HbA1Cconcentrations in patients of African descent with diabetes. A comprehensive search of PubMed, EMBASE, CINAHL, ZETOC, SIGLE databases was carried out. Results: Although nine studies (8 randomised controlled trials and 1 cohort study) met the inclusion criteria, relevant HbA1Cdata were available for 6 of the studies for the subsequent meta-analysis. Heterogeneity of meta-analysis was high (I2 = 92%), the random effects pooled standard mean difference favoured the intervention -0.66 (-1.15, -0.17), p = 0.009. After sensitivity analysis, I2 remained moderate to high at 69%. The random effects pooled standard mean difference continued to favour the intervention -0.48 (-0.81, -0.16), p = 0.009. Conclusion: There is evidence supporting the efficacy of educational and other non-pharmacological interventions in diabetes control in populations of African descent in English speaking developed countries. This conclusion is tempered by the significant heterogeneity of selected interventions and paucity of high quality research in the target population.
文摘Background Supporting therapies that provide stress and pain control of preterm and term newborns infants contribute positively to the neuropsychomotor development.Non-pharmacological interventions that involve manual techniques are described,considering protocols that can be reproduced by physical therapists,with positive and negative outcomes reports.Data sources Systematic review follows PRISMA 2020 statements guidelines.Primary and specific health sciences databases(Science Direct,Pubmed,Scielo,Embase and Scopus)were consulted between October 2021 and May 2022.Articles con-sidered were clinical trials,randomized or not,that included descriptions of the type of intervention as non-pharmacological and that studied the following outcomes:"pain"and"stress".Results Fifteen articles were selected for analysis,reaching a methodological quality of at least 3 on the Jadad Scale for the Quality of Researched Sources.The non-pharmacological therapies most applied in isolation were massage,swaddling or wrapping,gentle touch and kinesthetic stimulation,and the combined therapies were non-nutritive sucking and swad-dling,oral sucrose and swaddling,sensory stimulation and familiar odors,and sensory saturation.The outcomes found were relaxation,pain,and stress reduction after the application of painful procedures.The behavioral changes included crying,grimacing,yawning,sneezing,jerky arm or leg movements,startles,and finger flaring.The vital signs included heart rate,blood oxygen saturation level,and pulse respiration.Conclusions Combined techniques lead to better results in controlling neonatal pain when compared to isolated techniques.They can be applied both in preterm and term infants in a safe way and are reproducible in any health unit in a simple and economical way.
文摘Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.
基金Supported by Scientific Research Fund Project of Shanghai Sanda University,No.2024BSZX03.
文摘BACKGROUND Acupuncture is emerging as a promising treatment for insomnia.However,the determinants driving patients’decisions to pursue or adopt this treatment moda-lity remain underexplored.AIM To identify the key factors shaping the willingness of patients with insomnia to seek and engage in acupuncture from a patient-centered perspective.METHODS A semi-structured focus group design was used,with a research framework integrating the capability,opportunity,motivation-behavior model,and theoretical domains framework.The results were mapped onto constructs of a behavioral wheel derived from the capability,opportunity,motivation-behavior/theoretical domains framework matrix.Data analyses employed abductive thematic analysis.RESULTS Data saturation was achieved after ten focus group sessions,involving a total of 45 participants.Key facilitators for patients with insomnia seeking acupuncture included:(1)Cultural beliefs in ethnic medicine;(2)Concerns about the adverse effects of,and dependence on,hypnotics;(3)Expectations of improvement in comorbid symptoms;(4)Desire for more communication with the clinician;and(5)Incentives from peers and online key opinion leaders.Barriers were:(1)Limited knowledge of acupuncture indications;(2)Accessibility burden;(3)Needle-phobia;and(4)Safety concerns.Additionally,prior acupuncture experiences,family/friend attitudes,and treatment costs(reimbursement rate in health insurance)served as both facilitators and barriers.CONCLUSION The interrelated facilitators and barriers underscore that the decision to use acupuncture for insomnia is a complex issue involving efficacy/safety,culture,economics,information dissemination,and communication factors.Expanding patient education on acupuncture,increasing media exposure,and improving governmental oversight of this process are essential.Investing in high-quality acupuncture services in public hospital nighttime clinics and community health centers is expected to address accessibility challenges.Acupuncturists need to improve doctor-patient communication,including guiding patients to set treatment expectations that are grounded in reality to enhance service quality.For patients with significant needle-phobia,cognitive manipulation or hypnosis te-chniques may be employed to improve treatment compliance.
文摘Clinical hypnosis has been proposed as a non-pharmacological intervention in pediatric healthcare,drawing on children’s natural capacity for imagination and focused attention.It has been applied across a broad spectrum of medical and psychological conditions,yet its true clinical value remains a matter of debate.This narrative review synthesizes findings from randomized controlled trials,cohort studies,systematic reviews,and clinical case series on pediatric hypnotherapy.Literature was selected based on relevance,methodological quality,and diversity of application.Evidence suggests that pediatric hypnosis may reduce acute and chronic pain,support management of functional gastrointestinal disorders,alleviate anxiety and habit disorders,improve sleep,and provide symptom relief in chronic diseases such as cancer and cystic fibrosis.Techniques are individualized and developmentally tailored,often using guided imagery,storytelling,and self-hypnosis.Reported benefits include reduced symptom burden,decreased reliance on medications,and improved quality of life.However,the strength of evidence varies considerably across conditions.Limitations include a shortage of large-scale trials,variability in individual responsiveness,limited availability of trained clinicians,and ongoing skepticism from healthcare providers and caregivers.While pediatric hypnosis may show promise as a safe and empowering adjunctive therapy,its clinical efficacy remains to be firmly established across all conditions.Further large-scale,methodologically rigorous research is required to clarify its actual benefits,cost-effectiveness,and role within integrative,evidence-based pediatric care.
文摘BACKGROUND Intensive care units(ICUs)are stressful milieus for patients,particularly when under mechanical ventilation.Music is a non-pharmacological intervention that has shown a positive impact on physiological and psychological parameters in patients on mechanical ventilation.AIM To evaluate outcome of music therapy on patients who are critically ill to note the effect on ICU stays.METHODS One-hundred-and-thirty-six adult patients with acute respiratory failure requiring mechanical ventilation for 48 hours or more were randomized into the music therapy or routine care(control)groups.Patients were assessed for weaning criteria before music therapy was given.If eligible,a 30-minute music therapy was given prior to the extubation.Vital parameters were recorded at 5-minute intervals of therapy.Visual Analog Scale(VAS)-Dyspnea and VAS-Anxiety(VASA)were assessed before and after therapy.Richmond Agitation-Sedation Scale and Numerical Rating Scale scoring were conducted.RESULTS The difference in times of ventilator support in the music therapy intervention group(58.22±14.90 hours)and the control group(56.88±13.10 hours)was not statistically significant.ICU length of stay was significantly lower in the music therapy group(4.97±1.70 days vs control group:5.70±1.74 days).ICU mortality was significantly lower in the music therapy group as compared with the control group(7.4%vs 19.1%;P=0.043).At 0 minute the VAS-A scores of the music therapy(6.82±1.36)and control group(7.07±1.07)were comparable.During the remainder of the observation period,the VAS score of the music therapy group was significantly lower than that of the control group.CONCLUSION Music therapy is an inexpensive non-pharmacological intervention for patients in the ICU.However,future multicenter studies are warranted before routinely using music therapy in patients in the ICU.
文摘This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with sleep disturbances recruited from Zouping County Traditional Chinese Medicine Hospital.Participants were divided into control and experimental groups,and sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before and after the intervention.The experimental group received Chinese herbal foot bath therapy,while the control group did not.Post-intervention results showed a significant improvement in sleep quality for the experimental group,with a mean PSQI score of 7.79(SD=2.90),compared to 13.45(SD=2.57)in the control group,indicating continued poor sleep.Statistical analysis confirmed that the therapy led to significant improvements across overall and component PSQI scores.The study concludes that Chinese herbal foot bath therapy is a safe,non-invasive,and cost-effective method to enhance sleep quality among postpartum women,especially those of advanced maternal age.It holds promise as a complementary treatment option and could be integrated into standard postpartum care practices to address sleep disturbances without relying on pharmacological interventions.
基金supported by study protocol(No.DMIHER(DU)IEC/2023/22).
文摘Objective:Breast cancer in India is growing at an alarming rate,and the fact that it is currently being detected more frequently in the younger age groups is even more concerning.In India,a woman dies of breast cancer every 8 min,which is a terrible situation.Breast cancer claims one life for every two women who are diagnosed with it.However,the morbidity level is gradually increasing due to advanced medical treatment,but we need to be aware and alert.Methods:The research has been structured as a randomized controlled trial.A total of 180 breast cancer patients were taken from Acharya Vinoba Bhave Rural Hospital(AVBRH),Cancer Center Sawangi Meghe for the study as per inclusion and exclusion criteria.With intervention,the period of the study was 11 months.A signed consent form was taken from each participant and based on the answers before,during,and after the trial the data were analyzed using IBM SPSS v29.Results:The investigator believes that the Buerger-Allen exercise and Epsom salt foot bath will improve the symptoms in the symptomatic group of breast cancer patients and will prevent or delay the occurrence of peripheral neuropathy symptoms among the asymptomatic group as well as improve the overall quality of life(QoL).However,during the trial,if any of the study participants developed any side effects,they would be identified early and prompt treatment would be initiated.Conclusions:This study protocol aims to evaluate and compare the non-pharmacological treatment options for chemotherapy-induced peripheral neuropathy(CIPN)and to develop a new treatment option that will pave the way to lead a new non-pharmacological cost-effective treatment option for breast cancer patients which also could improve the QoL.
文摘Hypertension is a very prevalent risk factor for cardiovascular disease. The prevalence of resistant hypertension, i.e., uncontrolled hypertension with 3 or more antihypertensive agents including 1 diuretic, is between 5% and 30% in the hypertensive population. The causes of resistant hypertension are multifactorial and include behavioral and biological factors, such as nonadherence to pharmacological treatment. All current treatment guidelines highlight the positive role of physical exercise as a non-pharmacological tool in the treatment of hypertension. This paper draws attention to the possible role of physical exercise as an adjunct non-pharmacological tool in the management of resistant hypertension. A few studies have investigated it, employing different methodologies, and taken together they have shown promising results. In summary, the available evidence suggests that aerobic physical exercise could be a valuable addition to the optimal pharmacological treatment of patients with resistant hypertension.
文摘AIM:To investigate the effect of lifestyle interventions in the non-pharmacological management of type 2 diabetes via a mechanistic approach.METHODS:A randomized controlled trial was carried out on 60 type 2 diabetic male and female volunteers that fulfilled the inclusion criteria,with their proper consent and permission of the International Electrotechnical Commission for 1 year.30 patients were included in the test group and 30 patients in the control group.Demographic details,anthropometrical status,physical activity,food habits and blood glucose lipid profile of the volunteers were recorded at baseline,the test group was directed for lifestyle intervention and final blood glucose lipid data were collected at the end of one year of patient follow-up.RESULTS:After 1 year,the test group who had a lifestyle intervention was found to show a significant improvement in blood glucose lipid profile.The fasting plasma glucose level(FPG),postprandial plasma glucose level(PPG),glycosylated hemoglobin(HbA1c) and body mass index(BMI) values of the test group were reduced significantly,up to 145 ± 2.52,174 ± 2.59,6.3 ± 0.32 and 25 ± 0.41 respectively at the end of the study period,in comparison to the control group whereFPG,PPG,HbA1c and BMI values were 193 ± 3.36,249 ± 4.24,7.2 ± 0.42 and 26 ± 0.65 respectively.Improvement in the total cholesterol(TC),triglyceride(TG),high-density lipoproteins(HDL) and low-density lipoproteins(LDL) values of the test group was also remarkable in comparison to the control group.The TC,TG,HDL and LDL values of the test group were reduced significantly,up to 149 ± 3.32,124 ± 2.16,58 ± 0.62 and 118 ± 2.31,respectively.CONCLUSION:The significant improvement in the blood glucose lipid profile of the test group after 1 year signifies the value of non-pharmacological management of type 2 diabetes via lifestyle intervention strategies.
文摘Osteoporosis in men is a heterogeneous disease that has received little attention.However,one third of worldwide hip fractures occur in the male population.This problem is more prevalent in people over70 years of age.The etiology can be idiopathic or secondary to hypogonadism,vitamin D deficiency and inadequate calcium intake,hormonal treatments for prostate cancer,use of toxic and every disease or drug use that alters bone metabolism.Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis.However,risk factors in men are very heterogeneous.There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment.New treatments will offer new therapeutic prospects.The goal of this work is a revision of the present status knowledge about male osteoporosis.
文摘Purpose： The purpose of this study was to evaluate whether and to what extent the observed effects on self-rated sleep in a previous study using a combined treatment program with physical exercise and sleep education can be attributed by the physical activity （PA） component. Methods： The present study reports supplementary analysis of an already described and published study. Data were provided by a nonclinical sample of 98 normal-active adults with chronic initiating and the maintaining of sleep complaints. The additional analysis included sleep log, exercise log, and daily pedometer data which were collected during a baseline week and 6-week of a combined intervention. Results： The results indicate that the number of steps （p -- 0.02） and the duration of PA （p = 0.01） is significantly related to the improvement in subjective sleep measures and therefore reveal an independent effect within this combined sleep program. Sleep diary data （recuperation of sleep, number of awakenings after sleep onset, and wake time after sleep onset time） improved significant （all p 〈 0.01） over the intervention program. About 50% of the participants stated that the PA had an effect on their improvement. Conclusion： Improvements on subjective sleep quality after a combined intervention cannot be attributed to the cognitive component alone, but PA has an independent effect. Adults with chronic sleep complaints benefit from exercise. Therefore structured PA should be implemented in any sleep management programs.
文摘Sleep is a critical part of our daily routine.It impacts every organ and system of our body,from the brain to the heart and from cellular metabolism to immune function.A consistent daily schedule of quality of sleep makes a world of difference to our health and well-being.Despite its importance,so many individuals have trouble sleeping well.Poor quality sleep has such a detrimental impact on many aspects of our lives;it affects our thinking,learning,memory,and movements.Further,and most poignantly,poor quality sleep over time increases the risk of developing a serious medical condition,including neurodegenerative disease.In this review,we focus on a potentially new non-pharmacological treatment that improves the quality of sleep.This treatment,called photobiomodulation,involves the application of very specific wavelengths of light to body tissues.In animal models,these wavelengths,when applied at night,have been reported to stimulate the removal of fluid and toxic waste-products from the brain;that is,they improve the brain’s inbuilt house-keeping function.We suggest that transcranial nocturnal photobiomodulation,by improving brain function at night,will help improve the health and well-being of many individuals,by enhancing the quality of their sleep.
文摘BACKGROUND Syncope presents with diagnostic challenges and is associated with high healthcare costs.Neurogenic orthostatic hypotension(nOH)as one cause of syncope is not well established.We review a case of syncope caused by nOH in a patient with Parkinson's disease.CASE SUMMARY We describe a case of syncope caused by nOH in Parkinson's disease and review the literature.A 70-year-old man with Parkinson's disease had uncontrolled blood pressure for 1 mo,with blood pressure ranging from 70/40 to 220/112 mmHg,and once lost consciousness lasting for several minutes after getting up.Ambulatory blood pressure monitoring indicated nocturnal hypertension(up to 217/110 mmHg)and morning orthostatic hypotension(as low as 73/45 mmHg).Seated-to-standing blood pressure measurement showed that the blood pressure dropped from 173/96 mmHg to 95/68 mmHg after standing for 3 min from supine position.A diagnosis of nOH with supine hypertension was made.During the course of treatment,Midodrine could not improve the symptoms.Finally,the patient's blood pressure stabilized with simple strategies by strengthening exercises,reducing the duration of lying in bed in the daytime,and consuming water intake before getting up.CONCLUSION nOH is one of the causes of syncope.Ambulatory blood pressure monitoring is a cost-effective method for its diagnosis,and non-pharmacological measures are still the primary management methods.
文摘Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (CBT I) combined with light therapy and physical activity can be effective in the treatment of comorbid insomnia in older adults. Methods: Sixty-three (63) insomnia patients (47 female, 16 male) with an average age of 66.6 years participated in the program. Before and after the treatment, the participants completed questionnaires to assess their sleep quality (PSQI), day-time sleepiness (ESS), mood (BDI) and well-being (WHO-5-Index). In addition, they kept sleep diaries for six weeks. Results: Pre-post comparisons revealed a significant improvement in sleep latency and sleep quality, as well as a significant reduction of day-time sleepiness. In patients with both insomnia and depression, all depression scores improved slightly but significantly. Conclusions: Non-pharmacological combination treatment using CBT I, light therapy and physical activity seemed to be effective in older adults with comorbid insomnia and improve additionaly depressive symptoms.
