Journal of Integrative and Complementary Medicine

Health care workers (HCWs) faced unprecedented stress, anxiety, and burnout during the COVID-19 pandemic. Yoga, a mind–body practice combining physical postures, breathing, and meditation, has demonstrated benefits for mental and physical resilience. This systematic review evaluated the effectiveness of yoga interventions in addressing mental health challenges and promoting overall well-being among HCWs during the pandemic.

This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive searches of PubMed, EMBASE, and Cochrane CENTRAL were conducted up to November 2024 using terms including “yoga,” “COVID-19,” and “health care workers.” Eligible studies involved HCWs receiving yoga interventions compared with nonyoga controls. Outcomes included stress, anxiety, depression, sleep quality, and physiological parameters. Randomized controlled trials, cohort studies, and observational studies were included. Quality assessment was performed using the Cochrane Risk of Bias Tool (RoB 1.0). Certainty of evidence assessment was conducted with Grading of Recommendations Assessment, Development and Evaluation.

Of 134 studies identified, 11 met the inclusion criteria. Participants included HCWs from India, Turkey, and the United States, with intervention durations ranging from 2 to 12 weeks. Yoga consistently reduced stress, anxiety, and depression, with improvements in sleep quality and quality of life. Physiological benefits included enhanced autonomic function and reduced levels of inflammatory markers. App-based and tailored yoga protocols showed potential for scalability and accessibility. The overall quality of the included studies was moderate.

Yoga interventions demonstrated significant benefits in mitigating mental health challenges and enhancing overall well-being in HCWs during the COVID-19 pandemic. These findings underscore the value of yoga as a holistic support for HCWs in high-stress environments.

Athletic pubalgia, commonly referred to as sports hernia, is a recognized cause of chronic groin pain in athletes. This study aimed to evaluate whether adding Pilates to a rehabilitation program that included low-level laser therapy (LLLT) and low-intensity ultrasound (LIUS) would provide superior outcomes in pain reduction and in functional mobility and hip function.

In this randomized controlled trial, 88 male participants (18–45 years) diagnosed with sports hernia were randomly assigned to either an experimental group (Pilates + LLLT + LIUS) or a control group (LLLT + LIUS). Both groups received treatment three times per week for 6 weeks. Pain (primary outcome) was assessed using the Visual Analog Scale (VAS), functional mobility and hip function (secondary outcomes) were evaluated with the Lower Extremity Functional Scale (LEFS) and the Harris Hip Score (HHS), respectively, at baseline, after 6 weeks of intervention, and at a 6-week follow-up.

Both groups demonstrated significant improvements across all outcomes over time (p < 0.001). Compared with controls, the experimental group showed greater reductions in pain (VAS mean difference: −0.84; 95% CI: −1.26 to −0.42; p = 0.003); however, this did not exceed the minimal clinically important difference. In contrast, functional mobility (LEFS mean difference: +17.07; 95% CI: 14.88–19.26; p < 0.001) and hip function (HHS mean difference: +11.78; 95% CI: 9.10–14.46; p < 0.001) demonstrated both statistical and clinical significance in the experimental group compared with controls.

Incorporating Pilates into rehabilitation programs resulted in modest additional pain relief, yielding clinically meaningful improvements in functional mobility and hip function. Pilates can be considered a valuable complement to conventional modalities in sports hernia rehabilitation.

This randomized controlled study aimed to examine the effects of mandala coloring on perceived stress and anxiety levels in patients with type 2 diabetes.

This study was conducted between December 2023 and December 2024 with 92 inpatients in the endocrinology clinic of a university hospital. Patients were randomly assigned to the intervention group (n = 46) or control group (n = 46). The intervention group colored one mandala daily for 7 consecutive days, while the control group received routine care. Data were collected using the Personal Information Form, Perceived Stress Scale (PSS), and State Anxiety Scale (SAS). Statistical analyses were performed using two-way mixed ANOVA to examine group, time, and interaction effects, with Bonferroni correction applied for two primary outcomes. The study was reported in accordance with the CONSORT 2010 guidelines.

Compared with the control group, the intervention group showed significant reductions in the PSS total score (η² = 0.122, p = 0.000), Inadequate Self-Efficacy subscale (η² = 0.156, p < 0.001), Stress Perception subscale (η² = 0.067, p = 0.013), and SAS score (η² = 0.284, p = 0.000) after the intervention. No adverse events related to mandala coloring were reported.

Mandala coloring effectively reduced perceived stress and state anxiety in patients with type 2 diabetes. It may be considered a feasible nursing intervention for the psychological management of these patients.

This study aimed to examine the effects of foot baths applied during the active phase of labor on labor pain and childbirth comfort in nulliparous women.

This randomized controlled clinical study was conducted at a maternity hospital in Turkey between February and July 2024. The sample consisted of 196 primiparous women at 37–42 weeks of gestation, with a cervical dilation of at least 4 cm and a cephalic presentation. Participants were randomly assigned to the intervention (n = 98) and control (n = 98) groups. In the intervention group, participants received two 20-min foot baths at 4 cm and 9 cm cervical dilation. Data were collected using a personal information form, the visual analogue scale to assess labor pain, and the Childbirth Comfort Questionnaire to assess childbirth comfort.

