Dataset Information

Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: protocol of a quasi-experimental feasibility clinical trial.

ABSTRACT:

Background

About 69% of Americans living with spinal cord injury (SCI) suffer from long-term debilitating neuropathic pain, interfering with the quality of daily life. Neuropathic pain is refractory to many available treatments-some carrying a risk for opioid addiction-highlighting an urgent need for new treatments. In this study, we will test our hypothesis that Spring Forest Qigong™ will reduce SCI-related neuropathic pain by improving body awareness. We will determine whether remotely delivered Qigong is feasible and we will collect data on neuropathic pain, and other reported associations with pain such as spasms frequency and/or severity, functional performance, mood, and body awareness.

Methods

In this quasi-experimental pilot clinical trial study, adults with SCI will practice Qigong at home with a 45-min video, at least 3 × /week for 12 weeks. The Qigong practice includes movements with guided breathing and is individualized based on functional abilities, i.e., the participants follow along with the Qigong movements to the level of their ability, with guided breathing, and perform kinesthetic imagery by focusing on the feeling in the whole body as if doing the whole-body Qigong movement while standing. The highest, average, and lowest neuropathic pain ratings perceived in the prior week will be recorded weekly until the 6-week follow-up. The other outcomes will be collected at 5 time points: at baseline, midway during the Qigong intervention (6 weeks), after the Qigong intervention (12 weeks), after a 6-week and 1-year follow-up. Rate parameters for the feasibility markers will be estimated based on the participants who achieved each benchmark.

Discussion

The University of Minnesota (UMN)'s Institutional Review Board (IRB) approved the study (IRB #STUDY00011997). All participants will sign electronic informed consent on the secure UMN REDCap platform. The results will be presented at academic conferences and published in peer-reviewed publications.

Trial registration

ClinicalTrial.gov registration number: NCT04917107 , (this protocol paper refers to the substudy), first registered 6/8/2021.

SUBMITTER: Van de Winckel A

PROVIDER: S-EPMC10464017 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: protocol of a quasi-experimental feasibility clinical trial.

Van de Winckel Ann A Carpentier Sydney S Deng Wei W Zhang Lin L Battaglino Ricardo R Morse Leslie L

Pilot and feasibility studies 20230822 1

<h4>Background</h4>About 69% of Americans living with spinal cord injury (SCI) suffer from long-term debilitating neuropathic pain, interfering with the quality of daily life. Neuropathic pain is refractory to many available treatments-some carrying a risk for opioid addiction-highlighting an urgent need for new treatments. In this study, we will test our hypothesis that Spring Forest Qigong™ will reduce SCI-related neuropathic pain by improving body awareness. We will determine whether remotely ...[more]

