Through a randomized controlled clinical trial, the clinical efficacy of cheek acupuncture therapy in treating patients with moderate depressive disorder and explored its neuroimaging mechanisms was evaluated. This clinical study recruited participants with moderate depressive disorder who met the inclusion criteria and did not meet the exclusion criteria, admitted to the outpatient clinics of Zhejiang Provincial Hospital of Traditional Chinese Medicine's Acupuncture and Mental Health Departments (September 2022 - May 2025). Participants were systematically randomized into three groups: cheek acupuncture (AC), sham-cheek acupuncture (SAC), and medication control. The AC group received acupuncture at five standardized points: Head Point (CA-1, 1 cun superior to the midpoint of the zygomatic arch), Neck Point (CA-5 at the zygomatic arch base), Upper Jiao Point (CA-2 posterior to the mandible coronoid process where it intersects the inferior border of the zygomatic arch), Middle Jiao Point (CA-3 midpoint of the line connecting Upper Jiao and Lower Jiao points), and Lower Jiao Point (CA-4 at anterior margin of the mandibular angle). The needle insertion depth was approximately 5-7.5 mm without tonification or dispersion techniques, totaling 10 needles. The SAC group selected points 10 mm lateral to the AC group points along the anterior midline of the body, using blunt-tipped needles without skin penetration. Needles were retained for 30 min. Treatment frequency: three sessions per week. Treatment duration: 12 weeks. Total treatment sessions: 36. The drug group received oral sertraline. Researchers collected HAMD-17 and HAMA scores from patients at baseline, and at 1, 2, 3, 4, 8, and 12-weeks post-treatment. and at the 2-month follow-up after completion of treatment. fMRI scans were performed on the AC group before and after treatment. Statistical analysis and efficacy assessment were conducted using SPSS (Version 25.0) and R (Version 4.3.3) statistical analysis software. HAMD-17 scores in the AC group, SAC group, and drug group all decreased significantly compared to pre-treatment levels (P < 0.001), indicating that all three interventions effectively improved HAMD-17 scores in patients with moderate depression. The treatment efficacy of the AC group was superior to that of the SAC group and the drug group. A comparison of the scores two months post-treatment with those immediately following treatment revealed that both the AC group and the drug group exhibited a decline in scores during the follow-up period. Notably, the degree of improvement in HAMD-17 scores in the AC group was significantly greater than that in the SAC group and the drug group, indicating that AC can alleviate depressive symptoms in patients with moderate depression. Regarding the time to onset of effect, significant changes were observed in the AC, SAC, and drug groups starting from the second week of treatment. In the AC group, scores continued to decline significantly from the third to the fourth week and from the fourth to the eighth week, entering a plateau phase after the eighth week, with the therapeutic effect maintained through the follow-up period; in the SAC and drug groups, improvements were primarily observed in the early stages of treatment and remained stable in the later stages.fMRI results showed that after cheek acupuncture treatment, ReHo values at the cluster level in the left middle frontal gyrus (L-MFG) showed significant reduction, while ReHo values at the cluster level in the left superior frontal gyrus (L-SFG) were significantly increased. The HAMA scores in the AC group, SAC group, and drug group all showed significant differences compared to pre-treatment levels (P < 0.001), indicating that all three interventions were effective in alleviating anxiety symptoms in patients with moderate depression. The AC group demonstrated superior treatment outcomes compared to the SAC group and the drug group. Regarding the time to onset of effect, both the AC group and the SAC group showed significant improvement by the second week, while the drug group began to show significant improvement by the third week. Cheek acupuncture, sham cheek acupuncture, and drug can all improve the severity of depression and anxiety symptoms in patients with moderate depression, with cheek acupuncture demonstrating the greatest efficacy. The onset of action for all three treatments is similar, but cheek acupuncture shows sustained improvement.fMRI findings revealed that cheek acupuncture modulates neural activity synchrony in distinct prefrontal subregions (middle frontal gyrus and superior frontal gyrus) through differential regulation, thereby reshaping the functional connectivity in cognitive and emotional control circuits. This neural mechanism may represent a key biological basis for its therapeutic efficacy in alleviating depressive symptoms.
