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      Qigong Training Positively Impacts Both Posture and Mood in Breast Cancer Survivors With Persistent Post-surgical Pain: Support for an Embodied Cognition Paradigm

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          Abstract

          Theories of embodied cognition hypothesize interdependencies between psychological well-being and physical posture. The purpose of this study was to assess the feasibility of objectively measuring posture, and to explore the relationship between posture and affect and other patient centered outcomes in breast cancer survivors (BCS) with persistent postsurgical pain (PPSP) over a 12-week course of therapeutic Qigong mind-body training. Twenty-one BCS with PPSP attended group Qigong training. Clinical outcomes were pain, fatigue, self-esteem, anxiety, depression, stress and exercise self-efficacy. Posture outcomes were vertical spine and vertical head angles in the sagittal plane, measured with a 3D motion capture system in three conditions: eyes open (EO), eyes open relaxed (EOR) and eyes closed (EC). Assessments were made before and after the Qigong training. The association between categorical variables (angle and mood) was measured by Cramer’s V. In the EO condition, most participants who improved in fatigue and anxiety scales also had better vertical head values. For the EOR condition, a moderate correlation was observed between changes in vertical head angle and changes in fatigue scale. In the EC condition, most of the participants who improved in measures of fatigue also improved vertical head angle. Additionally, pain severity decreased while vertical spine angle improved. These preliminary findings support that emotion and other patient centered outcomes should be considered within an embodied framework, and that Qigong may be a promising intervention for addressing biopsychosocially complex interventions such as PPSP in BCSs.

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          Most cited references115

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          A Global Measure of Perceived Stress

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            Cancer treatment and survivorship statistics, 2019

            The number of cancer survivors continues to increase in the United States because of the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate every 3 years to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries; vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics; and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Data Base are presented for the most prevalent cancer types. Cancer-related and treatment-related short-term, long-term, and late health effects are also briefly described. More than 16.9 million Americans (8.1 million males and 8.8 million females) with a history of cancer were alive on January 1, 2019; this number is projected to reach more than 22.1 million by January 1, 2030 based on the growth and aging of the population alone. The 3 most prevalent cancers in 2019 are prostate (3,650,030), colon and rectum (776,120), and melanoma of the skin (684,470) among males, and breast (3,861,520), uterine corpus (807,860), and colon and rectum (768,650) among females. More than one-half (56%) of survivors were diagnosed within the past 10 years, and almost two-thirds (64%) are aged 65 years or older. People with a history of cancer have unique medical and psychosocial needs that require proactive assessment and management by follow-up care providers. Although there are growing numbers of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based resources are needed to optimize care.
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              The validity of the Hospital Anxiety and Depression Scale. An updated literature review.

              To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS). A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression? Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83. HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.

                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                21 February 2022
                2022
                : 13
                : 800727
                Affiliations
                [1] 1Laboratory of Biosystems, Institute of Physics, Universidade Federal da Bahia , Salvador, Brazil
                [2] 2Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital , Boston, MA, United States
                [3] 3Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital , Boston, MA, United States
                [4] 4Zakim Center for Integrative Therapies and Healthy Living, Harvard Medical School, Dana Farber Cancer Institute , Boston, MA, United States
                [5] 5Department of Family and Community Medicine, Osher Center for Integrative Medicine, University of California, San Francisco , San Francisco, CA, United States
                [6] 6Department of Philosophy, University of British Columbia , Vancouver, BC, Canada
                Author notes

                Edited by: Russell Sarwar Kabir, Hiroshima University, Japan

                Reviewed by: Michael Finn, Helen DeVos Children’s Hospital, United States; Marta Matamala-Gomez, University of Milano-Bicocca, Italy

                *Correspondence: Ana Paula Quixadá, apq.fisio@ 123456gmail.com

                This article was submitted to Movement Science and Sport Psychology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2022.800727
                8900705
                35265005
                326649ee-49d4-40f9-9bd1-36817bfe0c7b
                Copyright © 2022 Quixadá, Miranda, Osypiuk, Bonato, Vergara-Diaz, Ligibel, Mehling, Thompson and Wayne.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 23 October 2021
                : 06 January 2022
                Page count
                Figures: 4, Tables: 4, Equations: 0, References: 115, Pages: 12, Words: 9706
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                posture,mood,breast cancer,embodied cognition,qigong
                Clinical Psychology & Psychiatry
                posture, mood, breast cancer, embodied cognition, qigong

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