01 Anthroposophic medicine (AM), therapies and health

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https://hdl.handle.net/20.500.14430/2

This collection contains almost all items in the repository, except for back issues of journals. These items (publications) include articles, abstracts, book reviews, workshop and conference proceedings, presentations, etc. in various formats -- text, audio and visual. Examples of therapies: art therapy, rhythmical massage, speech therapy, therapeutic eurythmy. Example of health: dentistry

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Person-Centeredness in Integrative Health Care and Integrative Medical Education
(2017-04-27) Längler, Alfred; Schwermer, Melanie; Berger, Bettina; Schwarz, Christiane; Cramer, Holger; Boehm, Katja
Healing Architecture for Sick Kids.
(2019-01) Fricke, Oliver; Halswick, Daniel; Längler, Alfred; Martin, David
Scientific data are sparse on hospital design in child and adolescent psychiatry. The present article aims to give an overview of various concepts of hospital design and to develop concepts how architecture can consider the special needs of children and adolescents in their recovery from psychiatric diseases. Literature research is provided from PubMed and collected from architectural and anthroposophic bibliography. Access to daylight and nature, reduced level of noise and an atmosphere of privacy are general principles to support convalescence in patients. Especially in psychiatry, spatial structures and colour can strengthen appropriate social interrelations on both the patient and staff level. Authors suggest that children and adolescents benefit from architectural concepts which consider the issues: Welcome, Path, Territory, Area of Freedom, Outdoor Space, Access to Light, Motion in the Structure and Orientation of Space.
Individuating Through the 7 Life Processes
Life is a continual series of encounters between ourselves and the world. The extent to which we can learn from and be nourished by them, and then also give back or keep out what is not needed, determines our overall health and longevity. These processes of encounter lead to inner transformation and creative development as individuals. They can be described as seven discrete activities: The first three involve ways in which we take in the world around us and make it our own. They primarily include processes of breakdown and transformation. The last three relate to our inner creative activities- how we renew and regenerate ourselves. And the middle process integrates and harmonizes between these two polarities.
Activity-based mindfulness: large-scale assessment of an online program on perceived stress and mindfulness.
(2024-10-14) Timm, Eliane; Ko, Yobina Melanie; Hundhammer, Theodor; Berlowitz, Ilana; Wolf, Ursula
Mindfulness has emerged as key construct in mental health over past decades. While current mindfulness-based interventions (MBIs) are usually rooted in Asian contemplative traditions, mindfulness practices can equally be found in other knowledge systems, including integrative medicine systems such as anthroposophic medicine (AM). The (ABSR) program incorporates the latter as part of an 8-week-long online intervention combining mindfulness exercises, behavioral self-observation, and mindful movement practices derived from this integrative medicine frame. The program could offer additional means for cultivating mindfulness, thereby addressing the necessity for diverse approaches in conjunction with individual differences, diverse clinical demands, or restricted capacities to perform certain mindfulness practices. Using an observational repeated-measures design, the current study aimed to assess a large-scale online implementation of this program in terms of its feasibility, assessing perceived stress and mindfulness. Individuals who enrolled in any of the 37 ABSR program iterations carried out during 2023 and agreed to participate in the study completed online surveys including validated stress and mindfulness scales at the beginning, middle, end, and follow up of the intervention. Linear-mixed models were used for data analysis. A total of 830 individuals took part in the study, of which 53.5% filled in at least 2 surveys. In line with our expectation, mindfulness scores increased significantly over the course of the intervention, while stress scores decreased significantly in this timeframe. We further found differential effects of self-practice frequency and duration on the outcomes. This study provides a first indication of stress reduction in conjunction with the online implementation of this novel MBI. The work further suggests that this AM-based intervention indeed targets mindfulness, as do other MBIs, and that it is adaptable to an online format. However, given the observational single-arm design, controlled studies will be necessary to confirm these results. Nonetheless, the study adds a novel contribution to existent MBIs, which is significant in view of the need for diverse approaches to meet the heterogeneity of individual predispositions and clinical requirements. It remains to established by forthcoming research for which groups of individuals or clinical features this approach could be especially beneficial or less suitable.
