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Stress is an established risk factor for negative health outcomes. Salivary cortisol and testosterone concentrations increase in response to acute psychosocial stress. It's crucial to reduce stress for health and well-being through evidence-based interventions. Body-mind interventions such as meditation and Tai Chi have shown reduced cortisol levels but mixed results in testosterone concentration after stress. To address this research gap, we conducted a pilot randomized controlled trial to examine the modulating effects of a short-term (seven 20-minute sessions) mindfulness meditation on testosterone and cortisol in response to acute stress. Using one form of mindfulness meditation - Integrative Body-Mind Training (IBMT) and an active control-relaxation training (RT), we assessed salivary cortisol and testosterone concentrations at three stages of stress intervention - rest, stress, and an additional 20-min IBMT or RT practice. We found increased cortisol and testosterone concentrations after acute stress in both groups, but testosterone rise was not associated with cortisol rise. Moreover, an additional practice immediately after stress produced higher testosterone concentrations in the IBMT group than the RT group, whereas cortisol concentration increased in the RT group than in the IBMT group at the same time point. These findings indicate that brief mindfulness intervention modulates a dual-hormone profile of testosterone and cortisol in response to acute stress presumably via the co-regulation of hypothalamus-pituitary-adrenal and hypothalamus-pituitary-testicular axes.

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BACKGROUND: Cancer-related fatigue is one of the most common symptoms in cancer patients, usually accompanied by anxiety, depression and insomnia, which seriously affect patients' quality of life. Progressive muscle relaxation training is widely used for cancer-related fatigue, but the overall effect is unclear. OBJECTIVES: The aim of this study was to summarize the evidence on the effects of progressive muscle relaxation training on cancer-related fatigue and quality of life in cancer patients. DESIGN: Systematic review and meta-analysis. METHODS: Nine electronic databases (PubMed, Excerpta Medica Database (Embase), The Cochrane Library (Cochrane Central Register of Controlled Trials, CENTRAL), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang Database) were explored for randomized controlled trials (RCTs) published before February 2023. This study was reported based on the PRISMA 2020 statement. The Cochrane Collaboration's risk of bias assessment tool was used for methodological assessment, and the GRADE pro online assessment tool was used for evidence evaluation. The data were analyzed with the Review Manager 5.4 software. RESULTS: Twelve studies involving 1047 patients were included. Meta-analysis showed that progressive muscle relaxation training plus routine nursing produced more positive effects than routine nursing in improving cancer-related fatigue [SMD = -1.06, 95 % CI -1.49, -0.62, P < 0.00001], anxiety [SMD = -1.09, 95 % CI -1.40, -0.77, P < 0.00001], depression [SMD = -1.43, 95 % CI -1.76, -1.10, P < 0.00001], and quality of sleep [MD = -1.41, 95 % CI -1.74, -1.08, P < 0.00001]. However, there was no significant difference in improving quality of life [SMD = 0.27, 95 % CI -0.62, 1.15, P = 0.55]. Progressive resistance exercise plus routine nursing improved cancer-related fatigue more than progressive muscle relaxation training plus routine nursing [SMD = 1.11, 95 % CI 0.43, 1.78, P = 0.001]. There was low certainty of evidence that progressive muscle relaxation training improved cancer-related fatigue and quality of sleep, and the evidence that improved quality of life, anxiety and depression was very low. CONCLUSION: Current evidence suggested that progressive muscle relaxation training has the potential to improve cancer-related fatigue, anxiety, depression and quality of sleep in patients with cancer and is a low-load, simple exercise worthy of recommendation for cancer patients in fatigue state. Future research should focus on improving the methodological quality of randomized controlled trials to enhance the persuasive evidence of progressive muscle relaxation training efficacy.

