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Saoji AA, Das P, Devi NS. Yoga therapy as an adjunct to conventional management of systemic sclerosis: A case series. J Ayurveda Integr Med 2021; 12:705-709. [PMID: 34776323 PMCID: PMC8642665 DOI: 10.1016/j.jaim.2021.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/03/2022] Open
Abstract
Systemic sclerosis (SSc) is an autoimmune disorder leading to significant disability and loss of Quality of Life (QoL). Yoga has become popular in recent times for its potential therapeutic benefits. Since there are no scientific reports on the use of Yoga for SSc, we present two female cases (aged 49 and 29 respectively) of limited SSc (duration of illness 4 and 3 years respectively) who underwent Yoga therapy as an adjunct to conventional management in a residential setting for a period of five and four weeks, respectively. During their stay, they underwent a specifically designed Yoga module. After their discharge, they were followed-up for four weeks, during which they were asked to continue practicing Yoga for 1 h every day. Both of them reported a reduction in pain, stiffness, symptom scores, and improved QoL on discharge and at the follow-up compared to the values on admission. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), as biomarkers of inflammation, reduced on the discharge when compared to the baseline. No adverse events were noted during the stay and the follow-up. Thus, the present case series indicate a possible beneficial role of Yoga as an adjunct therapy to conventional management of SSc. Further studies in the area are warranted to ascertain the efficacy of Yoga for SSc.
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Affiliation(s)
- Apar Avinash Saoji
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India.
| | - Pranab Das
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Naorem Subhadra Devi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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Wojeck RK, Bailey DE, Somers TJ, Knisely MR. Self-management interventions in systemic sclerosis: A systematic review. Res Nurs Health 2021; 44:376-392. [PMID: 33651396 PMCID: PMC7971253 DOI: 10.1002/nur.22118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/12/2020] [Accepted: 02/02/2021] [Indexed: 11/07/2022]
Abstract
Systemic sclerosis is a rare and incurable autoimmune disease in which patients are challenged with self-managing their disease. Systematic evaluation of the essential self-management intervention components and self-management outcomes is necessary to assess the state of the science of self-management for patients with systemic sclerosis. As such, the purpose of this systematic review was to identify and describe self-management interventions and their impact on self-management outcomes in adults with systemic sclerosis. Studies were included if they contained a self-management intervention, incorporated at least one self-management outcome identified as a common data element by the National Institute of Nursing Research (i.e., patient activation, self-efficacy, self-regulation, global health), and were conducted in adults with systemic sclerosis. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched from the inception of each database to March 2020, yielding a total of 215 studies. Of these reports, 16 met the inclusion criteria for this review. There was notable variability in the types of self-management interventions and their effects on key self-management outcomes. Self-management interventions focused on improving physical function through rehabilitation programs were the most common interventions (n = 7). The poor methodological quality of the studies included in this systematic review, however, limited the synthesis of and recommendations for self-management interventions in adults with systemic sclerosis. Future research in systemic sclerosis should include key self-management outcomes in larger, more rigorously designed studies to allow for comparisons across studies and to advance the science of self-management.
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Affiliation(s)
- Robyn K. Wojeck
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | - Tamara J. Somers
- Department of Psychiatry and Behavioral, Sciences, Duke University, Durham, North Carolina, USA
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Showalter K, Hoffmann A, DeCredico N, Thakrar A, Arroyo E, Goldberg I, Hinchcliff M. Complementary therapies for patients with systemic sclerosis. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2019; 4:187-199. [PMID: 35382503 PMCID: PMC8922560 DOI: 10.1177/2397198319833503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/27/2019] [Indexed: 11/16/2022]
Abstract
Patients with systemic sclerosis often seek information regarding complementary and nutrition-based therapy. Some study results have shown that vitamins D and E, probiotics, turmeric, l-arginine, essential fatty acids, broccoli, biofeedback, and acupuncture may be beneficial in systemic sclerosis care. However, large randomized clinical trials have not been conducted. This review summarizes current data regarding various complementary therapies in systemic sclerosis and concludes with recommendations.