PMID: 37608389

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Project description:Introduction: Approximately 69% of 299,000 Americans with spinal cord injury (SCI) suffer debilitating chronic neuropathic pain, which is intractable to treatment. The aim of this study is to determine feasibility, as the primary objective, and estimates of efficacy of a remotely delivered Qigong intervention in adults with SCI-related neuropathic pain, as the secondary objective. Methods: We recruited adults with SCI-related neuropathic pain, with SCI ≥3 months, with complete or incomplete SCI, and highest neuropathic pain level of >3 on the Numeric Pain Rating Scale (NPRS), using nationwide volunteer sampling. Using a non-randomized controlled trial design, participants practiced Spring Forest Qigong's "Five Element Qigong Healing Movements" (online video) by combining movement to the best of their ability with kinesthetic imagery, at least 3x/week for 12 weeks. Adherence was automatically tracked through the Spring Forest Qigong website. Outcomes of neuropathic pain intensity (NPRS) were assessed weekly, and SCI-related symptoms were assessed at baseline, 6, and 12 weeks of Qigong practice and at 6-week and 1-year follow-ups. Results: We recruited 23 adults with chronic SCI (7/2021-2/2023). In total, 18 participants started the study and completed all study components, including the 6-week follow-up. Twelve participants completed the 1-year follow-up assessment. Feasibility was demonstrated through participants' willingness to participate, adherence, and acceptability of the study. Mean age of the 18 participants was 60 ± 12 years, and they were 15 ± 11 years post-SCI with the highest baseline neuropathic pain of 7.94 ± 2.33, which was reduced to 4.17 ± 3.07 after 12 weeks of Qigong practice (Cohen's d = 1.75). This pain relief remained at 6-week and 1-year follow-ups. Participants reported reduced spasm frequency (change score 1.17 ± 1.20, d = 0.98) and severity (0.72 ± 1.02, d = 0.71), reduced interference of neuropathic pain on mood (3.44 ± 2.53, d = 1.36), sleep (3.39 ± 2.40, d = 1.41), daily activities (3.17 ± 2.77, d = 1.14), greater ability to perform functional activities (6.68 ± 3.07, d = 2.18), and improved mood (2.33 ± 3.31, d = 0.70) after Qigong. Discussion: Remote Spring Forest Qigong's "Five Element Qigong Healing Movements" practice is feasible in adults with SCI-related neuropathic pain, with promising prolonged results of neuropathic pain relief and improvement in SCI-related symptoms after Qigong practice. Clinical trial registration: https://www.clinicaltrials.gov/ct2/show/NCT04917107, identifier NCT04917107.

Project description:Forest decline, in course of climate change, has become a frequently observed phenomenon. Much of the observed decline has been associated with an increasing frequency of climate change induced hotter droughts while decline induced by flooding, late-frost, and storms also play an important role. As a consequence, tree mortality rates have increased across the globe. Despite numerous studies that have assessed forest decline and predisposing factors for tree mortality, we still lack an in-depth understanding of (I) underlying eco-physiological mechanisms, (II) the influence of varying environmental conditions related to soil, competition, and micro-climate, and (III) species-specific strategies to cope with prolonged environmental stress. To deepen our knowledge within this context, studying tree performance within larger networks seems a promising research avenue. Ideally such networks are already established during the actual period of environmental stress. One approach for identifying stressed forests suitable for such monitoring networks is to assess measures related to tree vitality in near real-time across large regions by means of satellite-borne remote sensing. Within this context, we introduce the European Forest Condition monitor (EFCM)-a remote-sensing based, freely available, interactive web information tool. The EFCM depicts forest greenness (as approximated using NDVI from MODIS at a spatial resolution of roughly 5.3 hectares) for the pixel-specific growing season across Europe and consequently allows for guiding research within the context of concurrent forest performance. To allow for inter-temporal comparability and account for pixel-specific features, all observations are set in relation to normalized difference vegetation index (NDVI) records over the monitoring period beginning in 2001. The EFCM provides both a quantile-based and a proportion-based product, thereby allowing for both relative and absolute comparison of forest greenness over the observational record. Based on six specific examples related to spring phenology, drought, late-frost, tree die-back on water-logged soils, an ice storm, and windthrow we exemplify how the EFCM may help identifying hotspots of extraordinary forest greenness. We discuss advantages and limitations when monitoring forest condition at large scales on the basis of moderate resolution remote sensing products to guide users toward an appropriate interpretation.

