J Complement Integr Med. 2014; 11(3): 223–232
Deborah E. Bowden*, Danielle McLennan and John Gruzelier
A randomised controlled trial of the effects of Brain Wave Vibration training on mood and well-being Abstract
Introduction
Background: The goal was to investigate the effects of Brain Wave Vibration (BWV), a meditation practised in a class involving rhythmic movements of the head, neck and body practised with related yoga-style exercises, and to isolate the rhythmic effects. Methods: A randomised controlled trial was conducted with assessments pre- and post-trial and immediately before and after each session. Thirty-one healthy adults were assessed for mood, sleep, mindfulness, health and well-being, and pre- and post-class activation–deactivation. Participants were randomly assigned to either BWV in toto or a control group having similar yoga exercises without the rhythmic components. Participants completed eight to twelve 75-min classes of BWV or control training over 8–12 weeks. To control for expectation participants were told only that the aim was to compare two subtly different styles of Korean yoga. Results: The BWV group had comparatively greater improvements in sleep duration and efficiency, although they had higher baseline inefficiency, and post-trial they had better global sleep and well-being and fewer illness symptoms, and better tiredness and energy post-class. Both groups benefitted in mood, mindfulness and vitality post-trial with improved tension and calmness post-class. Conclusions: The participants of both interventions had better mood and well-being on the whole following the trial and were more relaxed immediately after a class. However, BWV training was unique in its benefits to sleep, health, wellbeing, energy and tiredness, warranting further research.
An exploratory randomised controlled trial was conducted with university students to investigate the effects of Brain Wave Vibration (BWV) training on mood and well-being. BWV is a moving meditation performed sitting or standing, beginning with gentle rhythmic shakes of the head and neck, developing into vibrations which may spread throughout the body. It aims to relax the body and create a peaceful, positive mind, while the vibrations are believed to tone up the brain’s arousal systems including the brain-stem reticular activating system which is a core sleep-energy centre and part of the subcortical–cortical arousal axis controlling energy distribution [1–3]. BWV is practised in a holistic fitness class with related nonvibrational yoga-style exercises, known as “Dahn yoga” or “Body and Brain Holistic Fitness (BBHF) Training”, which are part of the Health Smile Peace (HSP) movement developed in the 1980s by Ilchi Lee in South Korea [3]. It is distinct from whole-body vibration (WBV), an exercise increasingly used by physiotherapists and physical trainers believed to prevent injuries and facilitate healing [4], found to improve strength in patients with neurological diseases [5]. BBHF Training is comparable to Hatha yoga, which has origins in India, as both practices involve their own distinct forms of postures, breathing exercises, meditation and philosophical/ spiritual teachings, although Hatha yoga has no vibrational elements [6]. Evidence of the benefits of BWV was until recently only anecdotal, with a small number of studies conducted testing a range of psychometric and physiological parameters. In an earlier study we found that improved depression, stress, vitality, mindfulness, sleep latency and sleep quality followed 5 weeks of BWV training [6]. Jung et al. [7] found that regular practitioners had lower stress and negative affect than control participants, which may be associated with functional changes in brain regions related to internalised attention even when meditation is not being practised [8] and with differential effects on plasma catecholamines according
Keywords: Brain Wave Vibration, Dahn yoga, meditation, well-being DOI 10.1515/jcim-2013-0056 Received October 31, 2013; accepted May 13, 2014; previously published online June 13, 2014 *Corresponding author: Deborah E. Bowden, Department of Psychology, Goldsmiths College, University of London, London SE14 6NW, UK, E-mail: [email protected] Danielle McLennan, Dahn Yoga UK, London, UK John Gruzelier, Department of Psychology, Goldsmiths College, University of London, London, UK
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to brain derived neurotrophic factor and catechol O-methyl transferase (COMT) [9]. BWV exercises are essentially vibration exercises, and the therapeutic effectiveness of the practice is believed to rely largely on the vibrations; the current study was designed to test this theory. We aimed to isolate the effects of the BWV exercises, which are vibrational, from the other BBHF Training class exercises which are nonvibrational on measures of well-being and cognitive arousal, hypothesising greater benefits in the BWV group than in the controls. Training in yoga-style exercises for both groups was identical except that in controls the BWV exercises were substituted for similar postures but importantly with no vibrational elements. In the BWV class a standing WBV exercise was practised, whereas in controls static holding postures were performed. A sitting BWV vibrational exercise was also replaced with a sitting focused-attention meditation. To control for expectation, participants were told that the purpose was to compare two subtly different styles of Korean yoga.
Materials and methods
would be an effect size of 1, with an error probability of 0.05 and an allocation ratio of 1, the necessary sample size is 17 in each group. Therefore, since only 14 control participants completed the study, the trial was insufficiently powered for a significant difference between two independent samples of equal size to be observed using mixed ANOVA, which was the principle analysis used, as detailed in the section “Statistics.” A Consort Diagram is shown in Figure 1, illustrating each stage of the groups’ participation.
Procedure Pre- and post-intervention, participants completed a 40-min computerised questionnaire battery, as presented in the section “Results”. Participants attended 8–12 weekly classes (mean BWV: 10.41 (SD: 1.66); mean control: 10.21 (SD: 1.48)), as some participants were unable to attend 12 classes, even though four extra were held for participants to make up for classes missed. All classes were taught by the same qualified BBHF instructor. Music played at the HSP Centers was played during the classes.
Participants
Timeline of a 75-min BWV class
Following Goldsmiths Ethics Committee’s approval, 54 healthy participants were recruited through college advertisements over 3 months. Potential participants were screened with the Depression, Anxiety and Stress Scale [10] to exclude any with severe depression; all were found to be eligible. Thirty-one participants (17 BWV; 14 controls) completed the study, aged 18–37 years (27 female; 4 male) with 23 dropouts (10 BWV; 13 controls). Dropouts said they were too busy to participate, except for two BWVs who withdrew early due to illness or anxiety. On completion participants were paid £20.
1.
Design Each pair of participants recruited was randomly assigned to the two groups using a computerised random number generator that created either a “1” or a “2”, with equal probability. If “1” was generated the participant was assigned to BWV; if “2” was generated the participant became a control. G-Power was used to calculate the sample size needed as in Bowden et al. [11]. Predicting that there
0 min: Warm up (15 min). Patting exercises to release stagnant energy, stimulate meridians, open acupressure points and increase body awareness and energy/ blood circulation. 2. 15 min: Stretching and rhythm (15 min). To open meridians to promote energy circulation and better body and brain communication. 3. 30 min: Standing BWV (10 min). Whole-body rhythmic movements to revitalise the body, improve mood and promote brain health. 4. 40 min: Breathing postures (13 min). Four postures believed to accumulate energy in the abdomen, the “energy core”, to improve concentration, immunity and health [3]. 5. 53 min: Sitting Ji-gam and BWV (10 min). Ji-gam is a sitting energy meditation designed to improve concentration and peace of mind and is part of the BWV meditation, followed by BWV, where vibrations of the head and neck spread to the rest of the body while focusing on a positive thought. 6. 63 min: Warm down (10 min). Stretches and balancing. 7. 73 min: Sharing (2 min). Sharing of class experiences.
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Assessed for eligibility with the DASS (n = 54)
Enrollment Excluded (n = 0)
Allocation
Randomized (n = 54)
Allocated to BWV intervention (n = 27) Received allocated intervention (n = 17) Withdrew from trial (n = 10) (due to being too busy: n = 8) (due to illness: n = 1) (due to anxiety: n = 1)
Allocated to control intervention (n = 27) Received allocated intervention (n = 14) Withdrew from trial (n = 13) (due to being too busy: n = 13)
Analysis
Total analysed (n = 17) Excluded from PSQI analysis due to outliers (n = 1) Excluded from PSQI analysis due to outliers (n = 1)
Total analysed (n = 14) Excluded from PSQI analysis due to outliers (n = 1) Excluded from WEMWBS analysis due to failure to complete Post questionnaire (n = 3)
Figure 1 A Consort Diagram showing the stages of participation of the groups.
The control and BWV classes were identical essentially except that the control omitted the vibrational elements. Part 3, Standing BWV, was replaced by 10 min of static holding postures designed to increase muscular strength, improve balance and promote a calm, clear mind. Additionally, Part 5 of the BWV class, Sitting Ji-gam and BWV, was replaced by a 10-min sitting-still focusedattention meditation concentrating on a positive thought. Participants were requested to practise three exercises, as detailed below, at home daily for a total of 7–10 min and keep a diary to log their diligence. The toe-tapping exercise, Exercise 3 of the BWV group, has a vibrational element and so was not performed by the controls, who practised a breathing exercise instead.