Balance and gait impairments are prevalent after stroke, leading to increased fall risk and reduced independence. While conventional rehabilitation offers benefits, there is a need for effective adjunctive therapies. Yijinjing, a traditional mind-body exercise, may address these impairments by improving postural control and movement symmetry, but robust evidence from randomized trials is lacking. We conducted a randomized, controlled trial to determine whether a Yijinjing program could improve balance and walking function in patients with stroke. Seventy stroke patients were randomly assigned to either Yijinjing group receiving Yijinjing training (30 min/session, 5 sessions/week for 5 weeks) or control group receiving stretching training of the same duration. All patients underwent hospital-based conventional rehabilitation therapy throughout the study period. The primary outcome was the change after the 5-week intervention (estimated by a GEE model) in the Berg Balance Scale (BBS). Secondary outcomes included spatiotemporal gait parameters, Fugl-Meyer Assessment (FMA) and the Modified Barthel Index (MBI). Analyses were performed on an intention-to-treat basis. The two groups were comparable in demographic characteristic and motor impairment. After 5 weeks of intervention, the Yijinjing group [11.94 (10.05-13.83)] demonstrated significantly greater improvement in BBS scores than the control group [6.51 (5.38-7.64)], with a between-group mean difference [95% Confidence Intervals (CI)]: 5.51 (3.92-7.10), P < 0.001. Relative to the control group, the Yijinjing group also achieved superior gains in step length, gait speed, and gait asymmetry index (GAI) (P < 0.05), as well as in FMA and MBI scores (P < 0.01). Both groups demonstrated significant within-group improvements across all primary and secondary outcomes from baseline to post-treatment (P < 0.05). No serious adverse events were reported. This randomized controlled trial demonstrated that a 5-week Yijinjing training program, when added to conventional rehabilitation as a standalone behavioral intervention, appeared to be safe and effective in accelerating improvements in balance, gait, motor function, and activities of daily living in stroke survivors, with short-term benefits exceeding those of stretching training. These findings support integrating traditional Chinese mind-body training into contemporary neurorehabilitation practice. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2100042302), Registered on 17 January 2021.
Baduanjin, a traditional Chinese exercise, is commonly used in China as a rehabilitation intervention for patients who have undergone percutaneous coronary intervention (PCI) following an acute myocardial infarction (AMI) (AMI-PCI). However, current evidence supporting its application remains limited. To assess the clinical benefits and safety of Baduanjin in the rehabilitation of patients with AMI-PCI. PubMed, the Cochrane Library, CNKI, VIP, and Wanfang were systematically searched for randomised controlled trials (RCTs) assessing the therapeutic effects and safety of Baduanjin in patients with AMI-PCI. The search was conducted up to 18 January 2025. Data were analysed using RevMan 5.4. For dichotomous outcomes, effect sizes were expressed as risk ratios (RRs) with 95% confidence intervals (CIs); the number needed to treat (NNT) was calculated where appropriate. For continuous outcomes measured on the same scale, the mean difference (MD) with 95% confidence interval (CI) was used. When outcomes were assessed using different instruments or scales, results were synthesised descriptively. Thirteen studies involving 1293 participants (870 males and 423 females) were identified. Baduanjin significantly improved left ventricular ejection fraction (LVEF [MD = 6.20%, 95% CI (3.14, 9.25), Z = 3.98, P < 0.0001, 1003 participants] and 6-minute walk distance (6-MWD) [MD = 60.21 m, 95% CI (17.96, 102.46), Z = 2.79, P = 0.005, 589 participants]. It also led to clinically meaningful improvements in quality of life (QOL), as measured by the Seattle Angina Questionnaire [MD = 11.36, 95% CI (7.66, 15.06), Z = 6.02, P < 0.00001, 150 participants], the Angina Pectoris Quality of Life Questionnaire [MD = 3.71, 95% CI (0.92, 6.50), Z = 2.61, P = 0.009, 92 participants], and the WHOQOL-BREF [MD = 91.40, 95% CI (90.59, 92.21), Z = 220.28, P < 0.00001, 60 participants]. Significant reductions in anxiety and depression symptoms were observed across multiple instruments: on the Hamilton Anxiety Rating Scale, the mean reduction from baseline was greater in the Baduanjin group by 1.40 points [95% CI (0.47, 2.33), Z = 2.95, P = 0.003]; on the Generalized Anxiety Disorder-7 scale, post-intervention scores were lower in the Baduanjin group by 2.67 points [95% CI (2.20, 3.14), Z = 11.14, P < 0.00001]. Similarly, for depression, the mean reduction from baseline on the Hamilton Depression Rating Scale was greater by 2.80 points [95% CI (1.63, 3.97), Z = 4.71, P < 0.00001], and post-intervention scores on the Patient Health Questionnaire-9 were lower by 2.73 points [95% CI (2.25, 3.21), Z = 11.11, P < 0.00001]. Baduanjin did not appear to increase the risk of adverse events and may even reduce the incidence of certain cardiovascular adverse events [15/133 vs. 40/133, RR = 0.40, 95% CI (0.25, 0.65), Z = 3.75, P = 0.0002, NNT = 5]. The evidence suggests that Baduanjin may provide therapeutic benefits for patients with AMI-PCI, including improvements in cardiac function (LVEF), exercise capacity (6-MWD), QOL, and mental health. Moreover, the practice appears to be safe and may reduce the incidence of certain cardiovascular adverse events. These findings highlight the potential role of Baduanjin in the management and rehabilitation of patients with AMI-PCI, although further well-designed studies are warranted to confirm its efficacy. CRD 42025634145 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42025634145).