Labor pain was the primary outcome, and childbirth comfort was assessed as a secondary outcome. The intervention group reported significantly lower labor pain levels compared with the control group (p < 0.001). However, no significant differences were observed between the groups in the physical, psychospiritual, or environmental dimensions of comfort, nor in the total childbirth comfort scores (p = 1.000). Participants were continuously monitored for any adverse events, including discomfort, skin reactions, or circulatory symptoms; however, no such events were reported during the intervention.

Foot baths may contribute to reducing labor pain and possibly shortening the second stage of labor. However, given the multidimensional nature of childbirth comfort, interventions focusing solely on physical relaxation may not address all aspects of comfort. Therefore, integrating physical relaxation practices with psychosocial and environmental support is recommended, and further research is needed to confirm these findings.

Tobacco use is a leading cause of morbidity and mortality worldwide. Complementary therapies, such as auriculotherapy, are increasingly being explored for smoking cessation; however, inconsistent administration methods have limited definitive evidence. This study evaluated whether a single auriculotherapy session promotes smoking cessation.

In this multicenter, randomized, single-blind, superiority clinical trial conducted at a tertiary care university hospital and two private practices in France, we enrolled cigarette smokers aged ≥18 years who were motivated to quit. Participants were randomized into two groups using centralized computer-generated allocation: auriculotherapy (AUR) and sham auriculotherapy (SHAM). In the AUR group, specific ear points were treated with cryo-auriculotherapy (nitrous oxide gas applied for 2 sec). In the SHAM group, the same points were treated using an empty canister containing only a propellant gas. The participants were blinded to their group assignment. The primary outcome was the percentage of participants who achieved smoking cessation at 1 month, defined as a urinary cotinine level of <50 μg/L. Secondary outcomes included self-reported cessation, exhaled carbon monoxide levels, anxiety, depression, stress, weight gain, and auriculotherapy side effects.

Between November 16, 2021, and October 23, 2023, 90 participants were enrolled (45 in each group). The primary analysis included 36 participants in the AUR group and 32 in the SHAM group. Smoking cessation rates based on urinary cotinine <50 μg/L were similar: 18.8% (95% confidence interval [CI]: 0.09–0.35) in SHAM and 33.0% (95% CI: 0.20–0.50) in AUR (p = 0.174). No significant adverse events or unintended effects were observed.

A single cryo-auriculotherapy session did not significantly enhance smoking cessation compared with the sham session.

Xuebijing injection was approved for treating sepsis; however, the efficacy and safety of Xuebijing injection in population with sepsis need further evaluation. We aimed to evaluate the safety and efficacy of Xuebijing injection on sepsis.

We searched for potential randomized controlled trials about Xuebijing injection and sepsis from six public databases. Primary outcomes included the 28-day mortality and mortality during treatment. Our secondary outcomes were body temperature, APACHE Ⅱ score, and adverse events or reactions. All data were synthesized by the meta package.

A total of 3007 patients (1551 patients receiving the conventional treatment combined with Xuebijing injection and 1456 patients receiving the conventional treatment only) were included. We found Xuebijing injection reduced the 28-day mortality (risk ratio = 0.69 [0.60–0.78], p < 0.0001), mortality during treatment (risk ratio = 0.74 [0.62–0.88], p = 0.0009), APACHE II score (mean difference = 3.91 [2.45–5.38], p < 0.0001), and body temperature (mean difference = 0.43 [0.31–0.55], p < 0.0001) without obvious adverse events (risk ratio = 0.91 [0.77–1.07], p = 0.2405).

Xuebijing injection is effective and safe for treating sepsis. Additional methodologically sound trials with long-term mortality as an outcome measure could provide further insights into whether Xuebijing injection offers an enhanced therapeutic effect for sepsis.

Calcaneal spur is a common cause of chronic heel pain and functional disability. This study aimed to evaluate the efficacy and safety of individualized homeopathic (IH) medicines compared to placebo (PL) in managing this condition.

In this double-blind, randomized, PL-controlled trial, 128 participants with chronic heel pain from calcaneal spur were randomly assigned to receive either IH (n = 64) or an identical PL (n = 64) for 6 months. Both groups received standard advice on general management (such as foot exercises and contrast baths). The primary outcome was the change in pain intensity from baseline measured on a 100-mm visual analog scale (VAS). The secondary outcome was the change in lower extremity function measured by the Lower Extremity Functional Scale (LEFS). Outcomes were assessed at baseline, 3 months, and 6 months. Analysis was done using an intention-to-treat approach with a mixed-effects model for repeated measures.

The analysis revealed a statistically significant group × time interaction for VAS pain scores (F-value = 35.12, p < 0.001). At 6 months, the IH group showed a significantly greater mean reduction in pain compared to the PL group (mean difference: −33.28; 95% confidence interval [CI]: −44.3 to −22.2; p < 0.001). Similarly, a significant group × time interaction was observed for LEFS scores (F-value = 33.87, p < 0.001). At 6 months, the IH group had a greater improvement in function (mean difference: 13.78; 95% CI: 9.1–18.4; p < 0.001). Both results were clinically significant. No serious adverse events were reported.

Individualized homeopathy resulted in statistically and clinically significant improvements in pain and function for patients with calcaneal spur compared to PL. These findings suggest that homeopathy may be a viable treatment option for this condition.