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Well, the first round of Mitch Krucoff’s and Suzanne Crater’s MANTRA prayer study has been collated and published. The results, even in pilot form, are intriguing. The Duke University randomized clinical trials examined the effects of applying 4 CAM therapies - stress relaxation, imagery, touch therapy, and prayer - to cardiac patients in acute coronary intervention settings, such as the angiography lab – to measure their effects on short- and long-term procedural outcomes, including mortality.

150 Patients were randomized across 5 treatment groups: the 4 noetic conditions and standard care. Records were checked for post-procedure ischemia, death, myocardial infarction, heart failure, and urgent revascularization. Mortality was followed up for 6 months after hospitalization. Although results were not statistically significant because of the low numbers in each condition, there was a 25% to 30% absolute reduction in adverse effects in patients treated with any of the noetic therapies, as compared to standard therapy. And the lowest complication rates of all were observed in patients assigned to off-site prayer.

Friday, 15 August 2003 02:28

Guided imagery in cardiac surgery.

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In 1998, a research team led by Linda Halpin at the Inova Heart Center of Inova Fairfax Hospital compared cardiac surgical outcomes between two groups of heart patients - with and without guided imagery. A questionnaire was developed to assess the benefits of the guided imagery program to those who elected to participate in it, and, in addition, data from the hospital financial cost-accounting database were collected and matched to the two groups of patients.

Analysis of the data revealed that patients who completed the guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided.

Guided imagery is now used as a standard, complementary therapy to help reduce anxiety, pain, and length of stay among the cardiac surgery patients at Inova Fairfax.

Citation: Halpin LS, Speir AM, CapoBianco P, Barnett SD. Guided imagery in cardiac surgery. Outcomes in Management & Nursing Practice, 2002 Jul-Sep;6(3):132-7.

Essential hypertension and stress. When do yoga, psychotherapy and autogenic training help?

Another summary article from Germany by J.M. Hermann reports on the effectiveness of relaxation techniques, behavioral therapy and biofeedback for hypertension and stress, stating that these techniques lower elevated blood pressure by an average of 10 mmHg (systolic) and 5 mmHg (diastolic). Further, as a "secondary effect", these measures frequently prompt the hypertensive patient to adopt a more health-conscious lifestyle.

Citation: J. M. Hermann. Essential hypertension and stress. When do yoga, psychotherapy and autogenic training help? MMW Fortschr Med 2002 May 9;144(19):38-41.

A special report published in Circulation by the American Heart Association, The National Heart, Lung, and Blood Institute and the National Center for Complementary and Alternative Medicine examines the impact of mind-body techniques, and, because it is seen as the most widely researched method, Transcendental Medititation on Heart Disease.

The report states that the first major study to show that TM could reduce blood pressure was conducted by Robert Schneider with a population of hypertensive African Americans. In addition, this study showed that the technique had high cultural acceptability and compliance in a high-risk minority population.

In a huge study by Duke’s John Barefoot, PhD and his team, 1250 cardiac patients with coronary artery disease were assessed over a span of nearly 20 years for their levels of depression, to see if the degree of depression correlated in any way with mortality rates, and, if so, which features packed an especially mean punch. (Other research had already established the connection between depression and heart disease, but this study was designed to tease out what elements did the damage.)

The study showed that depressive symptoms did indeed predict survival. The risk of death increased by 40% for patients with negative affect, which meant downheartedness, sadness, irritability and restlessness. When negative affect was found in younger patients - under 51 mortality risk increased to a whopping 70%.

The other potent predictor of mortality was hopelessness.

Citation: Barefoot J, et al. Depressive symptoms and survival of patients with coronary artery disease. Journal of Psychosomatic Medicine. 2000 Nov-Dec; 62(6):790-5

Researchers from B. J. Medical College in Ahmedabad, India, studied numeric measures of respiratory function, cardiovascular parameters and lipid profiles of those practicing Raja Yoga meditation. The profiles of short and longterm meditators were compared with those of non-meditators.

The study found that vital capacity, tidal volume and breath holding were significantly higher in short and longterm meditators than in non-meditators. Longterm mediators had significantly higher vital capacity and expiratory pressure than short term meditators.

A woman with multiple health challenges, plus a recent 40-pound weight gain, asks which imagery resources would help and how to use them…

After a stress test reveals "mild to moderate ischemia", a woman wonders if mind-body methods such as guided imagery, transcendental meditation, hypnosis, yoga and stress management training can actually reverse coronary artery disease.

A woman who had a heart attack 6 months earlier, asks what imagery would be best to add to her regimen of weight loss, exercise, massage and work with a personal trainer..

A woman uses guided imagery for aortic valve replacement, open heart surgery, for both the surgery itself and for recovery in the ICU, and says she surprised the ICU nurses with her recovery time..
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