Baduanjin exercise has shown promise in improving symptoms in patients with fibromyalgia syndrome (FMS), though existing studies are often limited by small sample sizes and a reliance on subjective measures. More robust evidence is needed to further establish its clinical benefits. To evaluate the effects of Baduanjin exercise on disease impact, pain, sleep quality, fatigue, and muscle activation in patients with FMS, using both subjective and objective measures. This assessor-blinded, two-arm randomized controlled trial was conducted at a university-affiliated hospital in Changchun. Adults with a formal diagnosis of FMS were randomly assigned (1:1) to Baduanjin group or control group. The Baduanjin group engaged in 30 min of supervised Baduanjin exercise daily for 4 weeks, while the control group received standard therapy for the same duration. Assessments were conducted at baseline, week 4, and week 8. The primary outcome was the change in Fibromyalgia Impact Questionnaire (FIQR) score. Secondary outcomes included Visual Analog Scale (VAS), Widespread Pain Index (WPI), Pittsburgh Sleep Quality Index (PSQI), and Multidimensional Fatigue Inventory (MFI-20). Surface electromyography (sEMG) was used as an exploratory measure of muscle activation, quantified by the root mean square (RMS) of the signal. Analyses followed the intention-to-treat principle. Seventy-four participants (mean [SD] age, 47.96 [9.54] years; 41 [55.41%] female) were randomized to the Baduanjin (n = 37) and control (n = 37) groups. At week 4, the Baduanjin group showed a significant improvement in disease impact (FIQR; MD, -4.49 points; P = 0.005), muscle activation (sEMG RMS; MD, +24.9 μV left, +26.4 μV right; P = 0.014 and P = 0.038), pain intensity (VAS; MD, -0.78 points; P = 0.037), pain extent (WPI; MD, -1.91 points; P < 0.001), sleep quality (PSQI; MD, -1.65 points; P = 0.001), and fatigue (MFI-20; MD, -4.74 points; P = 0.001) compared with the control group. At week 8, between-group differences in pain intensity and disease impact were no longer significant, but improvements in pain extent, sleep quality and fatigue persisted in the Baduanjin group. Mild adverse events were reported in both groups, with no serious adverse events. Baduanjin exercise is a safe and effective non-pharmacological intervention that provides short-term improvements in overall disease burden and multidimensional symptoms in FMS, supporting its use as a complementary mind-body strategy in clinical management. ITMCTR2025001832.
Medial epicondylitis, a tendinopathy of the flexor-pronator origin, remains less studied than lateral epicondylitis, especially regarding exercise-based interventions. Eccentric exercise has demonstrated benefits in other tendinopathies, but its role in medial epicondylitis has not been systematically evaluated. To synthesize clinical evidence on the effectiveness of eccentric exercise in reducing pain and improving function in medial epicondylitis. Following PRISMA guidelines, five databases (PubMed, Web of Science, Scopus, SPORTDiscus, Google Scholar) were searched from inception to January 2025. Clinical studies evaluating eccentric loading of the wrist flexor-pronator musculature as a primary intervention component for medial epicondylitis were included. Two reviewers independently screened the records, extracted the data, and assessed the risk of bias. Five studies (n = 143 patients) were included, comprising randomized controlled trials (RCT), pre-post studies, and comparative analyses. Eccentric exercise was associated with significant within-group reductions in pain and improvements in functional outcomes across included studies. Between-group superiority was demonstrated in one RCT. Combined interventions showed superior outcomes compared with ultrasound in one trial, while other comparative studies demonstrated significant within-group improvements without clear between-group differences. Sustained pain relief and functional improvement at 11-year follow-up were reported in a single uncontrolled study. Heterogeneity in intervention protocols and small sample sizes precluded meta-analysis. Current evidence suggests that eccentric exercise may reduce pain and improve function in medial epicondylitis, particularly when incorporated into multimodal conservative management. However, the overall certainty of evidence remains low, and larger high-quality randomized trials are required to confirm these findings.
This study aims to preliminarily evaluate the role of Guide Chi and Regulate Spirit(GCRS) Tuina in enhancing walking function in post-stroke patients with walking dysfunction; secondly, by using functional near-infrared spectroscopy (fNIRS), it investigates the effect of GCRS Tuina on the restoration of brain function in this patient population. Participants in the control group received 4-week rehabilitation treatment, while those in the Combined Tuina Group (CTG) additionally received GCRS Tuina therapy for another 4 weeks on this basis. Functional Ambulation Category (FAC), Fugl - Meyer Assessment Scale for Lower Extremity Motor Function (FMA - LE), and Modified Barthel Index (MBI) were evaluated at the baseline and after 4 treatment weeks. A gait and motion analysis system was used to measure step length, stride, walking speed, and step frequency. FNIRS was used to measure the resting-state functional connectivity(FC) strength, as well as the β - value and HbO2 concentration mean during the walking task. A total of 60 participants completed the randomized, and 53 completed the trial and entered the statistical analysis. Compared with the Single Rehabilitation Group(SRG), the CTG group had higher FAC, FMA-LE, and MBI scores after 4 weeks. After the treatment course, the standardized step length, stride, walking speed, and step frequency of the CTG were higher than SRG. At the Region of Interest(ROI) level, the CTG exhibited 13 inter-ROI FC strengths that were higher than SRG, and the differences could survive the FDR correction (PFDR<0.05). Under the walking task, the CTG group had higher β values in 18 channels and higher Oxyhemoglobin(HbO2) concentrations in 19 channels than the SRG (PFDR <0.05). GCRS Tuina therapy can significantly improve patients' walking function, enhance lower limb motor ability and daily living ability. It can improve walking efficiency. Tuina can significantly increase the FC and enhance the activation levels and HbO2 concentrations. The stimulation of Tuina may help reconstruct the brain's motor control network, restore impaired motor function, promote the occurrence of neural plasticity, strengthen the neural circuits in the cognitive-motor-sensory cortex to improve walking function. This study has been registered with the International Traditional Medicine Clinical Trial Registry (ITMCTR2024000654).