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Purpose: Prior studies found that the prevalence of anxiety, depression, stress and insomnia were relatively high in COVID-19 patients. This study aimed to explore the efficacy of OnPR on mental health outcomes in patients with asymptomatic or mildly symptomatic COVID-19. Patients and methods: We employed a randomized controlled trial following the CONSORT guidelines. The Thai Clinical Trials Registry identification number of this study is TCTR20220729003. We used a block of 4 randomizations generated by a computer program. The intervention group (n = 38) received the OnPR program, and the control group (n = 36) received care as usual. OnPR was an online psychological intervention comprising psychoeducation, sleep hygiene education and relaxation techniques. OnPR was provided by qualified therapists trained with a standard protocol. The primary outcomes were depression, anxiety, and stress, which were determined by the Depression Anxiety and Stress Scale-21 (DASS-21). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Outcomes were compared between groups at pre-intervention and post-intervention at 1, 4, and 12 weeks using paired t-test or Wilcoxon signed-rank test. In addition, a linear mixed model was employed to demonstrate the effect changes of OnPR over time. All analyses were two-tailed, with a significance level of 0.05. Results: Of 74 Thai participants, 89.2 % were female, and 11.8 % were male. The average age was 31 years. Participants' baseline characteristics were not statistically significant between the intervention and control groups except for depression and stress scores from DASS-21. OnPR resulted in significantly better improvement in depression, anxiety, stress, and sleep quality. The mean differences between groups of DASS-21 scores in depression, anxiety and stress at 7-day follow-up were -4.69, -3.29, and -5.50 respectively. The differences continue to be significant at 4-week and 12-week follow-ups. The mean difference between groups of PSQI at 7-day follow-up is -0.91. Conclusion: OnPR improved mental health outcomes, and the effect on depression, anxiety and stress lasted for at least a 12-week follow-up period. In addition, it could enhance sleep quality after the intervention.

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Acupressure mats are promoted as stress management tools for easy and effective self-application, promising reduced stress and increased well-being. However, the scientific evidence for these effects is based on few experimental studies and lacks the examination of acupressure mats as a solitary relaxation tool. Our study aimed to examine which changes in stress and well-being can be expected from the use of acupressure mats by healthy young people on the subjective and psychophysiological level. Unexperienced participants practiced relaxation for three weeks either with an acupressure mat or without any tools (active control group [CG]). As a results, subjective well-being and stress decreased, while sleep quality and concentration endurance increased across groups. Blood pressure (BP), heart rate (HR), pain threshold and pain tolerance did not change significantly from pre- to post-training measurements. Most importantly, no significant differences were found between groups, indicating that training with an acupressure mat yielded no superior effects compared with an active control condition in healthy young students. As a conclusion, taking time to relax has some but limited beneficial effects on the subjective levels independent of the specific method for healthy students. Potential beneficial effects of acupressure mats might be bound to specific impairments, such as tension pain.

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Noise fears represent the most common behavioural problem in dogs. This manuscript provides an overview of diverse approaches for alleviating fear of noises in dogs and the supporting evidence. In the treatment of noise fears, both short-term solutions to prevent trauma or the deterioration of fear during unavoidable noise events and longer-term training need to be considered. Environmental management, the provision of incentives (food/play) during noise exposure, and, when indicated, anxiolytic medication, can safeguard dogs' welfare during noise events. Most "alternative" products (such as nutraceuticals, herbal remedies, pheromones, homeopathy, Bach flowers, and essential oils) are unlikely to be sufficient as monotherapy for noise fears, whereas there is good evidence for the efficacy of several anxiolytic medications. In the longer term, counterconditioning to real-life noises, relaxation training, and desensitisation/counterconditioning using noise recordings have been shown to improve fear of noises in dogs. Preventative training appears to be highly effective in preventing the development of noise fears in puppies and adult dogs.

