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Publications (172)
Introduction
Fear of cancer recurrence (FCR) is prevalent and distressing among survivors of cancer. Evidence‐based mind‐body and cognitive‐behavioral skills lack integration and testing in scalable formats.
Objective
This pilot randomized controlled trial (NCT04876599) tested a synchronous, virtual mind‐body group resiliency intervention for FCR...
Background
Concussions are common, particularly among young adults, and often are associated with persistent, debilitating, and hard-to-treat symptoms. Anxiety and concussion symptoms often amplify each other, and growing evidence indicates that anxiety plays a key role in symptoms persistence after concussion. Targeting anxiety early after concuss...
Objective
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic and debilitating illness with symptoms such as post-exertional malaise and cognitive dysfunction that can be challenging for patients to manage independently. Randomized controlled trials (RCTs) have examined mind-body and psychological approaches that teach patients...
Background
Following acute coronary syndrome (ACS), up to 40% of patients report elevated depressive symptoms which is associated with a two-fold increase in mortality risk due to behavioral and biological mechanisms. Mindfulness-Based Cognitive Therapy (MBCT) delivered via synchronous group videoconferencing could help reduce depressive symptoms....
Background
Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied...
Background
Approximately one-half of all adults with HIV experience chronic pain. Needed are nonpharmacological approaches to improve pain management in this population.
Methods
For this study, we conducted in-depth qualitative interviews (n = 20) with thirteen adults with HIV and 7 HIV care providers regarding their perceptions of Tai Chi for chr...
Background: Yoga may promote health via a complex modulation of inflammation. Little is known about oxylipins, a class of circulating mediators involved in inflammation resolution. Objective: To explore the acute effects of yoga exercise on systemic levels of oxylipins. Methods: This is a secondary analysis of a three-arm (high-intensity-yoga: HY,...
Background
Tai Chi (TC), a mind-body exercise, may be a potential exercise maintenance strategy for patients with chronic obstructive pulmonary disease (COPD) after pulmonary rehabilitation. We sought to characterize the acute cardiorespiratory response during TC versus walking in patients with COPD after a 24-week intervention.
Methods
Cardioresp...
Introduction
Insomnia is highly prevalent and difficulty falling asleep is the most common complaint. The transition from wakefulness to sleep is characterized by a shift from sympathetic to parasympathetic regulation, which can be assessed by heart rate dynamics. Using a machine learning approach, we aimed to explore whether heart rate dynamics du...
Background
Given the deleterious effects of physical inactivity in persons with chronic obstructive pulmonary disease (COPD) and/or heart failure (HF), interventions that promote long-term daily physical activity are needed. Mindful Steps, designed to promote walking behaviors in COPD and HF, is a multicomponent intervention that integrates mind-bo...
503
Background: Up to 70% of cancer survivors have elevated fear of cancer recurrence (FCR). Behavioral approaches are promising for managing FCR but lack testing in a scalable, synchronous, remotely-delivered, group format. This NCCIH-funded pilot RCT tested an adapted mind-body resiliency program (IN FOCUS) in comparison to a usual care control (...
Chronic musculoskeletal pain is prevalent and undertreated in older adults. In particular, multisite pain is associated with serious functional consequences and falls and appears to be a novel geriatric syndrome. The causes of multisite pain are often multifactorial, and emerging evidence supports a complex pathway whereby multisite pain leads to c...
Introduction
Pre-sleep stress or hyperarousal is a known key etiological component in insomnia disorder. However, physiological alterations during the sleep onset period are not well-understood. We aimed to characterize heart rate variability (HRV) in patients with insomnia during sleep onset.
Methods
Using data from the Sleep Heart Health Study a...
Background: Methods of conservative management for breast cancer-related lymphedema (BCRL) are burdensome in terms of time, cost, and convenience. In addition, many patients are not candidates for surgical treatment. Preliminary results have demonstrated possible beneficial effects of acupuncture for patients with BCRL. In this small pilot study, w...
Background:
Multisite musculoskeletal pain is highly prevalent among older adults yet undertreated. Studies support the promise of Tai Chi for managing pain and lowering fall risk. Since the COVID-19 pandemic, effective alternatives to classroom-based exercise programming are warranted.