Migraine, a highly prevalent and disabling condition affecting over one billion people worldwide, poses significant socio-economic challenges, including reduced quality of life, impaired mental health, and decreased productivity. While pharmacological treatments exist, their limitations drive interest in complementary approaches such as medical hypnosis, proven effective in chronic pain management. This systematic review, registered on PROSPERO (ID: CRD42024509302), evaluates the scientific evidence supporting hypnosis for migraine treatment. Following PRISMA guidelines, a comprehensive search was conducted in PubMed, MEDLINE, EMBASE, Cochrane Reviews, and PsycINFO. Inclusion criteria encompassed randomized controlled or quasi-experimental studies on adult migraine sufferers using hypnosis as a standalone intervention. Nine studies involving 406 participants were analyzed, though a meta-analysis was precluded by the heterogeneity of study designs, populations, and outcome measures. Control conditions varied, including standard care and medication, while outcomes assessed ranged from migraine frequency and severity to psychological factors and medication use. The included studies employed two primary hypnosis techniques: to enhance internal resources and mental imagery, with some combining both. Results consistently demonstrated hypnosis's effectiveness in reducing migraine symptoms, often outperforming other non-pharmacological interventions with fewer resources required. However, significant methodological limitations were noted, including inadequate sample descriptions and lack of statistical power calculations. This review underscores the potential of hypnosis in migraine management but highlights the need for rigorous research to address methodological gaps and refine intervention strategies. Recommendations for future studies are proposed, as further studies are needed to fill methodological gaps and deepen understanding of its role in migraine management.
Poor sleep quality is closely associated with autonomic dysregulation and increased risks of cardiovascular, metabolic, and mental disorders. Foot reflexology is a widely used complementary therapy; however, its physiological mechanisms and comparative efficacy remain insufficiently explored. This study aimed to compare the effects of manual reflexology treatment (MRT) and foot massage equipment (FEM) on autonomic nervous system function, sleep quality, insomnia severity, and fatigue in adults with poor sleep quality. Using a randomized crossover design, 32 participants with poor sleep quality received MRT and FEM interventions for 6 weeks each (once weekly, 30-40 min/session). Heart rate (HR), blood pressure, and heart rate variability (HRV; time- and frequency-domain indices) were assessed at weeks 1 and 6 before and after each intervention. Subjective outcomes included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Fatigue Assessment Scale (FAS). Following MRT, participants demonstrated significantly greater reductions in global PSQI scores and all PSQI components compared with FEM. MRT also resulted in larger improvements in insomnia severity and both mental and physical fatigue. In contrast, FEM primarily improved physical fatigue. Physiologically, MRT induced an immediate decrease in HR and significant increases in HRV time-domain indices (SDNN, RMSSD, pNN50), which were sustained after 6 weeks. Frequency-domain analysis further revealed reduced LF, increased HF, and a lower LF/HF ratio, indicating enhanced parasympathetic activity and cumulative autonomic modulation. In conclusion, programmed manual reflexology, delivered according to the TIDieR framework, is more effective than mechanical foot massage in improving autonomic balance, sleep quality, insomnia severity, and fatigue in individuals with poor sleep quality. These findings support MRT as a feasible and evidence-based non-pharmacological complementary intervention for sleep health promotion. TRIAL REGISTRATION: clinicaltrials.gov; NCT Number: NCT07402460; Registered 3 February 2026.
