Interventions Lecture 3 Flashcards
Mindfulness
paying attention in a particular way - on purpose, in the present moment and non-judgementally to the unfolding experience moment by moment
- development of awareness of the present moment experience with compassion
- nonjudgemental observation of the ongoing stream of internal and external stimuli as they arise
- meets people where they are, viewing them as a whole rather than broken
qualities of mindfulness
- present moment
- fundamental kindness
- nonjduging
- acceptance
- non -striving
- not knowing
- letting go
Midfulness & PT
chronic conditions create neurophysiological changes in the PNS and CNS
-integrating principles of mindfulness with traditional exercises can address these changes to assist patients in dealing with stress and anxiety
applications; prevention of injury, rehab, increased tolerance of uncomfortable painful medication treatments
Stress response
- breathing rate increases
- blood flow to skeletal muscles increses
- HR increases
- blood sugar increases
- blood pressure increases
- pupils dialate
- intestinal muscles relax
Physiologic/Neurologic responses to mindful mediation
- increases in immune system
- reduction in stress
- reduction is serum cortisol
- reduction in HR & BP
- pain modulation
- emotional regulation
- minimize anxiety and depression
- positive effect on attention regulation
- improved body awareness
- insomnia
- weight control
mindfulness practice leads to increases in regional brain
gray matter -hippocampus -cingulate cortex -tempo-parietal junction -cerebellum decrease in right amygdala grey matter -major impact on memory processes, emotional regulation, processing
Proposed mechanisms: attention regulation
improved cognitive control may generate less negative appraisal of pain by cultivating acceptance, reducing anticipation or expectation
Proposed mechanisms: body awareness
may impact neural processing
Proposed mechanisms: emotional regulation
enhance mood, deduce anxeity, and depressinon, decease fear
-change in perspective of one’s self
Novice vs experienced meditators (brain changes)
- both increase activity in insula
- experienced only: increases in frontal cortex and anterior cingulate gyrus
how stress and/or hurrying can make us fall
- our minds tend to wander and stop us from staying present
- we think about the source of our stress instead of the task at hand
- we are more likely to miss important changes in the environment
- we don’t take time to assess whether something we are doing is safe
- we can become overtired, which increases falls
Mindfulness study with TUG (timed up and go test) and Tinetti (gait test) control vs. intervention
no impact on TUG or balance
significant impact on gait
proposed mechanism: relationship between neurocognitive function/attention and gait
Mindful breathing
- sit in supportive chair
- feet on the ground
- close your eyes
- silence the environment
- start by focusing your breath
Mindfulness & sleep
- brain requires sleep for effective recovery and restoration of energy stores
- 2/3 of individuals fail to get between 7-9 hours of sleep each night; results in daytime impairments
- lack of sleep is linked to disease
Mindfulness & sleep (2)
- effective for insomnia; getting to sleep & staying asleep
- improving quality of sleep
- decreased rumination (negative emotional response loop, arousal, attention & distorted perceptions)
Mindfulness & pain
- small effect on improved pain symptoms
- decreased depression
- moderate evidence for change in mental-health related QOL
- low evidence for change in physical health related QOL
Body scan
- sit in supportive position
- close your eyes
- bring attention to your breath
- start at head or toes snd systemically move up or down your body
- pause, what sensations do you notice
- no judgement, no trying to correct anything
- then move to the next part of the body
- each time your attention wanders, simply notice that this is happening, then gently direct your attention back to exploring sensations in the body
Mindfulness adverse effects
majority of effects consistent with signs of dysregulated arousal, dissociation, anxiety, insomnia
Transient negative effects: 57% reported 1 side effect
27% - 2 side effects
Lasting bad effects (14%); more intense and longer lasting
-associated with greater informal practice
Words/phrases to avoid
- now we are going to
- just
- kind of
- try to
- sort of
- okay, so
- tell your patient what they “should be” feeling
- you know what I mean
combining mindfulness with progressive relaxation
use body scan
scan the area then relax that area as much as possible
consider using contract-relax to increase awareness & relaxation
