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  • 1
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    Multimodal Therapy Concept and Aerobic Training in Breast Cancer Patients With Chronic Cancer-Related Fatigue
    SAGE Publications ; 2013
    In:  Integrative Cancer Therapies Vol. 12, No. 4 ( 2013-07), p. 301-311
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 12, No. 4 ( 2013-07), p. 301-311
    Abstract: Cancer-related fatigue (CRF) and sleep disorders are some of the most wearing and common symptoms in disease-free breast cancer patients (BC). Aerobic training (AT) is the treatment with the best available evidence, even though it seems to be insufficient with regards to improvements in cognitive fatigue. We introduced a new multimodal therapy concept (MM) consisting of psycho-, sleep-education and new approaches based on anthroposophic medicine such as eurythmy and painting therapy. Study design: This pilot study will test the implementation of MM and yield first results of the MM and AE in our centres. Methods: 31 out of 34 patients suffering from BC and CRF were fully assessed in a ten-week intervention study. 21 patients chose MM and 10 decided on AT. CRF was measured with the help of the Cancer Fatigue Scale (CFS-D), and the global quality of sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). We also captured autonomic regulation (aR) and patients’ satisfaction with questionnaires. Statistical analysis was done with SAS 9.1.3 for windows. Results: The new MM therapy can be implemented with high satisfaction among patients. Significant improvements were found in the MM group with regards to CFS-D, global quality of sleep, sleep efficiency (PSQI), aR and rest/activity regulation compared to baseline (all p 〈 0.05). In the AT group aR orthostatic-circulatory and rest/activity regulation improved significantly (p 〈 0.05), too. However, no improvement in cognitive fatigue was seen in either group. Conclusion: The multimodal therapy concept was feasible and improved cancer fatigue, sleep quality, autonomic and rest-/activity regulation in breast cancer patients. It may therefore constitute a valuable treatment option in addition to aerobic training for BC patients with CRF. A further study with larger sample size needs to be carried out to assess the efficacy of combined multimodal-aerobic therapy.
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/1534735412464552
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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  • 2
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    The effect of osteopathic medicine on pain in musicians with nonspecific chronic neck pain: a randomized controlled trial
    SAGE Publications ; 2020
    In:  Therapeutic Advances in Musculoskeletal Disease Vol. 12 ( 2020-01), p. 1759720X2097985-
    Details
    In: Therapeutic Advances in Musculoskeletal Disease, SAGE Publications, Vol. 12 ( 2020-01), p. 1759720X2097985-
    Abstract: Nonspecific chronic neck pain (cNP) is common in adult violinists and violists and is often treated with osteopathic medicine (OM), although the effectiveness of this treatment has not been determined to date. This study aimed to evaluate the effectiveness and safety of OM in adult violinists and violists with cNP. Methods: In a two-armed randomized controlled single-center open trial, adult violinists and violists, including music students, with cNP (⩾12 weeks) were randomized to either five individualized OM sessions (OM group) or to no intervention (control group, CG) in the outpatient clinic for integrative medicine, Charité - Universitätsmedizin Berlin, Germany. All patients received a musicians’ medicine consultation and paracetamol on demand. The primary outcome parameter was the neck pain intensity on a visual analog scale (VAS, 0–100 mm, 0 = no pain, 100 = worst imaginable pain) after 12 weeks. Secondary outcomes included neck pain disability (Neck Disability Index, NDI, 0–100%) after 12 weeks. The last follow-up visit was after 52 weeks. Statistical analysis included analysis of covariance adjusted for respective baseline value. Results: Altogether, 62 outpatients were included [OM group ( n = 28), CG ( n = 34); 81% female; mean age, 41.6 ± 11.1 years; mean baseline neck pain, 55.9 ± 11.6 mm]. After 12 weeks, OM was associated with an improvement in the OM group versus the CG in neck pain on the VAS [14.6 mm (95% confidence interval 8.0; 21.2) versus 40.8 mm (34.7; 46.9), p  〈  0.001, Cohen’s d = 1.4], and neck pain disability as determined by the NDI [8.8% (6.7; 10.8) versus 17.2% (15.3; 19.1), p  〈  0.001]. Some improvements were maintained until 52 weeks of follow-up. No serious adverse events were obser ved. Conclusions: The results of this study suggest that OM might be effective in reducing pain intensity in adult violinists and violists with nonspecific cNP. Further studies should investigate the efficacy of OM in comparison with a sham procedure and with other effective therapy methods in high-quality multicenter trials. Trial registration: WHO Trial Registration https://apps.who.int/trialsearch/NoAccess.aspx?aspxerrorpath=/trialsearch/Trial2.aspx by German Clinical Trials Register DRKS00009258, Universal Trial Number (UTN): U1111-1173-5943.
