title: Potential health benefits of simulated laughter: a narrative review of the literature and recommendations for future research.
abstract: BACKGROUND
  Scientific research has shown that laughter may have both preventive and therapeutic values. Health-related benefits of laughter are mainly reported from spontaneous laughter interventional studies. While the human mind can make a distinction between simulated and spontaneous laughter, the human body cannot. Either way health-related outcomes are deemed to be produced. Simulated laughter is thus a relatively under-researched treatment modality with potential health benefits. The aim of this review was firstly to identify, critically evaluate and summarize the laughter literature; secondly to assess to which extent simulated laughter health-related benefits are currently sustained by empirical evidence; and lastly to provide recommendations and future directions for further research.
  
  
  METHODS
  A comprehensive laughter literature search was performed. A list of inclusion and exclusion criteria was identified. Thematic analysis was applied to summarize laughter health-related outcomes, relationships, and general robustness.
  
  
  RESULTS
  Laughter has shown different physiological and psychological benefits. Adverse effects are very limited and laughter is practically lacking in counter-indications. Despite the limited number of publications, there is some evidence to suggest that simulated laughter has also some effects on certain aspects of health, though further well-designed research is warranted.
  
  
  CONCLUSIONS
  Simulated laughter techniques can be easily implemented in traditional clinical settings for health and patient care. Their effective use for therapeutic purposes needs to be learned, practiced, and developed as any other medical strategy. Practical guidelines and further research are needed to help health care professionals (and others) implement laughter techniques in their health care portfolio.
authors.affiliation: Laughter Research Network, Barcelona, Spain. ramon.morari@gmail.com
authors.forename: Ramon
authors.initials: R
authors.lastname: Mora-Ripoll
mesh_terms: D006262:Health; D006801:Humans; D007845:Laughter / Q000502:physiology* / Q000523:psychology; D027641:Laughter Therapy / Q000379:methods*; D016896:Treatment Outcome