BACKGROUND:Restless legs syndrome (RLS) is common in maintenance hemodialysis (MHD) patients, with limited pharmacological options due to adverse effects. This study aimed to evaluate the effects of adding abdominal massage to Sanjiao acupuncture for RLS in MHD patients. METHODS:In a single-center randomized trial (March-September 2025, with follow-up through December 2025), 88 MHD patients with moderate-to-severe RLS were assigned to Sanjiao acupuncture (n = 44) or combined therapy (n = 44). Both groups received conventional MHD; the combined group added abdominal massage. Interventions were performed 3 times weekly for 3 weeks, 1.5 h before dialysis session end. The primary outcome was serial International Restless Legs Syndrome Rating Scale (IRLS) scores at different timepoints compared with baseline. Secondary outcomes included the overall responder rate based on IRLS reduction rate at endpoint, the Pittsburgh Sleep Quality Index (PSQI), and 3-month recurrence rate. Adverse events were monitored as safety indicators. Efficacy analyses were performed on both the intention-to-treat (ITT) population (n = 88, with missing data imputed using baseline observation carried forward) and the per-protocol (PP) population (n = 80). RESULTS:Both groups showed significant reductions in serial IRLS scores from baseline (both P < 0.001), with the combined group demonstrating further reduction from week 1 to endpoint compared with the acupuncture group (P < 0.05). In the ITT analysis, the combined group showed a higher responder rate than the acupuncture group (72.7% vs. 47.7%, P = 0.029) and lower endpoint IRLS scores (median 0.00 vs. 14.50, P = 0.029). The PP analysis yielded consistent results (responder rate: 80.0% vs. 52.5%, P = 0.018; endpoint IRLS: median 0.00 vs. 12.00, P = 0.017). Both groups improved in PSQI (P < 0.01), with no significant between-group difference. At 3-month follow-up, recurrence showed a numerical difference favoring combined therapy (12.5% vs. 23.8%), though this exploratory analysis was severely underpowered and the between-group difference was not statistically significant (P = 0.297). Adverse events were similar between groups (15.9% vs. 13.6%, P = 0.772), with no serious events. CONCLUSIONS:The addition of abdominal massage to Sanjiao acupuncture was associated with greater improvement in RLS symptoms in MHD patients with favorable safety, supporting the use of adjunctive abdominal massage as a non-pharmacological option for RLS in end-stage renal disease, though the specific contribution of massage independent of increased therapeutic contact time remains to be determined.
BACKGROUND:The Traditional Chinese Medicine (TCM) constitution framework classifies adults as Pinghe (balanced constitution) or as having one or more biased constitution patterns. Whether these questionnaire-based categories correspond to peripheral immune-cell composition remains unclear. METHODS:We analysed 853 adults in a cross-sectional study with TCM constitution classification and flow-cytometry lymphocyte subset percentages. Constitution variables were analysed as binary indicators. Group differences were summarized with effect sizes, 95% confidence intervals (CI), Mann-Whitney U tests, false discovery rate correction, and age- and sex-adjusted regression. A self-developed KNN-graph Deep Graph Infomax model was used as a secondary internal classification analysis. RESULTS:Pinghe was present in 569 participants (66.7%, 95% CI 63.5-69.8), and 284 participants were non-Pinghe. No individual immune-cell marker remained significant after false discovery rate correction. Pinghe participants showed a higher total CD3-CD56 + natural killer-cell percentage and a lower total CD3 + T-cell percentage than non-Pinghe participants, with small effect sizes. The post hoc total NK-cell/total T-cell ratio was higher in Pinghe after adjustment for age and sex. The deep-learning model showed moderate internal discrimination but requires external validation. CONCLUSION:Pinghe constitution was associated with limited differences in peripheral lymphocyte composition. Longitudinal and functional immune studies are needed to determine whether these small differences reflect stable constitution-related immune profiles.