BWV group home-practice Exercise 1 (1–2 min three times a day). Solar-plexus tapping. Exercise 2 (4 min). Sitting BWV. Exercise 3 (2 min). Toe-tapping exercises while lying in bed at night. Control group home-practice Exercise 1 (1–2 min three times a day). Solar-plexus tapping. Exercise 2 (4 min). Sitting-still meditation, focussing on a positive goal. Exercise 3 (2 min). Breathing exercises while lying still in bed.
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Statistics
Table 1
Separate mixed ANOVAs compared the pre-intervention (Pre) and post-intervention (Post) scale scores for measures “Sleep”, “Mood”, “BWV benefits”, “Well-being”, “Health”, “Vitality” and “Mindfulness” in the section “Results”. The within-subjects factor was Session1 (Pre/ Post), relating to the change in the scores of the participants as a whole over the course of the trial, and the between-subjects factor was Group (BWV/control), relating to the relative changes of the groups. For measure “Cognitive arousal”, a similar mixed ANOVA compared pre-class and post-class total activation scores with a within-subjects factor of Session2 (Pre-class/Post-class) and a between-subjects factor of Group (BWV/control). Planned contrasts for within-group changes were conducted with paired t-tests. Since the study was exploratory, no corrections for multiple comparisons were made unless stated otherwise.
Pre and Post mean (SD) PSQI scores.
Sleep quality
Pre Post
Sleep disturbance
Pre Post
Sleep duration
Pre Post
Sleep efficiency
Pre Post
Sleep latency
Pre Post
Medication
Results
Pre Post
The participants were essentially naïve to yoga practice except 2 BWV and 1 control. The diaries indicated that home-practice was conducted a mean of 4.3 (SD: 1.36) days per week; a one-way ANOVA found no group difference (F ¼ 0.149, ns). There were no baseline group differences on any of the scales as disclosed by one-way ANOVAs (F 2.447, p 0.104), unless stated otherwise.
Daytime dysfunction
Pre Post
Global sleep
Pre Post
BWV
Control
Total
1.31 (0.79) 1.13 (0.62) 1.19 (0.54) 1.19 (0.54) 1.13 (1.09) 0.88 (0.81) 0.63 (0.89) 0 (0) 1.75 (0.77) 1.38 (0.5) 0 (0)* 0 (0) 1.25 (0.68) 1.06 (0.85) 7.25 (2.41) 6.11 (2.59)
1.08 (0.64) 0.92 (0.76) 1.38 (0.51) 1.15 (0.55) 0.54 (0.78) 1.08 (0.76) 0.08 (0.28) 0.15 (0.38) 1.62 (0.77) 1.54 (0.88) 0.077 (0.28) 0 (0) 1.15 (0.55) 1 (0.71) 5.92 (1.71) 5.85 (3.05)
1.21 (0.73) 1.03 (0.68) 1.28 (0.53) 1.17 (0.54) 0.86 (0.99) 0.97 (0.78) 0.38 (0.73) 0.07 (0.26) 1.69 (0.76) 1.45 (0.69) 0.03 (0.18) 0 (0) 1.21 (0.62) 1.03 (0.78) 6.66 (2.19) 6 (2.75)
Standard deviations are shown in parentheses.
Pre- to Post-trial assessment Primary measures Sleep Pittsburgh Sleep Quality index (PSQI) [12] means for global sleep and subscale scores are shown in Table 1. Two participants were excluded from the PSQI analysis – a control with a Pre global sleep score 2.82 SDs above the sample mean and a BWV participant with a Post score 2.75 SDs above the Post sample mean. While the mixed ANOVA found no change for global sleep overall (F(1, 27) ¼ 2.589, ns), a paired t-test found significant improvement following BWV (t(1, 15) ¼ 2.3, p ¼ 0.036) and controls (t(1, 12) ¼ 0.098, ns). The mean changes are shown in Figure 2 for each of the subscales except for medication, as only one participant took medication.
For the subscale sleep efficiency there was a nearsignificant improvement overall (F(1, 27) ¼ 3.965, p ¼ 0.057) and a significant Session1 Group interaction (F(1, 27) ¼ 6.503, p ¼ 0.017). Paired t-tests disclosed that the BWV group significantly improved (t(1, 15) ¼ 2.825, p ¼ 0.013), although the controls did not (t(1, 12) ¼ –0.562, ns). However, an independent samples t-test found that the BWV group had a comparatively higher baseline inefficiency score, allowing more room for improvement (t(1, 15) ¼ 2.142, p ¼ 0.041). There was also a tendency towards a Session1 Group interaction for the subscale sleep duration (F(1, 27) ¼ 3.735, p ¼ 0.064), although there was no main effect of Session1 (F(1, 27) ¼ 0.5, ns). Paired t-test found that the controls were nonsignificantly worse post-trial (t(1, 12) ¼ –1.723, p ¼ 0.12) and there was no change following
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Figure 2 The mean (SE) improvement of the groups for the PSQI subscales.
BWV (t(1, 15) ¼ 0.939, ns). Here the baseline scores of the groups did not differ (t(1, 27) ¼ 1.633, ns). The whole sample had a tendency towards an improvement in the subscale sleep latency (F(1, 27) ¼ 3.121, p ¼ 0.089). For the remaining subscales, however, there were no main effects of Session1 (F 1.241, p 0.275). Nor were there Session1 Group interactions for these subscales or for global sleep (F 2.142, p 0.155). Mood Mood was assessed using the Profile of Mood States (POMS) [13] and the questionnaire used to screen participants, the DASS [10]. Table 2 shows the mean POMS scores, total mood disturbance and subscales, and Table 3 shows the DASS scores, total DASS and subscales. Considering the total scores first, a mixed ANOVA found a significant improvement in total mood disturbance overall (F(1, 29) ¼ 5.27, p ¼ 0.029). Considering the groups separately however disclosed that only the improvement with BWV approached significance (BWV: t(1, 16) ¼ 1.876, p ¼ 0.08; control: t(1,13) ¼ 1.477, p ¼ 0.23). Similarly, a near-significant improvement was seen in the whole sample in total DASS, (F(1, 29) ¼ 4.172, p ¼ 0.051), although here neither group improved notably separately (BWV: t(1, 16) ¼ 1.387, p ¼ 0.21; control: t(1, 13) ¼ 1.508, p ¼ 0.15). The whole sample had a significant improvement in depression as evinced by both the POMS
Table 2
Mean (SD) Pre and Post POMS scores.
Tension-anxiety
Pre Post
Depression-dejection
Pre Post
Anger-hostility
Pre Post
Fatigue-inertia
Pre Post
Vigour-activity
Pre Post
Confusion-bewilderment
Pre Post
Total mood disturbance
Pre Post
BWV
Control
Total
12.59 (6.08) 9.76 (4.37) 16.06 (12.11) 7.88 (6.95) 8.12 (5.31) 7.47 (4.56) 12.24 (5.55) 9.29 (5.14) 12.65 (6.83) 14.94 (5.86) 11.88 (5.46) 9.24 (4.29) 48.24 (27.57) 28.71 (22.73)
11.29 (5.17) 9.79 (5.92) 12 (10.05) 7.86 (9.69) 8.57 (7.61) 8.93 (7.34) 8.43 (5.21) 7.21 (4.82) 11.79 (5.51) 15.86 (4.91) 10.79 (4.46) 9.29 (4.23) 39.29 (28.77) 27.86 (29.98)
12 (5.63) 9.77 (5.04) 14.23 (11.23) 7.87 (8.16) 8.32 (6.34) 8.13 (5.91) 10.52 (5.65) 8.35 (5.03) 12.26 (6.18) 15.35 (5.38) 11.39 (4.98) 9.26 (4.19) 44.19 (28.01) 28.32 (25.8)
Standard deviations are shown in parentheses.
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Table 3
Bowden et al.: The effects of Brain Wave Vibration training on well-being
Mean (SD) DASS scores.