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Heart rate variability biofeedback (HRVB) is a behavioral intervention that uses resonance frequency breathing to synchronize the heart rate and breathing patterns. This study aimed to explore how many sessions of wearable HRVB devices are needed to increase the HRV index and decrease breathing rates and to compare the HRVB protocol with other psychological intervention programs in HRV indices and breathing rates. Sixty-four participants were randomly assigned to either the HRVB or relaxation training (RT) group. Both groups received interbeat intervals (IBIs) and breathing rates measurement at the pre-training baseline, during training, and post-training baseline from weeks 1 to 4. IBIs were transformed into HRV indices as the index of the autonomic nervous system. The Group × Week interaction effects significantly in HRV indices and breathing rates. The between-group comparison found a significant increase in HRV indices and decreased breathing rates in the HRVB group than in the RT group at week 4. The within-session comparison in the HRVB group revealed significantly increased HRV indices and decreased breathing rates at weeks 3 and 4 than at weeks 1 and 2. There was a significant increase in HRV indices and a decrease in breathing rates at mid- and post-training than pre-training in the HRVB group. Therefore, 4 weeks of HRVB combined with a wearable device are needed in increasing HRV indices and decrease breathing rates compared to the relaxation training. Three weeks of HRVB training are the minimum requirement for increasing HRV indices and reducing breathing rates compared to the first week of HRVB.

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Objective: Noise pollution has been listed as one of the three major types of pollution, along with air and water pollution. Hospitals should pay attention to noise control, which is of great importance for the treatment and rehabilitation of patients. This study focuses on the application value of noise control and relaxation training. Methods: This study retrospectively collected and analyzed the clinical data of 184 patients who underwent skin laser cosmetology in Ningbo Yinzhou No. 2 Hospital from January 2021 to December 2022. Twelve patients who did not meet the criteria were excluded, and the remaining 172 patients were divided based on the type of intervention into the control group (CG, n = 82) and the study group (SG, n = 90). The CG received relaxation training and routine noise management, while the SG received noise control combined with relaxation training. The intervention effect was discussed from the aspects of noise, psychology, and satisfaction. Results: After the intervention, the SG had overtly lower noise levels and lower scores of anxiety and depression compared to the CG (all P < 0.001). Correlation analysis showed that noise levels were positively correlated with scores of anxiety and depression (r = 0.553, r = 0.592, P < 0.001). The two groups had no significant difference in total satisfaction (P > 0.05). Conclusion: Noise poses a significant threat to the human body. Strengthening noise control in hospitals is beneficial for patients' recovery. Combining noise control with relaxation training is an intervention method worthy of clinical application. It can improve the hospitalization environment and reduce the noise levels to a great extent, thereby improving the psychological state of patients and enhancing the medical satisfaction.

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Objective: To examine the current peer-reviewed literature on pediatric concussion and mild traumatic brain injury (mTBI) service delivery models (SDMs) and relevant cost analyses. Data Sources: PubMed, Embase (Elsevier), CINAHL Plus (EBSCO), APA PsycINFO (EBSCO), and Web of Science Core Collection, limited to human trials published in English from January 1, 2001, to January 10, 2022. Study Selection: Included articles that (1) were peer-reviewed; (2) were evidence-based; (3) described service delivery and/or associated health care costs; and (4) focused on mTBI, concussion, or postconcussion symptoms of children and adolescents. Studies describing emergency department-based interventions, adults, and moderate to severe brain injuries were excluded. Data Extraction: The initial search resulted in 1668 articles. Using Rayyan software, 2 reviewers independently completed title and abstract screening followed by a full-text screening of potentially included articles. A third blinded reviewer resolved inclusion/exclusion conflicts among the other reviewers. This resulted in 28 articles included. Data Synthesis: Each of the 28 articles were grouped into 1 of the following 3 categories: generalist-based services (7), specialist-based services (12), and web/telemedicine services (6). One article discussed both generalists and specialists. It was clear that specialists are more proactive in their treatment of concussion than generalists. Most of the research on generalists emphasized the need for education and training. Four studies discussed costs relevant to SDMs. Conclusions: This review highlights the need for more discussion and formalized evaluation of SDMs to better understand concussion management. Overall there is more literature on specialist-based services than generalist-based services. Specialists and generalists have overarching similarities but differ often in their approach to pediatric concussion management. Cost analysis data are sparse and more research is needed.