This study evaluated the effects of cognitive-behavioral therapy (CBT) combined with abdominal breathing training (ABT) and/or music therapy (MT) on negative emotions and subjective well-being in glioma patients undergoing chemotherapy. Glioma patients receiving first-time chemotherapy at Henan Provincial People's Hospital from January 2022 to December 2023 were enrolled. Participants were randomly assigned to control (routine nursing), ABT (routine nursing + CBT + ABT), MT (routine nursing + CBT + MT), and combined (routine nursing + CBT + ABT + MT) groups. Anxiety, depression, and subjective well-being were assessed using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and General Well-being Scale (GWBS) after the first and after the fourth chemotherapy cycles. The study included 43, 45, 44, and 42 participants in the control, ABT, MT, and combined groups, respectively. Compared to the control group, CBT+MT and CBT+ABT interventions significantly reduced anxiety (-16.90%, P < 0.001, and -22.90%, P = 0.003, respectively) and depression (-20.52%, P < 0.001, and -14.00%, P < 0.001, respectively). However, the combined intervention did not significantly reduce anxiety (P = 0.486) or depression (P = 0.313). Subjective well-being significantly improved in the CBT+MT (+25.26%, P < 0.001), CBT+ABT (+25.92%, P < 0.001), and combined (+34.50%, P = 0.009) groups compared with the control group. CBT combined with ABT or MT may effectively alleviate anxiety and depression in glioma patients undergoing chemotherapy. The combination of ABT and MT with CBT significantly improved subjective well-being. These findings provide a reference for clinical interventions aimed at enhancing emotional well-being in this patient population.
This study aimed to examine the feasibility and preliminary outcome trends of a 12-week structured Cha-Cha dance training program on balance-related performance, fall-related functional indicators, and cognitive function in patients with mild-to-moderate Parkinson's disease. Fourteen participants with PD (Hoehn and Yahr stages 1-3, aged 55-75 years) were recruited. While maintaining their routine pharmacological treatment, participants engaged in a 12-week intervention consisting of two 1.5-hour sessions per week focused on basic Cha-Cha dance steps. Balance function was assessed using the Berg Balance Scale (BBS), the Single-Legged Closed-eyed Standing Test (SCST), and the Timed Up and Go Test (TUGT). Cognitive function was evaluated with the Montreal Cognitive Assessment Scale (MoCA), the Stroop Color-Word Task, and the Flanker Task. This pilot feasibility study used a single-group pre-post design. Pre- and post-intervention data were compared using paired-sample t-tests or Wilcoxon signed-rank tests. After the 12-week intervention, participants showed statistically significant improvements in several balance-related and cognitive outcomes. BBS scores increased significantly (before: 37.57 ± 4.48, after: 40.00 ± 4.47 and p = 0.001); SCST duration on both legs increased significantly (p < 0.05); and TUGT completion time decreased significantly (before: 12.98 ± 1.39 s, after: 10.16 ± 1.05 s and p < 0.001). Total MoCA scores also increased (before: 23.86 ± 2.74, after: 26.07 ± 1.98, p < 0.001), with particularly marked improvements in attention and delayed recall (p < 0.05). In the Stroop task, accuracy improved by 15% and response time decreased by 15%; in the Flanker task, accuracy improved by 27% and response time decreased by 9%. Both accuracy improvements and response time reductions were statistically significant (p < 0.001). In this single-group pilot feasibility study, a 12-week structured Cha-Cha dance training program appeared to be a safe and feasible non-pharmacological intervention for individuals with mild-to-moderate PD. The observed changes may indicate preliminary improvements in balance-related performance, fall-related functional indicators, and selected cognitive outcomes; however, in the absence of a control group, these findings should be interpreted as indicative rather than confirmatory evidence. Larger controlled studies are needed to determine efficacy.
Sleep disorders (SD) are highly prevalent in patients with Alzheimer's disease (AD); however, effective pharmacological interventions are often limited by adverse effects or insufficient efficacy. This study aims to evaluate the clinical synergistic value and the "sleep-cognition co-modulation" effect of sedative-tranquilizing acupuncture, a specialized non-pharmacological therapy, in managing AD-SD comorbidity. This is a multicenter, randomized, controlled trial (RCT) involving 72 participants diagnosed with both AD and SD. Participants will be randomly assigned (1:1:1) to one of three groups: the control group, receiving standard care (donepezil hydrochloride combined with cognitive behavioral therapy for insomnia [CBT-I]); the acupuncture group, receiving sedative-tranquilizing acupuncture in addition to standard care; and the sham acupuncture group, receiving sham acupuncture plus standard care. The primary outcome measure is the change from baseline in the Pittsburgh Sleep Quality Index (PSQI) score. Secondary outcomes include cognitive function (Mini-Mental State Examination [MMSE]), quality of life (Quality of Life in Alzheimer's Disease [AD-QOL] scale), and psychological symptoms (Hamilton Anxiety Scale [HAMA] and the 17-item Hamilton Depression Scale [HAMD-17]). Furthermore, peripheral biochemical markers, polysomnography (PSG) parameters, and neuroimaging data will be analyzed to explore underlying mechanisms. All analyses will be performed on an intention-to-treat (ITT) basis. This trial is expected to provide robust clinical evidence regarding whether sedative-tranquilizing acupuncture can effectively assist in improving sleep quality and cognitive function in patients with AD-SD comorbidity. The findings will further elucidate the potential neurobiological mechanisms of acupuncture and offer a novel integrative strategy for the management of AD-related sleep disturbances. This protocol was approved by the Ethics Committee of Nanchang Hongdu Hospital of Traditional Chinese Medicine (KYKS-2024044-1(X-2) and registered with the International Traditional Medicine Clinical Trial Registry (https://itmctr.ccebtcm.org.cn/mgt/project/user/user-project-view/09DB9DBC-F576-4AF9-AF4E-D6D88E1B1B6B).