Aims:
To recruit 100 racially diverse older adults with mul...
Study objectives:
Heart rate variability (HRV) measures provide valuable insights into physiology, however, gaps remain in understanding circadian patterns in heart rate dynamics. We aimed to explore day-night differences in heart rate dynamics in chronic cardiopulmonary patients compared to healthy controls.
Methods:
Using 24-hour heart rate da...
College-aged individuals with anxiety are vulnerable to developing persistent concussion symptoms, yet evidence-based treatments for this population are limited. Understanding these individuals’ perspectives is critical for developing effective interventions. We conducted qualitative interviews with 17 college-aged individuals (18–24 years old) wit...
Background
There is a knowledge gap in the physiological effects of short-term yoga exercise interventions.
Objective
To evaluate the feasibility of a randomized controlled trial (RCT) assessing the acute effects of a yoga exercise protocol practiced at 2 intensities (high or moderate) on temporal responses of a battery of systemic circulatory cyt...
Chronic musculoskeletal pain is prevalent, challenging to treat, and often disabling. Evidence supports the role of psychological factors in pain-related outcomes, and it is now accepted that rehabilitation should combine physical and psychological approaches (ie, psychologically informed practice). This Perspective articulates a vision for technol...
Objective
To conduct a systematic review evaluating the impact of stretching on inflammation and its resolution using in vivo rodent models. Findings are evaluated for their potential to inform the design of clinical yoga studies to assess the impact of yogic stretching on inflammation and health.
Methods
Studies were identified using four databas...
People living with HIV (PLWH) experience higher rates of comorbid chronic pain conditions compared to the general population. Managing HIV and chronic pain, two stigmatized health conditions, can exacerbate physical and psychological suffering. The current qualitative study was designed to increase our understanding of the experience of living with...
Background
For cancer survivors, there is a paucity of fear of recurrence (FOR) interventions that integrate empirically supported mind-body and psychological skills for managing FOR and are delivered in scalable formats.
Objective
To adapt an evidence-based resiliency intervention to address FOR among cancer survivors.
Methods
A multidisciplinar...
The goal of this study was to evaluate feasibility and acceptability of a remote Tai Chi program in diverse older adults with multisite pain and risk for falls during the COVID-19 pandemic. Adults aged ≥65y living in diverse Boston neighborhoods were invited through mailed letters to participate in a recruitment and screening survey. Eligible adult...
Objective
We evaluated exercise interventions for cognitive appraisal of chronic low-back pain (cLBP) in an underserved population.
Methods
We conducted a secondary analysis of the Back to Health Trial, showing yoga to be non-inferior to physical therapy (PT) for pain and function outcomes among adults with cLBP (n = 320) recruited from primary ca...
Introduction: The past several years have witnessed a significant increase in interest among the public in mindfulness with an unmistakable growth in the scientific literature investigating mindfulness-based therapies. A myriad of therapeutic uses of mindfulness have been studied. Given this burgeoning interest, the authors' objective was to conduc...
In this pilot feasibility randomized controlled trial, participants with moderate to severe COPD were randomized to a 12-week tai chi or MBB intervention. Participants were assessed at baseline, 12 weeks, and 24 weeks. Feasibility, as assessed by intervention adherence, was the primary outcome. We also estimated preliminary between-group difference...
Mind-body modalities are promising strategies to maintain the benefits gained after completion of conventional pulmonary rehabilitation (PR) in persons with COPD.
In this pilot randomised controlled study, we examined Tai Chi in persons with COPD after completing PR. Participants were randomised 2:2:1 to Tai Chi (TC), usual care (UC), or group walk...
Study objectives:
Although subjective-objective sleep discrepancy has long been observed in patients with insomnia, the profiles of this discrepancy are poorly understood. Further, sleep discrepancy in insomnia with sleep comorbidities remains underexplored. We sought to better characterize sleep discrepancy among patient groups with and without i...
Introduction
Current diagnostic classifications define insomnia based on self-reported sleep difficulties. However, differences between self-reported and objectively measured sleep parameters (subjective-objective sleep discrepancy or sleep misperception) are very common. Insomnia and sleep apnea cause common impairments that overlap and have negat...