Expert consensus-based clinical recommendation for an integrative anthroposophic treatment of acute bronchitis in children: A Delphi survey.
(2021-08) Wopker, Pilar Marie; Schwermer, Melanie; Sommer, Simon; Längler, Alfred; Fetz, Katharina; Ostermann, Thomas; Zuzak, Tycho Jan
Acute bronchitis is one of the most common pediatric diseases. In addition to conventional therapies, a frequent use of complementary and alternative medicine (CAM) has been stated. Anthroposophic medicine (AM) is one of the most practiced complementary and integrative medicine (CIM) approaches in Central Europe but hitherto no consensus-based clinical recommendations or guidelines are available. Therefore, a consensus-based recommendation leading to an informed and reasonable use of AM in the treatment of acute bronchitis in pediatrics was developed. A total of 61 physicians in Germany with expertise in the field of anthroposophic pediatrics was invited to complete an online multistep Delphi process. Two independent reviewers quantitatively and qualitatively evaluated the results. The survey was completed when >75 % consensus was achieved. The clinical recommendation comprises 15 subitems related to treatment as well as clinical and psychosocial aspects. All items reached strong consensus (>90 %; N = 9) or consensus (75-90 %; N = 6). The comprehensive clinical recommendation creates a scientific base for the anthroposophic integrative treatment of acute bronchitis in children in Germany. It will make the anthroposophic approach more applicable, understandable and comparable to a wider public of physicians and other health professionals in Germany.
Is There a Scientific Basis to Homeopathy?
(Spikenard Farm Honeybee Sanctuary, 2024) Martin, David
Essay for month of November 2025. We gratefully acknowledge that open access has been granted by both the publisher and the author.
Nutrition in Cancer from an Integrative Medical Point of View
(Camphill Village Kimberton Hills, 2023) Martin, David
Essay for month of December 2024. We gratefully acknowledge that open access has been granted by both the publisher and the author.
Consensus-based guideline for the supportive anthroposophic therapies to treat children with pseudocroup (stenosing laryngotracheitis).
(2024-09) Schwermer, Melanie; Läengler, Alfred; Zuzak, Tycho Jan
Purpose: Supportive anthroposophic therapies are used to treat children with pseudocroup by pediatricians in outpatient and inpatient settings. Anthroposophic treatment comprises forms of creative therapies, external applications as well as remedies, which production is based on the knowledge of the human being, nature and substances. A scientifically based guideline for these therapies is lacking. Due to insufficient study situation, we developed a consensus-based guideline to make therapy decisions more transparent and facilitate clinical routine. Methods: An online Delphi process with 67 anthroposophic pediatricians was conducted. Recommendations were accepted when reaching more than 75 % of expert agreement; otherwise, recommendations were revised and assessed by the experts once again. Results: Recommendations for general interventions and for anthroposophic remedies (Bryonia/Spongia comp.; Larynx/Apis comp.) as well as for external applications (embrocation with lavender oil) were developed. Recommendations have a consensus of 96.4 % or more. Conclusion: The consensus-based guideline provides practical recommendations for the supportive anthroposophic therapies for pseudocroup. The implementation and practicability of this guideline has to be investigated. Keywords: Anthroposophic medicine; Bryonia/Spongia comp.; Croup; Delphi process; Larynx/Apis comp; Pseudocroup.
Expert consensus-based clinical recommendation for an integrative anthroposophic treatment approach to acute tonsillitis in childhood.
(2024-05) Büttner, Rebecca; Schwermer, Melanie; Ostermann, Thomas; Läengler, Alfred; Zuzak, Tycho Jan
Background: Medical guidelines are an important basis for qualitative and cost-effective patient care. However, there is a lack of clinical recommendations in anthroposophic medicine (AM), an integrative medicine approach frequently practised in Europe. Acute tonsillitis, which includes tonsillopharyngitis, is a common childhood disease. that is mostly caused by a viral infection. Symptomatic treatment is therefore of high importance, and AM can offer several therapy options. Methods: 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprises five survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel. Results: Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%). Conclusion: The clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well. Keywords: Acute tonsillitis; Anthroposophic medicine; Child; Complementary and alternative medicine; Consensus-based clinical recommendation; Delphi survey; Integrative medicine.