    Type of Medium: Online Resource
    ISSN: 1759-720X , 1759-7218
    URL: Article
    DOI: 10.1177/1759720X20979853
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2516075-8
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  • 3
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    Impact of Acupuncture on Antihistamine Use in Patients Suffering Seasonal Allergic Rhinitis: Secondary Analysis of Results from a Randomised Controlled Trial
    SAGE Publications ; 2018
    In:  Acupuncture in Medicine Vol. 36, No. 3 ( 2018-06), p. 139-145
    Details
    In: Acupuncture in Medicine, SAGE Publications, Vol. 36, No. 3 ( 2018-06), p. 139-145
    Abstract: Seasonal allergic rhinitis (SAR) is a common disease that has detrimental effects on the quality of life (QoL) of affected individuals. Approximately 18% of patients try to alleviate their symptoms through acupuncture. The ACUSAR (ACUpuncture in Seasonal Allergic Rhinitis) study (ClinicalTrials.gov registration no. NCT00610584) assessed the impact of acupuncture on SAR, showing significant improvements in rhinitis-specific QoL (RQoL) and in rescue medication (RM) use. Objective A secondary analysis of SAR patients’ use of antihistamine. Methods Patients were randomised into three study groups: acupuncture plus RM, sham acupuncture plus RM, and RM alone. The patients documented their medication use before and during the intervention period (8 weeks). The main outcome was the number of days with antihistamine use. Statistical analyses were conducted using parametric and non-parametric tests. The robustness of the results was tested by sensitivity analyses using non-parametric bootstrapping. Results The data from 414 patients were analysed. The acupuncture group used antihistamines significantly less often compared with the other groups (acupuncture vs sham acupuncture: mean difference −4.49 days, p=0.01; acupuncture vs RM: mean difference −9.15 days, p 〈 0.001). Approximately 38% of the acupuncture group did not use any antihistamine in contrast to only 16% in the RM group. The pre-post comparison suggested that the acupuncture patients did not need to increase the days of antihistamine use to alleviate their symptoms, unlike the other groups. Conclusions Acupuncture appeared to significantly reduce the number of days of antihistamine use while improving RQoL and SAR symptoms; it can therefore be considered a valuable, additional treatment option for patients with SAR. Trial Registration Number NCT00610584; Post-results.
    Type of Medium: Online Resource
    ISSN: 0964-5284 , 1759-9873
    URL: Article
    DOI: 10.1136/acupmed-2017-011382
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 4
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    Prophylactic Acupuncture Treatment during Chemotherapy in Patients with Breast Cancer – Results of a Qualitative Study nested in a Randomized Pragmatic Trial
    SAGE Publications ; 2021
    In:  Integrative Cancer Therapies Vol. 20 ( 2021-01), p. 153473542110582-
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 20 ( 2021-01), p. 153473542110582-
    Abstract: In a randomized controlled trial, compared with standard care alone in breast cancer, acupuncture as a prophylactic treatment did not show better quality of life or fewer side effects of chemotherapy (NCT01727362 [clinicaltrials.gov]). The aim of the qualitative part of this mixed methods study was to better understand the subjective perspectives of the patients regarding quality of life during chemotherapy and the perceived effects of acupuncture. Methods: In a nested retrospective qualitative study, semi-structured telephone interviews were conducted with 5 responders and 5 non-responders (defined by the outcome of the primary parameter FACT-B) who were randomly selected from both study arms. The interviews were digitally recorded, pseudonymized, transcribed, and then deductively and inductively analyzed according to Qualitative Content Analysis using MAXQDA ® software. Results: A total of 20 patients were included in the qualitative part of the study. In both groups, most women stated that their quality of life was surprisingly better than what they had expected before starting the chemotherapy. All patients of the acupuncture group experienced the acupuncture treatments as relaxing and beneficial, mentioning a friendly setting, and empathic attitude of the therapist. Most of these patients stated that the acupuncture treatment reduced chemotherapy-induced side effects. The patients reported that acupuncture was supportive for coping with the disease in a salutogenic way. For all patients, finding strategies to cope with life-threatening cancer and the side effects of chemotherapy was essential, for example, keeping a positive attitude toward life, selecting social contacts, and staying active as much as possible. Conclusions: Patients in the acupuncture group reported positive effects on psychological and physical well-being after receiving the study intervention. For all patients, having coping strategies for cancer seemed to be more important than reducing side effects. Therefore, further studies should focus more on coping strategies and reducing acute side effects.
