Anxiety Disorders
Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 8:41, 2008.
In the 27 studies reviewed, relaxation-training therapy proved to be an effective method for reducing anxiety.

Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. “Meditation therapy for anxiety disorders.” The Cochrane Database of Systematic Reviews. Issue 1, 2006.
Two randomized controlled studies met the criteria for this systematic review. Both meditation and other relaxation techniques (such as kundalini yoga and biofeedback) were equally effective in helping patients cope with anxiety disorders. For all techniques, patients had significantly improved scores on anxiety, current mood and symptoms of distress. Work, social functioning and family relations also improved. There was no improvement in sleep disturbance or marital relations.

Cancer Care
Smith JE, Richardson J, Hoffman C, Pilkington K. “Mindfulness-Based Stress Reduction as supportive therapy in cancer care: systematic review.” Journal of Advanced Nursing. 52(3):315-27, 2005.
This paper reports a systematic review of the evidence on the effectiveness of Mindfulness-Based Stress Reduction for cancer supportive care. Mindfulness-Based Stress Reduction is a therapeutic approach that has been used with patients with a variety of conditions. Three randomized controlled clinical trials and seven uncontrolled clinical trials were reviewed. Studies report positive results, including improvements in mood, sleep quality and reductions in stress. The more Mindfulness-Based Stress Reduction was practiced the greater the improved outcomes. Mindfulness-Based Stress Reduction showed potential as a clinically valuable tool for self-care for patients living with cancer.

Chronic Pain
Veehof MM, Oskam MJ, Schreurs KM, Bohlmeijer ET. Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain. 152(3):533-42, 2011.
Acceptance-based interventions such as mindfulness-based stress reduction program and acceptance and commitment therapy are alternative approaches to cognitive behavioral therapy for treating patients wtih chronic pain. In this systematic review and meta-analysis twenty-two studies were included, totaling 1235 patients with chronic pain. The results suggest that a mindfulness-based stress reduction program and acceptance and commitment therapy can be good alternatives to cognitive behavioral therapy. More high-quality studies are needed. Acceptance-based therapies have small to medium effects on physical and mental health in chronic pain patients comparable to those of cognitive behavioral therapy.

Chiesa A, Serretti A. Mindfulness-based interventions for chronic pain: a systematic review of the evidence. Journal of Alternative & Complementary Medicine. 17(1): 83-93, 2011.
Ten studies were included in this review. Mindfulness-based interventions showed nonspecific effects for the reduction of pain symptoms and the improvement of depressive symptoms in patients with chronic pain. There were also some improvements in psychologic measures related to chronic pain including pain coping. Further research in larger studies is warranted.

Carroll D, Seers K. “Relaxation for the relief of chronic pain: a systematic review.” Journal of Advanced Nursing. 27(3):476-87, 1998.
Nine randomized controlled clinical trials involving 414 patients with a variety of chronic pain conditions were evaluated. Three studies showed a significant difference in pain outcomes for the relaxation group as compared to other treatment groups. Significant differences in favor of relaxation were found for rheumatoid arthritis, ulcerative colitis and in one cancer pain trial. The remaining studies did not support the effectiveness of relaxation in pain management. Methodological problems in many of the studies suggest the need for further high quality research.

Health of the Elderly
Lindberg DA. “Integrative review of research related to meditation, spirituality, and the elderly.” Geriatric Nursing. 26(6):372-7, 2005
Increased attention has been given to meditation/relaxation strategies to improve physical health, reduce pain, enhance immune response, improve emotional well-being, and foster spiritual growth. This article reviews research conducted in the last 25 years about meditation and spirituality as it relates to the health of the elderly. Research has shown that meditation can be taught to the elderly, even those with dementia. The results also support the hypothesis that meditation and spiritual practices could promote significant social and emotional benefits for those in social isolation.

Heart Disease
Walton KG, Schneider RH, Nidich SI, et al. “Psychosocial stress and cardiovascular disease Part 2: effectiveness of the Transcendental Meditation program in treatment and prevention.” Behavioral Medicine. 28(3):106-23, 2002.
Psychosocial stress is a risk factor for cardiovascular disease that may respond to behavioral or psychosocial interventions. This review focuses on a natural medicine approach that research indicates reduces both psychosocial and traditional risk factors for cardiovascular disease — the Transcendental Meditation (TM) program. Randomized controlled trials, meta-analyses, and other controlled studies indicate this meditation technique reduces risk factors and can slow or reverse the progression of pathophysiological changes underlying cardiovascular disease. Studies with this technique have revealed reductions in blood pressure, carotid artery intima-media thickness, myocardial ischemia, left ventricular hypertrophy, mortality, and other relevant outcomes.