Immune Checkpoint Blockade Combined with AbnobaViscum Therapy Is Linked to Improved Survival in Advanced or Metastatic Non-Small-Cell Lung Cancer Patients: A Registry Study in Accordance with the ESMO Guidance for Reporting Real-World Evidence.
(2024-12-18) Schad, Friedemann; Thronicke, Anja; Hofheinz, Ralf; Klein, Reinhild; Grabowski, Patricia; Oei, Shiao Li; Wüstefeld, Hannah; Grah, Christian
Background: Recent advancements in cancer treatment have shown the potential of immune checkpoint blockade (ICB) plus Viscum album L. therapy in improving survival rates for patients with advanced or metastatic non-small-cell lung cancer (NSCLC). The objective of this study was to investigate factors associated with improved survival in NSCLC patients treated with a combination of ICB and abnobaViscum®. Methods: Patients with advanced or metastatic NSCLC from the accredited Network Oncology registry were included in this real-world data study adhering to ESMO-GROW criteria with ethics approval. Survival outcomes were compared between patients receiving ICB therapy alone versus those receiving combinational ICB plus abnobaViscum® therapy using Kaplan-Meier and multivariable Cox proportional hazard analysis. Results: Among 300 patients (median age 68 years; male/female ratio 1.19), 222 received ICB alone (CTRL group) and 78 received combinational therapy (COMB group). Overall survival was significantly prolonged in the COMB group by 7 months compared to CTRL (13.8 months vs. 6.8 months, p = 0.005) with a survival rate of 16.5% in the COMB group vs. 8.0% in the CTRL group. In programmed death-ligand 1 positive (≥1%) patients treated with first-line ICB, the addition of abnobaViscum® reduced the adjusted hazard of death by 75% (aHR: 0.25; 95%CI: 0.11-0.60, p = 0.02). Conclusions: The addition of abnobaViscum® to ICB is significantly associated with improved survival in patients with advanced or metastatic NSCLC patients, irrespective of age, stage, Eastern cooperative oncology group status, surgery, or radiation. Potential mechanisms include immune modulation, reduced primary ICB resistance, and tumor microenvironment modifications. The findings warrant further validation in randomized controlled trials or registry-based randomized controlled trials. Trial registration: The study was registered (DRKS00013335). Keywords: PD-1 inhibitor; PD-L1 inhibitor; abnobaViscum® therapy; lung cancer; non-small-cell lung cancer; survival.
Statement to an Insufficient Systematic Review on L. Therapy.
(2020) Matthes, Harald; Thronicke, Anja; Hofheinz, Ralf; Baars, Erik W.; Martin, David; Huber, Roman; Breitkreuz, Thomas; Bar-Sela, Gil; Galun, Daniel; Schad, Friedemann
Background: Up to 88% of oncological patients apply complementary therapies and up to 77% apply complementary mistletoe therapy in the context of integrative oncological approaches. An evidence-based consultation of oncological health professionals regarding complementary therapies used in Germany is missing. Therefore, a new S3-Guideline for Complementary Medicine in the Treatment of Oncological Patients is under development and is anticipated to be finalized in November 2020. It will be based on evidence-based publications and systematic reviews on complementary therapies in oncology. A recently published two-part systematic review on mistletoe treatment in oncology has been reevaluated. Methods: The latest published systematic two-part review on mistletoe has been systematically proofread and checked in compliance with the Cochrane Handbook for Systematic Reviews of Intervention and the AMSTAR 2 (A MeaSurement Tool to Assess Systematic Reviews) tool. Results: The here discussed two-part review is incomplete, lacks sound accuracy including insufficient assessment of the risk of bias, and contains imprecise statements. In addition, it does not sufficiently comply with the Cochrane Handbook for Systematic Reviews of Intervention and the AMSTAR 2 tool. Conclusion: In view of the approaching release of a new guideline in the field of complementary therapies in oncology, the present statement draws attention to a lack of profound methodology of conductance of a recently released systematic review on mistletoe. In consequence, a comprehensive overview of published mistletoe studies, i.e., a meta-analysis with a sound methodology of conductance, is necessary.