Purpose This study aimed to investigate its effects on self-esteem and quality of life in patients with stoma. Methods This randomized controlled trial was conducted through the “Association of Colostomy and Ostomy Patients” between November 2021 and April 2023. The research population consisted of 192 patients who attended the association, and the sample consisted of 74 patients who met the inclusion criteria. After obtaining institutional and ethics committee approval, a total of four sessions of laughter therapy were delivered to participants in the intervention group via video calls over WhatsApp by the certified researcher. The data were collected using a Personal Information Form, the Rosenberg Self-Esteem Scale, and the City of Hope-Quality of Life-Ostomy Questionnaire. Data were analyzed using SPSS version 26. Results After laughter therapy, in the posttest and the 3rd-month follow-up measurements, the participants in the intervention group were determined to have significantly higher self-esteem and quality of life levels than those in the control group (p<0.001). In addition, it was determined that the quality of life of the individuals in the intervention group increased more in each measurement. Conclusion Laughter therapy is an effective complementary intervention for improving self-esteem and quality of life in patients with stoma. Its low cost, ease of application, and lack of side effects support its wider use in nursing practice. Additionally, future studies including larger samples and participants from different sociocultural backgrounds are recommended to enhance the generalizability of the findings.
Background Multimodal exercise is recommended for sarcopenia, but feasible community-based programs that integrate functional and muscle-mass outcomes remain insufficiently tested. Methods We conducted a 12-week randomized controlled trial in 80 adults aged 60–84 years with sarcopenia, allocated 1:1:1:1 to Baduanjin group (BDJ), resistance-band training group (RBG), multimodal exercise group (MME), or an older control group (OC); 65 completed follow-up. Exercise groups completed a 30-min core intervention five times weekly. Primary outcomes were gait speed (GS) and Short Physical Performance Battery (SPPB); secondary outcomes were maximum grip strength (MGS), appendicular skeletal muscle mass index (ASMI), and exploratory regional lean mass. Results Significant group-by-time interactions were observed for GS and SPPB (both p ≤ 0.001). GS declined in OC but improved only in MME; at Week 12, all exercise groups exceeded OC. SPPB improved in all exercise groups, with BDJ and MME higher than OC at Week 12. For secondary outcomes, the interaction was significant for ASMI but not MGS. MME increased MGS within group, whereas RBG and MME increased ASMI. Exploratory analyses suggested greater lower-limb lean-mass gains after MME than after OC or BDJ, with no clear advantage over RBG. Conclusions A 12-week program combining Baduanjin with resistance-band training may provide a feasible community strategy for improving functional performance and muscle health in older adults with sarcopenia. These findings should be interpreted in light of the modest sample, short duration, lack of longer follow-up, and limitations in body composition assessment; longer trials using more precise measures are needed.
OBJECTIVES:This study examines how perceived social support within a Facebook-based online health community is associated with psychological well-being and physical activity among women with diabetes. It distinguishes a direct psychological pathway from a sequential behavioural pathway involving self-efficacy and motivation to engage in healthy behaviours. STUDY DESIGN:Cross-sectional survey. METHODS:Data were collected from 103 women with diabetes who participated in the "Slow Diabète" program developed by the French Federation of Diabetes and joined its closed Facebook group. Participants completed an online questionnaire assessing perceived informational and emotional support, self-efficacy, motivation to engage in healthy behaviours, physical activity, and psychological well-being. The hypothesized relationships were tested using partial least squares structural equation modelling (PLS-SEM). RESULTS:Perceived social support was positively associated with psychological well-being (β = 0.577, p < 0.001) and self-efficacy (β = 0.444, p < 0.001). Self-efficacy was positively associated with motivation to engage in healthy behaviours (β = 0.661, p < 0.001), which was, in turn, positively associated with physical activity (β = 0.453, p < 0.001). However, perceived social support was not directly associated with physical activity, and physical activity was not significantly associated with psychological well-being. The model explained 33% of the variance in psychological well-being. CONCLUSION:The findings distinguish two pathways associated with perceived social support in an online health community: a direct psychological pathway to greater well-being and a sequential behavioural pathway to physical activity through self-efficacy and motivation. Online social interaction alone may therefore contribute to psychological well-being, whereas influencing health behaviours may require program components specifically designed to strengthen self-efficacy and motivation. These findings should be interpreted cautiously given the small, female-only, self-selected sample, the cross-sectional design, and the limited measurement of physical activity.