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/15347354211058207
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 5
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    Impact of a Multimodal and Combination Therapy on Self-Regulation and Internal Coherence in German Breast Cancer Survivors With Chronic Cancer-Related Fatigue: A Mixed-Method Comprehensive Cohort Design Study
    SAGE Publications ; 2020
    In:  Integrative Cancer Therapies Vol. 19 ( 2020-01), p. 153473542093561-
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 19 ( 2020-01), p. 153473542093561-
    Abstract: Background: Recent studies have proved the relevance of salutogenetic variables for fatigue management in breast cancer survivors with cancer-related fatigue (CRF). This comprehensive cohort design study is the first to examine the impact of 2 multimodal therapies, multimodal therapy (MT) and combined therapy (CT), compared with standard aerobic training (AT) on salutogenetic variables (self-regulation and internal coherence) and distress in breast cancer survivors with CRF. Methods: A total of 105 patients started the therapies and n = 84 completed the Self-regulation Scale, the Internal Coherence Scale, the Cancer Fatigue Scale, and the Hospital Anxiety and Depression Scale at baseline, 10 weeks after treatment (T1) and n = 81 after 6 months (T2). Patient satisfaction and qualitative feedback regarding therapy quality was assessed at T1. A general linear model including allocation type, therapy arm (MT/CT/AT), and bias-adjusting propensity scores tested the superiority of both multimodal therapies versus AT for all questionnaires at T1 and T2. Results: MT and CT were superior to AT to improve self-regulation and patients’ satisfaction at T1. Additionally, CT showed superiority for self-regulation at T2 (all P 〈 .05). Compared with AT, internal coherence was significantly higher for patients in the MT arms at T2, respectively (all P 〈 .01). Pearson’s correlations between self-regulation, internal coherence, and CRF improved from baseline to T2 (Mean r = −0.60). Qualitative feedback confirmed patients’ benefits in several health-related categories. Conclusions: Self-regulation and internal coherence are manipulable variables with relevant CRF associations. They can be positively affected by multimodal therapies. Alongside patients’ satisfaction and qualitative feedback they help refine treatment.
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/1534735420935618
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 6
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    Effects of yoga on chronic neck pain: a systematic review and meta-analysis
    SAGE Publications ; 2017
    In:  Clinical Rehabilitation Vol. 31, No. 11 ( 2017-11), p. 1457-1465
    Details
    In: Clinical Rehabilitation, SAGE Publications, Vol. 31, No. 11 ( 2017-11), p. 1457-1465
    Abstract: The aim of this review was to systematically assess and meta-analyze the effectiveness of yoga in relieving chronic neck pain. Methods: PubMed/MEDLINE, the Cochrane Library, Scopus, and IndMED were screened through January 2017 for randomized controlled trials assessing neck pain intensity and/or neck pain-related disability in chronic neck pain patients. Secondary outcome measures included quality of life, mood, and safety. Risk of bias was assessed using the Cochrane tool. Results: Three studies on 188 patients with chronic non-specific neck pain comparing yoga to usual care were included. Two studies had overall low risk of bias; and one had high or unclear risk of bias for several domains. Evidence for short-term effects was found for neck pain intensity (standardized mean difference (SMD) = −1.28; 95% confidence interval (CI) = −1.18, −0.75; P  〈  0.001), neck pain-related disability (SMD = −0.97; 95% CI = −1.44, −0.50; P  〈  0.001), quality of life (SMD = 0.57; 95% CI = 0.17, 0.197; P = 0.005), and mood (SMD = −1.02; 95% CI = −1.38, −0.65; P  〈  0.001). Effects were robust against potential methodological bias and did not differ between different intervention subgroups. In the two studies that included safety data, no serious adverse events occurred. Conclusion: Yoga has short-term effects on chronic neck pain, its related disability, quality of life, and mood suggesting that yoga might be a good treatment option.