Rhythmical massage therapy in chronic disease: a 4-year prospective cohort study.
(2007) Hamre, Harald J; Witt, Claudia M.; Glockmann, Anja; Ziegler, Renatus; Willich, Stefan N.; Kiene, Helmut
Objective: Rhythmical massage therapy is used in 24 countries but has not yet been studied in outpatient settings. The objective was to study clinical outcomes in patients receiving rhythmical massage therapy for chronic diseases. Design: Prospective 4-year cohort study. Setting: Thirty-six (36) medical practices in Germany. Participants: Eighty-five (85) outpatients referred to rhythmical massage therapy. Outcome measures: Disease and Symptom Scores (physicians' and patients' assessment, respectively, 0-10) and SF-36. Disease Score was measured after 6 and 12 months, and other outcomes after 3, 6, 12, 18, 24, and 48 months. Results: Most common indications were musculoskeletal diseases (45% of patients; primarily back and neck pain) and mental disorders (18%, primarily depression and fatigue). Median disease duration at baseline was 2.0 years (interquartile range 0.5-6.0). Median number of rhythmical massage therapy sessions was 12 (interquartile range 9-12), and median therapy duration was 84 (49-119) days. All outcomes improved significantly between baseline and all subsequent follow-ups. From baseline to 12 months, Disease Score improved from (mean +/- standard deviation) 6.30 +/- 2.01 to 2.77 +/- 1.97 (p < 0.001), Symptom Score improved from 5.76 +/- 1.81 to 3.13 +/- 2.20 (p < 0.001), SF-36 Physical Component score improved from 39.55 +/- 9.91 to 45.17 +/- 9.88 (p < 0.001), and SF-36 Mental Component score improved from 39.27 +/- 13.61 to 43.78 +/- 12.32 (p = 0.028). All these improvements were maintained until the last follow-up. Adverse reactions to rhythmical massage therapy occurred in 4 (5%) patients; 2 patients stopped therapy because of adverse reactions. Conclusions: Patients receiving rhythmical massage therapy had long-term reduction of chronic disease symptoms and improvement of quality of life.
Anthroposophic therapy for migraine: a two-year prospective cohort study in routine outpatient settings.
(2010) Hamre, Harald; Witt, Claudia M.; Kienle, Gunver; Glockmann, Anja; Ziegler, Renatus; Rivoir, Andreas; Willich, Stefan N.; Kiene, Helmut
Background and Methods: Anthroposophic treatment for migraine is provided by physicians and includes special artistic and physical therapies and special medications. We conducted a prospective cohort study of 45 consecutive adult outpatients (89% women) starting anthroposophic treatment for migraine under routine conditions. Main outcomes were Average Migraine Severity (physician and patient ratings 0-10, primary outcome), Symptom Score (patient rating, 0-10), and quality of life (SF-36); main follow-up time point was after six months. Results: The anthroposophic treatment modalities used were medications (67% of patients), eurythmy therapy (38%), art therapy (18%), and rhythmical massage therapy (13%). Median therapy duration was 105 days. In months 0-6, conventional prophylactic antimigraine medications were used by 14% (n=5/36) of evaluable patients. From baseline to six-month follow-up, physician-rated Average Migraine Severity improved by 3.14 points (95% confidence interval 2.40-3.87, p<0.001); patient-rated Average Migraine Severity improved by 2.82 points (2.05-3.64, p<0.001); and Symptom Score improved by 2.32 points (1.68-2.95, p<0.001). In addition, three SF-36 scales (Social Functioning, Bodily Pain, Vitality), the SF-36 Physical Component summary measure, and the SF-36 Health Change item improved significantly. All improvements were maintained at last follow-up after 24 months. Patients not using conventional prophylactic antimigraine medications had improvements similar to the whole cohort. Conclusions: Patients with migraine under anthroposophic treatment had long-term improvement of symptoms and quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that anthroposophic therapies may be useful in the long-term care of patients with migraine. Keywords: Anthroposophy, combined modality therapy, drug therapy, eurythmy therapy, migraine, prospective studies.