BACKGROUND:The global prevalence of mental health disorders, including posttraumatic stress disorder (PTSD), has increased substantially; engagement with nature has been shown to support recovery. This systematic review and exploratory meta-analysis examined the application and effectiveness of nature therapies in the treatment of PTSD for the clinical adult population. METHODS:In this review, 11 studies were included following a systematic process using the PRISMA framework, encompassing a total sample of 654 participants. A exploratory meta-analysis was conducted based on six of these studies. RESULTS:Most studies showed a significant reduction in PTSD symptoms after participation in nature therapy. The exploratory meta-analysis indicated a large effect size for pre- to post-intervention outcomes (Cohen's d = -0.82 [-1.14, -0.50] (k = 3), p < .001), but no significant effect size when comparing experimental and control groups (Cohen's d = -2.11 [-4.61, 0.39] (k = 3), p = .098). DISCUSSION:However, these estimates are based on a small number of studies, and the exploratory nature of the analysis warrants cautious interpretation. Overall, the findings suggest that nature therapy may offer beneficial effects as a complementary approach in the treatment of PTSD.
Perioperative anxiety is a major challenge in the perioperative management of mental health. Statistics show that approximately 38.1% of surgical patients experience moderate-to-severe anxiety, which significantly impacts their quality of life and social function. In recent years, auricular neuromodulation (ANM) has emerged as a prominent research focus in the treatment of mood disorders, owing to its advantages, including safety, precision, and high efficacy. While preliminary studies have suggested the therapeutic potential of ANM in various chronic neurological and psychiatric conditions, robust clinical evidence specifically addressing the unique temporal window of the perioperative period is limited. Furthermore, the neurobiological mechanisms through which ANM alleviates perioperative anxiety are yet to be fully elucidated. This article is the first to comprehensively summarize the auricular targets, mechanisms, clinical efficacy and safety, existing technical limitations, and future development trends of auricular nerve electrical stimulation, binaural beat technology, and auricular therapy. We aim to provide a theoretical basis for the individualized treatment of perioperative anxiety with ANM and the development of innovative ANM technologies.
Computer Vision Syndrome (CVS), also referred to as Digital Eye Strain (DES), is a common condition among college students and other digital-device users and is associated with prolonged near work, reduced blinking, and sustained visual attention. Conventional preventive strategies, including ergonomic optimization and scheduled visual breaks, primarily address environmental risk factors but do not directly target the perceptual–motor mechanisms underlying visual fatigue and oculomotor inefficiency. Perceptual–Motor Vision Training (PMVT) is an emerging complementary, non-pharmacological approach designed to enhance accommodation, vergence, oculomotor control, visuomotor integration, and visual information processing through structured visuomotor exercises. This narrative review synthesizes evidence from vision science, motor learning, and applied performance research to evaluate the potential role of PMVT in preventing or mitigating CVS-related visual fatigue in college students. Available evidence suggests that PMVT may improve selected visual and visuomotor functions. However, because most supporting studies involve athletic, pediatric, clinical, or non-CVS populations, its effectiveness for preventing CVS in healthy college students remains unproven. PMVT should therefore be considered an investigational complementary approach alongside ergonomic and behavioral strategies. Despite promising theoretical and preliminary empirical support, current evidence is limited by heterogeneous outcome measures, a scarcity of randomized controlled trials in non-athletic populations, and insufficient specification of training dosage and protocols. Future interdisciplinary research is required to establish standardized perceptual–motor metrics, determine dose–response relationships, and evaluate the clinical effectiveness and feasibility of PMVT as a low-cost complementary intervention for reducing digital task–related visual fatigue and improving visual performance in student populations.