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BACKGROUND: Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder which affects up to 3% of children and adolescents. OCD in children and adolescents is generally treated with cognitive behavioural therapy (CBT), which, in more severely affected patients, can be combined with antidepressant medication. The TECTO trial aims to compare the benefits and harms of family-based CBT (FCBT) versus family-based psychoeducation/relaxation training (FPRT) in children and adolescents aged 8 to 17 years. This statistical analysis plan outlines the planned statistical analyses for the TECTO trial. METHODS: The TECTO trial is an investigator-initiated, independently funded, single-centre, parallel-group, superiority randomised clinical trial. Both groups undergo 14 sessions of 75 min each during a period of 16 weeks with either FCBT or FPRT depending on the allocation. Participants are randomised stratified by age and baseline Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score. The primary outcome is the CY-BOCS score. Secondary outcomes are health-related quality of life assessed using KIDSCREEN-10 and adverse events assessed by the Negative Effects Questionnaire (NEQ). Primary and secondary outcomes are assessed at the end of the intervention. Continuous outcomes will be analysed using linear regression adjusted for the stratification variables and baseline value of the continuous outcome. Dichotomous outcomes will be analysed using logistic regression adjusted for the stratification variables. The statistical analyses will be carried out by two independent blinded statisticians. DISCUSSION: This statistical analysis plan includes a detailed predefined description of how data will be analysed and presented in the main publication before unblinding of study data. Statistical analysis plans limit selective reporting bias. This statistical analysis plan will increase the validity of the final trial results. TRIAL REGISTRATION: ClinicalTrials.gov NCT03595098. July 23, 2018.

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Women with breast cancer experience social disruption during and after treatment. Brief cognitive-behavioral (CBT) and relaxation (RT) interventions may improve social disruption by increasing positive affect. Using the Broaden-and-Build Theory as a framework, this study examined whether short-term CBT- and RT-related increases in positive affect mediate long-term reductions in social disruption in women with breast cancer undergoing treatment (N = 183). This secondary analysis used latent change score and growth models to test 6- and 12-month intervention effects on positive affect and social disruption, respectively; a parallel-process model assessed mediation. RT demonstrated larger reductions in social disruption across 12 months compared to CBT and a health education control. Six-month latent change in positive affect was significant but not driven by condition. There was a significant direct effect linking the latent slopes of positive affect and social disruption but meditation was not observed. These preliminary findings hint at the value of promoting positive affect and inform the development of brief behavioral interventions that aim to augment social functioning among women surviving breast cancer.

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The aim of the present study was to assess the impact of a relaxation training program (RT), a cognitive training program (CT), and the combination of both on changes in cognitive status, emotional status, and experience of pain in older adults with mild cognitive impairment (MCI). Fifty care home residents underwent either RT (26 participants) or CT (24 participants) in the first training period, followed by the combined relaxation and cognitive training program in the second. Psychological tests on cognitive performance, mood disturbance/well-being, depression, and experience of pain were implemented at three time points of measurement, before (t1), after (t2) the first training period, and after the second training period (t3). Both RT and CT with the subsequent combined training program in the second training period, respectively, increased cognitive performance and well-being, and reduced mood disturbance, depression, and the experience of pain. The study showed the non-inferiority of RT in respect of cognitive and emotional status in care home residents with MCI compared to the more frequently implemented CT. Both training programs are high in acceptability and positive outcomes on cognitive, emotional, and pain status support the use of a combination of RT and CT.