Depression
Pre Post
Anxiety
Pre Post
Stress
Pre Post
Total DASS
Pre Post
BWV
Control
Total
4.44 (3.95)* 2.81 (2.71) 2.88 (2.19) 2.56 (1.71) 5.69 (2.6) 4.75 (2.72) 13 (6.39) 10.13 (4.9)
4.21 (3.98) 2.07 (2.56) 2.86 (2.07) 2.57 (2.62) 6.07 (4.03) 5.29 (3.43) 13.14 (8.2) 9.93 (6.32)
4.33 (3.9) 2.47 (2.62) 2.87 (2.1) 2.57 (2.14) 5.87 (3.29) 5 (3.03) 13.07 (7.16) 10.03 (5.51)
Standard deviations are shown in parentheses.
subscale depression-dejection (F(1, 29) ¼ 6.285, p ¼ 0.018) and the DASS subscale depression (F(1, 29) ¼ 8.901, p ¼ 0.006). Separate examination of the groups found a near-significant decrease in depression-dejection with BWV (t(1, 16) ¼ 2.061, p ¼ 0.056), while there was no change in the controls (t(1, 13) ¼ 1.688, p ¼ 0.12). However, for DASS depression, the controls had the greater improvement (BWV: t(1, 16) ¼ 1.781, p ¼ 0.095; control: t(1, 13) ¼ 2.5, p ¼ 0.027). Figure 3 shows the
improvement of the groups in depression-dejection and depression. A marked increase was also seen overall in the POMS subscale vigour-activity (F(1, 29) ¼ 9.127, p ¼ 0.005). Here the control group alone showed a significant improvement (BWV: t(1, 16) ¼ –1.341, P ¼ 0.20; control: t(1, 13) ¼ –3.954, p ¼ 0.002). No further significant changes were seen in any POMS or DASS subscale in the whole sample (F 2.841, p 0.103) or in the groups separately (t 1.475, p 0.16). Nor were Session1 Group interactions found for the total POMS or DASS scores or for any of the subscales (F 0.381, p 0.542).
Secondary measures BWV benefits The VAS of BWV benefits (VAS), a visual analogue scale developed by Bowden et al. [6], was used to assess 20 benefits commonly reported by practitioners of BWV, in the form of statements, where participants assigned a percentage score to each statement to indicate the extent that it applied to them. Mean scores for each item are shown in Table 4. One BWV participant was excluded with a Pre score 2.579 SD above the sample mean. Since analyses were conducted for 20 items, the confidence level was adjusted to p ¼ 0.0025 (0.05/20). Significant improvements were found using mixed
Figure 3 The mean (SE) improvement in the POMS depression-dejection and DASS depression subscales.
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Bowden et al.: The effects of Brain Wave Vibration training on well-being
Table 4
Table 4
Mean (SD) Pre and Post VAS scores. BWV Control
I have had high vitality levels
Pre Post
I have felt tense
Pre Post
I have had headaches
Pre Post
I have felt confident
Pre Post
I have had aches and pains
Pre Post
I have felt calm
Pre Post
I have found it easy to focus
Pre Post
I have slept well
Pre Post
My body has felt flexible
Pre Post
I have felt aware of my emotions Pre Post I have had good digestion
Pre Post
I have experienced self-doubt and insecurities
Pre Post
I have had good circulation
Pre Post
47.35 (24.05)* 58.53 (21.42) 54.71 (27.64) 45.88 (25.81) 29.71 (33.66) 21.71 (29.61) 49.24 (20.09) 62.94 (20.31) 32.06 (32.74) 23.06 (20.56) 47.94 (21.94)* 60.59 (21.5) 36.76 (25.86) 54.12 (26.05) 48.24 (21.79) 59.41 (23.58) 41.56 (15.68) 64.38 (17.59) 73.53 (19.02) 76.47 (14.23) 75.88 (21.88)* 70.29 (24.65) 67.94 (21.51) 43.82 (28.15) 54.12 (32.99) 74.41 (19.75)
56.43 (18.75) 61.07 (17.12) 53.57 (25.15) 41.79 (28.92) 30.71 (29.28) 32.86 (34.51) 53.93 (15.46) 62.5 (20.73) 35.36 (32.84) 33.57 (25.22) 46.79 (22.24) 57.14 (15.28) 45 (18.08) 55.36 (18.45) 61.71 (18.55) 70.71 (20.93) 52.5 (18.99) 59.64 (25.3) 71.79 (14.49) 75.36 (20.89) 63.57 (24.37) 73.57 (21.43) 55.71 (31.55) 42.5 (30.18) 60.36 (29.77) 70.71 (22.77)
(Continued ) BWV Control
Total 51.45 (21.95) 59.68 (19.32) 54.19 (26.11) 44.04 (26.87) 30.16 (31.24) 26.74 (31.87) 51.35 (18.02) 62.74 (20.16) 33.55 (32.28) 27.81 (23.01) 47.42 (21.71) 59.03 (18.73) 40.48 (22.71) 54.68 (22.58) 54.32 (21.19) 64.52 (22.78) 46.67 (17.88) 62.17 (21.28) 72.74 (16.87) 75.97 (17.24) 70.32 (23.49) 71.77 (22.93) 62.42 (26.77) 43.23 (28.59) 56.94 (31.22) 72.74 (20.89)
(continued )
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I have had a positive outlook
Pre Post
My head has felt clear and not foggy
Pre Post
I have felt grounded
Pre Post
I have found it easy to cope with Pre life’s stresses Post I have felt aware of physical sensations in my body
Pre Post
I have felt in control of my emotions
Pre Post
I have had good interpersonal relationships
Pre Post
61.47 (21.63) 74.41 (20.3) 53.24 (25.06) 67.65 (21) 57.94 (20.47)* 64.71 (23.62) 47.94 (21) 67.35 (21.51) 70.59 (24.8) 74.12 (19.3) 45.29 (24.78) 69.41 (15.5) 73.53 (22.9) 78.82 (21.1)
69.29 (21.74) 77.21 (15.15) 55.36 (19.16) 64.21 (23.67) 61.07 (15.83) 67.86 (18.88) 53.57 (20.33) 61.36 (22.42) 67.5 (17.62) 74.14 (19.87) 57.14 (26.22) 66.5 (18.16) 77.14 (20.82) 82.86 (17.73)
Total 65 (21.68) 75.68 (17.92) 54.19 (22.25) 66.1 (21.93) 59.35 (18.29) 66.13 (21.32) 50.48 (20.55) 64.65 (21.77) 69.19 (21.57) 74.13 (19.23) 50.65 (25.71) 68.1 (16.53) 75.16 (21.7) 80.65 (19.44)
Standard deviations are shown in parentheses.
ANOVA for three items overall, although paired t-tests for the separate groups disclosed a significant change only with BWV for the item “I have felt flexible”, which improved substantively (t(1, 15) ¼ –4.788, p < 0.001); the results are presented in Table 5. However, the Session1 Group interaction for this item was nonsignificant (F(1, 28) ¼ 5.041, p ¼ 0.033), as were the interactions for the other 19 items (F 2.309, p 0.114). Well-being Warwick-Edinburgh Mental Well-being Scale (WEMWBS) [14] mean Total Well-being scores are shown in Table 6. Three controls failed to complete the Post WEMWBS and were excluded from the analysis. Mindfulness was significantly higher overall post-trial (F(1, 26) ¼ 3.365, p ¼ 0.018), although this was largely due to the improvement following BWV (t(1, 16) ¼ –2.746, p ¼ 0.014), for the change in the controls was nonsignificant (t(1, 10) ¼ –1.00, p ¼ 0.32). The Session1 Group interaction was also nonsignificant (F(1, 26) ¼ 2.005, p ¼ 0.169).
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Table 5
Bowden et al.: The effects of Brain Wave Vibration training on well-being
ANOVA and paired t-test results for each item of the VAS (p < 0.0025). ANOVA main
Paired t-test
Session effect
I have had high vitality levels I have felt tense I have had headaches I have felt confident I have had aches and pains I have felt calm I have found it easy to focus I have slept well My body has felt flexible I have felt aware of my emotions I have had good digestion I have experienced self-doubt/insecurities I have had good circulation I have had a positive outlook My head has felt clear and not foggy I have felt grounded I have found it easy to cope with life’s stresses I have felt aware of physical sensations I have felt in control of my emotions I have had good interpersonal relationships
BWV
Control
F
Sig.
t
Sig.
t
Sig.