OBJECTIVE:To examine the effects of exercise snacking (ES) on neuromuscular performance in insufficiently active adults. METHODS:Six databases were searched from inception to July 17, 2026. Randomized controlled trials and non-randomized studies of interventions involving insufficiently active adults undertaking ES interventions were included. Outcomes were functional performance, muscular strength, and muscular power. A three-level random-effects meta-analysis was performed. Risk of bias was assessed with RoB 2 or ROBINS-I, and certainty of evidence was evaluated using GRADE. RESULTS:Nine studies (13 reports) involving 313 participants were included. In the primary three-level model, ES showed a small positive overall effect on neuromuscular performance (g = 0.37, 95% CI 0.16-0.58, p = 0.001), which remained supported under trial-clustered robust inference with small-sample adjustment. Domain-specific estimates for muscular power/velocity, functional performance, and muscular strength were positive but imprecise and were not statistically supported after small-sample robust adjustment. Robust moderator tests provided no evidence of between-subgroup differences, and the certainty of evidence was low for all outcomes. CONCLUSION:Current low-certainty evidence suggests that ES may produce a small improvement in overall neuromuscular performance. However, domain-specific effects remain uncertain because of the limited number of independent trials, and the overall prediction interval crossed zero, indicating uncertainty across future populations and settings. Larger, preregistered randomized controlled trials are needed to confirm these preliminary findings.
OBJECTIVE:Previous studies have shown that plyometric training (PT) improves neuromuscular function and explosive power but not maximal strength. Blood flow restriction training (BFR) combined with low-intensity resistance training (RT) increases muscle mass and strength. This study investigated the effects of PT, and BFR combined with PT on lower-limb muscle function. METHODS:Twenty elite basketball players were randomly assigned to two groups: PT-alone group (PT, n = 10) and BFR combine with PT group (PT-BFR, n = 10). All participants underwent bodyweight-based plyometric training three times per week for eight weeks. Peak torque values for hip and knee flexion and extension, as well as root mean square (RMS) values derived from electromyography, were measured before and after the intervention. RESULTS:After the 8-week intervention, both groups showed significant improvements in knee flexion and extension peak torque at 180°/s (all p < 0.01). Between-group comparisons revealed greater gains in the PT-BFR group for hip extension and flexion at 60°/s (p = 0.036-0.002; ηp2 = 0.225-0.233). RMS of the rectus femoris increased significantly more in the PT-BFR group than in the PT group (right: p = 0.004, ηp2 = 0.385; left: p = 0.020, ηp2 = 0.266), whereas no significant changes were observed in the gastrocnemius, tibialis anterior, or biceps femoris (all p > 0.05). CMJ height also improved more in the PT-BFR group, with a significant group × time interaction (p = 0.042, ηp2 = 0.210). CONCLUSION:Both training protocols enhanced bilateral lower-limb strength, with notable gains in the non-dominant leg; however, the magnitude did not differ substantially between groups. In contrast, compared with PT alone, BFR combined with PT produced superior enhancements in lower-limb muscle strength and neuromuscular recruitment. These findings suggest that when PT is employed to improve explosive power, it may be effectively combined with BFR to further augment muscular strength.