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Affiliation(s)
- Kimberly Showalter
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA
| | - Aileen Hoffmann
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nicole DeCredico
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anjali Thakrar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Esperanza Arroyo
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Isaac Goldberg
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Monique Hinchcliff
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medicine, Section of Rheumatology, Allergy and Clinical Immunology, Yale University School of Medicine, New Haven, CT, USA
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Abstract
RATIONALE Bee venom has been reported to demonstrate antinociceptive and anti-inflammatory effects in experimental studies, but there remain questions regarding the clinical use of bee venom, especially for scleroderma. This case report shows the successful outcome of bee venom acupuncture for circumscribed morphea in a patient with systemic sclerosis, which is considered to be a rare condition. PATIENT CONCERNS A 64-year-old Korean woman had circular white areas (3 and 1 cm diameter) with severe itch in the right lateral iliac crest. Based on an initial diagnosis of systemic sclerosis (1 year prior to presentation at our clinic), she had been treated with painkillers, steroids, antitussive expectorants, and aspirin, with minimal effect on her recent skin symptoms. DIAGNOSES In this study, the diagnosis of circumscribed morphea was based on localized skin symptoms of the patient with systemic sclerosis. INTERVENTIONS The patient visited Gachon University Korean Medical Hospital for treatment of topical skin symptoms. After being evaluated for bee venom compatibility, she was administered subcutaneous bee venom acupuncture along the margins of the patches (superficial circumscribed lesions) using the shallow surround needling method twice per week for 1 week and then once per week for the following 3 weeks. OUTCOMES Itch levels were evaluated before each treatment session: by her second visit, her itch had decreased from 8 to 3 on a 10-point numerical rating scale; by her sixth visit, her itch had decreased from 3 to 0. She did not experience adverse effects, and these improvements were maintained until the 2-month follow-up evaluation. LESSONS Bee venom treatment demonstrates the potential to serve as an effective localized therapy for circumscribed morphea.
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Affiliation(s)
- Ji Hye Hwang
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Gachon University, Seongnam
| | - Kyung-Ho Kim
- Department of Acupuncture and Moxibustion Medicine, Dongguk University Ilsan Oriental Hospital, Goyang, Republic of Korea
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Lee HY, Kim SY, Cho MK, Choi JY, Hong M, Lee JH, Lee I, Hong JW, Han CW, Kwon JN. A case report of generalized morphea treated with herbal medication and moxibustion. ACTA ACUST UNITED AC 2015. [DOI: 10.13048/jkm.15037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Altizer KP, Nguyen HT, Neiberg RH, Quandt SA, Grzywacz JG, Lang W, Bell RA, Arcury TA. Relationship between nonprescribed therapy use for illness prevention and health promotion and health-related quality of life. J Appl Gerontol 2014; 33:456-73. [PMID: 24781966 DOI: 10.1177/0733464812453518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES This study describes the nonprescribed therapy use (prayer, over-the-counter medications [OTC's], home remedies, vitamins, herbs and supplements, and exercise) for health promotion among rural elders. It also delineates the association of such therapy use with physical and mental health-related quality of life (HRQoL). METHOD The sample (N = 200) consisted of African American and White elders from south-central North Carolina. Participants completed baseline interviews and repeated measures of nonprescribed therapy use over a 6-month follow-up. RESULTS Prayer had the highest percentage (80.7%) of use for health promotion followed by OTC (54.3%); vitamins only (49.3%); herbs and supplements (40.5%); exercise (31.9%); and home remedies (5.2%). Exercise was significantly associated with better physical HRQoL (p < .05). However, elders who used nonprescribed therapies had poorer mental HRQoL than nonusers, adjusting for potential confounders. CONCLUSION This analysis suggests that use of some nonprescribed therapies for health promotion is associated with poorer mental HRQoL.