2.641 4.353 0.386 6.44 0.871 5.753 9.67 4.639 18.421 0.595 0.181 11.538 5.803 5.243 4.759 1.684 8.244 1.617 11.876 1.54
> 0.1 0.046 > 0.1 0.017 > 0.1 0.023 0.004 0.04 < 0.001 > 0.1 > 0.1 0.002 0.023 0.029 0.037 > 0.1 0.008 > 0.1 0.002 > 0.1
–1.489 1.392 1.154 –2.157 1.097 –1.836 –2.418 –1.494 –4.788 –0.478 0.706 2.663 –2.362 –1.956 –2.114 –0.821 –2.619 –0.63 –3.268 –0.748
> 0.1 > 0.1 > 0.1 0.047 > 0.1 0.085 0.028 > 0.1 < 0.001 > 0.1 > 0.1 0.017 0.031 0.068 0.051 > 0.1 0.019 > 0.1 0.005 > 0.1
–0.824 1.53 –0.354 –1.472 0.225 –1.606 –2.305 –1.849 –1.4 –0.645 –1.618 2.634 –1.106 –1.318 –1.061 –1.199 –1.481 –1.186 –1.604 –1.236
> 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 0.038 0.087 > 0.1 > 0.1 > 0.1 0.021 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1
Health The presence of illness symptoms in the past 2 weeks was assessed using the Illness Symptoms Questionnaire (ISQ) [6, 11, 15]. Table 6 also shows the mean Total Illness scores, the sum of the 20 items. There was a near-significant improvement in Total Illness in the whole sample (F(1, 29) ¼ 3.84, p ¼ 0.06), mainly due to a decrease with BWV (t(1, 16) ¼ 1.92, p ¼ 0.073), as there was no change in the controls (t(1, 13) ¼ 0.901, p ¼ 0.35). No Session1 Group interaction was found (F(1, 29) ¼ 0.402, ns). Vitality Subjective Vitality Scale (SVS) [16] mean scores are also shown in Table 6. Vitality increased substantively overall (F(1, 29) ¼ 12.156, p ¼ 0.002) and in the groups separately (BWV: t(1, 16) ¼ –2.678, p ¼ 0.016; control: t(1, 13) ¼ – 2.503, p ¼ 0.026). There was no Group Session1 interaction (F(1, 29) ¼ 0.493, ns). Mindfulness Mindfulness Attention Awareness Scale (MAAS) [17] mean scores for the mean of MAAS items are again shown in Table 6. There was a highly significant increase in mindfulness overall (F(1, 29) ¼ 18.24, p < 0.001) and both groups improved significantly separately (BWV: t(1, 16) ¼ –3.242, p ¼ 0.005; control: t(1, 13) ¼ –2.912,
p ¼ 0.012). No Group Session1 interaction was found (F(1, 29) ¼ 0.209, ns).
Pre- to Post-class assessment Cognitive arousal Activation–Deactivation Adjective Check List (AD-ACL) [18] means are also shown in Table 6. Separate mixed ANOVAs for the AD-ACL subscales found highly significant improvements post-class overall in all four subscales (tension: F(1, 29) ¼ 51.248, p > 0.001; calmness: F(1, 29) ¼ 91.065, p > 0.001; energy: F(1, 29) ¼ 9.468, p ¼ 0.005; tiredness: F(1, 29) ¼ 10.238, p ¼ 0.003). Paired t-tests also disclosed highly substantive improvements in both groups in tension (BWV: t(1, 16) ¼ 5.1, p > 0.001; control: t(1, 13) ¼ 5.539, p > 0.001) and calmness (BWV: t(1, 16) ¼ –6.296, p > 0.001; control: t(1, 13) ¼ –8.059, p > 0.001). However, the BWV group alone improved significantly in energy (t(1, 16) ¼ –3.307, p ¼ 0.004; control: t(1, 13) ¼ –1.455, p ¼ 0.18) and tiredness (BWV: t(1, 16) ¼ 3.964, p ¼ 0.001; control: t(1, 13) ¼ 0.965, p ¼ 0.31). Group Session2 interactions were not found for any subscale however (F 2.616, p 0.117).
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Bowden et al.: The effects of Brain Wave Vibration training on well-being
Table 6 Mean (SD) of the total WEMWBS, total ISQ, total SVS, mean MAAS and the AD-ACL subscales.
Well-being
Pre Post
Total ISQ
Pre Post
Total SVS
Pre Post
Mean MAAS
Pre Post
AD-ACL tension
Pre Post
AD-ACL calmness
Pre Post
AD-ACL energy
Pre Post
AD-ACL tiredness
Pre Post
BWV
Control
Total
45 (7.18) 49.53 (4.89) 10.24 (6.77) 6.88 (5.06) 19.53 (6.77) 25.12 (5.06) 3.7 (0.49) 4.23 (0.52) 10.24 (3.14) 7.51 (1.38) 12.02 (2.23) 15.7 (2.06) 12.6 (2.54) 13.86 (2.55) 11.87 (1.95) 10.32 (2.04)
47 (6.4) 48.27 (7.46) 8.21 (8.32) 6.5 (4.55) 21.57 (5.57) 25.29 (6.64) 3.7 (0.63) 4.13 (0.73) 10.61 (1.79) 8.35 (1.85) 11.7 (1.52) 15.28 (1.96) 11.61 (1.93) 12.52 (2.04) 12.4 (1.88) 11.9 (2.74)
45.79 (6.83) 49.04 (5.93) 9.32 (7.45) 6.71 (4.76) 20.45 (6.24) 25.19 (5.72) 3.7 (0.55) 4.18 (0.61) 10.41 (2.58) 7.89 (1.64) 11.88 (1.92) 15.51 (1.99) 12.15 (2.3) 13.25 (2.39) 12.11 (1.9) 11.03 (2.47)
Standard deviations are shown in parentheses.
Discussion While participants overall showed benefits to mood, depression, well-being, vitality, mindfulness and health over the trial, many items improved with BWV alone, including the primary measures of global sleep, sleep efficiency and total mood disturbance. The BWV group had comparatively greater improvements in sleep duration (p ¼ 0.064) and sleep efficiency (p ¼ 0.017), although with the latter they had higher inefficiency baseline scores. They alone were also significantly better in the secondary measures of flexibility, well-being, tiredness and energy, with a tendency towards fewer illness symptoms. In contrast, the control group alone significantly improved in only one measure, POMS vigour-activity. It is noted though that corrections for multiple comparisons
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were made only for the VAS, so the significant findings on the other measures should be interpreted with caution. Nonetheless, the results tentatively support our hypothesis that BWV may be more beneficial than the other class exercises and the static holding postures and guided attention meditation practised by the controls. This is the first scientific investigation of this theory, for previous research has evaluated the effects of BWV combined with other BBHF Training class exercises [6–9]. The control exercises were similar to the BWV group but involved no vibrational element, raising the question of whether the rhythmic movements of the head, neck and body may have facilitated greater benefits. However, the controls also practised no “Ji-gam”, an energy meditation integral to BWV training, which may have influenced the results. As with our earlier study which found BWV to improve depression, stress, vitality, sleep latency and sleep quality [6], here BWV benefitted both ends of the mood/arousal continuum. While both groups had lower depression and vitality, only the BWV group had significantly better global sleep post-trial and improved energy and tiredness post-class. This is in accordance with the conjectured involvement of the brain-stem arousal sleep/ wake regulatory systems [3], a more detailed account of which is given in our earlier publication [6]. The trial had limitations including a small sample size, for while 54 participants were recruited, due to the high dropout rate only 31 completed the study, warranting further caution in the interpretation of the results. A larger sample size may have resulted in greater group differences, as may have a less healthy participant sample, as there would have been greater potential for improvement. Also, as no follow-up data were collected it is not known for what period the observed benefits were maintained. Furthermore, while the class teacher and experimenter made every effort to interact with all participants in the same manner, as they were not blinded to the participants’ group allocations there was the possibility for bias. Notwithstanding the above, improvements were seen to occur with BWV training, supporting its therapeutic effectiveness. Further research is warranted into its efficacy and possible scientific mechanisms, such as the theoretical involvement of the brain-stem reticular activating system. Acknowledgments: We gratefully acknowledge the support of the Korea Institute of Brain Science to include a postdoctoral fellowship for the first author.
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Conflict of interest statement Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research support played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report or in the decision to submit the report for publication. Research funding: None declared. Employment or leadership: None declared. Honorarium: None declared.
References 1. Moruzzi G, Magoun HW. Brain stem reticular formation and activation of the EEG. Electroencephalogr Clin Neurophysiol 1949;1:455–73. 2. Duffy E. Activation and behavior. New York, NY: John Wiley & Sons, 1962. 3. Lee I. Brain wave vibration: getting back into the rhythm of a happy, healthy life. Best Life Media, 2008. 4. Issurin VB. Vibrations and their applications in sport. A review. J Sports Med Phys Fitness 2005;45:324–36. 5. Pozo-Cruz BD, Adsuar JC, Parraca JA, Pozo-Cruz JD, et al. Using whole-body vibration training in patients affected with common neurological diseases: a systematic literature review. J Altern Complement Med 2012;18:29–41. 6. Bowden D, Gaudry C, An SC, Gruzelier JH. A comparative randomised controlled trial of the effects of Brain Wave Vibration Yoga, Iyengar Yoga and Mindfulness on mood, vitality, mindfulness and well-being. Evidence-Based Complement Altern Med 2012;2012:13. DOI:10.1155/2012/234713. 7. Jung YH, Kang DH, Jang JH, Park HY. Kwon, the effects of mind-body training on stress reduction, positive affect, and plasma catecholamines. Neurosci Lett 2010;479:138–42.