PURPOSE
Chronic obstructive pulmonary disease (COPD) is associated with dyspnea, decreased physical activity, and reduced quality-of-life. While pulmonary rehabilitation is helpful, maintenance of physical activity afterwards is problematic. We sought to explore qualitatively the multi-dimensional, biopsychosocial experience of patients with COPD w...
Background:
Despite current rehabilitation programs, long-term engagement in physical activity remains a significant challenge for patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF). Novel strategies to promote physical activity in these populations are greatly needed. Emerging literature on the benefits of both mind...
Purpose
Chronic obstructive pulmonary disease (COPD) is associated with multiple psychosocial and behavioral factors. Prior research suggests that mind-body interventions may support the development and maintenance of healthy behaviors and improve health-related quality-of-life in such patients. We sought to qualitatively explore cognitive, psychos...
Background
Informal caregivers, often family and friends, experience significant psychological and physical distress leading to reductions in health and quality of life (QOL). Mind-body interventions focused on caregivers are often limited and do not address multiple barriers, including caregivers’ economic, geographic, and time constraints. Transl...
BACKGROUND
Despite current rehabilitation programs, long-term engagement in physical activity remains a significant challenge for patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF). Novel strategies to promote physical activity in these populations are greatly needed. Emerging literature on the benefits of both mind-b...
Clinical Case
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“Katie” is a 38-year-old married non-Hispanic white woman with a history of spontaneous coronary artery dissection (SCAD), who was referred for psychotherapy by her cardiologist for the treatment of anxiety and stress symptoms; these symptoms were negatively impacting her quality of life (QoL), r...
Affect intolerance/sensitivity, defined as one's sensitivity to, or inability to tolerate, affective states, is a transdiagnostic process implicated in the development and maintenance of numerous forms of psychopathology. Mindfulness and acceptance interventions are posited to improve affect intolerance/sensitivity; however, there has been no quant...
Background
Every year, approximately 42 million people sustain a mild traumatic brain injury (mTBI, also known as concussion), with particularly high rates among college-aged individuals. A substantial proportion of these people (44%-64%) develop persistent symptoms that are challenging to treat, costly, and associated with significant disability....
BACKGROUND
Every year, approximately 42 million people sustain a mild traumatic brain injury (mTBI, also known as concussion), with particularly high rates among college-aged individuals. A substantial proportion of these people (44%-64%) develop persistent symptoms that are challenging to treat, costly, and associated with significant disability....
BACKGROUND
Every year, approximately 42 million people suffer a mild traumatic brain injury (mTBI, aka concussion), with particularly high rates among college-age individuals. A substantial proportion (44%-64%) go on to develop persistent symptoms that are challenging to treat, costly, and associated with significant disability. Anxiety has emerged...
Background
Despite therapeutic advances, the management of chronic obstructive pulmonary disease (COPD) remains complex. There is growing interest in multidimensional, mind-body exercises to improve both physical and psychosocial aspects of COPD burden. Few US data are available in this population on tai chi (TC) a mind-body exercise incorporating...
![Median [Q1, Q3] for each outcome by group at baseline and endpoint](publication/346057821/figure/tbl2/AS:984546912776195@1611745684762/Median-Q1-Q3-for-each-outcome-by-group-at-baseline-and-endpoint_Q320.jpg)
Aims:
Tai chi exercise has been shown in a prior randomized controlled trial to improve depression symptoms and quality of life (QoL) in patients with heart failure (HF), but correlates of these improvements are not well known. The purpose of this secondary analysis was to explore whether tai chi is associated with improvements in biopsychosocial...
Insomnia is highly prevalent among patients with breast cancer (BC). Although cognitive behavioral therapy for insomnia (CBT-I) is available in integrative oncology settings, it poses unique challenges for BC survivors. Our review aimed to assess the evidence for the therapeutic effects of CBT-I on insomnia in BC. Randomized controlled trials (RCTs...
Background: Informal caregivers, often family and friends, experience significant psychological and physical distress leading to reductions in health and quality of life (QOL). Mind-body interventions focused on caregivers are often limited and do not address multiple barriers, including caregivers’ economic, geographic, and time constraints. Trans...
