Mind–body interventions

Health and fitness interventions that are supposed to work on a physical and mental level such as yoga, tai chi, and pilates.

Mind–body interventions (MBI) (often used interchangeably with Mind-body training (MBT))<ref name="NCCIH 2014">

Framework for Developing and Testing Mind and Body Interventions(link). NCCIH.

2014-04-24.

Accessed 2019-07-23.

</ref><ref name=" pubmeddev LM Al.">,

 Active mind-body movement therapies as an adjunct to or in comparison with pulmonary rehabilitation for people with chronic obstructive pulmonary disease, 
 The Cochrane Database of Systematic Reviews, 
 2018,
 Vol. 10,
 pp. CD012290,
 DOI: 10.1002/14651858.CD012290.pub2,
 PMID: 30306545,
 PMC: 6517162,</ref> describes health and fitness interventions that are supposed to work on a physical and mental level such as yoga, tai chi, and pilates.<ref name="Jung Ha">Jung, Ye-Ha, 
 The Effects of an Online Mind-Body Training Program on Stress, Coping Strategies, Emotional Intelligence, Resilience and Psychological State, 
 PLOS ONE, 
 
 Vol. 11(Issue: 8),
 
 DOI: 10.1371/journal.pone.0159841,
 PMID: 27479499,
 PMC: 4968838,</ref><ref name="Lee Mancuso">Lee, Sung W, 
 Prospective Study of New Participants in a Community-based Mind-body Training Program, 
 Journal of General Internal Medicine, 
 
 Vol. 19(Issue: 7),
 pp. 760–765,
 DOI: 10.1111/j.1525-1497.2004.30011.x,
 PMID: 15209590,
 PMC: 1492489,</ref><ref name="Gruicic Benton pp. 798–814">Gruicic, Dusan, 
 Development of managers' emotional competencies: mind-body training implication, 
 European Journal of Training and Development, 
 
 Vol. 39(Issue: 9),
 pp. 798–814,
 DOI: 10.1108/ejtd-04-2015-0026,</ref>

The category was introduced in September 2000 by the United States National Center for Complementary and Integrative Health (NCCIH) and encompasses alternative medicine interventions.<ref>US National Library of Medicine. National Institutes of Health Collection Development Manual. Complementary and Alternative Medicine. 8 October 2003. Online Version. Retrieved 31 July 2015.</ref> It excludes scientifically validated practices such as cognitive behavioral therapy. Cochrane Reviews have found that studies in this area are small and have low scientific validity.<ref name=" pubmeddev J Al. 2017">,

 Yoga versus non-standard care for schizophrenia, 
 The Cochrane Database of Systematic Reviews, 
 
 Vol. 9,
 pp. CD012052,
 DOI: 10.1002/14651858.CD012052.pub2,
 PMID: 28956893,
 PMC: 6483630,</ref><ref name=" pubmeddev JS Al. 2014">, 
 Yoga for secondary prevention of coronary heart disease, 
 The Cochrane Database of Systematic Reviews, 
 
 
 pp. CD009506,
 DOI: 10.1002/14651858.CD009506.pub4,
 PMID: 26130018,</ref><ref name=" pubmeddev A Al. 2013"/><ref name=" pubmeddev Z Al. 2017">, 
 Mindfulness-based stress reduction for family carers of people with dementia, 
 The Cochrane Database of Systematic Reviews, 
 
 Vol. 8,
 pp. CD012791,
 DOI: 10.1002/14651858.CD012791.pub2,
 PMID: 30106471,
 PMC: 6513415,</ref><ref name="Cochrane 2016">, 
 Tai Chi for chronic obstructive pulmonary disease (COPD), 
 Cochrane Database of Systematic Reviews, 
 
 
 pp. CD009953,
 DOI: 10.1002/14651858.CD009953.pub2,
 PMID: 27272131,
 
 
 Full text,
 Accessed on: 2019-07-23.</ref><ref name="Cebolla Demarzo Martins Soler p=e0183137">Cebolla, Ausiàs, 
 Unwanted effects: Is there a negative side of meditation? A multicentre survey, 
 PLOS ONE, 
 