OBJECTIVE:To assess the effectiveness of dry needling (DN) in reducing spasticity among post-stroke patients through meta-analysis. DATA SOURCES:PubMed, Web of Science, PEDro, Cochrane Library, CINAHL, and Embase were searched up to April 2026, alongside manual searches of reference lists. STUDY SELECTION:Randomized controlled trials (RCTs) involving adults (>18 years) with post-stroke spasticity, investigating DN alone or as part of a multimodal intervention, were included. DATA EXTRACTION:Two reviewers independently extracted data, primarily focusing on changes in the Modified Ashworth Scale (MAS) and the Modified Modified Ashworth Scale (MMAS). DATA SYNTHESIS:Eleven RCTs (276 patients) were included. Overall, DN significantly reduced spasticity compared to the control group (mean difference [MD] = -0.65). DN was effective for both upper (MD = -0.40) and lower limbs (MD = -1.02), with the most robust effect in ankle plantar flexors (MD = -1.05). Significant improvements occurred whether DN was compared to sham interventions (MD = -0.45) or added to conventional neurorehabilitation (MD = -0.76). While study quality was generally high (PEDro scores 5-9/10), GRADE certainty was Moderate to Low due to small sample sizes and blinding bias. CONCLUSIONS:DN is an effective short-term intervention and a potent adjunct to standard rehabilitation for reducing post-stroke spasticity in both upper and lower extremities. Further research is needed to evaluate its long-term functional impact.
BACKGROUND:Cancer patients frequently experience a debilitating and interconnected symptom cluster comprising pain, fatigue, and sleep disturbance (P-F-S), which negatively impacts their quality of life and treatment outcomes. Emotional Freedom Techniques (EFT), a mind-body intervention combining cognitive exposure with acupoint stimulation, has shown potential for addressing psychological distress, yet its effectiveness on this specific physiological symptom cluster remains underexplored. OBJECTIVES:This systematic review and meta-analysis aimed to evaluate the efficacy of EFT in alleviating cancer-related sleep disturbance, with narrative syntheses for its effects on pain and fatigue. METHODS:We searched eight databases, including the Cochrane Library, Embase, PubMed, Web of Science, CBM, WeiPu, CNKI, and WanFang from their inception to February 2026. Randomised controlled trials (RCTs) assessing EFT in adult cancer patients, with sleep disturbance as the primary outcome, were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the Cochrane tool. A random-effects model meta-analysis was performed for sleep disturbance, with subgroup analyses. Narrative syntheses were conducted for pain and fatigue due to insufficient or heterogeneously measured data. RESULTS:Nine RCTs involving 760 patients were included. Six studies using the Pittsburgh Sleep Quality Index (PSQI) were included in the quantitative synthesis. EFT significantly reduced sleep disturbance (MD = -3.00, 95% CI: -4.39 to -1.61, P < 0.01) with high heterogeneity (I² = 97%). Subgroup analyses revealed stronger effects in the 4‑week duration subgroup (MD = -6.50, 95% CI: -7.29 to -5.71, P < 0.01), single sessions ≥ 30 min (MD = -3.23, 95% CI: -4.88 to -1.57, P < 0.01), and intervention frequency ≥ 7 sessions/week (MD = -3.71, 95% CI: -6.24 to -1.18, P < 0.01); EFT alone and combined interventions were equally effective; benefits were significant in breast cancer patients (MD = -2.62, 95% CI: -3.82 to -1.43, P < 0.01) but not in other cancers. Narrative synthesis supported that EFT may relieve fatigue and pain. Sensitivity analysis confirmed robustness, and no publication bias was detected. CONCLUSION:EFT demonstrated beneficial effects on sleep disturbance among cancer patients; however, the statistically significant quantitative evidence was primarily observed in breast cancer populations. The optimal intervention characteristics, including 4-week protocols, single sessions ≥ 30 min, and higher frequency, require further confirmation in diverse cancer populations. Narrative evidence suggests that EFT may also provide potential benefits for fatigue and pain. EFT may represent a promising complementary intervention for managing the pain-fatigue-sleep disturbance symptom cluster in cancer patients; however, further high-quality randomized controlled trials are warranted to strengthen the current evidence.