Inadequate management of pain and anxiety can prolong hospitalization and increase healthcare costs. Integrative and Complementary Health Practices (ICHP) emerge as safe, accessible, and easily applied alternatives or complements to conventional treatments. Aromatherapy utilizing chamomile essential oil is highlighted for its sedative, anxiolytic, and analgesic properties. To map the existing knowledge regarding the use of chamomile essential oil aromatherapy in the management of pain and anxiety in hospitalized patients within hospital settings. A scoping review was conducted according to the Joanna Briggs Institute (JBI) guidelines and reported following the PRISMA-ScR checklist. Seventeen studies were included in this review. The literature is predominantly recent (2020-2025) and geographically concentrated in Iran (41.1%). The most frequently represented clinical settings were obstetrics and cardiology (29.4% each). The most evaluated outcomes were anxiety and pain; reductions in these symptoms were reported in 58.8% and 41.1% of the studies, respectively. Chamomile demonstrated efficacy in consistently reducing anxiety, as well as a mild yet significant analgesic effect. Furthermore, the intervention resulted in improved vital signs and hemodynamic stability, with a reduction in heart rate and blood pressure in cardiac patients. German Chamomile (Matricaria chamomilla) was the most cited species. No significant adverse events were reported in the studies, reinforcing the favorable safety profile of chamomile. Aromatherapy with chamomile essential oil presents promising results in the management of pain and anxiety in hospital environments, as well as in the improvement of vital signs.
While the positive impact of mind-body exercises on alleviating negative emotions in cancer patients is well-established, the most effective type of exercise for this population remains unclear. This systematic review and network meta-analysis (NMA) evaluated evidence from randomized controlled trials (RCTs) to compare the effectiveness of various mind-body exercise modalities in improving emotional well-being among cancer patients. Potentially eligible RCTs assessing anxiety and depression in cancer patients in relation to mind-body exercise interventions were retrieved from eight databases from inception to August 2025. Adverse events were set as secondary outcome measures. Review Manager v5.4 and Stata v17.0 were utilized for pairwise meta-analysis and NMA, respectively. The risk of bias was assessed using the Cochrane tool version 2.0, and the Confidence in Network Meta-Analysis web-based tool was employed to evaluate the certainty of evidence. Sixty-four RCTs involving 4448 participants were included. Across the studies that reported on adverse events (13 of 64 RCTs), no serious adverse events were documented. Pairwise meta-analysis revealed that the mind-body exercise group outperformed the control group in alleviating anxiety (SMD = -1.14, 95% CI [-1.42, -0.87], p < 0.00001) and depression (SMD = -0.87, 95% CI [-1.10, -0.64], p < 0.00001). In the NMA, treatment rankings for anxiety were: Baduanjin > Qigong > Yoga > Tai Chi > control. For depression, the rankings were Wuqinxi > Baduanjin > Qigong > Tai Chi > Yoga > Pilates > control. However, the certainty for network estimates ranged from moderate to very low, primarily attributed to the risk of bias and imprecision. Among the interventions studied, Baduanjin may be associated with relatively greater anxiolytic effects, while Wuqinxi may be more effective in alleviating depressive symptoms among cancer patients. Given the very low to moderate certainty of evidence and the star-shaped network with only indirect comparisons, these preliminary findings should be interpreted with caution.
Sleep disorders have become a widespread public health challenge closely linked to cognitive decline, immune dysfunction, and chronic diseases. While pharmacological and cognitive-behavioral therapies remain standard treatments, their limitations-such as dependency and relapse-necessitate effective, low-risk alternatives. Tai Chi, a traditional Chinese mind-body exercise emphasizing mindfulness, breathing, and gentle movement, has been increasingly recognized for its potential to enhance sleep quality. However, global research in this area remains scattered and lacks integrative synthesis. This study aims to systematically map the global research landscape, collaboration networks, and thematic evolution of Tai Chi in improving sleep health, synthesizing the findings from existing literature and identifying its knowledge structure and emerging public health relevance. Publications related to Tai Chi and sleep (2000-2025) were retrieved from the Web of Science Core Collection and PubMed databases. Scientometric and bibliometric analyses were performed using CiteSpace, VOSviewer, Carrot2, and Tableau Public to evaluate publication trends, countries, institutions, authorship, journal co-citations, and keyword clusters. A total of 688 publications were identified, showing a rapid increase in research output after 2015. China and the United States together contributed nearly 70% of global publications, with the University of California, Los Angeles, and the University of Hong Kong as leading institutions. Three dominant research clusters emerged: (1) Neuromodulation and physiological mechanisms regulating autonomic and hypothalamic-pituitary-adrenal (HPA) axis balance; (2) Psychological and emotional regulation improving stress, anxiety, and depression; (3) Clinical and preventive applications among elderly, cardiovascular, psychiatric, and cancer populations. Recent randomized controlled trials have suggested that Tai Chi may offer comparable efficacy to cognitive behavioral therapy for insomnia and its potential role in multidimensional health enhancement. This scientometric analysis provides the first comprehensive overview of global Tai Chi research on sleep improvement. The findings suggest that Tai Chi may serve as a culturally adaptable, cost-effective, and holistic intervention for sleep health promotion, bridging traditional exercise and modern public health frameworks.