 Vol. 12(Issue: 9),
 
 DOI: 10.1371/journal.pone.0183137,
 PMID: 28873417,
 PMC: 5584749,</ref>

Since 2008, authors documenting research conducted on behalf of the NCCIH have used terms "mind and body practices" and "mind-body medicine" interchangeably with mind-body interventions to denote therapies, as well as physical and mental rehabilitative practices, which "focus on the relationships between the brain, mind, body, and behavior, and their effect on health and disease."<ref>Wahbeh, H., Haywood, A., Kaufman, K., and Zwickey, H., Mind–body medicine and immune system outcomes: a systematic review. The Open Complementary Medicine Journal, Vol. 1, 2009, pp25-34.</ref> The center has also stated that "mind and body practices include a large and diverse group of procedures or techniques administered or taught by a trained practitioner or teacher".<ref>Complementary, Alternative, or Integrative Health: What’s In a Name? US Department of Health and Human Services. Public Health Service. National Institutes of Health. NIH Publication No. D347. Online Version. Retrieved 31 July 2015.</ref>

Definitions

The United States National Center for Complementary and Integrative Health (NCCIH) defines mind-body interventions as activities that purposefully affect mental and physical fitness, listing activities such as yoga, tai chi, pilates, guided imagery, guided meditation and forms of meditative praxis, hypnosis, hypnotherapy, and prayer, as well as art therapy, music therapy, and dance therapy.<ref name="NCCIH 2014"/><ref>Complementary, Alternative, or Integrative Health: What's In a Name? US Department of Health and Human Services. Public Health Service. National Institutes of Health. NIH Publication No. D347. Online Version. Retrieved 31 July 2015.</ref><ref>Straus, S. E., Expanding Horizons of Healthcare: Five Year Strategic Plan 2001-2005. 25 September 2000. US Department of Health and Human Services. Public Health Service. National Institutes of Health. NIH Publication No. 01-5001. Online Version Retrieved 31 July 2015.</ref><ref>Straus, S. E., Expanding Horizons of Healthcare: Five Year Strategic Plan 2001–2005. 25 September 2000. US Department of Health and Human Services. Public Health Service. National Institutes of Health. NIH Publication No. 01-5001. Online Version Retrieved 31 July 2015.</ref>

The Cochrane Library contains 3 systematic reviews that explicitly cite and define MBI as MBT.<ref name="pmidhttps://doi.org/10.1002/14651858.CD007559.pub2">

Redirecting(link). National Center for Biotechnology Information.

Accessed 2019-07-23.

</ref><ref name=" pubmeddev A Al. 2013">,

 Mind and body therapy for fibromyalgia, 
 The Cochrane Database of Systematic Reviews, 
 
 
 pp. CD001980,
 DOI: 10.1002/14651858.CD001980.pub3,
 PMID: 25856658,</ref><ref name=" pubmeddev LM Al."/> The reviews consider biofeedback, mindfulness, autogenic training, hypnotherapy, imagery, meditation, and prayer as MBT despite them focusing more strictly on the mind.

One review uses a narrower definition, defining MBT as an ‘active’ intervention in which mental and physical exercises are alternated.<ref name=" pubmeddev LM Al."/> A web search will yield mentions of mind-body training in offerings of entities that give yoga, pilates, or meditation training, but explicit definitions are rare. ^{(July 2019)}

Origins and history

Western MBI was popularized in the early 20th century but dates back to Ancient Greece.<ref name="Hoffman Gabel 2015 p. "/> The Greek values of strength and beauty in combination with Greek mythology led to activities intended to promote confidence. ^{(July 2019)}

Eastern MBI in the form of yoga originated in Ancient India and has been around since at least 500 BCE and possibly as early as 3300 BCE.<ref name="Crangle 1994 p. ">E.F.,

 The Origin and Development of Early Indian Contemplative Practices. online version, 
  
 Harrassowitz Verlag, 
 1994, 
 Series: Studies in Oriental religions, 
  
 ISBN 978-3-447-03479-1, 
  
  
 Accessed: 2019-07-23. 
 Pages: 4–7,</ref><ref name="Zimmer Campbell 1951 p. ">H.R., 
  
 Philosophies of India. online version, 
  
 Princeton University Press, 
 1951, 
 Series: A.W. Mellon lectures in the fine arts, 
  
