Yoga & Mindfulness
Yoga
Yoga has been practiced in India for its proposed physical and mental benefits for thousands of years. Yoga (which means ‘union’ in Sanskrit) aims at uniting mind and body. Strategies include:
- poses that promote strength, balance and flexibility
- breathing techniques that have soothing and energizing effects
- meditation to develop mental calm and emotional clarit.
Research has demonstrated that yoga interventions have positive effects for patients with a variety of medical conditions including hypertension, asthma, multiple sclerosis, tuberculosis, back pain, fibromyalgia, and cancer.
Together with colleagues Jim and Kimberly Carson (mindfulyogaworks.org), we developed a novel Mindful Yoga intervention for women with breast cancer. It uses a comprehensive approach including gentle and functional physical postures complemented by breathing exercises, meditation techniques, and group discussions.
Yoga for Menopause Symptoms in Breast Cancer Survivors
In a sample of survivors of early stage breast cancer experiencing menopausal symptoms, the yoga program led to improvements in hot flashes, fatigue, joint pain, sleep disturbance, emotional distress, and vigor.
Read the study
This study was funded by the Susan Komen Foundation.
Yoga for Metastatic Breast Cancer
In studies focused on women with metastatic breast cancer, we found that Mindful Yoga was highly acceptable to patients, but that the yoga intervention’s mode of delivery, involving eight in-person group sessions, may need to be modified to improve feasibility for this population. The yoga intervention led to modest improvements in cancer-related symptoms including pain interference, fatigue, anxiety, and depression.
Read the study
We also found a dose/response relationship was found between yoga practice duration, and daily pain. When patients had spent relatively more time practicing yoga, they were more likely to experience lower pain on the following day. Meditation practice showed the strongest association with lower daily pain.
This study was funded by the National Center for Complementary and Integrative Health.
Mindfulness
Mindfulness is defined as paying attention on purpose to the current moment, with acceptance. Mindfulness involves the focused practice of increasing awareness of all aspects of one’s experience—thoughts, feelings, and physical sensations—in a non-judgmental manner.
Mindfulness practice emphasizes the cultivation of meta-awareness (awareness of awareness), acceptance, and equanimity (lack of reactivity). These skills increase an individual's ability to choose where their attention is focused at any given moment, and how to respond skillfully to stressful or unpleasant events or symptoms.
Research has shown that mindfulness training leads to reduced psychological distress in various patient populations. However, mindfulness therapy is typically provided face-to-face in group settings which makes it inaccessible to many patients due to time and distance. We have adapted mindfulness training to a self-directed app and have been studying the usefulness of this approach.
Mindfulness Training for ICU Survivors
One group of patients who might benefit from mindfulness are those who are sick enough to be admitted to an intensive care unit (ICU). These patients commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. In studies led by Duke palliative care researcher Dr. Christopher Cox, we developed a self-directed mindfulness-based training program called LIFT for ICU survivors. In a pilot randomized trial, we found that most patients completed the four weekly app-based sessions and reported positive feedback about the program. We also found that the LIFT program led to significant reductions in depression, anxiety, and physical symptoms.
We are currently testing several versions of the LIFT app using the multiphase optimization strategy (MOST) framework. At the conclusion of this trial, we will deliver a mobile mindfulness system that is fully optimized for usability, efficiency, scalability, and clinical impact.
Mindfulness and Acupuncture for Patients Undergoing Spine Surgery
We are also currently collaborating with Dr. Trevor Lentz, a physical therapist and health services researcher at Duke, who is testing the LIFT program in combination with acupuncture to improve pain-related outcomes among patients undergoing spine surgery.
The above studies were funded by the National Center for Complementary and Integrative Health.