OBJECTIVE:To systematically evaluate the acute effects of short-bout accumulated exercise (SBAE) interrupting prolonged sedentary behaviour on postprandial glucose, insulin, and triglycerides in adults. METHODS:Systematic searches in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, SPORTDiscus, and CNKI (inception to 10 December 2025) identified randomised crossover trials comparing SBAE (≤10 min/bout, inter-bout interval ≥30 min or adequate recovery) with continuous sedentary behaviour. Outcomes included postprandial glucose, insulin, and triglyceride AUCs. Standardised mean differences (SMD) were pooled using random-effects models. RESULTS:Thirty-one publications reporting data from 29 independent cohorts involving 573 unique participants (mean age 47.8 ± 20.3 years; 47.5% female; mean BMI 29.0 ± 5.1 kg/m²) were included. Compared with continuous sedentary behaviour, SBAE significantly reduced glucose AUC (SMD = -0.53, 95% CI: -0.71 to -0.34, P < 0.001) and insulin AUC (SMD = -0.58, 95% CI: -0.85 to -0.31, P < 0.001), but not triglyceride AUC (SMD = -0.17, 95% CI: -0.48 to 0.15, P = 0.306).Exploratory subgroup analyses showed statistically significant reductions in glucose and insulin for walking and for inter-bout intervals < 60 min, but not for standing alone or intervals ≥ 60 min. A statistically significant insulin-lowering effect was observed in obese individuals. CONCLUSION:SBAE acutely improves postprandial glucose and insulin control. Exploratory subgroup analyses showed statistically significant effects for walking and for inter-bout intervals < 60 min, but these comparisons are observational and no formal interaction test was conducted. These findings provide preliminary evidence for acute SBAE in sedentary populations, though long-term health effects and real-world generalisability require further investigation.
Background 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. Methods 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. Results 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). Conclusion 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. Trial registration This study has been registered with the International Traditional Medicine Clinical Trial Registry (ITMCTR2024000654).
BACKGROUND:Transcranial alternating current stimulation (tACS) is a non-invasive neuromodulation technique, emerging as a potential therapeutic option for musculoskeletal pain management. OBJECTIVE:To comprehensively evaluate the efficacy and safety of tACS for alleviating pain and improving sleep quality in adults with musculoskeletal pain. METHODS:We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Seven major databases and other sources were searched from inception until April 2026. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A random-effects model was used to pool standardized mean differences (SMDs). The certainty of evidence was evaluated using the Grading of Recommendation Assessment, Development, and Evaluation framework. RESULTS:Six RCTs involving 232 participants were included. Meta-analysis showed that tACS could significantly reduce pain intensity compared to control (SMD = -0.355, 95% CI: -0.625 to -0.084, p = 0.010, I² = 28.7%). However, no significant improvement was found for sleep quality (SMD = 0.004, 95% CI: -0.310-0.317, p = 0.982, I² = 0.0%). Adverse effects were mild and transient, comparable to sham stimulation. The overall certainty of evidence was rated as low for both pain and sleep quality outcomes. CONCLUSION:Current evidence suggests that tACS may be beneficial for musculoskeletal pain; however, the available evidence remains limited and should be interpreted cautiously. The effect of tACS on sleep quality remains uncertain because of the limited number of available studies. Future well-designed RCTs with standardized outcome measures, condition-specific stimulation protocols, and longer follow-up are required to establish the efficacy and long-term safety of tACS.