 ISBN 978-0-691-01758-7, 
  
  
 Accessed: 2019-07-23.</ref><ref name="Samuel 2008 p. ">G., 
  
 The Origins of Yoga and Tantra: Indic Religions to the Thirteenth Century. online version, 
  
 Cambridge University Press, 
 2008, 
  
  
 ISBN 978-1-139-47021-6, 
  
  
 Accessed: 2019-07-23.</ref>

A renewed interest developed in mind-body work in the late 19th and early 20th century. Possibly due to visits from yoga gurus and increased interest, some medical practitioners and movement specialists developed movement therapies with a deliberate mental focus.<ref name="Hoffman Gabel 2015 p. "/>

Two prominent names in modern mind-body training are Joseph Pilates (1880-1967) and Margaret Morris (1891-1980). A famous statement of Joseph Pilates was “Physical fitness is the first requisite of happiness.”<ref name="Morris Jeayes 2003 p. ">M.,

 My Life in Movement. online version, 
  
 International Association of MMM Limited, 
 2003, 
  
  
 ISBN 978-0-9531034-1-6, 
  
  
 Accessed: 2019-07-23.</ref> Margaret Morris had a background in dance and claimed a connection between a free dance and a free mind.<ref name="Hoffman Gabel 2015 p. ">Hoffman, Jonathan, 
 The origins of Western mind–body exercise methods, 
 Physical Therapy Reviews, 
 
 Vol. 20(Issue: 5–6),
 pp. 315–324,
 DOI: 10.1080/10833196.2015.1125587,
 PMID: 27695277,
 PMC: 5022134,</ref><ref name=" pubmeddev P Al. 2018">, 
 High-intensity interval exercise induces greater acute changes in sleep, appetite-related hormones, and free-living energy intake than does moderate-intensity continuous exercise, 
 Applied Physiology, Nutrition, and Metabolism, 
 
 Vol. 44(Issue: 5),
 pp. 557–566,
 DOI: 10.1139/apnm-2018-0503,
 PMID: 30332549,</ref>

In conventional medicine

All mind-body interventions focus on the interaction between the brain, body, and behavior and are practiced with intention to use the mind to alter physical function and promote overall health and well-being.<ref>Elkins, G., Fisher, W., and Johnson, A., Mind–body therapies in integrative oncology. In Current Treatment Options in Oncology, Vol. 11, Nos. 3-4, 2010, pp128-140.</ref><ref>Wieland, L.S., Manheimer E., Berman B.M., Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration. Alternative Therapies in Health and Medicine, Vol. 17, No. 2, 2011, pp50-59.</ref>

However, the NCCIH does not consider mind-body interventions as within the purview of complementary and alternative medicine when there is sufficient scientific evidence for the benefit of such practices along with their professional application in conventional medicine. Cognitive behavioral therapy is defined by the NCCIH as a mind-body intervention because it utilizes the mind's capacity to affect bodily function and symptoms, but also there is sufficient scientific evidence and mainstream application for it to fall outside the purview of complementary and alternative medicine. <ref>US National Library of Medicine. National Institutes of Health Collection Development Manual. Complementary and Alternative Medicine. 8 October 2003. Online Version. Retrieved 31 July 2015.</ref>

Evidence for efficacy

Most studies of MBI and related techniques are small and have low scientific validity, a finding that dominates many Cochrane Reviews.<ref name=" pubmeddev J Al. 2017"/><ref name=" pubmeddev JS Al. 2014"/><ref name=" pubmeddev A Al. 2013"/><ref name=" pubmeddev Z Al. 2017"/><ref name="Cochrane 2016"/><ref name="Cebolla Demarzo Martins Soler p=e0183137"/> Some of the individual studies do show positive results, but this may be due to chance or placebo effects and the significance may diminish when groups are randomized.