Dyadic Tai Chi interventions are increasingly employed for care recipient-caregiver dyads, improving safety, benefits, and interpersonal connections. However, research shows considerable heterogeneity in defining and implementing caregiver roles and engagement, highlighting the need for clearer standards to support evidence-based practice. To review and clarify the roles and engagement levels of caregivers during dyadic Tai Chi interventions. A scoping review was conducted following the methodological framework and reported per PRISMA-ScR guidelines. Systematic search was performed across nine databases (PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, Embase, PsycINFO, Google Scholar, CNKI, and WanFang). Of the 20 articles included, more than one third (35%, n = 7) failed to define caregivers or specify inclusion criteria. Where specified, criteria commonly included age restrictions, active caregiving roles, cognitive competence, cohabitation/frequent contact, and primary family caregiver status. Family caregivers were the most common type (70%, n = 14), followed by unpaid (20%, n = 4) and paid caregivers (10%, n = 2). Their roles varied substantially, including active co-designing practice regimens, monitoring adherence and ensuring safety, and assisting with data collection. Key attributes of dyadic Tai Chi interventions included the mode of task execution (dyadic co-execution), varying caregiver engagement (passive presence, parallel engagement, and interactive engagement), and target populations: care recipients (55%, n = 11), dyads (40%, n = 8), and caregivers only (5%, n = 1). The findings clarify caregivers' roles and engagement levels during dyadic Tai Chi interventions. The observed heterogeneity highlights the complexity and dynamic attributes, indicating a greater standardization in future research.
Plantar cutaneous sensation declines with age, leading to alterations in the plantar pressure distribution and increased postural instability in older adults. Textured insoles stimulate the plantar surface, which can modify plantar pressure distribution and improve postural sway during standing. Although the distribution of plantar cutaneous receptors varies across regions of the plantar surface, the effects of region-specific plantar stimulation on plantar pressure distribution and postural sway remain unclear. This study aimed to examine the effects of region-specific plantar stimulation using textured insoles on postural stability and plantar pressure during quiet standing in community-dwelling older adults. Forty-three community-dwelling older adults (men and women) participated in this study. Postural stability was assessed by measuring the center of pressure (COP) using a force platform, and plantar pressure was measured using a pressure distribution measurement system. COP and plantar pressure were recorded simultaneously. Textured insoles were randomly inserted to stimulate the different regions of the plantar surface, and postural stability and plantar pressure were measured during quiet standing with eyes closed. Textured insoles applied to the forefoot significantly increased plantar pressure in the lateral forefoot region. However, no significant differences in COP were observed among the insole conditions. Forefoot textured insoles can alter plantar pressure during quiet standing in older adults, which may influence postural control. Further research is needed to examine other factors influencing postural sway and to explore interventions for older adults at risk of falls.
Insomnia is a common sleep disorder, and many individuals seek alternative treatments like homeopathy. However, evidence for its effectiveness remains controversial. This systematic review and meta-analysis evaluated the effectiveness of homeopathic interventions for insomnia and sleep-wake disorders. A comprehensive search of PubMed, MEDLINE, CINAHL, and the Cochrane Library was conducted for studies published between 2010 and 2025. We included randomized controlled trials (RCTs) and non-randomized studies involving adults (≥18 years) with primary insomnia receiving any homeopathic intervention compared to placebo, no treatment, or active care. Primary outcomes included validated sleep quality measures (e.g., Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI). Four reviewers independently performed study selection, data extraction, and risk of bias assessment using RoB 2.0 and ROBINS-I. A random-effects meta-analysis was conducted for controlled trials, and a narrative synthesis for non-randomized studies. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). The search yielded 1304 records; 9 studies (six RCTs and three non-randomized) met inclusion criteria. Meta-analysis showed a moderate positive effect of homeopathy on sleep outcomes (SMD (Hedges' g) = 0.63 95% CI [-0.13, 1.39], p = 0.1051) but it is not statistically significant with substantial heterogeneity (I² = 88.26%) and publication bias (Egger's test, t = 2.8471, df = 4, p = 0.0465). Most studies had high or critical risk of bias, and overall certainty was low. There was no statistically significant difference between homeopathic interventions and control conditions for improving insomnia. This finding is based on low certainty evidence, with the primary limitations being a high risk of bias in the included studies and substantial unexplained heterogeneity. Therefore, current evidence is insufficient to support the effectiveness of homeopathic interventions for insomnia, and high-quality, rigorously designed trials are needed to provide a definitive answer. PROSPERO CRD42025649926.