Hypertension
Anderson JW, Liu C, Kryscio RJ. University of Kentucky. Blood pressure response to transcendental meditation: a meta-analysis. American Journal of Hypertension. 21(3):310-6, 2008.
In the 9 studies included in this meta-analysis, transcendental meditation more effectively reduced systolic and diastolic blood pressure than the control condition. The regular practice of transcendental meditation may have the potential to reduce systolic and diastolic blood pressure by approximately 4.7 and 3.2 mm Hg, respectively. These are clinically meaningful changes.

Dickinson H, Campbell F, Beyer F, et al. Relaxation therapies for the management of primary hypertension in adults: a Cochrane review. Journal of Human Hypertension. 22(12):809-20, 2008.
This review of 25 studies found that there was a statistically significant relationship between relaxation and lower blood pressure.

Insomnia
Morin CM, et al. “Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review.” Sleep. 22(8):1134-56, Dec. 15, 1999.
Based on a review of 48 clinical trials and two meta-analyses conducted by a task force appointed by the American Academy of Sleep Medicine, findings indicate reliable and lasting changes in several sleep parameters for patients with chronic insomnia. Results indicate that between 70% and 80% of patients benefit from treatment. Progressive muscle relaxation met the American Psychological Association criteria for empirically-supported psychological treatments for insomnia.

Menopausal Symptoms
Innes KE, Selfe TK, Vishnu A. Mind-body therapies for menopausal symptoms: a systematic review. Maturitas. 66(2):135-49, 2010.
Twenty-one papers representing 18 clinical trials from 6 countries were included. Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low-frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms. Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms.

Phobias
Sanchez-Meca J, Rosa-Alcazar AI, Marin-Martinez F, et al. Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis. Clinical Psychology Review. 30(1):37-50, 2010.
In the 42 studies analyzed, the combination of relaxation training and breathing retraining was most effective for treating patients with panic disorder.

Stress Management
Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med. 15(5):593-600, 2009.
Mindfulness-based stress reduction (MBSR) is a clinically
standardized meditation that has shown consistent effectiveness for many mental and physical disorders. Less attention has been given to the possible benefits that it may have in healthy subjects. The aim of the present review and meta-analysis is to better investigate current evidence about the efficacy of MBSR in healthy subjects, with a particular focus on its benefits for stress reduction. Ten studies were included in this review. MBSR showed a nonspecific effect on stress reduction in comparison to an inactive control, both in reducing stress
and in enhancing spirituality values. A direct comparison study between MBSR and standard relaxation training found that both treatments were equally able to reduce stress. Furthermore, MBSR was able to reduce ruminative thinking and trait anxiety, as well as to increase empathy and self-compassion.

Substance Abuse
Zgierska A, Rabago D, Chawla N, et al. Mindfulness meditation for substance use disorders: a systematic review. Subst Abus. 30(4):266-94, 2009.
Relapse is common in substance use disorders (SUDs), even among treated
individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for substance abuse disorders. Twenty-five studies were included in the review. Overall, although preliminary evidence suggests MM efficacy and safety,conclusive data for MM as a treatment of substance abuse is lacking. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action.

Surgical Pain
Seers K, Carroll D. “Relaxation techniques for acute pain management: a systematic review.” Journal of Advanced Nursing. 27(3):466-75, 1998.
In this review of seven studies involving 362 patients with acute pain after surgery or during surgical procedures, three trials showed significantly less pain sensation and/or pain distress in patients who used relaxation. No difference was found in the other four studies. The evidence was considered inconclusive and relaxation was not recommended as the main treatment for pain management in the acute care setting. Further high quality studies are suggested.

Vipassana Meditation
Chiesa A. Vipassana meditation: systematic review of current evidence. J Altern Complement Med. 2010 Jan;16(1):37-46.
Vipassana meditation (VM) is one of the most ancient types of minfulness meditative practices. Despite the growing interest toward the neurobiological and clinical Seven mainly poor-quality studies were identified on current evidence on neuro-imaging and clinical evidence about Vipassana meditation. Three neuro-imaging studies suggested that VM practice could be associated with the activation of the prefrontal and the anterior cingulate cortex during meditative periods, and with increased thickness in cortical areas related to attention as well as increased subcortical gray matter in right insula and hippocampus in long-term meditators. Three clinical studies in incarcerated populations suggested that VM could reduce alcohol and substance abuse but not post-traumatic stress disorder symptoms in prisoners. One clinical study in healthy subjects suggested that VM could enhance more mature defenses and copying styles. Thus current studies provided preliminary results about neurobiological and clinical changes related to VM practice. Further research is needed to answer critical questions about long-term effects of Vipassana medidation.

Content last modified on Oct 11, 2011