    Type of Medium: Online Resource
    ISSN: 0269-2155 , 1477-0873
    URL: Article
    DOI: 10.1177/0269215517698735
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 7
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    The Acupuncture Randomised Trial (Art) for Tension-Type Headache - Details of the Treatment
    SAGE Publications ; 2005
    In:  Acupuncture in Medicine Vol. 23, No. 4 ( 2005-12), p. 157-165
    Details
    In: Acupuncture in Medicine, SAGE Publications, Vol. 23, No. 4 ( 2005-12), p. 157-165
    Abstract: The goal of this paper is to describe the characteristics of physicians and their interventions in a large, multicentre randomised trial of acupuncture for tension-type headache known as ARTTTH, in order to enable acupuncturists to assess the study interventions. Methods Participating physicians were recruited whose qualifications met or surpassed those of physicians currently accredited for providing acupuncture by state health funding agencies in Germany. Semi-standardised treatment strategies for acupuncture and minimal acupuncture were developed in a consensus process with acupuncture experts. A total of 270 patients suffering from episodic or chronic tension-type headache were randomised to 12 sessions of semi-standardised acupuncture (three predefined ‘basic’ points, recommendations for additional points given, but individual choice of additional points possible), standardised minimal acupuncture (superficial needling of at least 5 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list. Forty two physicians, trained and experienced in acupuncture, from 28 centres in Germany participated in the trial. Results The median duration of acupuncture training of trial physicians was 500 hours (range 140 to 1350 hours). Physicians had 10 ( 〈 1 to 25) years acupuncture experience. The three ‘basic’ points (GB20, GB21 and LR3) were treated in 96%, 82% and 97% of sessions, respectively. Frequently treated optional points included LI4 (67%), SP6 (50%) and ST36 (46%). Ten of the 42 physicians stated that they would have treated patients differently outside the trial. The trial found a significant effect of acupuncture over waiting list but not over minimal acupuncture. Conclusions In general, trial physicians complied well with the predefined interventions. A relevant minority of participating trial physicians stated that they would have treated patients differently outside the trial.
    Type of Medium: Online Resource
    ISSN: 0964-5284 , 1759-9873
    URL: Article
    DOI: 10.1136/aim.23.4.157
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
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  • 8
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    Implementation of a Mindful Walking Intervention in Breast Cancer Patients After Their Primary Oncologic Treatment: Results of a Qualitative Study Within a Randomized Controlled Trial
    SAGE Publications ; 2024
    In:  Integrative Cancer Therapies Vol. 23 ( 2024-01)
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 23 ( 2024-01)
    Abstract: Breast cancer survivors often suffer from diagnosis- and therapy-related long-term side effects, such as cancer related fatigue, restricted stress resilience and quality of life. Walking as a physical activity and mindfulness practice have been shown to be helpful in studies. The aim of this study was to compare the individual experiences and subjectively perceived effects of walking in combination with mindfulness practice with moderate walking alone in breast cancer patients. This paper focuses on the qualitative results of a mixed-methods pilot study. Methods: Breast cancer patients who had finished their primary oncologic treatment at least 6 months ago were randomized to an 8-week group intervention program of either mindful walking or moderate walking. Within the qualitative study part, semi-structured focus group interviews (2 interviews per study arm) were conducted and analyzed using a qualitative content analysis approach. Audio recorded interviews were transcribed verbatim and pseudonymized. The subsequent data analysis was performed by using MAXQDA ® . Results: A total of 51 women (mean age 55.8 [SD 10.9] years) were included in the RCT, among these 20 (mean age 56.7 [SD 12.0] years) participated in the focus group interviews (n = 11 patients of the mindful walking group; n = 9 patients of the walking group). Breast cancer patients in both groups described different effects in the complex areas of self-efficacy, coping, body awareness and self-reflection. While mindful walking primarily promoted body awareness and inner strength by mindfulness in breast cancer patients, moderate walking promoted self-efficacy by a confidence of their body and an easily integrated and accepted way of physical activity. Conclusions: Study interventions and the study setting triggered processes and reflections on one’s own health and situation. However, mindful walking and moderate walking seem to address different resources. This important knowledge may help oncologists and other therapists to assess what type of interventions can best meet the needs and requirements of individual patients. Trial registration: DKRS00011521; prospectively registered 21.12.2016; https://drks.de/search/de/trial/DRKS00011521