Project description:Crop phenology is very important in regular crop monitoring. Generally, phenology is monitored through field observation surveys or satellite data. The relationships between ground observations and remotely sensed derived phenological data can enable near-real-time monitoring over large areas, which has never been attempted on hazelnuts. In this study, we extracted phenological metrics derived from MODIS Enhanced Vegetation Index (EVI) in hazelnut production regions and compared them with the spring ground phenological data (BBCH scale) from orchards located in the same area of Turkey over the period from 2019 to 2022. We observed a specific temporal dynamic between remote sensing phenometrics and ground observations. The metrics Greenup, Upturning Date, and Threshold 20% metrics corresponded to the early of EVI growth and were synchronous with the female flowering of hazelnut and ending before bud break. The metrics Threshold 50% and Start of season were associated with the steepest portion of the EVI curve, i.e., canopy greening and thickening, and occurred between ovaries enlargement and leaves unfolding. The metrics Peak of Season, Stabilization Date, and Maturity corresponded to the end of spring vegetative growth. The main outcomes are that (i) female flowering occurred before 20% of vegetation development (BBCH 64P occurred about one month before Threshold 20%), (ii) phenometrics from satellite remote sensing (i.e., Upturning Date and Threshold 20%) well-reflected leaf emergence (rs = 0.30 and rs = 0.32, respectively; p < 0.05) and unfolding (rs = 0.35 and rs = 0.39, respectively; p < 0.05), and (iii) cluster appearance temporally aligned with the peak of the EVI curve (Stabilization Date and BBCH 71P differed by around 4 days). Our method is transferable to operational phenology monitoring, and future applications will consider the senescence season and the effect of environmental variability on the comprehension of vegetation dynamics.

Project description:BackgroundExercise-based cardiac rehabilitation (CR) is recommended for coronary heart disease (CHD). However, poor uptake of and poor adherence to CR exercise programs have been reported globally. Delivering CR exercise classes remotely may remove some of the barriers associated with traditional hospital- or center-based CR.ObjectiveWe have developed a bespoke platform, Eastern Corridor Medical Engineering Centre-Cardiac Rehabilitation (ECME-CR), to support remotely delivered CR exercise. This pilot trial sought to test the ECME-CR platform and examine the efficacy and feasibility of a remote CR exercise program compared to a traditional center-based program.MethodsIn all, 21 participants with CHD were recruited and assigned to either the intervention or control group. Both groups performed the same 8-week exercise program. Participants in the intervention group took part in web-based exercise classes and used the ECME-CR platform during the intervention period, whereas participants in the control group attended in-person classes. Outcomes were assessed at baseline and following the 8-week intervention period. The primary outcome measure was exercise capacity, assessed using a 6-minute walk test (6MWT). Secondary outcomes included measurement of grip strength, self-reported quality of life, heart rate, blood pressure, and body composition. A series of mixed between-within subjects ANOVA were conducted to examine the mean differences in study outcomes between and within groups. Participant adherence to the exercise program was also analyzed.ResultsIn all, 8 participants (male: n=5; age: mean 69.7, SD 7.2 years; height: mean 163.9, SD 5.4 cm; weight: mean 81.6, SD 14.1 kg) in the intervention group and 9 participants (male: n=9; age: mean 69.8, SD 8.2 years; height: mean 173.8, SD 5.2 cm; weight: mean 94.4, SD 18.0 kg) in the control group completed the exercise program. Although improvements in 6MWT distance were observed from baseline to follow-up in both the intervention (mean 490.1, SD 80.2 m to mean 504.5, SD 93.7 m) and control (mean 510.2, SD 48.3 m to mean 520.6, SD 49.4 m) group, no significant interaction effect (F1,14=.026; P=.87) nor effect for time (F1,14=2.51; P=.14) were observed. No significant effects emerged for any of the other secondary end points (all P>.0275). Adherence to the exercise program was high in both the intervention (14.25/16, 89.1%) and control (14.33/16, 89.6%) group. No adverse events or safety issues were reported in either group during the study.ConclusionsThis pilot trial did not show evidence of significant positive effect for either the remotely delivered or center-based program. The 6MWT may not have been sufficiently sensitive to identify a change in this cohort of participants with stable CHD. This trial does provide evidence that remote CR exercise, supported with digital self-monitoring, is feasible and may be considered for individuals less likely to participate in traditional center-based programs.International registered report identifier (irrid)RR2-10.2196/31855.

Dataset Information

Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: protocol of a quasi-experimental feasibility clinical trial.

Background

Methods

Discussion

Trial registration

Publications

Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: protocol of a quasi-experimental feasibility clinical trial.

Similar Datasets

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