Proponents of MBI techniques suggest that a rationale for mind-body training is that the mind follows the body and the body follows the mind. The body-mind connection can be attributed to hormones and chemicals released during movement,<ref name="Leisman Moustafa Shafir p. ">Leisman, Gerry,

 Thinking, Walking, Talking: Integratory Motor and Cognitive Brain Function, 
 Frontiers in Public Health, 
 2016,
 Vol. 4,
 pp. 94,
 DOI: 10.3389/fpubh.2016.00094,
 PMID: 27252937,
 PMC: 4879139,</ref> although the mind-body connection is dominated by the brain and is considered to be more of a neurological mechanism. There are some indications that movement complexity may have an impact on brain development.<ref name=" pubmeddev T Al. 2019">, 
 Meditation therapy for anxiety disorders, 
 The Cochrane Database of Systematic Reviews, 
 
 
 pp. CD004998,
 DOI: 10.1002/14651858.CD004998.pub2,
 PMID: 16437509,</ref>

When it comes to explicitly alternating mental and physical exercise sections, proponents rationalize that physical activity induces an elevated heart-rate and increases in stress, which mimics conditions in which athletes need their mental skills the most.<ref name="Welcome to 2Mynds">

What is 2Mynds Mind-Body Training (MBT)(link). Welcome to 2Mynds.

Accessed 2019-07-23.

</ref> It is believed that these conditions make training more functional and there is some limited scientific evidence supporting effectiveness because of this type of approach.<ref name=" pubmeddev LM Al."/>

There are documented benefits of several mind-body interventions derived from scientific research: first, by MBI use contributing to the treatment a range of conditions including headaches, coronary artery disease and chronic pain; second, in ameliorating disease and the symptoms of chemotherapy-induced nausea, vomiting, and localized physical pain in patients with cancer; third, in increasing the perceived capacity to cope with significant problems and challenges; and fourth, in improving the reported overall quality of life. In addition, there is evidence supporting the brain and central nervous system's influence on the immune system and the capacity for mind-body interventions to enhance immune function outcomes, including defense against and recovery from infection and disease.<ref>Ernst, E., Pittler, M.H., Wider, B., and Boddy, K., Mind–body therapies: are the trial data getting stronger? Alternative Therapy in Health and Medicine, Vol. 13, No. 5, 2007, pp62–64.</ref><ref>Rutledge, J.C., Hyson, D.A., Garduno, D., Cort, D.A., Paumer, L., and Kappagoda, C. T., Lifestyle modification program in management of patients with coronary artery disease: the clinical experience in a tertiary care hospital. Journal of Cardiopulmonary Rehabilitation, Vol. 19, No. 4, 1999, pp226–234.</ref><ref>Wahbeh H., Elsas, S. M., Oken, B.S., Mind–Body Interventions: applications in neurology. Neurology, Vol. 70, No. 24, 2008, pp2321–2328.</ref><ref>Rutledge, J.C., Hyson, D.A., Garduno, D., Cort, D. A, Paumer, L., and Kappagoda, C. T., Lifestyle modification program in management of patients with coronary artery disease: the clinical experience in a tertiary care hospital. Journal of Cardiopulmonary Rehabilitation Vol. 19, No. 4, 1999, pp226–234.</ref><ref>Mundy, E.A,. DuHamel, K.N., Montgomery, G. H., The efficacy of behavioral interventions for cancer treatment-related side effects. Seminars in Clinincal Neuropsychiatry, Vol. 8, No. 4, 2003, pp253–275.</ref><ref>Astin, J. A., Shapiro, S. L., Eisenberg, D. M., and Forys, K. L., Mind–body medicine: state of the science, implications for practice. Journal of the American Board of Family Practice, Vol. 16, No. 2, 2003, pp131-147.</ref><ref>Irwin, M. R., Human psychoneuroimmunology: 20 years of discovery. Brain, Behavior, and Immunity, Vol. 22, No. 2, 2008, pp129-139.</ref><ref>Ader, R. and Cohen, N., Behaviorally conditioned immunosuppression. Psychosomatic Medicine, Vol. 37, No. 4, 1975, pp333–340.</ref>

Side effects are rarely reported in mind-body training. Although some studies have indicated that meditation can have undesired adverse effects on specific clinical populations (e.g., people with a history of PTSD), although these are smaller studies.<ref name="Lindahl Fisher Cooper Rosen p=e0176239">Lindahl, Jared R.,

 The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists, 
 PLOS ONE, 
 
 Vol. 12(Issue: 5),
 
 DOI: 10.1371/journal.pone.0176239,
 PMID: 28542181,
 PMC: 5443484,</ref><ref name="Schlosser Sparby Vörös Jones p=e0216643">Schlosser, Marco, 
 Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations, 
 PLOS ONE, 
 