BACKGROUND:Traumatic brain injury (TBI) is the most common neurological disorder and a leading cause of global mortality and disability. Although growing evidence suggests potential benefits of Hyperbaric Oxygen Therapy (HBOT) for TBI, its efficacy remains controversial. METHODS:We systematically searched PubMed, Embase, Cochrane Library, and Web of Science from inception to March 2026. Randomized controlled trials (RCTs) evaluating HBOT versus any comparator including sham, standard care and no treatment in adults with TBI were included. Two independent reviewers screened records, extracted data, and assessed risk of bias using the Cochrane Risk of Bias tool. Heterogeneity was assessed using the I² statistic. Effect sizes were pooled using random/fixed-effects models per heterogeneity results. RESULTS:8 studies involving 570 participants were included. HBOT significantly improved computerized cognitive performance (SMD = 0.23, 95% CI: 0.07-0.40, p = 0.004, I² = 0%), executive function and processing speed (SMD = -0.59, 95% CI: -0.93 to -0.26, p = 0.0005, I² = 30%), memory function (SMD = 0.33, 95% CI: 0.03-0.63, p = 0.03, I² = 0%), and sleep quality (MD = 1.98, 95% CI: 0.07-3.88, p = 0.04, I² = 65%). No significant benefits were observed for Glasgow Outcome Scale (RR = 1.57, 95% CI: 0.55-4.44, I² = 87%), PTSD symptoms (MD = -3.05, 95% CI: -7.05-0.95, I² = 67%), neurobehavioral symptoms (MD = -9.06, 95% CI: -32.13-14.00, I² = 97%), and emotional distress (SMD = 0.25, 95% CI: -0.32-0.81, I² = 85%). Most adverse events were mild and transient. CONCLUSION:HBOT demonstrates domain‑specific benefits for cognitive function and sleep quality in TBI patients, predominantly those with mild TBI. However, evidence for PTSD, neurobehavioral symptoms, and emotional distress remains uncertain. Furthermore, the applicability of current evidence to moderate-to-severe TBI populations is restricted.
Objective Reiki is a biofield therapy, usually involving close contact, where practitioners serve as passive conduits for an energy which stimulates healing responses. Sham Reiki control groups are necessary to separate out effects of touch and human presence. The prevalence and types of sham Reiki protocols and whether they show placebo effects have received little attention. This scoping review addresses those gaps. Methods Studies were eligible if they were randomized controlled trials of Reiki administered in-person for a therapeutic purpose, included a sham Reiki control group and were published in peer-reviewed journals. Studies were excluded if they combined Reiki with another modality. Results Thirty-five studies of 154 (22%) fulfilled inclusion criteria. In most cases (28/35; 80%) the sham protocol mimicked the Reiki protocol except that the practitioner lacked Reiki training. Twelve of these 28 studies showed significant improvements in outcomes for sham Reiki, indicating a placebo effect. In 6 of 7 studies with differing sham Reiki and Reiki protocols, a placebo effect was not observed. In 19 studies where sham outcomes were compared with those from included no-treatment control groups 8, showed a placebo effect. In 6 of 35 studies (17%) where the sham practitioner had links with Reiki, only one showed a placebo effect. Conclusions Inclusion of sham Reiki groups in published Reiki research is limited. Most utilize similar protocols for sham Reiki and Reiki. The placebo effect is more likely when sham Reiki and Reiki protocols are similar and/or if the sham practitioner is not connected with Reiki.
BACKGROUND:This systematic review and meta-analysis aimed to assess the effects of oral propolis on inflammatory and oxidative stress biomarkers in adults and to explore whether these effects differ by clinical phenotype and propolis origin. METHODS:PubMed, Scopus, and Web of Science were systematically searched up to August 2025 for randomized controlled trials comparing oral propolis with placebos. Evaluated outcomes included C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD), total antioxidant capacity (TAC), malondialdehyde (MDA), and pro-oxidant-antioxidant balance (PAB). The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS:Eighteen trials involving 498 participants were included. Most studies used Iranian poplar-type or Brazilian propolis at 250-1500 mg per day for 4-104 weeks. Pooled analyses indicated that propolis supplementation was associated with reductions in hs-CRP, IL-6, and TNF-α levels, while CRP and IL-10 showed no significant changes. GPx, GSH, SOD, and TAC exhibited increases; however, these findings were accompanied by substantial heterogeneity and low certainty of evidence. Furthermore, MDA and PAB levels showed no statistically significant changes. CONCLUSIONS:Oral propolis may improve selected inflammatory and antioxidant biomarkers in adults, particularly hs-CRP, IL-6, TNF-α, and GPx levels. However, the evidence for several outcomes remains limited by substantial heterogeneity and low certainty. The current findings support a possible context-dependent effect according to the clinical phenotype and product characteristics, but more standardized trials are needed.