8. Janga JH, Jungb WH, Kanga DH, Byuna MS. Increased default mode network connectivity associated with meditation. Neurosci Lett 2011;487:358–62. 9. Jung YH, Kang DH, Byun MS, Shim G, Kwon SJ, Jang GE, et al. Influence of brain-derived neurotrophic factor and catechol O-methyl transferase polymorphisms on effects of meditation on plasma catecholamines and stress. Stress 2012;15: 97–104. 10. Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the depression anxiety stress scales (DASS) in clinical samples. Behav Res Ther 1997;35:79–89. 11. Bowden D, Goddard L, Gruzelier JH. A randomised controlled single-blind trial of the effects of Reiki and positive imagery on well-being and salivary cortisol. Brain Res Bull 2010; 81:66–82. 12. Buysse DJ, Reynolds CF, Monk TH, Berman SR, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatr Res 1989;28:193–213. 13. McNair D, Lorr M, Droppleman L. Profile of mood states (POMS). Nursing measurement tools and instruments, UB Center for Nursing Research, UBIR Home, 1989. 14. Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, et al. The Warwick-Edinburgh mental well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 2007;5:63. 15. Bowden D, Goddard L, Gruzelier JH. A randomised controlled single-blind trial of the efficacy of Reiki at benefitting mood and well-being. Evidence-based Complement Altern Med 2011;2011:8. DOI:10.1155/2011/381862. 16. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 2003;84:822–48. 17. Ryan RM, Frederick C. On energy, personality and health: subjective vitality as a dynamic reflection of wellbeing. J Personal 1997;65:529–65. 18. Thayer RE. Activation-deactivation adjective check list: current overview and structural analysis. Psychol Rep 1986;58:607–14.
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Deborah E. Bowden*, Danielle McLennan and John Gruzelier
A randomised controlled trial of the effects of Brain Wave Vibration training on mood and well-being Abstract
Introduction
Background: The goal was to investigate the effects of Brain Wave Vibration (BWV), a meditation practised in a class involving rhythmic movements of the head, neck and body practised with related yoga-style exercises, and to isolate the rhythmic effects. Methods: A randomised controlled trial was conducted with assessments pre- and post-trial and immediately before and after each session. Thirty-one healthy adults were assessed for mood, sleep, mindfulness, health and well-being, and pre- and post-class activation–deactivation. Participants were randomly assigned to either BWV in toto or a control group having similar yoga exercises without the rhythmic components. Participants completed eight to twelve 75-min classes of BWV or control training over 8–12 weeks. To control for expectation participants were told only that the aim was to compare two subtly different styles of Korean yoga. Results: The BWV group had comparatively greater improvements in sleep duration and efficiency, although they had higher baseline inefficiency, and post-trial they had better global sleep and well-being and fewer illness symptoms, and better tiredness and energy post-class. Both groups benefitted in mood, mindfulness and vitality post-trial with improved tension and calmness post-class. Conclusions: The participants of both interventions had better mood and well-being on the whole following the trial and were more relaxed immediately after a class. However, BWV training was unique in its benefits to sleep, health, wellbeing, energy and tiredness, warranting further research.
An exploratory randomised controlled trial was conducted with university students to investigate the effects of Brain Wave Vibration (BWV) training on mood and well-being. BWV is a moving meditation performed sitting or standing, beginning with gentle rhythmic shakes of the head and neck, developing into vibrations which may spread throughout the body. It aims to relax the body and create a peaceful, positive mind, while the vibrations are believed to tone up the brain’s arousal systems including the brain-stem reticular activating system which is a core sleep-energy centre and part of the subcortical–cortical arousal axis controlling energy distribution [1–3]. BWV is practised in a holistic fitness class with related nonvibrational yoga-style exercises, known as “Dahn yoga” or “Body and Brain Holistic Fitness (BBHF) Training”, which are part of the Health Smile Peace (HSP) movement developed in the 1980s by Ilchi Lee in South Korea [3]. It is distinct from whole-body vibration (WBV), an exercise increasingly used by physiotherapists and physical trainers believed to prevent injuries and facilitate healing [4], found to improve strength in patients with neurological diseases [5]. BBHF Training is comparable to Hatha yoga, which has origins in India, as both practices involve their own distinct forms of postures, breathing exercises, meditation and philosophical/ spiritual teachings, although Hatha yoga has no vibrational elements [6]. Evidence of the benefits of BWV was until recently only anecdotal, with a small number of studies conducted testing a range of psychometric and physiological parameters. In an earlier study we found that improved depression, stress, vitality, mindfulness, sleep latency and sleep quality followed 5 weeks of BWV training [6]. Jung et al. [7] found that regular practitioners had lower stress and negative affect than control participants, which may be associated with functional changes in brain regions related to internalised attention even when meditation is not being practised [8] and with differential effects on plasma catecholamines according
Keywords: Brain Wave Vibration, Dahn yoga, meditation, well-being DOI 10.1515/jcim-2013-0056 Received October 31, 2013; accepted May 13, 2014; previously published online June 13, 2014 *Corresponding author: Deborah E. Bowden, Department of Psychology, Goldsmiths College, University of London, London SE14 6NW, UK, E-mail: [email protected] Danielle McLennan, Dahn Yoga UK, London, UK John Gruzelier, Department of Psychology, Goldsmiths College, University of London, London, UK
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to brain derived neurotrophic factor and catechol O-methyl transferase (COMT) [9]. BWV exercises are essentially vibration exercises, and the therapeutic effectiveness of the practice is believed to rely largely on the vibrations; the current study was designed to test this theory. We aimed to isolate the effects of the BWV exercises, which are vibrational, from the other BBHF Training class exercises which are nonvibrational on measures of well-being and cognitive arousal, hypothesising greater benefits in the BWV group than in the controls. Training in yoga-style exercises for both groups was identical except that in controls the BWV exercises were substituted for similar postures but importantly with no vibrational elements. In the BWV class a standing WBV exercise was practised, whereas in controls static holding postures were performed. A sitting BWV vibrational exercise was also replaced with a sitting focused-attention meditation. To control for expectation, participants were told that the purpose was to compare two subtly different styles of Korean yoga.
Materials and methods
would be an effect size of 1, with an error probability of 0.05 and an allocation ratio of 1, the necessary sample size is 17 in each group. Therefore, since only 14 control participants completed the study, the trial was insufficiently powered for a significant difference between two independent samples of equal size to be observed using mixed ANOVA, which was the principle analysis used, as detailed in the section “Statistics.” A Consort Diagram is shown in Figure 1, illustrating each stage of the groups’ participation.
Procedure Pre- and post-intervention, participants completed a 40-min computerised questionnaire battery, as presented in the section “Results”. Participants attended 8–12 weekly classes (mean BWV: 10.41 (SD: 1.66); mean control: 10.21 (SD: 1.48)), as some participants were unable to attend 12 classes, even though four extra were held for participants to make up for classes missed. All classes were taught by the same qualified BBHF instructor. Music played at the HSP Centers was played during the classes.
Participants
Timeline of a 75-min BWV class
Following Goldsmiths Ethics Committee’s approval, 54 healthy participants were recruited through college advertisements over 3 months. Potential participants were screened with the Depression, Anxiety and Stress Scale [10] to exclude any with severe depression; all were found to be eligible. Thirty-one participants (17 BWV; 14 controls) completed the study, aged 18–37 years (27 female; 4 male) with 23 dropouts (10 BWV; 13 controls). Dropouts said they were too busy to participate, except for two BWVs who withdrew early due to illness or anxiety. On completion participants were paid £20.
1.
Design Each pair of participants recruited was randomly assigned to the two groups using a computerised random number generator that created either a “1” or a “2”, with equal probability. If “1” was generated the participant was assigned to BWV; if “2” was generated the participant became a control. G-Power was used to calculate the sample size needed as in Bowden et al. [11]. Predicting that there
0 min: Warm up (15 min). Patting exercises to release stagnant energy, stimulate meridians, open acupressure points and increase body awareness and energy/ blood circulation. 2. 15 min: Stretching and rhythm (15 min). To open meridians to promote energy circulation and better body and brain communication. 3. 30 min: Standing BWV (10 min). Whole-body rhythmic movements to revitalise the body, improve mood and promote brain health. 4. 40 min: Breathing postures (13 min). Four postures believed to accumulate energy in the abdomen, the “energy core”, to improve concentration, immunity and health [3]. 5. 53 min: Sitting Ji-gam and BWV (10 min). Ji-gam is a sitting energy meditation designed to improve concentration and peace of mind and is part of the BWV meditation, followed by BWV, where vibrations of the head and neck spread to the rest of the body while focusing on a positive thought. 6. 63 min: Warm down (10 min). Stretches and balancing. 7. 73 min: Sharing (2 min). Sharing of class experiences.
