An add-on training program involving breathing exercises, cold exposure, and meditation attenuates inflammation and disease activity in axial spondyloarthritis – A proof of concept trial

Abstract

ObjectivesThe primary objective of this trial was to assess safety and anti-inflammatory effects of an add-on training program involving breathing exercises, cold exposure, and meditation in patients with axial spondyloarthritisMethodsThis study was an open-label, randomised, one-way crossover clinical proof-of-concept trial. Twenty-four patients with moderately active axial spondyloarthritis(ASDAS >2.1) and hs-CRP ≥5mg/L were included and randomised to an intervention (n = 13) and control group (n = 11) group that additionally received the intervention after the control period. The intervention period lasted for 8 weeks. The primary endpoint was safety, secondary endpoints were change in hs-CRP, serum calprotectin levels and ESR over the 8-week period. Exploratory endpoints included disease activity measured by ASDAS-CRP and BASDAI, quality of life (SF-36, EQ-5D, EQ-5D VAS), and hospital anxiety and depression (HADS).ResultsWe found no significant differences in adverse events between groups, with one serious adverse event occurring 8 weeks after end of the intervention and judged ‘unrelated’. During the 8-week intervention period, there was a significant decline of ESR from (median [interquartile range] to 16 [9–26.5] to 9 [5–23] mm/hr, p = 0.040, whereas no effect was found in the control group (from 14 [8.3–27.3] to 16 [5–37] m/hr, p = 0.406). ASDAS-CRP declined from 3.1 [2.5–3.6] to 2.3 [1.9–3.2] in the intervention group (p = 0.044). A similar trend was observed for serum calprotectin (p = 0.064 in the intervention group versus p = 0.182 in the control group), but not for hs-CRP.ConclusionsThis proof-of-concept study in axial spondyloarthritis met its primary endpoint with no safety signals during the intervention. There was a significant decrease in ESR levels and ASDAS-CRP upon the add-on training program in the intervention group. These findings warrant full-scale randomised controlled trials of this novel therapeutic approach in patients with inflammatory conditions.Trial registrationClinicalTrials.gov; NCT02744014

A novel Wim Hof psychophysiological training program to reduce stress responses during an Antarctic expedition

“…The WHM is based on cold exposure and special meditation techniques and was developed by a Dutch athlete named Wim Hof who exposed himself to extreme cold temperatures. The WHM consists of three main components: 1) breathing exercises, 2) various types of cold exposure, 1 , 2 and meditation related to mindful body awareness, including enhancement of willpower and self-awareness. 3 – 6 …”

“…The WHM is based on cold exposure and special meditation techniques and was developed by a Dutch athlete named Wim Hof who exposed himself to extreme cold temperatures. The WHM consists of three main components: 1) breathing exercises, 2) various types of cold exposure, 1,2 and meditation related to mindful body awareness, including enhancement of willpower and self-awareness. [3][4][5][6] There are only a few studies on this novel training program and its psychophysiological effects, but findings suggest that the WMH has positive effects on immune and endocrine functions.…”

“…[3][4][5][6] There are only a few studies on this novel training program and its psychophysiological effects, but findings suggest that the WMH has positive effects on immune and endocrine functions. 1,2,5,6 A recent neuroimaging study using functional magnetic resonance imaging analyses showed that the WHM training program activates primary control centers for descending pain/ cold stimuli modulation in the periaqueductal gray, possibly initiating a stress-induced analgesic response. In addition, this study reported that the WHM activated the left anterior and right middle insula, which are associated with self-reflection, and that respiration practice may affect sympathetic activation.…”

Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress?

“…Breathing techniques and meditation have shown to decrease inflammation in Axial Spondyloarthritis (Buijze et al, 2019). Breathing techniques, especially the expiratory techniques improve lung functions, and immune response in bronchial asthma patients (Asimakos et al, 2018).…”

Impact of Exercise Intensity on Calprotectin Levels in Healthy Volunteers and Patients with Inflammatory Rheumatic Diseases

“…Moreover, the authors showed a correlation between the decrease in circulating calprotectin following the program and improved symptoms. In another study, published in 2019 by Buijze et al, a slight decrease in calprotectin concentration was observed following their program but was not significant in patients with spondyloarthritis [ 86 ]. This result may be explained by the program’s content, which consisted of breathing exercise, cold exposure, and meditation without any muscular mobilization exercise, unlike Levitova et al [ 85 ].…”