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- Title
A PILOT STUDY OF MIND-BODY CHANGES IN ADULTS WITH ASTHMA WHO PRACTICE MENTAL IMAGERY.
- Authors
Epstein, Gerald N.; Halper, James P.; Manhart Barrett, Elizabeth Ann; Birdsall, Carole; McGee, Monnie; Baron, Kim P.; Lowenstein, Stephen
- Abstract
Context • Despite the growing number of studies of imagery and the use of complementary and alternative modalities as treatments for asthma, research on mental imagery in adults with asthma is practically nonexistent. The purpose of this feasibility study was to lay groundwork for a larger follow-up clinical trial. Objective • To determine whether pulmonary function, asthma symptoms, quality of life, depression, anxiety, and power differ over time in adults with asthma who do and do not prative mental imagery (MI). (Power is the ability to make aware choices with the intention of freely involving oneself in creating desired change.) Design • Randomized controlled study using univariate repeated measure analysis of variance (ANOVA) and replacement through block design. Setting • Lenox Hill Hospital an affiliate of New York University Medical School. New York NY. Subjects • Sixty-eight adults with symptomatic asthma, after 4 weeks of baseline data collection and analysis, met requirements for this randomized controlled study. Thirty-three completed pulmonary function as well as self-report test at 4 time points over 17 weeks. The 16 experimental participants also completed the 4-session imagery protocol. Intervention • Individual imagery instruction (week 1) and follow-up (weeks 4, 9, 15). Participants were given 7 imagery exercises to select from and practice 3 times a day for a total of 15 minutes. Main Outcomes Measures • 1) Spirometry (FEV1); 2) medication use; 3) Asthma Quality of Life Questionnarie; 4) Beck Depression Inventory; 5) Spiclberger Anxiety Scales (A-State and A-Trait); 6) Barrett Power as Knowing Participating in Change Tool, Version II; 7) Epstein Balloon Test of Ability to Image. Results • There was little evidence of statistical change in this feasibility study; yet valueable lessons were learned. Paired t-test indicated there was a significant difference in the total power socres in the imagery group, and in the expected direction (two-tailed, t-statistic = -2.3, P = 0.035) and the choice sub-scales (two-tailed, t-statistic = -2.93, P = 0.01) of the power instrument from weeks one to 16 of the study. Eight of 17 (47%) participants in the MI group reduced or discontinued their medications. Three of 16 (19%) participants in the control group reduced their meditations; none discontinued. Chi-square indicated differences between groups (X = 4.66, P = 0.05). Persons who reduced or discontinued their medications showed neither an increase in palmonary function prior to medication discontinuation, nor a fall in these parameters following discontinuation. Conclusions • Findings related to major outcome measure must be viewed with caution due to the small sample size resulting from attrition related to labor intensiveness and, therefore, low statistical power. However, the study did provide significant data to plan a larger scale study of the use of mental imagery with adult asthmatics. The study also demonstrated that imagery is inexpensive, safe and, with training, can be used as an adjunct therapy by patients themselves. Its efficacy needs additional exploration. Further research for adults with asthma who practice imagery is important, as current treatment are not entirely efficacious. Lesions learned in this study may facilitate improvement in research designs.
- Subjects
ASTHMA; LUNG diseases; MENTAL imagery; MEDICAL function tests; CLINICAL trials; MENTAL depression
- Publication
Alternative Therapies in Health & Medicine, 2004, Vol 10, Issue 4, p66
- ISSN
1078-6791
- Publication type
Article