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Acupuncture-based modalities: novel alternative approaches in the treatment of gastrointestinal dysmotility in patients with systemic sclerosis. Explore (NY) 2013; 10:44-52. [PMID: 24439095 DOI: 10.1016/j.explore.2013.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The gastrointestinal (GI) dysmotility of systemic sclerosis (SSc, scleroderma) patients requires careful evaluation and intervention. The lack of effective prokinetic drugs motivate researchers to search for alternative treatments. OBJECTIVES We present an overview of the pathophysiology of SSc GI dysmotility and the advances in its management, with particular focus on acupuncture-related modalities and innovative therapies. DATA SOURCES Original research articles were identified based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline methodology. We have searched the MEDLINE database using Medical Subject Heading (MeSH) for all English and non-English articles with an English abstract from 2005 to October 2012. RESULTS Only four original articles of various study designs were found studying Complementary and Alternative Medicine (CAM) therapies for SSc patients. Despite the small patient study numbers, CAM treatments, acupressure, and transcutaneous electroacupuncture, showed self-reported and physiologic evidence of improvement of GI functioning and/or symptoms in SSc patients. CONCLUSIONS CAM therapies include experimental modalities with the potential to offer relief of symptoms from GI dysmotility. Larger studies are needed to investigate their optimal use in patient subsets to tailor therapies to patient needs.
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Tomura T, Yoshimasu K, Fukumoto J, Takemura S, Sakaguchi S, Miyai N, Miyashita K. Validity of a diagnostic scale for acupuncture: application of the item response theory to the five viscera score. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:928089. [PMID: 23690864 PMCID: PMC3638591 DOI: 10.1155/2013/928089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/15/2013] [Accepted: 03/15/2013] [Indexed: 11/17/2022]
Abstract
In acupuncture therapy, diagnosis, acupoints, and stimulation for patients with the same illness are often inconsistent among between Traditional Chinese Medicine (TCM) practitioners. This is in part due to the paucity of evidence-based diagnostic methods in TCM. To solve this problem, establishment of validated diagnostic tool is inevitable. We first applied the Item Response Theory (IRT) model to the Five Viscera Score (FVS) to test its validity by evaluating the ability of the questionnaire items to identify an individual's latent traits. Next, the health-related QOL scale (SF-36), a suitable instrument for evaluating acupuncture therapy, was administered to evaluate whether the FVS can be used to make a health-related diagnosis. All 20 items of the FVS had adequate item discrimination, and 13 items had high item discrimination power. Measurement accuracy was suited for application in a range of individuals, from healthy to symptomatic. When the FVS and SF-36 were administered to other subjects, a part of which overlap with the first subjects, we found an association between the two scales, and the same findings were obtained when symptomatic and asymptomatic subjects were compared regardless of age and sex. In conclusion, the FVS may be effective in clinical diagnosis.
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Affiliation(s)
- Taro Tomura
- Department of Oriental Medicine, Kansai Vocational College of Medicine, 6-18-13 Karita, Sumiyoshi-ku, Osaka 558-0011, Japan
- Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
| | - Kouichi Yoshimasu
- Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
| | - Jin Fukumoto
- Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
| | - Shigeki Takemura
- Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
| | - Shunji Sakaguchi
- Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
- Acupuncture-Moxibustion and Sports Trainer Science, Kansai University of Health Sciences, 2-11-1 Wakaba, Kumatori, Sennan, Osaka 590-0482, Japan
| | - Nobuyuki Miyai
- School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, Wakayama 641-0011, Japan
| | - Kazuhisa Miyashita
- Department of Hygiene, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
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Lund I, Näslund J, Lundeberg T. Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist's perspective. Chin Med 2009; 4:1. [PMID: 19183454 PMCID: PMC2644695 DOI: 10.1186/1749-8546-4-1] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Accepted: 01/30/2009] [Indexed: 01/06/2023] Open
Abstract
Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During 'true' acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture). A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a 'limbic touch response'. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to 'true' acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.
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Affiliation(s)
- Iréne Lund
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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