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/15347354241237972
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2024
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  • 9
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    Efficacy, Effectiveness, Safety and Costs of Acupuncture for Chronic Pain – Results of a Large Research Initiative
    SAGE Publications ; 2006
    In:  Acupuncture in Medicine Vol. 24, No. 1_suppl ( 2006-12), p. 33-39
    Details
    In: Acupuncture in Medicine, SAGE Publications, Vol. 24, No. 1_suppl ( 2006-12), p. 33-39
    Abstract: The aim of the ‘Acupuncture Model Project of the Techniker Krankenkasse’ was to determine efficacy, effectiveness, safety and cost effectiveness of acupuncture treatment in standard medical care. Methods We evaluated a total of 304 674 patients (34.5% men, aged 53.1?13.8 and 65.5% women, aged 49.5±14.2) who were in the care of over 10 000 physicians and received on average 10?3 acupuncture treatments for chronic pain (osteoarthritis of the hip or knee, low back pain, neck pain, headache) during a period of three months. Results and conclusions Our findings demonstrate that for the diagnoses examined, acupuncture in addition to usual care was an effective and safe treatment. Whether the effects of acupuncture can be attributed primarily to specific or nonspecific mechanisms appeared to depend on the diagnosis, and should be investigated in further studies. Using acupuncture as an adjunctive treatment was more expensive than usual care alone, but was cost-effective according to internationally accepted threshold values.
    Type of Medium: Online Resource
    ISSN: 0964-5284 , 1759-9873
    URL: Article
    DOI: 10.1136/aim.24.Suppl.33
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
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  • 10
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    Feasibility and Possible Effects of Mindful Walking and Moderate Walking in Breast Cancer Survivors: A Randomized Controlled Pilot Study With a Nested Qualitative Study Part
    SAGE Publications ; 2022
    In:  Integrative Cancer Therapies Vol. 21 ( 2022-01), p. 153473542110660-
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 21 ( 2022-01), p. 153473542110660-
    Abstract: Breast cancer (BC) survivors often suffer from disease- and therapy-related long-term side-effects. The study aim was to explore the feasibility, adherence, and individual experiences as well as possible effects of 2 different walking interventions in BC patients. Methods: This randomized controlled, pragmatic pilot trial included a qualitative study component. BC patients were randomized to either mindful walking (MFW) with mindfulness exercises and walking or moderate walking (MW) alone in weekly group sessions over 8 weeks. After 8 and 16 weeks, satisfaction, and self-perceived effectiveness as well as different health-related outcomes including health-related (WHOQOL-BREF) and disease-specific quality of life (FACT-G), perceived stress (PSQ) and cancer-related fatigue (CFS-D) were assessed. ANCOVA was used to evaluate differences in study outcomes. Qualitative data included 4 focus group interviews including 20 patients and were analyzed using a directed qualitative content analysis approach. Results: Altogether, 51 women (mean age 55.8 years (SD 10.9)) were randomized (n = 24 MFW; n = 27 MW). Both groups would recommend the course to other BC patients (MFW 88.9%; MW 95.2%) and showed possible improvements from baseline to week 8, without statistically significant difference between groups: WHOQOL-BREF (MFW: adjusted mean 65.4 (95% confidence interval (CI), 57.1-73.7); MW: 61.6 (53.6-69.6)); FACT-G (MFW: 76.0 (71.5-80.5); MW: 73.0 (68.5-77.4)); PSQ (MFW: 45.3 (40.5-50.1); MW: 45.4 (40.8-50.0)); CFS-D (MFW: 24.3 (20.8-27.8); MW: 25.5 (22.1-28.8)). Improvements lasted until the 16-weeks follow-up. The qualitative analysis suggested that MFW primarily promoted mindfulness, self-care, and acceptability in BC patients, whereas MW activated and empowered the patients as a result of the physical exercise. Conclusion: Both study interventions were positively evaluated by patients and showed possible pre-post effects in disease-specific health-related outcomes without differences between groups. The qualitative analysis results indicate that different resources and coping strategies were addressed by the 2 study interventions. Trial registration: DKRS00011521; prospectively registered 21.12.2016; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML & TRIAL_ID=DRKS00011521 .
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/15347354211066067
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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