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Assessed for eligibility with the DASS (n = 54)
Enrollment Excluded (n = 0)
Allocation
Randomized (n = 54)
Allocated to BWV intervention (n = 27) Received allocated intervention (n = 17) Withdrew from trial (n = 10) (due to being too busy: n = 8) (due to illness: n = 1) (due to anxiety: n = 1)
Allocated to control intervention (n = 27) Received allocated intervention (n = 14) Withdrew from trial (n = 13) (due to being too busy: n = 13)
Analysis
Total analysed (n = 17) Excluded from PSQI analysis due to outliers (n = 1) Excluded from PSQI analysis due to outliers (n = 1)
Total analysed (n = 14) Excluded from PSQI analysis due to outliers (n = 1) Excluded from WEMWBS analysis due to failure to complete Post questionnaire (n = 3)
Figure 1 A Consort Diagram showing the stages of participation of the groups.
The control and BWV classes were identical essentially except that the control omitted the vibrational elements. Part 3, Standing BWV, was replaced by 10 min of static holding postures designed to increase muscular strength, improve balance and promote a calm, clear mind. Additionally, Part 5 of the BWV class, Sitting Ji-gam and BWV, was replaced by a 10-min sitting-still focusedattention meditation concentrating on a positive thought. Participants were requested to practise three exercises, as detailed below, at home daily for a total of 7–10 min and keep a diary to log their diligence. The toe-tapping exercise, Exercise 3 of the BWV group, has a vibrational element and so was not performed by the controls, who practised a breathing exercise instead.
BWV group home-practice Exercise 1 (1–2 min three times a day). Solar-plexus tapping. Exercise 2 (4 min). Sitting BWV. Exercise 3 (2 min). Toe-tapping exercises while lying in bed at night. Control group home-practice Exercise 1 (1–2 min three times a day). Solar-plexus tapping. Exercise 2 (4 min). Sitting-still meditation, focussing on a positive goal. Exercise 3 (2 min). Breathing exercises while lying still in bed.
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Statistics
Table 1
Separate mixed ANOVAs compared the pre-intervention (Pre) and post-intervention (Post) scale scores for measures “Sleep”, “Mood”, “BWV benefits”, “Well-being”, “Health”, “Vitality” and “Mindfulness” in the section “Results”. The within-subjects factor was Session1 (Pre/ Post), relating to the change in the scores of the participants as a whole over the course of the trial, and the between-subjects factor was Group (BWV/control), relating to the relative changes of the groups. For measure “Cognitive arousal”, a similar mixed ANOVA compared pre-class and post-class total activation scores with a within-subjects factor of Session2 (Pre-class/Post-class) and a between-subjects factor of Group (BWV/control). Planned contrasts for within-group changes were conducted with paired t-tests. Since the study was exploratory, no corrections for multiple comparisons were made unless stated otherwise.
Pre and Post mean (SD) PSQI scores.
Sleep quality
Pre Post
Sleep disturbance
Pre Post
Sleep duration
Pre Post
Sleep efficiency
Pre Post
Sleep latency
Pre Post
Medication
Results
Pre Post
The participants were essentially naïve to yoga practice except 2 BWV and 1 control. The diaries indicated that home-practice was conducted a mean of 4.3 (SD: 1.36) days per week; a one-way ANOVA found no group difference (F ¼ 0.149, ns). There were no baseline group differences on any of the scales as disclosed by one-way ANOVAs (F 2.447, p 0.104), unless stated otherwise.
Daytime dysfunction
Pre Post
Global sleep
Pre Post
BWV
Control
Total
1.31 (0.79) 1.13 (0.62) 1.19 (0.54) 1.19 (0.54) 1.13 (1.09) 0.88 (0.81) 0.63 (0.89) 0 (0) 1.75 (0.77) 1.38 (0.5) 0 (0)* 0 (0) 1.25 (0.68) 1.06 (0.85) 7.25 (2.41) 6.11 (2.59)
1.08 (0.64) 0.92 (0.76) 1.38 (0.51) 1.15 (0.55) 0.54 (0.78) 1.08 (0.76) 0.08 (0.28) 0.15 (0.38) 1.62 (0.77) 1.54 (0.88) 0.077 (0.28) 0 (0) 1.15 (0.55) 1 (0.71) 5.92 (1.71) 5.85 (3.05)
1.21 (0.73) 1.03 (0.68) 1.28 (0.53) 1.17 (0.54) 0.86 (0.99) 0.97 (0.78) 0.38 (0.73) 0.07 (0.26) 1.69 (0.76) 1.45 (0.69) 0.03 (0.18) 0 (0) 1.21 (0.62) 1.03 (0.78) 6.66 (2.19) 6 (2.75)
Standard deviations are shown in parentheses.
Pre- to Post-trial assessment Primary measures Sleep Pittsburgh Sleep Quality index (PSQI) [12] means for global sleep and subscale scores are shown in Table 1. Two participants were excluded from the PSQI analysis – a control with a Pre global sleep score 2.82 SDs above the sample mean and a BWV participant with a Post score 2.75 SDs above the Post sample mean. While the mixed ANOVA found no change for global sleep overall (F(1, 27) ¼ 2.589, ns), a paired t-test found significant improvement following BWV (t(1, 15) ¼ 2.3, p ¼ 0.036) and controls (t(1, 12) ¼ 0.098, ns). The mean changes are shown in Figure 2 for each of the subscales except for medication, as only one participant took medication.
For the subscale sleep efficiency there was a nearsignificant improvement overall (F(1, 27) ¼ 3.965, p ¼ 0.057) and a significant Session1 Group interaction (F(1, 27) ¼ 6.503, p ¼ 0.017). Paired t-tests disclosed that the BWV group significantly improved (t(1, 15) ¼ 2.825, p ¼ 0.013), although the controls did not (t(1, 12) ¼ –0.562, ns). However, an independent samples t-test found that the BWV group had a comparatively higher baseline inefficiency score, allowing more room for improvement (t(1, 15) ¼ 2.142, p ¼ 0.041). There was also a tendency towards a Session1 Group interaction for the subscale sleep duration (F(1, 27) ¼ 3.735, p ¼ 0.064), although there was no main effect of Session1 (F(1, 27) ¼ 0.5, ns). Paired t-test found that the controls were nonsignificantly worse post-trial (t(1, 12) ¼ –1.723, p ¼ 0.12) and there was no change following
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Figure 2 The mean (SE) improvement of the groups for the PSQI subscales.
BWV (t(1, 15) ¼ 0.939, ns). Here the baseline scores of the groups did not differ (t(1, 27) ¼ 1.633, ns). The whole sample had a tendency towards an improvement in the subscale sleep latency (F(1, 27) ¼ 3.121, p ¼ 0.089). For the remaining subscales, however, there were no main effects of Session1 (F 1.241, p 0.275). Nor were there Session1 Group interactions for these subscales or for global sleep (F 2.142, p 0.155). Mood Mood was assessed using the Profile of Mood States (POMS) [13] and the questionnaire used to screen participants, the DASS [10]. Table 2 shows the mean POMS scores, total mood disturbance and subscales, and Table 3 shows the DASS scores, total DASS and subscales. Considering the total scores first, a mixed ANOVA found a significant improvement in total mood disturbance overall (F(1, 29) ¼ 5.27, p ¼ 0.029). Considering the groups separately however disclosed that only the improvement with BWV approached significance (BWV: t(1, 16) ¼ 1.876, p ¼ 0.08; control: t(1,13) ¼ 1.477, p ¼ 0.23). Similarly, a near-significant improvement was seen in the whole sample in total DASS, (F(1, 29) ¼ 4.172, p ¼ 0.051), although here neither group improved notably separately (BWV: t(1, 16) ¼ 1.387, p ¼ 0.21; control: t(1, 13) ¼ 1.508, p ¼ 0.15). The whole sample had a significant improvement in depression as evinced by both the POMS
Table 2
Mean (SD) Pre and Post POMS scores.
Tension-anxiety
Pre Post
Depression-dejection
Pre Post
Anger-hostility
Pre Post
Fatigue-inertia
Pre Post
Vigour-activity
Pre Post
Confusion-bewilderment
Pre Post
Total mood disturbance
Pre Post
BWV
Control
Total
12.59 (6.08) 9.76 (4.37) 16.06 (12.11) 7.88 (6.95) 8.12 (5.31) 7.47 (4.56) 12.24 (5.55) 9.29 (5.14) 12.65 (6.83) 14.94 (5.86) 11.88 (5.46) 9.24 (4.29) 48.24 (27.57) 28.71 (22.73)
11.29 (5.17) 9.79 (5.92) 12 (10.05) 7.86 (9.69) 8.57 (7.61) 8.93 (7.34) 8.43 (5.21) 7.21 (4.82) 11.79 (5.51) 15.86 (4.91) 10.79 (4.46) 9.29 (4.23) 39.29 (28.77) 27.86 (29.98)
12 (5.63) 9.77 (5.04) 14.23 (11.23) 7.87 (8.16) 8.32 (6.34) 8.13 (5.91) 10.52 (5.65) 8.35 (5.03) 12.26 (6.18) 15.35 (5.38) 11.39 (4.98) 9.26 (4.19) 44.19 (28.01) 28.32 (25.8)
Standard deviations are shown in parentheses.