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Introduction: People with depression often complain of dysfunction in cognitive processes, particularly attention. Pharmacotherapy is one of the most commonly used methods of treating depressive disorders and related attention difficulties. Patients also benefit from various forms of psychotherapy and frequently support themselves with alternative therapeutic methods. The purpose of this study was to examine whether a 15-min-long relaxation training session could improve the efficiency of attention and perceptiveness in individuals diagnosed with depressive disorders. Methods: Forty-two individuals participated in the study, including 20 individuals diagnosed with recurrent depressive disorder (rDD) and 22 healthy subjects (comparison group, CG). The so-called continuous performance test in the Polish version (Attention and Perceptiveness Test, APT) was applied in the study. In the first stage, the participants completed the 6/9 version of the APT test and then took part in a 15-min relaxation training session (autogenic training developed by the German psychiatrist Johannes Heinrich Schultz). The next step of the study was to perform APT again (parallel version­3/8). Results: The analyses showed statistically significant differences (p < 0.001) in the results obtained in the two versions of APT between the studied groups (rDD versus CG) in terms of the perceptual speed index. These differences were seen both before and after the introduction of the relaxation training. There was a statistically significant difference in the value of the perceptual speed index before and after the applied relaxation training for the subjects with depression (p = 0.004) and for the whole study group (p = 0.008). A significant correlation of illness symptom severity with decreased attentional efficiency was observed in the rDD group (perceptual speed index)­both before (r = −0.864; p < 0.001) and after the relaxation training (r = −0.785; p < 0.001). Conclusions: The continuous performance test (APT) is a reliable indicator of impaired attention efficiency among patients with depressive symptoms compared to healthy subjects. 15-min-long one-time relaxation exercise has a beneficial effect on attention efficiency measured by APT in people with depression.

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Background: Muscle relaxation training is a method of gradually relaxing the whole body by consciously controlling the process of muscle contraction and relaxation, which is mostly used to improve the physical and mental health of breast cancer patients and improve the quality of life of patients. We conducted a systematic review to compare the effects of muscle relaxation training and conventional nursing on the psychological health and quality of life (QoL) of breast cancer patients. The results of this study provide a basis for nursing program selection of breast cancer patients. Methods: The PubMed, EMbase, Web of Science, The Cochrane Library, China national knowledge infrastructure (CNKI), WanFang Data, (China Biology Medicine disc) CBM, and WWW.CQVIP.COM (VIP) databases were searched to retrieve articles on randomized controlled trials (RCTs) or quasi-RCTs on the effects of muscle relaxation training on the mental health and QoL of breast cancer patients. The search period ran from the establishment of the databases to August 31st, 2021. Two researchers independently screened the literature, extracted the data, and The Cochrane Handbook for Systematic Reviews of Interventions assessed the risk of bias in the included studies. Stata 15.0 software was then used for the meta-analysis. Results: Funnel plots were analyzed by E Egger's test and Begg's test. The results of the test (P>0.05) showed that the possibility of publication bias was small. A total of 13 RCTs and quasi-RCTs, comprising 1,355 patients, were included in the meta-analysis. The results for the outcome measures were as follows: level of depression [weighted mean difference (WMD) =-9.31, 95% confidence interval (CI): -11.96 to -6.65, level of anxiety (WMD =-8.96, 95% CI: -10.06 to -7.86)], and QoL (WMD =13.13, 95% CI: 7.24, 19.02). The results showed that muscle relaxation training can significantly reduce depression and anxiety in breast cancer patients, improve their quality of life, and can be used as the first choice for breast cancer patients to improve negative emotions. Discussion: Muscle relaxation training significantly reduced the depression and anxiety of breast cancer patients, improved their QoL, and brought about both psychological and QoL improvements.

