A systematic scoping review of complementary and alternative medicine mind and body practices to improve the health of veterans and military personnel.
BACKGROUND
Meditation, imagery, acupuncture, and yoga are the most frequently offered mind and body practices in the Department of Veterans Affairs. Yet, the research on mind and body practices has been critiqued as being too limited in evidence and scope to inform clinical treatment.


OBJECTIVE
We conducted a systematic scoping review of mind and body practices used with veterans or active duty military personnel to identify gaps in the literature and make recommendations for future primary research.


METHODS
Following systematic literature review methodology, we searched 5 databases using 27 different National Center for Complementary and Alternative Medicine-defined mind and body practices as text words, keywords, and MeSH terms through June 30, 2014. We also conducted handsearches of 4 previous reviews.


METHODS
Active duty military members or veterans 18 years or older participating in mind and body practice interventions globally.


METHODS
Data were extracted from studies meeting 5 inclusion criteria. The quality of randomized controlled trials (RCTs) was assessed using an existing checklist.


RESULTS
Of 1819 studies identified, 89 interventions (50 RCTs) published between 1976 and 2014, conducted in 9 countries, using 152 different measures to assess 65 health and well-being outcomes met our inclusion criteria. Most interventions took place in the United States (n=78). Meditation practices (n=25), relaxation techniques including imagery (n=20), spinal manipulation including physical therapy (n=16), and acupuncture (n=11) were the most frequently studied practices. Methodological quality of most RCTs was rated poorly.


CONCLUSIONS
Meditation and acupuncture practices are among the most frequently offered and studied mind and body practices. Future research should include yoga as it is currently understudied among veterans and military personnel. A repository of mind and body intervention outcome measures may further future research efforts, as would conducting pragmatic trials and more robust RCTs.
*Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford Departments of †Health Policy and Management ‡Psychiatry, Boston University School of Medicine, Boston, MA §Center for Excellence for Stress and Mental Health, VA San Diego Healthcare System ∥Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA ¶Integrative Health and Wellness Program, War Related Injuries and Illness Center, Washington DC VA Medical Center, Washington, DC #Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Medical Center, North Hills **RAND Corporation, Santa Monica, CA.
A Rani
AR
Elwy
Jennifer M
JM
Johnston
Jill E
JE
Bormann
Amanda
A
Hull
Stephanie L
SL
Taylor
D000529:Complementary Therapies / Q000706:statistics & numerical data*; D006801:Humans; D008889:Military Personnel; D026441:Mind-Body Therapies / Q000706:statistics & numerical data; D014481:United States; D014728:Veterans