Pulpa dentis D30 for acute reversible pulpitis: A prospective cohort study in routine dental practice.
(2011) Hamre, Harald; Mittag, Inge; Glockmann, Anja; Kiene, Helmut; Tröger, Wilfried
Background: Pulpa dentis D30 (PD: dental pulp of the calf, prepared in a homeopathic D30 potency) has been used in acute reversible pulpitis for pain relief and to avoid or postpone invasive dental treatment. Primary study objective: To study short-term clinical outcomes of PD therapy for acute reversible pulpitis in routine dental practice. Methods/design: Prospective, observational, open-label, single-arm cohort study. Setting: Eleven dental primary care practices in Germany. Participants and intervention: Thirty-two patients starting monotherapy with PD for acute reversible pulpitis without visible or radiological abnormalities. PD was applied as 1-mL submucous injections into the mucobuccal fold, repeated daily as needed. Primary outcome measures: Avoidance of invasive dental treatment (pulp capping, root canal therapy, tooth extraction) and remission of pain, measured on a 0-10 point scale (partial remission: reduction by > or =3 points; complete remission: reduction from > or =4 points to 0-1 points) during the 10-day follow-up period. Results: Median pain duration was 14.0 days. The patients received a median of two PD applications (range 1-7). A total of 81% (n=26/32) of patients did not require invasive dental treatment, and 19% (n= 6) had root canal therapy. Remission status was evaluable in 24 patients. Of these, 63% (n = 15/24) achieved pain remission, 58% (n = 14) remitted without invasive dental treatment (complete remission: n=12, partial remission: n=2), and 29% (n= 7) had a close temporal relationship between PD and remission (ratio "time to remission after first PD application vs pain duration prior to first PD application" <1:10). Conclusion: In this study of PD for acute reversible pulpitis, 58% of evaluable patients achieved pain remission without invasive dental treatment. The open-label pre-post design does not allow for conclusions about comparative effectiveness. However, more than one-fourth of evaluable patients remitted with a close temporal relationship between the first PD application and pain remission, suggesting a causal relationship between therapy and remission.
Eurythmy Therapy in anxiety.
(2011) Kienle, Gunver; Hampton Schwab, Jane; Murphy, John Bernard; Andersson, Peter; Lunde, Gunvor; Kiene, Helmut; Hamre, Harald
Anxiety is a highly frequent condition; many patients seek complementary treatment. One of these is anthroposophic medicine (AM) using therapeutic approaches that are based on a distinct concept of the human organism, illness, and healing. AM is applied in anxiety; however, little is known about underlying therapeutic concepts, the effectiveness, and the modalities of clinical reasoning and judgment. Presented is a 21-year-old woman who had suffered from severe and increasing anxiety for 6 months, which had led to social isolation and complete sick leave from work. She had attended an AM health care center and counseling at a psychiatric hospital but had not improved significantly after 6 months. Eurythmy therapy (EYT) was then applied for 8 weeks. Within the AM pathophysiological context, the patient was diagnosed as having stress-induced anxiety based on a juvenile disturbance of the rhythmical system. Associated symptoms were specific anomalies in the patient's eurythmy movement pattern, a "breathed-in-upwards syndrome." In the EYT sessions, clear interconnections between EYT-exercises and symptom-relief were observable, paralleled by a substantial relief of the patient's anxiety. EYT might have some impact on anxiety syndrome and should be investigated in more detail. Video: http://ifaemm.de/Video/EURYTHMY_all.flv
From Reductionism to Holism: Systems-oriented Approaches in Cancer Research.