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Table 3
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Mean (SD) DASS scores.
Depression
Pre Post
Anxiety
Pre Post
Stress
Pre Post
Total DASS
Pre Post
BWV
Control
Total
4.44 (3.95)* 2.81 (2.71) 2.88 (2.19) 2.56 (1.71) 5.69 (2.6) 4.75 (2.72) 13 (6.39) 10.13 (4.9)
4.21 (3.98) 2.07 (2.56) 2.86 (2.07) 2.57 (2.62) 6.07 (4.03) 5.29 (3.43) 13.14 (8.2) 9.93 (6.32)
4.33 (3.9) 2.47 (2.62) 2.87 (2.1) 2.57 (2.14) 5.87 (3.29) 5 (3.03) 13.07 (7.16) 10.03 (5.51)
Standard deviations are shown in parentheses.
subscale depression-dejection (F(1, 29) ¼ 6.285, p ¼ 0.018) and the DASS subscale depression (F(1, 29) ¼ 8.901, p ¼ 0.006). Separate examination of the groups found a near-significant decrease in depression-dejection with BWV (t(1, 16) ¼ 2.061, p ¼ 0.056), while there was no change in the controls (t(1, 13) ¼ 1.688, p ¼ 0.12). However, for DASS depression, the controls had the greater improvement (BWV: t(1, 16) ¼ 1.781, p ¼ 0.095; control: t(1, 13) ¼ 2.5, p ¼ 0.027). Figure 3 shows the
improvement of the groups in depression-dejection and depression. A marked increase was also seen overall in the POMS subscale vigour-activity (F(1, 29) ¼ 9.127, p ¼ 0.005). Here the control group alone showed a significant improvement (BWV: t(1, 16) ¼ –1.341, P ¼ 0.20; control: t(1, 13) ¼ –3.954, p ¼ 0.002). No further significant changes were seen in any POMS or DASS subscale in the whole sample (F 2.841, p 0.103) or in the groups separately (t 1.475, p 0.16). Nor were Session1 Group interactions found for the total POMS or DASS scores or for any of the subscales (F 0.381, p 0.542).
Secondary measures BWV benefits The VAS of BWV benefits (VAS), a visual analogue scale developed by Bowden et al. [6], was used to assess 20 benefits commonly reported by practitioners of BWV, in the form of statements, where participants assigned a percentage score to each statement to indicate the extent that it applied to them. Mean scores for each item are shown in Table 4. One BWV participant was excluded with a Pre score 2.579 SD above the sample mean. Since analyses were conducted for 20 items, the confidence level was adjusted to p ¼ 0.0025 (0.05/20). Significant improvements were found using mixed
Figure 3 The mean (SE) improvement in the POMS depression-dejection and DASS depression subscales.
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Bowden et al.: The effects of Brain Wave Vibration training on well-being
Table 4
Table 4
Mean (SD) Pre and Post VAS scores. BWV Control
I have had high vitality levels
Pre Post
I have felt tense
Pre Post
I have had headaches
Pre Post
I have felt confident
Pre Post
I have had aches and pains
Pre Post
I have felt calm
Pre Post
I have found it easy to focus
Pre Post
I have slept well
Pre Post
My body has felt flexible
Pre Post
I have felt aware of my emotions Pre Post I have had good digestion
Pre Post
I have experienced self-doubt and insecurities
Pre Post
I have had good circulation
Pre Post
47.35 (24.05)* 58.53 (21.42) 54.71 (27.64) 45.88 (25.81) 29.71 (33.66) 21.71 (29.61) 49.24 (20.09) 62.94 (20.31) 32.06 (32.74) 23.06 (20.56) 47.94 (21.94)* 60.59 (21.5) 36.76 (25.86) 54.12 (26.05) 48.24 (21.79) 59.41 (23.58) 41.56 (15.68) 64.38 (17.59) 73.53 (19.02) 76.47 (14.23) 75.88 (21.88)* 70.29 (24.65) 67.94 (21.51) 43.82 (28.15) 54.12 (32.99) 74.41 (19.75)
56.43 (18.75) 61.07 (17.12) 53.57 (25.15) 41.79 (28.92) 30.71 (29.28) 32.86 (34.51) 53.93 (15.46) 62.5 (20.73) 35.36 (32.84) 33.57 (25.22) 46.79 (22.24) 57.14 (15.28) 45 (18.08) 55.36 (18.45) 61.71 (18.55) 70.71 (20.93) 52.5 (18.99) 59.64 (25.3) 71.79 (14.49) 75.36 (20.89) 63.57 (24.37) 73.57 (21.43) 55.71 (31.55) 42.5 (30.18) 60.36 (29.77) 70.71 (22.77)
(Continued ) BWV Control
Total 51.45 (21.95) 59.68 (19.32) 54.19 (26.11) 44.04 (26.87) 30.16 (31.24) 26.74 (31.87) 51.35 (18.02) 62.74 (20.16) 33.55 (32.28) 27.81 (23.01) 47.42 (21.71) 59.03 (18.73) 40.48 (22.71) 54.68 (22.58) 54.32 (21.19) 64.52 (22.78) 46.67 (17.88) 62.17 (21.28) 72.74 (16.87) 75.97 (17.24) 70.32 (23.49) 71.77 (22.93) 62.42 (26.77) 43.23 (28.59) 56.94 (31.22) 72.74 (20.89)
(continued )
229
I have had a positive outlook
Pre Post
My head has felt clear and not foggy
Pre Post
I have felt grounded
Pre Post
I have found it easy to cope with Pre life’s stresses Post I have felt aware of physical sensations in my body
Pre Post
I have felt in control of my emotions
Pre Post
I have had good interpersonal relationships
Pre Post
61.47 (21.63) 74.41 (20.3) 53.24 (25.06) 67.65 (21) 57.94 (20.47)* 64.71 (23.62) 47.94 (21) 67.35 (21.51) 70.59 (24.8) 74.12 (19.3) 45.29 (24.78) 69.41 (15.5) 73.53 (22.9) 78.82 (21.1)
69.29 (21.74) 77.21 (15.15) 55.36 (19.16) 64.21 (23.67) 61.07 (15.83) 67.86 (18.88) 53.57 (20.33) 61.36 (22.42) 67.5 (17.62) 74.14 (19.87) 57.14 (26.22) 66.5 (18.16) 77.14 (20.82) 82.86 (17.73)
Total 65 (21.68) 75.68 (17.92) 54.19 (22.25) 66.1 (21.93) 59.35 (18.29) 66.13 (21.32) 50.48 (20.55) 64.65 (21.77) 69.19 (21.57) 74.13 (19.23) 50.65 (25.71) 68.1 (16.53) 75.16 (21.7) 80.65 (19.44)
Standard deviations are shown in parentheses.
ANOVA for three items overall, although paired t-tests for the separate groups disclosed a significant change only with BWV for the item “I have felt flexible”, which improved substantively (t(1, 15) ¼ –4.788, p < 0.001); the results are presented in Table 5. However, the Session1 Group interaction for this item was nonsignificant (F(1, 28) ¼ 5.041, p ¼ 0.033), as were the interactions for the other 19 items (F 2.309, p 0.114). Well-being Warwick-Edinburgh Mental Well-being Scale (WEMWBS) [14] mean Total Well-being scores are shown in Table 6. Three controls failed to complete the Post WEMWBS and were excluded from the analysis. Mindfulness was significantly higher overall post-trial (F(1, 26) ¼ 3.365, p ¼ 0.018), although this was largely due to the improvement following BWV (t(1, 16) ¼ –2.746, p ¼ 0.014), for the change in the controls was nonsignificant (t(1, 10) ¼ –1.00, p ¼ 0.32). The Session1 Group interaction was also nonsignificant (F(1, 26) ¼ 2.005, p ¼ 0.169).
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Table 5
Bowden et al.: The effects of Brain Wave Vibration training on well-being
ANOVA and paired t-test results for each item of the VAS (p < 0.0025). ANOVA main
Paired t-test
Session effect
I have had high vitality levels I have felt tense I have had headaches I have felt confident I have had aches and pains I have felt calm I have found it easy to focus I have slept well My body has felt flexible I have felt aware of my emotions I have had good digestion I have experienced self-doubt/insecurities I have had good circulation I have had a positive outlook My head has felt clear and not foggy I have felt grounded I have found it easy to cope with life’s stresses I have felt aware of physical sensations I have felt in control of my emotions I have had good interpersonal relationships
BWV
Control
F
Sig.
t
Sig.
t
Sig.