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BACKGROUND: Cognitive behavioural therapy (CBT) is the recommended first-line treatment for children and adolescents with obsessive-compulsive disorder (OCD), but evidence concerning treatment-specific benefits and harms compared with other interventions is limited. Furthermore, high risk-of-bias in most trials prevent firm conclusions regarding the efficacy of CBT. We investigate the benefits and harms of family-based CBT (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in youth with OCD in a trial designed to reduce risk-of-bias. METHODS: This is an investigator-initiated, independently funded, single-centre, parallel group superiority randomised clinical trial (RCT). Outcome assessors, data managers, statisticians, and conclusion drawers are blinded. From child and adolescent mental health services we include patients aged 8-17 years with a primary OCD diagnosis and an entry score of ≥16 on the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). We exclude patients with comorbid illness contraindicating trial participation; intelligence quotient < 70; or treatment with CBT, PRT, antidepressant or antipsychotic medication within the last 6 months prior to trial entry. Participants are randomised 1:1 to the experimental intervention (FCBT) versus the control intervention (FPRT) each consisting of 14 75-min sessions. All therapists deliver both interventions. Follow-up assessments occur in week 4, 8 and 16 (end-of-treatment). The primary outcome is OCD symptom severity assessed with CY-BOCS at end-of-trial. Secondary outcomes are quality-of-life and adverse events. Based on sample size estimation, a minimum of 128 participants (64 in each intervention group) are included. DISCUSSION: In our trial design we aim to reduce risk-of-bias, enhance generalisability, and broaden the outcome measures by: 1) conducting an investigator-initiated, independently funded RCT; 2) blinding investigators; 3) investigating a representative sample of OCD patients; 3) using an active control intervention (FPRT) to tease apart general and specific therapy effects; 4) using equal dosing of interventions and therapist supervision in both intervention groups; 5) having therapists perform both interventions decided by randomisation; 6) rating fidelity of both interventions; 7) assessing a broad range of benefits and harms with repeated measures. The primary study limitations are the risk of missing data and the inability to blind participants and therapists to the intervention. TRIAL REGISTRATION: ClinicalTrials.gov : NCT03595098, registered July 23, 2018.

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In the present study, we assessed the impact of kindergarten-based progressive muscle relaxation (PMR) on attention and executive functioning of 5-6-year-old children. In this randomized-controlled trial, 52 children (26 female; 26 male; M age = 5.4, SD = 0.2 years) from two private Tunisian kindergartens were randomly assigned to experimental and control groups. Over 12 weeks, 18 children performed PMR in two 30-minute sessions/week, another 17 children performed generic physical education (PE) for two 30-minute sessions/week, and 17 children in a control group (CG) had no systematically guided physical activity and engaged in usual self-chosen activities like free play or artisanal activities during kindergarten hours. Prior to (T0) and after (T1) the 12-week PMR intervention, all participants completed the Visuomotor Precision and Statue subtests of the Neuropsychological Evaluation Battery (NEPSY-2), the Teddy Bear Cancellation Test, and the Rey Simple Figure Test. Although there were no significant group differences at T0, repeated measures analysis of variance revealed higher scores for the PMR group relative to both the PE and CG groups on measures of attention, visuomotor precision, memory, and motor inhibition. PMR provided an effective relaxation technique and enhanced attention and executive functioning of these 5-6-year-old children, with important implications for assisting learning and academic achievement among young children.

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BACKGROUND AND OBJECTIVES: Behavioral therapies such as the Comprehensive Behavioral Intervention for Tics (CBIT) are recommended as the first-line treatment for Tourette's Disorder. This treatment approach is comprised of three central components: habit reversal training, functional assessment/intervention, and relaxation training. Despite its combined efficacy, the contribution of each therapeutic component in CBIT for reducing tic severity remains undetermined. The study evaluated the efficacy of relaxation training alone or alongside other CBIT components for reducing tic severity. METHODS: In this multiple-baseline study, participants completed a baseline assessment (A), 4 weekly sessions of relaxation training followed by a posttreatment assessment (B), 8 weekly sessions of CBIT followed by a posttreatment assessment (C), and a 1 month posttreatment follow up assessment (D). Six participants (83% male) aged 10-18 with Tourette's Disorder completed study procedures. Primary outcomes of tic severity was the Yale Global Tic Severity Scale (YGTSS). RESULTS: A repeated measures ANOVA revealed a significance reduction in tic severity over time (p = .010). While post-hoc tests revealed a moderate non-significant reduction in tic severity after relaxation training (d =.23), large significant reductions in tic severity were observed after the combined treatment of relaxation training and CBIT (d = 1.17) that were maintained at a 1-month follow-up visit (d = 1.53). LIMITATIONS: Findings are limited by the small sample size. CONCLUSIONS: While relaxation training is effective when included in conjunction with CBIT, relaxation training alone is not effective in reducing tic severity in patients with Tourette's Disorder.