(2012-11) Kienle, Gunver; Kiene, Helmut
Somatic mutation theory of cancer has directed cancer research during the last century. A deluge of information on cellular, molecular, and genetic behavior was uncovered, but so was a mind-numbing complexity that still challenges research and concepts, and expectations in the war on cancer have by and large not been fulfilled. A change of paradigm beyond reductionism has been called for, especially as research ubiquitously points at the importance of tissue, microenvironment, extracellular matrix, embryonic and morphogenetic fields, and fields of tissue maintenance and organization in the processes of carcinogenesis, cancer control, and cancer progression, as well as in the control of cellular and genetic behavior. Holistic, organismic systems concepts open new perspectives for cancer research and treatment, as well as general biological understanding.
In support of clinical case reports: a system of causality assessment.
(2013-03) Kiene, Helmut; Hamre, Harald; Kienle, Gunver
The usefulness of clinical research depends on an assessment of causality. This assessment determines what constitutes clinical evidence. Case reports are an example of evidence that is frequently overlooked because it is believed they cannot address causal links between treatment and outcomes. This may be a mistake. Clarity on the topic of causality and its assessment will be of benefit for researchers and clinicians. This article outlines an overall system of causality and causality assessment. The system proposed involves two dimensions: horizontal and vertical; each of these dimensions consists of three different types of causality and three corresponding types of causality assessment. Included in this system are diverse forms of case causality illustrated with examples from everyday life and clinical medicine. Assessing case causality can complement conventional clinical research in an era of personalized medicine.
The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development.
(2013-09) Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David S.
A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design.
Methodological Aspects of Integrative and Person-Oriented Health Care Evaluation.
(2017) Kienle, Gunver; Hamre, Harald; Kiene, Helmut
A 4-year non-randomized comparative phase-IV study of early rheumatoid arthritis: integrative anthroposophic medicine for patients with preference against DMARDs versus conventional therapy including DMARDs for patients without preference.
(2018) Hamre, Harald J; Pham, Van N; Kern, Christian; Rau, Rolf; Klasen, Jörn; Schendel, Ute; Gerlach, Lars; Drabik, Attyla; Simon, Ludger
While disease-modifying antirheumatic drugs (DMARDs) are a mainstay of therapy for rheumatoid arthritis (RA), some patients with early RA refuse DMARDs. In anthroposophic medicine (AM), a treatment strategy for early RA without DMARDs has been developed. Preliminary data suggest that RA symptoms and inflammatory markers can be reduced under AM, without DMARDs. Two hundred and fifty-one self-selected patients aged 16-70 years, starting treatment for RA of <3 years duration, without prior DMARD therapy, participated in a prospective, non-randomized, comparative Phase IV study. C-patients were treated in clinics offering conventional therapy including DMARDs, while A-patients had chosen treatment in anthroposophic clinics, without DMARDs. Both groups received corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). Primary outcomes were intensity of RA symptoms measured by self-rating on visual analog scales, C-reactive protein, radiological progression, study withdrawals, serious adverse events (SAE), and adverse drug reactions in months 0-48. The groups were similar in most baseline characteristics, while A-patients had longer disease duration (mean 15.1 vs 10.8 months, <0.0001), slightly more bone destruction, and a much higher proportion of women (94.6% vs 69.7%, <0.0001). In months 0-12, corticosteroids were used by 45.7% and 81.6% (<0.0001) and NSAIDs by 52.8% and 68.5% (=0.0191) of A- and C-patients, respectively. During follow-up, both groups not only had marked reduction of RA symptoms and C-reactive protein, but also some radiological disease progression. Also, 6.2% of A-patients needed DMARDs. Apart from adverse drug reactions (50.4% and 69.7% of A- and C-patients, respectively, =0.0020), none of the primary outcomes showed any significant between-group difference. Study results suggest that for most patients preferring anthroposophic treatment, satisfactory results can be achieved without use of DMARDs and with less use of corticosteroids and NSAIDs than in conventional care. Because of the non-randomized study design, with A-patients choosing anthroposophic treatment, one cannot infer how this treatment would have worked for C-patients.

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