OBJECTIVE:This study aims to systematically evaluate the effects of Five-Element Music Therapy (FEMT) on emotional state, sleep quality, and quality of life in cancer patients undergoing chemotherapy. METHODS:We systematically searched 8 databases for randomized controlled trials (RCTs) comparing FEMT with standard care or control music interventions. Cochrane Risk of Bias Tool 2 (ROB2) was used to assess the quality of included RCTs. Meta-analysis was performed using Review Manager 5.4, and sensitivity analysis was conducted with Stata 18 software. GRADE system was used to assess evidence quality. Additionally, trial sequence analysis (TSA) was employed to evaluate the reliability of conclusions regarding intervention effects. RESULTS:A total of 20 RCTs (1588 patients) were included. Meta-analysis results showed that compared with control group, FEMT significantly reduced anxiety scores (Self-Rating Anxiety Scale (SAS): MD = -7.16, 95% CI: -9.56 to -4.67, p < 0.00001; Hamilton Anxiety Rating Scale (HAMA): MD = -5.19, 95% CI: -9.94 to -0.45, p = 0.03) and depression scores (Self-Rating Depression Scale (SDS): MD = -7.07, 95% CI: -7.90 to -6.24, p < 0.00001; Hamilton Depression Rating Scale (HAMD): MD = -5.89, 95% CI: -7.39 to -4.39, p < 0.00001), and improved sleep quality (Pittsburgh Sleep Quality Index (PSQI): MD = -2.52, 95% CI: -2.89 to -2.16, p < 0.00001). Regarding quality of life, FEMT significantly improved Quality of Life Core Questionnaire (QLQ-C30) overall health status scores (MD = 9.27, 95% CI: 5.68-12.86, p < 0.00001), physical function, and emotional function on the QOL-C30 scale, while reducing symptom scores for fatigue and sleep disturbance. FEMT also modulated immune function (increased CD3+% and CD4+%) and inflammatory markers (increased superoxide dismutase (SOD), decreased nitric oxide (NO)). However, the methodological quality of included studies was generally low, with most outcomes graded as low or very low certainty evidence. CONCLUSION:Current evidence suggests that FEMT may effectively alleviate anxiety and depression in chemotherapy patients, improve sleep and quality of life, and exert certain physiological regulatory effects. However, due to limitations in the number, characteristics and methodological quality of studies, the generalizability of this therapy outside of China remains unclear; further validation is needed through high-quality, large-scale, international, multicenter RCTs.
Background Mental health disorders contribute to disability worldwide. Chronic stress can lead to cardiovascular diseases, metabolic syndrome, and immune dysfunction, posing a major public health challenge. Meditation-based approaches improve stress resilience and overall wellbeing. Sahaj Samadhi Meditation (SSM) is a mantra-based meditative practice, with a limited but emerging evidence base. This scoping review aimed to summarise the existing evidence. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute methodology (JBI), we searched PubMed, PsycINFO, Web of Science, and Scopus (from inception to July 2026), along with clinical trial registries. Studies assessing SSM as the primary intervention were included. Screening and data extraction were conducted independently by two reviewers. The protocol was registered in the Open Science Framework (https://osf.io/2rckd). Results Eleven studies were included: five experimental studies, one community survey, two clinical intervention studies, and three registered protocols. Experimental studies showed consistent differences in attentional processing, perceptual stability, and neurophysiological markers, including higher frontal theta coherence and increased mismatch negativity responses among SSM practitioners. Patients with glaucoma and chronic pain reported modest improvements in sleep quality and depressive symptoms. Protocols evaluate late-life depression, opioid-related outcomes and chronic pain in SSM practitioners. All studies were small with substantial heterogeneity. Conclusions SSM may influence psychological, neurophysiological, and cognitive parameters. However, these findings are based on small samples with narrow evidence base. Large trials with standardised protocols are required to recommend SSM for clinical use or integrate into community-based health programmes.