2.641 4.353 0.386 6.44 0.871 5.753 9.67 4.639 18.421 0.595 0.181 11.538 5.803 5.243 4.759 1.684 8.244 1.617 11.876 1.54
> 0.1 0.046 > 0.1 0.017 > 0.1 0.023 0.004 0.04 < 0.001 > 0.1 > 0.1 0.002 0.023 0.029 0.037 > 0.1 0.008 > 0.1 0.002 > 0.1
–1.489 1.392 1.154 –2.157 1.097 –1.836 –2.418 –1.494 –4.788 –0.478 0.706 2.663 –2.362 –1.956 –2.114 –0.821 –2.619 –0.63 –3.268 –0.748
> 0.1 > 0.1 > 0.1 0.047 > 0.1 0.085 0.028 > 0.1 < 0.001 > 0.1 > 0.1 0.017 0.031 0.068 0.051 > 0.1 0.019 > 0.1 0.005 > 0.1
–0.824 1.53 –0.354 –1.472 0.225 –1.606 –2.305 –1.849 –1.4 –0.645 –1.618 2.634 –1.106 –1.318 –1.061 –1.199 –1.481 –1.186 –1.604 –1.236
> 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 0.038 0.087 > 0.1 > 0.1 > 0.1 0.021 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1 > 0.1
Health The presence of illness symptoms in the past 2 weeks was assessed using the Illness Symptoms Questionnaire (ISQ) [6, 11, 15]. Table 6 also shows the mean Total Illness scores, the sum of the 20 items. There was a near-significant improvement in Total Illness in the whole sample (F(1, 29) ¼ 3.84, p ¼ 0.06), mainly due to a decrease with BWV (t(1, 16) ¼ 1.92, p ¼ 0.073), as there was no change in the controls (t(1, 13) ¼ 0.901, p ¼ 0.35). No Session1 Group interaction was found (F(1, 29) ¼ 0.402, ns). Vitality Subjective Vitality Scale (SVS) [16] mean scores are also shown in Table 6. Vitality increased substantively overall (F(1, 29) ¼ 12.156, p ¼ 0.002) and in the groups separately (BWV: t(1, 16) ¼ –2.678, p ¼ 0.016; control: t(1, 13) ¼ – 2.503, p ¼ 0.026). There was no Group Session1 interaction (F(1, 29) ¼ 0.493, ns). Mindfulness Mindfulness Attention Awareness Scale (MAAS) [17] mean scores for the mean of MAAS items are again shown in Table 6. There was a highly significant increase in mindfulness overall (F(1, 29) ¼ 18.24, p < 0.001) and both groups improved significantly separately (BWV: t(1, 16) ¼ –3.242, p ¼ 0.005; control: t(1, 13) ¼ –2.912,
p ¼ 0.012). No Group Session1 interaction was found (F(1, 29) ¼ 0.209, ns).
Pre- to Post-class assessment Cognitive arousal Activation–Deactivation Adjective Check List (AD-ACL) [18] means are also shown in Table 6. Separate mixed ANOVAs for the AD-ACL subscales found highly significant improvements post-class overall in all four subscales (tension: F(1, 29) ¼ 51.248, p > 0.001; calmness: F(1, 29) ¼ 91.065, p > 0.001; energy: F(1, 29) ¼ 9.468, p ¼ 0.005; tiredness: F(1, 29) ¼ 10.238, p ¼ 0.003). Paired t-tests also disclosed highly substantive improvements in both groups in tension (BWV: t(1, 16) ¼ 5.1, p > 0.001; control: t(1, 13) ¼ 5.539, p > 0.001) and calmness (BWV: t(1, 16) ¼ –6.296, p > 0.001; control: t(1, 13) ¼ –8.059, p > 0.001). However, the BWV group alone improved significantly in energy (t(1, 16) ¼ –3.307, p ¼ 0.004; control: t(1, 13) ¼ –1.455, p ¼ 0.18) and tiredness (BWV: t(1, 16) ¼ 3.964, p ¼ 0.001; control: t(1, 13) ¼ 0.965, p ¼ 0.31). Group Session2 interactions were not found for any subscale however (F 2.616, p 0.117).
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Bowden et al.: The effects of Brain Wave Vibration training on well-being
Table 6 Mean (SD) of the total WEMWBS, total ISQ, total SVS, mean MAAS and the AD-ACL subscales.
Well-being
Pre Post
Total ISQ
Pre Post
Total SVS
Pre Post
Mean MAAS
Pre Post
AD-ACL tension
Pre Post
AD-ACL calmness
Pre Post
AD-ACL energy
Pre Post
AD-ACL tiredness
Pre Post
BWV
Control
Total
45 (7.18) 49.53 (4.89) 10.24 (6.77) 6.88 (5.06) 19.53 (6.77) 25.12 (5.06) 3.7 (0.49) 4.23 (0.52) 10.24 (3.14) 7.51 (1.38) 12.02 (2.23) 15.7 (2.06) 12.6 (2.54) 13.86 (2.55) 11.87 (1.95) 10.32 (2.04)
47 (6.4) 48.27 (7.46) 8.21 (8.32) 6.5 (4.55) 21.57 (5.57) 25.29 (6.64) 3.7 (0.63) 4.13 (0.73) 10.61 (1.79) 8.35 (1.85) 11.7 (1.52) 15.28 (1.96) 11.61 (1.93) 12.52 (2.04) 12.4 (1.88) 11.9 (2.74)
45.79 (6.83) 49.04 (5.93) 9.32 (7.45) 6.71 (4.76) 20.45 (6.24) 25.19 (5.72) 3.7 (0.55) 4.18 (0.61) 10.41 (2.58) 7.89 (1.64) 11.88 (1.92) 15.51 (1.99) 12.15 (2.3) 13.25 (2.39) 12.11 (1.9) 11.03 (2.47)
Standard deviations are shown in parentheses.
Discussion While participants overall showed benefits to mood, depression, well-being, vitality, mindfulness and health over the trial, many items improved with BWV alone, including the primary measures of global sleep, sleep efficiency and total mood disturbance. The BWV group had comparatively greater improvements in sleep duration (p ¼ 0.064) and sleep efficiency (p ¼ 0.017), although with the latter they had higher inefficiency baseline scores. They alone were also significantly better in the secondary measures of flexibility, well-being, tiredness and energy, with a tendency towards fewer illness symptoms. In contrast, the control group alone significantly improved in only one measure, POMS vigour-activity. It is noted though that corrections for multiple comparisons
231
were made only for the VAS, so the significant findings on the other measures should be interpreted with caution. Nonetheless, the results tentatively support our hypothesis that BWV may be more beneficial than the other class exercises and the static holding postures and guided attention meditation practised by the controls. This is the first scientific investigation of this theory, for previous research has evaluated the effects of BWV combined with other BBHF Training class exercises [6–9]. The control exercises were similar to the BWV group but involved no vibrational element, raising the question of whether the rhythmic movements of the head, neck and body may have facilitated greater benefits. However, the controls also practised no “Ji-gam”, an energy meditation integral to BWV training, which may have influenced the results. As with our earlier study which found BWV to improve depression, stress, vitality, sleep latency and sleep quality [6], here BWV benefitted both ends of the mood/arousal continuum. While both groups had lower depression and vitality, only the BWV group had significantly better global sleep post-trial and improved energy and tiredness post-class. This is in accordance with the conjectured involvement of the brain-stem arousal sleep/ wake regulatory systems [3], a more detailed account of which is given in our earlier publication [6]. The trial had limitations including a small sample size, for while 54 participants were recruited, due to the high dropout rate only 31 completed the study, warranting further caution in the interpretation of the results. A larger sample size may have resulted in greater group differences, as may have a less healthy participant sample, as there would have been greater potential for improvement. Also, as no follow-up data were collected it is not known for what period the observed benefits were maintained. Furthermore, while the class teacher and experimenter made every effort to interact with all participants in the same manner, as they were not blinded to the participants’ group allocations there was the possibility for bias. Notwithstanding the above, improvements were seen to occur with BWV training, supporting its therapeutic effectiveness. Further research is warranted into its efficacy and possible scientific mechanisms, such as the theoretical involvement of the brain-stem reticular activating system. Acknowledgments: We gratefully acknowledge the support of the Korea Institute of Brain Science to include a postdoctoral fellowship for the first author.
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Bowden et al.: The effects of Brain Wave Vibration training on well-being
Conflict of interest statement Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research support played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report or in the decision to submit the report for publication. Research funding: None declared. Employment or leadership: None declared. Honorarium: None declared.
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