Background: Informal caregivers, often family and friends, experience significant psychological and physical distress leading to reductions in health and quality of life (QOL). Mind-body interventions focused on caregivers are often limited and do not address multiple barriers, including caregivers’ economic, geographic, and time constraints. Trans...
Mind–body interventions (MBIs) include a wide range of behavioral therapies, such as meditation, Tai Chi, yoga, and relaxation techniques. Though heterogeneous, most MBIs are multimodal and include therapeutic components, such as mindfulness, breath awareness, and physical movement. These interventions modulate key neurocognitive, psycho-emotional,...
Objective
To identify differences in patient-physician interactions associated with improvements in GERD symptoms in a randomized controlled trial comparing integrative medicine and primary care/standard visits.
Methods
We analyzed video recordings of 2-minute excerpts (thin slices) from the beginning, middle, and end of 21 study visits (11 standa...
OBJECTIVE: Interventions for fear of recurrence (FOR) of cancer have nominal effects, perhaps due to limited integration of empirically supported skills. This pilot trial tested the acceptability and feasibility of a multimodal, mind-body resiliency intervention targeting FOR among survivors of various cancers.
METHODS: Early stage cancer survivor...
Objective:
Children with epilepsy experience cognitive deficits and well-being issues that have detrimental effects on their development. Pharmacotherapy is the standard of care in epilepsy; however, few interventions exist to promote cognitive development and to mitigate disease burden. We aimed to examine the impact of two different modalities o...
The Ehlers‐Danlos syndromes (EDS) and associated hypermobility spectrum disorders (HSD) are a heterogenous group of connective tissue disorders associated with significant morbidity. The urogenital aspects of these disorders are understudied and there is little guidance on the prevalence, types, or outcomes of urogenital complications in EDS/HSD. O...
Background
The objective was to assess the feasibility of a prenatal yoga randomized controlled trial (RCT) for gestational low back pain (LBP), mobility, and maternal well-being.
Methods
In this pilot, women aged 18 to 39 years with uncomplicated pregnancies at 12 to 26 weeks were randomized, stratified by presence of LBP, to attend a weekly yoga...
The purpose of this exploratory study was to examine the effects of Tai Chi on blood levels of beta endorphin (β-endorphin) and inflammatory markers in older adults with chronic pain. Forty community-dwelling older adults with chronic pain were randomized to Tai Chi or light physical exercise, and each offered twice weekly for 12 weeks. Following t...
Purpose:
Fear of cancer recurrence is highly prevalent among adult survivors of cancer. The role of fear of recurrence in the emotional distress of survivors of cancer, as well as health behaviors that may directly affect their health, remains unclear. To advance oncology practice, this study sought to examine the extent to which fear of recurrenc...
Background/Objective
High levels of chronic stress negatively impact the hippocampus and are associated with increased incidence of mild cognitive impairment (MCI) and Alzheimer’s disease. While mindfulness meditation may mitigate the effects of chronic stress, it is uncertain if adults with MCI have the capacity to learn mindfulness meditation.
M...
Measures characterizing the complexity of heart rate (HR) dynamics have been informative in predicting age- and disease-related decline in cardiovascular health, but few studies have evaluated whether mind-body exercise can impact HR complexity. This study evaluated the effects of long-term Tai Chi (TC) practice on the complexity of HR dynamics usi...
Objectives
Cardiac rehabilitation (CR) programmes are standard of care for patients following a coronary event. While such exercise-based secondary prevention programme do offer benefits, they are used by less than 30% of eligible patients and attrition within these programmes is high. This project is a nested qualitative assessment of a pilot prog...
Background:
Previous systematic reviews have indicated that exercise-based cardiac rehabilitation (ExCR) for patients with heart failure (HF) has a beneficial effect on health-related quality-of-life (HRQoL) and exercise capacity. However, there is uncertainty regarding potential differential effects of ExCR across HF patient subgroups.
Objective...
Background:
Mind-body exercise interventions are typically multimodal, complex, and pluralistic, and few have been developed with the goal of therapeutically targeting a specific medical population. It is thus important that clinical trials evaluating mind-body interventions provide some justification for the use of the specific protocol being eva...
