Can training in either meditation or exercise reduce acute respiratory infection burden amongst elderly?
Date of publication of randomized controlled trial: July/August 2012
Design
Randomized controlled trial (RCT).
Participants
154 participants aged 50 years or older reporting either 2 or more colds in the last 12 months or an average of 1 or more cold per year (mean age: 59.3 years, male%: 18%).
Intervention
Intervention 1: Meditation using mindfulness-based stress reduction (MBSR) program which included weekly 2.5 hour group sessions and 45 minutes of daily at-home practice for 8 weeks;
Intervention 2: Moderate-intensity exercise with same duration and frequency as MBSR intervention.
Comparator
Comparison 1: MBSR versus control group that received no intervention;
Comparison 2: Moderate-intensity exercise versus control group that received no intervention.
Major Outcomes
Outcome 1: Proportion of participants with acute respiratory infection (ARI) illness, measured at the end of intervention;
Outcome 2: Days of ARI illness, measured at the end of intervention;
Outcome 3: Number of missed work days, measured at the end of intervention.
Settings
This trial was conducted in an outpatient setting.
Comparison    Mindfulness meditation versus no intervention
Main Results
Compared to no intervention, MBSR did not show a significantly reduction in the percentage of participants with acute respiratory infection (ARI) illness (proportion difference: -0.14, 95% CI: -0.32 to 0.06). Also, no significant reductions in ARI illness days (mean difference (MD): -3.85, 95% CI: -7.99 to 0.29) and missed work days (MD: -0.9, 95% CI: -2.7 to 0.9) were observed.
Comparison 1: Mindfulness meditation versus control amongst elderly with previous ARI illness
Outcomes (units) No. of studies (Total number of participants) Proportion of participants with ARI illnesses/No. of participants Heterogeneity test (I2) Proportion differences (95% CI) Overall quality of evidence*
Intervention Comparator
1 1 (154) 0.41/51 0.55/51 Not applicable because there is only 1 trial. -0.14 (-0.32 to 0.06) Moderate
Outcomes (units) No. of studies (Total number of participants Mean (SD)/No. of participants Heterogeneity test (I2) MD (95% CI) Overall quality of evidence*
Intervention Comparator
2 (days) 1 (154) 5.04(9.87)/51 8.89 (11.09)/51 Not applicable because there is only 1 trial. -3.85 (-7.99 to 0.29) Moderate
3 (days) 1 (154) 1.9 (4.4)/51 2.8 (4.8)/51 Not applicable because there is only 1 trial. -0.9 (-2.7 to 0.9) Moderate
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    Moderate-intensity exercises versus no intervention
Main Results
Compared to no intervention, moderate-intensity exercises did not significantly reduce the percentage of participants developing ARI illness (proportion differences: -0.19, 95% CI: -0.37 to 0.01), ARI illness days (MD: -3.76, 95% CI: -7.75 to 0.24) and missed work days (MD: -0.9, 95% CI: -2.7 to 0.9).
Comparison 2: Moderate intensity exercise versus control amongst elderly at week 8
Outcomes (units) No. of studies (Total number of participants) Proportion of participants with ARI illnesses/No. of participants Heterogeneity test (I2) Proportion differences (95% CI) Overall quality of evidence*
Intervention Comparator
1 1 (154) 0.36/47 0.55/51 Not applicable because there is only 1 trial. -0.19 (-0.37 to 0.01) Moderate
Outcomes (units) No. of studies (Total number of participants) Mean (95% CI)/No. of participants Heterogeneity test (I2) MD (95% CI) Overall quality of evidence*
Intervention Comparator
2 (days) 1 (154) 5.13 (7.94)/47 8.89 (11.09)/51 Not applicable because there is only 1 trial. -3.76 (-7.75 to 0.24) Moderate
3 (days) 1 (154) 1.9 (3.9) /47 2.8 (4.8) /51 Not applicable because there is only 1 trial. -0.9 (-2.7 to 0.9) Moderate
Keys: MD = mean difference; CI = confidence interval.
Comparison    Mindfulness meditation versus no intervention
Main Results
Compared to no intervention, MBSR did not show a significantly reduction in the percentage of participants with acute respiratory infection (ARI) illness (proportion difference: -0.14, 95% CI: -0.32 to 0.06). Also, no significant reductions in ARI illness days (mean difference (MD): -3.85, 95% CI: -7.99 to 0.29) and missed work days (MD: -0.9, 95% CI: -2.7 to 0.9) were observed.
Comparison 1: Mindfulness meditation versus control amongst elderly with previous ARI illness
Outcomes (units) 1
No. of studies (Total number of participants) 1 (154)
Proportion of participants with ARI illnesses/No. of participants Intervention 0.41/51
Comparator 0.55/51
Proportion differences (95% CI) -0.14 (-0.32 to 0.06)
Overall quality of evidence* Moderate
Outcomes (units) 2 (days) 3 (days)
No. of studies (Total number of participants 1 (154) 1 (154)
Mean (SD)/No. of participants Intervention 5.04(9.87)/51 1.9 (4.4)/51
Comparator 8.89 (11.09)/51 2.8 (4.8)/51
MD (95% CI) -3.85 (-7.99 to 0.29) -0.9 (-2.7 to 0.9)
Overall quality of evidence* Moderate Moderate
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    Moderate-intensity exercises versus no intervention
Main Results
Compared to no intervention, moderate-intensity exercises did not significantly reduce the percentage of participants developing ARI illness (proportion differences: -0.19, 95% CI: -0.37 to 0.01), ARI illness days (MD: -3.76, 95% CI: -7.75 to 0.24) and missed work days (MD: -0.9, 95% CI: -2.7 to 0.9).
Comparison 2: Moderate intensity exercise versus control amongst elderly at week 8
Outcomes (units) 1
No. of studies (Total number of participants) 1 (154)
Proportion of participants with ARI illnesses/No. of participants Intervention 0.36/47
Comparator 0.55/51
Proportion differences (95% CI) -0.19 (-0.37 to 0.01)
Overall quality of evidence* Moderate
Outcomes (units) 2 (days) 3 (days)
No. of studies (Total number of participants) 1 (154) 1 (154)
Mean (95% CI)/No. of participants Intervention 5.13 (7.94)/47 1.9 (3.9) /47
Comparator 8.89 (11.09)/51 2.8 (4.8) /51
MD (95% CI) -3.76 (-7.75 to 0.24) -0.9 (-2.7 to 0.9)
Overall quality of evidence* Moderate Moderate
Keys: MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to no intervention, MBSR did not provide beneficial effect in reducing the number of participants with ARI illness, ARI illness days and missed work days amongst elderly. Compared to no intervention, moderate-intensity exercises did not provide beneficial effect in reducing the number of participants with ARI illness, ARI illness days and missed work days amongst elderly. For all outcomes in the two comparisons, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported in the included trials.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/22778122
The synopsis is based on the following article:
Barrett B, Hayney MS, Muller D, Rakel D, Ward A, Obasi CN, et al. Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Ann Fam Med. 2012 Jul-Aug;10(4):337-46.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.