 Vol. 14(Issue: 5),
 
 DOI: 10.1371/journal.pone.0216643,
 PMID: 31071152,
 PMC: 6508707,</ref>

There is limited high-quality evidence as well with regard to the effect of intensity and duration. In a small study observing 87 healthy female participants undergoing either mind-body training or no training,<ref name="Jung Ha"/> participants who actively participated in an online program showed significantly greater resilience toward stress, anger, anxiety, and depression at 8 weeks than at 4 weeks into the study.<ref name="Jung Ha"/> However, this study was not randomized and the placebo effect may be large on the subjective psychological test scores.<ref>Vallance, Aaron K.,

 Something out of nothing: the placebo effect, 
 Advances in Psychiatric Treatment, 
 
 Vol. 12(Issue: 4),
 pp. 287–296,
 DOI: 10.1192/apt.12.4.287,
 
 
 
 Full text,</ref>

Popularity

Mind-body interventions are the most commonly used form of complementary and alternative medicine in the United States,<ref>Barnes, P. M., Powell-Griner, E., McFann, K., and Nahin, R. L., Complementary and alternative medicine use among adults: Seminars in Integrative Medicine, Vol. 2, No. 2, 2002, pp54-71.</ref><ref>Barnes, P. M., Powell-Griner, E., McFann, K., and Nahin, R. L. (2004, June). Complementary and alternative medicine use among adults: United States, 2002. Seminars in Integrative Medicine, Vol. 2, No. 2, pp54-71.</ref><ref>Ni, H., Simile, C., and Hardy, A. M., Utilization of complementary and alternative medicine by United States adults: results from the 1999 national health interview survey. Medical care, Vol. 40, No. 4, 2002, pp353-358.</ref><ref>Su, D., and Li, L., (2011). Trends in the use of complementary and alternative medicine in the United States: 2002–2007. Journal of health care for the poor and underserved, Vol. 22, No. 1, 2001, 296-310.</ref><ref>Barnes, P. M., Powell-Griner, E., McFann, K., and Nahin, R. L., Complementary and alternative medicine use among adults: United States, 2002. Seminars in Integrative Medicine Vol. 2, No. 2, 2004, pp54-71. WB Saunders.</ref> with yoga and meditation being the most popular forms.<ref>Ni, H., Simile, C., and Hardy, A. M., Utilization of complementary and alternative medicine by United States adults: results from the 1999 national health interview survey. Medical Care, Vol. 40, No. 4, 2002, pp353-358.</ref><ref>Barnes, P., Powell-Griner, E., McFann, K., and Nahin, R., CDC Advance Data Report 343. Complementary and Alternative Medicine Use Among Adults: United States, 2002. May 27, 2004.</ref><ref>Barnes, P.M., Bloom B., Nahin, R., CDC National Health Statistics Report 12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007 December 10, 2008.</ref><ref>Clarke, T.C., Black L.I., Stussman B.J., Barnes P.M., and Nahin, R.L., Trends in the use of complementary health approaches among adults: United States, 2002–2012. National Health Statistics Reports 79. Hyattsville, MD: National Center for Health Statistics, 2015.</ref><ref>Black, L.I., Clarke T.C., Barnes, P.M., Stussman B.J., and Nahin, R.L., Use of complementary health approaches among children aged 4-17 years in the United States: National Health Interview Survey, 2007-2012. National Health Statistics Reports 78. Hyattsville, MD: National Center for Health Statistics, 2015.</ref><ref>Nahin, R. L., Estimates of pain prevalence and severity in adults: United States, 2012. Journal of Pain, Vol. 6, No. 8, 2015, pp769-780.</ref>

See also

• Acupuncture
• Alexander technique
• Art therapy
• Breathing exercises
• Chiropractic
• Dance therapy
• Feldenkrais Method
• Guided imagery
• Guided meditation
• Hypnosis
• Hypnotherapy
• Massage therapy
• Meditation
• Music therapy
• Osteopathic manipulation
• Pilates
• Prayer
• Progressive muscle relaxation
• Qigong
• Rolfing
• Tai chi
• Trager approach
• Yoga

References

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