Background
Cardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept...
Background:
Surveys have reported that as high as 80% of plastic surgery patients utilize integrative medicine approaches including natural products (NPs) and mind-body practices (MBPs). Little is known regarding the evidence of benefit of these integrative therapies specifically in a plastic surgery patient population.
Methods:
We conducted a s...
Background
Chronic pain is associated with poorer cognition and mobility, and fall risk in older adults. AimsTo investigate the feasibility of a randomized controlled trial of mind-body exercise (Tai Chi) versus a light physical exercise in older adults with multisite pain. Methods
Adults aged ≥ 65 years with multisite pain who reported falling in...
Aims
To undertake an individual patient data (IPD) meta‐analysis to assess the impact of exercise‐based cardiac rehabilitation (ExCR) in patients with heart failure (HF) on mortality and hospitalisation, and differential effects of ExCR according to patient characteristics: age, sex, ethnicity, New York Heart Association functional class, ischaemic...
Increased attention has focused on methods to increase empathy, compassion, and prosocial behavior. Meditation practices have traditionally been used to cultivate prosocial outcomes, and recently investigations have sought to evaluate their efficacy for these outcomes. We conducted a systematic review and meta-analysis of meditation for prosocial e...
Objective: Fear of cancer recurrence (FCR) is a common existential concern and source of distress among adults with a cancer history. Multiple randomized controlled trials (RCTs) have examined mind‐body approaches to mitigating FCR. We summarized characteristics of these trials and calculated their pooled effects on decreasing FCR.
Methods: Six el...
Objectives: Lung cancer is the leading cause of cancer death, yet lung screening remains underutilized. Lung cancer screening uncertainty (LCSU), including referral clarity and the perceived accuracy of screening, may hinder utilization and represent an unmet psychosocial need. This study sought to identify correlates of LCSU among lung screening p...
Homeopathy is used by just over 2% of the U.S. population, predominantly for respiratory, otorhinolaryngology, and musculoskeletal complaints. Individual users who see a homeopathic provider for care are more likely to perceive the therapy as helpful than those who do not; however, only 19% of users in the United States see a provider. The rest pre...
Background
More than 60% of patients decline participation in cardiac rehabilitation after a myocardial infarction. Options to improve physical activity (PA) and other risk factors in these high‐risk individuals are limited. We conducted a phase 2 randomized controlled trial to determine feasibility, safety, acceptability, and estimates of effect o...
Chronic pain is associated with a decline in physical function and an increased risk of falls in older adults. This study examined the effects of Tai Chi on pain severity, pain interference and physical function in older adults with multisite pain. Fifty-four community-dwelling older adults with multisite pain who reported falling in the past year...
Accumulating evidence supports that chronic pain is associated with poorer cognitive function and mobility, and fall risk in older adults. This study investigated the feasibility of a randomized controlled trial of a Tai Chi intervention in older adults with multisite pain who are at risk for falls. Adults aged ≥65y with multisite pain (≥ 2 sites)...
Objective:
This pilot, randomized clinical trial investigates the effectiveness of tai chi as the primary treatment for Chinese Americans with major depressive disorder (MDD).
Methods:
67 Chinese Americans with DSM-IV MDD and no treatment for depression were recruited between March 2012 and April 2013 and randomized (1:1:1) into a tai chi interv...
This study is important for several reasons. First, and somewhat surprisingly, it represents the first large-scale trial with more than 100 participants per study group evaluating t'ai chi for pain. Second, the findings support that t'ai chi is at least as good as the current gold standard of physical therapy for treating OA, making it a sound alte...
Objective:
This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery.
Design:
Randomized, controlled pilot trial.
Setting:
Beth Israel Deaconess Medical Center, Boston, MA, USA.
Interventions:
Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive...
Objective:
To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF).
Subjects and methods:
We randomized 100 patients with chronic systolic HF (NYHA Class 1-3, eject...
Purpose:
Exercise self-efficacy is one of the strongest predictors of physical activity behavior. Prior literature suggests that tai chi, a mind-body exercise, may increase self-efficacy; however, this is not extensively studied. Little is known about the factors associated with development of exercise self-efficacy in a population with heart fail...