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Many people find it difficult to practice progressive muscle relaxation (PMR) regularly. We attempted to improve relaxation quantity (i.e. adherence), and relaxation quality via placebo. A total of 100 women were randomly assigned to a standard group, which practiced PMR at home every day for two weeks, or a placebo group, which practiced PMR for two weeks with additional daily placebo treatment. To monitor adherence to relaxation practice, we used a smartphone app. The placebo group practiced more often than the standard group. Both groups did not differ in their reported relaxation level after the daily exercises.

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Objective:To explore the effect of music relaxation training combined with Huangqi Jianzhong Decoction oral administration and foot bath on fatigue status and quality of life in patients with cancer related fatigue.Methods:A total of 90 patients with cancer related fatigue in our hospital from January 2019 to October 2020 were selected. The patients were divided into 2 groups by random number table method, with 45 in each group. Both groups were given health and diet education. The control group was given music relaxation training, and the observation group took Huangqi Jianzhong Decoction oral administration and foot bathing on the basis of the control group. Both groups have a course of treatment of 4 weeks, a total of 3 courses. The TCM syndrome scores were observed before and after treatment, and the Piper Fatigue Score (PFS) was used to evaluate fatigue status, and the Karnofsky functional state score was used to evaluate the quality of life of patients, evaluation of clinical efficacy.Results:After treatment, 43 patients in the observation group and 42 patients in the control group were analyzed. The total effective rate of the observation group was 83.72% (36/43), which was significantly higher than 64.29% (27/42) of the control group ( χ2=4.18, P=0.041). After treatment, the TCM syndrome scores in the observation group was significantly lower than that of the control group ( t=2.48, P=0.015). After treatment, the Karnofsky functional state score in the observation group was significantly higher than that of the control group ( t=2.83, P=0.006). After treatment, the emotion score (4.35±1.02 vs. 5.03±1.01, t=3.09), feeling score (4.31±1.06 vs. 5.00±1.02, t=3.06) and total score (4.23±1.07 vs. 4.87±1.10, t=2.72) in the observation group were significantly lower than those in the control group ( P<0.01). Conclusion:Music relaxation training combined with Huangqi Jianzhong Decoction oral administration and foot bathing can alleviate the fatigue state of CRF patients and improve the quality of life.

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We assessed the feasibility of using a consumer friendly, heart rate variability biofeedback (HRVB) wearable device in conjunction with a remote stress management coach to reduce symptoms of anxiety. We utilized a discreet, continuously wearable electrocardiogram device, the Lief Smart Patch, which measures and records heart rate and HRV in real time, and guides HRVB exercises using vibrations and visual cues. During the 8-week study, participants (N = 14) wore the Lief Smart Patch, participated in HRVB with the device, utilized the mobile app, and communicated with a remote stress management coach. We collected self-report survey responses to measure symptoms of anxiety (GAD-2) and depression (PHQ-2) every 2 weeks, as well as HRV data throughout the study. Participants' mean GAD-2 score began at 4.6 out of 6. By the trial's completion, the group's mean GAD-2 score dropped to 1.7 (t(13) = 11.0, p < .001) with only 2 of the 14 subjects remaining over the clinical threshold of high anxiety. Similarly, the group's mean PHQ-2 score dropped from 2.93 to 1.29 (t(13) = 3.54, p < .01). In addition, participants increased their HRV (RMSSD) by an average of + 11.4 ms after participating in a low dose biofeedback exercise. These findings suggest that engaging in HRVB through a discreet wearable device in conjunction with a remote stress management program may be effective for reducing symptoms of anxiety and depression.

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Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid (GABA) levels and cerebral blood flow (CBF) in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress (t = 4.02, P < 0.001), anxiety (z = 2.33, P = 0.02), fatigue (t = 3.35, P = 0.004), and sleep quality (t = 4.14, P < 0.001) improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms (t = -5.25, P < 0.001). The prefrontal GABA levels decreased (t = 2.53, P = 0.02), while relative CBF increased (t = -3.32, P = 0.004) after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention (t = 2.22, P = 0.04). The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress.