Name: Praticando Mindfulness Combinado com Tai Chi para o Manejo da Neuropatia Periférica Diabética
Uploaded: 2023-07-14T12:30:00
Description: Watch this Scientific Journal Video about Practicing Mindfulness Combined with Tai Chi for Diabetic Peripheral Neuropathy Management at JoVE.com

practicing mindfulness combined with tai chi for diabetic peripheral neuropathy management

Tai Chi com treinamento de atenção plena para controlar a neuropatia periférica diabética

Diabetes Mellitus (DM) is a serious health concern globally, affecting millions of people worldwide1. The International Diabetes Federation (IDF) reveals that the prevalence of DM could increase up to 12.2% by 20452. Type 2 diabetes (T2DM) accounts for about 90% of DM2. Patients with T2DM, particularly those who struggle to control their blood glucose levels, are likely to suffer from adverse complications, including macrovascular disease, microangiopathy, and diabetic peripheral neuropathy (DPN)3. DPN is a prevalent microvascular complication, with at least 50% of DM patients showing DPN signs and symptoms over time4. Unfortunately, DPN is often ignored, and the actual figures of patients suffering are much higher than reported in most cases2.
Patients with poor glycemic control are prone to developing DPN with an insidious onset. The initial symptoms of DPN are often unremarkable, which makes it easy for patients to overlook the condition. When obvious symptoms and functional impairment appear, irreversible neurological damage has been caused5. DPN has a complex clinical presentation. Patients suffer from long-term metabolic disturbances and oxidative stress damage. This can result in symmetrical limb numbness, pain, or paresthesia6,7. As the disease progresses, neurological and vascular injuries are further aggravated, eventually leading to irreversible tissue damage8. The incidence of diabetic foot ulcers and amputations is associated with mortality from DPN9. In addition, as symptoms of DPN often persist, many patients experience depression, sleep disturbances, and activity limitations, leading to a decrease in overall quality of life and even disability10.
Currently, lifestyle interventions (including exercise, diet, psychotherapy, etc.) are well recognized as effective treatments for DPN patients in addition to glycemic control and pharmacotherapy11. According to the American Diabetes Association (ADA), &#34;valuable exercise is beneficial to all patients with DM&#34;. For example, it can improve glycolipid metabolism and insulin resistance1. Studies have shown that exercise can improve metabolic, vascular damage, and neurological function in patients with DPN12,13. However, patients with DPN are reluctant to exercise due to a lack of motility, pain, and fear of foot injury.
The diabetic peripheral neuropathy (DPN) patients&#39; physical discomfort and limitations on daily activities, according to the Fear-Avoidance Model (FAM), can reduce their capacity for social interaction, which in turn can contribute to negative emotional reactions like anxiety and depression14. Conversely, negative emotions can affect glycemic control and increase the rate of complications15,16,17,18. Therefore, mind-body therapy is recommended for DPN, which focuses on the interaction between thoughts, emotions, bodies, and behaviors. The aim is to achieve homeostasis of the body and mind.
Tai Chi is a traditional Chinese mind-body exercise. Tai Chi has received much attention from scholars worldwide because of its unique exercise modes and therapeutic effects on diseases. Multiple high-quality clinical trials published in international journals have confirmed the effectiveness of Tai Chi for the treatment and rehabilitation of chronic diseases such as Parkinson&#39;s disease19, stroke20, metabolic syndrome21, knee arthritis22, and breast cancer23. Tai Chi belongs to a class of moderate-intensity aerobic exercises that uses continuous body spiral exercise and regulated breathing to improve aerobic capacity, muscle strength, balance, and exercise capacity. Traditional Chinese medicine holds that Tai Chi can balance yin and Yang, run Qi and blood, and relax meridians24. It is a suitable form of exercise for patients with DPN. Many studies have found that Tai Chi improves insulin resistance and blood lipids, and reduces the incidence of anxiety and depression25,26. In addition, Tai Chi could improve quality of life and decrease body mass index for patients with T2DM 27.
Mindfulness training is another prominent mind-body intervention that focuses on cultivating an intentional, moment-to-moment, nonjudgmental awareness of experience28. It helps to enhance attention to the present experience, including thoughts, feelings, breathing, and body sensations. Zeidan&#39;s research found that mindfulness training could make patients more objectively evaluate discomfort and improve self-regulation29. Wielgosz&#39;s study showed that the biggest problem of exercise intervention was poor compliance, which could be solved by adding mindfulness training to exercise30. Mindfulness training combined with exercise could effectively improve patients&#39; willingness to move, increase the time and frequency of movement, and promote patients&#39; perceiving body sensations in activity.
Meanwhile, exercise combined with mindfulness training can expand patients&#39; vision and enhance their understanding of themselves. This helps the body to become more flexible, relaxed, and balanced, effectively relieving the negative experience of patients. The concept of mindfulness training is consistent with the idea of &#34;unity of form and spirit&#34; of Tai Chi. Most patients with DPN often receive misinformation from the feet provided by the brain due to impaired sensory function31. Mindfulness training can enhance the effect of movement through psychological regulation and nervous regulation32. Therefore, this study aims to verify the feasibility of mindfulness training combined with Tai Chi and explore its effect on DPN patients.

Autor em destaque: Integrando o Tai Chi com o treinamento de atenção plena para alcançar um exercício eficaz de mente e corpo 

Efeitos do Treinamento de Mindfulness Combinado com Tai Chi em Pacientes com Neuropatia Periférica Diabética

Our research focused on the Chinese traditional sports Tai Chi. We are exploring the possibility and the effectiveness of mindfully training combined with Tai Chi as the mind-body exercise for treating diabetic peripheral neuropathy. Ensuring that subjects complete three intensive training sessions per week is an important challenge in this study.Our research show that Tai Chi can be well-integrated with mindfulness training. Our outline the steps to integrate mindfulness training with Tai Chi. It will pave the way for the future development of Tai Chi, making this traditional sports more engaging and beneficial for practitioner.In the future, we will focus on the application of mindfulness training combined with Tai Chi in other chronic diseases. We will also make efforts to promote mindfulness training combined with Tai Chi.

Watch this Scientific Journal Video about Practicing Mindfulness Combined with Tai Chi for Diabetic Peripheral Neuropathy Management at JoVE.com

Praticando Mindfulness Combinado com Tai Chi para o Manejo da Neuropatia Periférica Diabética

Para começar o treinamento de atenção plena combinado com Tai Chi, selecione um espaço aberto e tranquilo. Espalhe o tapete de yoga e sente-se nele para realizar meditação mindfulness. Inspire e expire lenta e profundamente de três a quatro vezes, concentrando-se na sensação de ar, entrando pelas narinas, enchendo o peito e o abdômen e, em seguida, saindo do corpo.Em seguida, permita que o ritmo respiratório volte ao normal e não controle a respiração. Em seguida, concentre-se em vários elementos, como respiração, sensação física, pistas de áudio, processos de pensamento e emoções, enquanto relaxa conscientemente o corpo. Transição para a varredura do corpo mindfulness deitado em decúbito dorsal no tapete de ioga.Pernas afastadas a uma distância natural, olhos quase fechados e braços ao lado do corpo sem fazer contato com o corpo. Concentre-se nas sensações em todo o corpo, desde os dedos dos pés até o cérebro. Se adormecer, opte por sentar-se para evitar cochilar durante os exercícios de escaneamento corporal mindfulness.Em seguida, execute o Tai chi ou movimento de atenção plena, concentrando-se em cada movimento individual com o objetivo de manter um estado de atenção plena profunda durante todo o processo. Tome nota do estresse e relaxamento alternados nos músculos das pernas, bem como a sensação tátil dos pés tocando o chão. Para finalizar a atividade, faça exercícios de relaxamento tanto para os membros superiores quanto para os inferiores.Além disso, realize ajustes respiratórios por uma duração de 10 minutos, o que atua como uma conclusão de equilíbrio relaxada para a atividade. Sente-se em estado meditativo, abstenha-se de fazer julgamentos sobre os pensamentos que surgem e sempre aceite esses conceitos. Após a intervenção, houve diferença estatisticamente significante no escore TCSS do GCMT, sendo o grupo praticante de mindfulness com Tai Chi, o grupo que pratica apenas Tai Chi e o grupo controle, ou GC.O escore TCSS do GCMT foi significativamente menor do que o GC e o TCSS. O escore MAAS do GCMT não só melhorou após a intervenção, como também foi significativamente maior do que o do GC e do GT. Após a intervenção, houve diferença estatisticamente significante nos escores da EVA entre os três grupos. O escore do GCMT foi significativamente menor que os demais grupos. Tendência semelhante foi observada no caso dos níveis séricos de fator de necrose alfa ou TNF alfa.Após a intervenção, houve diferença estatisticamente significante nos escores do DSQL entre os três grupos. O escore DSQL do GCMT foi significativamente menor que o dos outros grupos.

Research

JoVE Journal

Medicine

Practicing Mindfulness Combined with Tai Chi for Diabetic Peripheral Neuropathy Management

Effects of Mindfulness Training Combined with Tai Chi in Patients with Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. One of its crucial therapy approaches is mind-body ...