Digital media use in early childhood has increased rapidly in recent years. However, findings on its developmental correlates remain inconsistent, particularly across different domains of early learning. Guided by ecological and cognitive stimulation frameworks, this study examined associations between weekday time spent on electronic devices and multiple indicators of language and cognitive development in preschool children aged 3-5 years. Because the National Survey of Children's Health captures time-based exposure only, the present analyses address overall device-use duration rather than content, context, or co-use. Cross-sectional analyses used data from the 2016 National Survey of Children's Health. Of 15,402 preschool-aged children in the survey, 6905 with non-missing data on exposure, outcomes, and co-variates were included in the complete-case analytic sample. Caregivers reported children's weekday electronic-device use, excluding schoolwork, and early learning outcomes including beginning sounds, letter recognition, rhyming, verbal expression, name writing, counting, and shape recognition. For consistency with the reported odds ratios, outcomes were analyzed as dichotomized indicators in multi-variable logistic regression models adjusted for child age, sex, race/ethnicity, household poverty ratio, parental education level, household size, sleep duration, prematurity, and working-poor household status. Weekday electronic-device use was not significantly associated with most language outcomes. Greater amount of device use was associated with lower odds of name writing and higher odds of counting. Sociodemographic and household characteristics were also associated with several outcomes. Sleep-duration estimates were large and imprecise in several models and are therefore interpreted cautiously. In this cross-sectional sample, associations between weekday electronic-device use and development were domain-specific rather than uniform across outcomes. These findings support cautious interpretation of time-based screen measures and highlight the importance of considering family context, sleep, and the qualitative features of media use that were not measured in the present dataset.
Cancer and its treatments affect patients' physical and psychological well-being. Laughter therapy is a non-pharmacological intervention with potential to relieve these effects. To evaluate the effects of laughter therapy in patients with cancer. A systematic review of randomized controlled trials (RCTs) was conducted to evaluate laughter therapy in cancer patients. Searches were performed in MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov through September 1 of 2025. In pairs, the authors independently performed study selection, data extraction, and risk of bias assessment. Meta-analyses used random-effects models, and evidence certainty was assessed using the GRADE approach. Sixteen RCTs including 1127 patients were analyzed. Laughter therapy probably results in an important reduction in anxiety (SMD: -0.54, 95% CI: -0.84 to -0.24). It probably results in little to no difference in quality of life (MD: -0.65, 95% CI: -7.15-5.86), and in nausea-vomiting severity (MD: -0.45, 95% CI: -0.80 to -0.09; moderate certainty). It may also lead to an important reduction in pain, and in stress, but may result in little to no difference in nausea frequency (low certainty). However, the evidence regarding depressive symptoms, fatigue, mood, and vomiting frequency is very uncertain (very low certainty). Laughter therapy probably reduces anxiety and may reduce pain and stress in patients with cancer. However, these findings should be interpreted considering limitations related to risk of bias, heterogeneity among interventions, and imprecision due to small sample sizes. Further high-quality RCTs are needed to confirm these findings and compare different modalities of laughter therapy.
This review evaluates the effects of wearable device-telemonitored Baduanjin on exercise tolerance and cardiac function in patients with chronic heart failure (CHF). A comprehensive literature search was performed in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database and Chinese Biomedical Literature Database (CBM) from their inception to 1 January 2026. The search aimed to identify randomised controlled trials investigating Baduanjin for CHF that explicitly used wearable devices. Study screening, data extraction and Cochrane RoB 2.0 bias assessment were performed independently by two reviewers with discrepancies were resolved by a third. Given significant clinical heterogeneity across the included studies, a narrative synthesis of the findings was conducted, supported by tabulated presentation of outcome data. Three randomized controlled trials involving 248 participants were included. Individual studies reported that wearable device-telemonitored Baduanjin was associated with improvements in several clinical outcomes in patients with CHF. Reported benefits included increased 6-minute walking distance (568.58 m vs. 367.47 m, P < 0.05), higher peak oxygen uptake (19.00 vs. 17.00 ml/[kg·min], P < 0.001) and improved left ventricular ejection fraction (52.60% vs. 45.28% and 42.79%, P < 0.05). Improvements were also observed in quality of life, depression symptoms, cardiovascular readmission in the intervention group of individual studies. No exercise-related adverse events were reported. Current evidence suggests that wearable device-telemonitored Baduanjin may potentially improve key outcomes in patients with chronic heart failure, However, these findings are based on a narrative synthesis of individual studies and should therefore be interpreted cautiously. Further high-quality, standardised randomised controlled trials are urgently needed.