The questionnaire on autonomic regulation: A useful concept for integrative medicine?

doi:10.1016/S2095-4964(16)60264-9

Abstract

The concept of autonomic regulation (aR) reflects the relevance of the function of different autonomic systems for health. aR can be captured by questionnaires. We differentiate between a trait or constitutional aR questionnaire version including 12 (short-version) or 18 items, respectively, with three subscales (orthostatic-circulatory, rest/activity and digestive regulation), and an 18-item state aR questionnaire on the preceding week with four subscales (rest/activity, orthostatic-circulatory, thermo- and digestive regulation). The validated questionnaires show satisfying to good reliability and robust validity with clear construct validity. In this article, we summarized the actually available literature on aR and the use of aR questionnaires in clinical and observational studies. We described the relationship of high aR with health and in case of low aR or loss of regulation with disease and functional disorder in the three (four) different subscales and functional systems, such as rest/activity, orthostatic-circulatory or digestive regulation (thermoregulation) with the consecutive therapeutic need. Finally, we gave perspectives of its further application in clinical research.

Key words: Anthroposophic medicine, Autonomic regulation, Delivery of health care, Integrative medicine, Questionnaire

Matthias Kröz, Marcus Reif, Danilo Pranga, Roland Zerm, Friedemann Schad, Erik Wim Baars, Matthias Girke. The questionnaire on autonomic regulation: A useful concept for integrative medicine?. Journal of Integrative Medicine, 2016, 14(5): 315-321.

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References

1 Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F. The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.J Natl Cancer Inst. 1993; 85(5): 365-376.
2 Ware J, Snow K, Kosinski M, Gandek B, Boston M.SF-36 health survey manual & interpretation guide. Boston: The Health Institute, New England Medical Center. 1993.
3 Girke M, Hoppe JD, Matthiessen PF, Willich SN. Welches Menschenverständnis leitet eine komplementärmedizinische Therapie—Anthroposophische Medizin? Medizin und Menschenbild. Köln: Deutscher Ärzte-Verlag.2006: 75-92. German.
4 NCCIH. What is complementary and alternative medicine? (2012-05) [2016-04-26]. https://nccih.nih.gov/sites/nccam. nih.gov/files/D347_05-25-2012.pdf.
5 Consortium of Academic Health Centers for Integrative Medicine. Definition of integrative medicine. (2005) [2016-04-26]. 2005) [2016-04-26]. http://www.imconsortium.org/about/about-us.cfm.
6 Girke M. The physician-patient relationship. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz.2007; 50(9): 1128- 1132. German.
7 Antonovsky A.Unraveling the mystery of health: how people manage stress and stay well. San Francisco: Jossey- Bass. 1987.
8 Hildebrandt G. Hygiogenese. Therapiewoche.1977; 27(30): 5384-5397. German.
9 Gutenbrunner C, Göbel T, Heckmann C, Kühl J, Schad W, Strüh H. Hygiogenese und Salutogenese—Versuch einer (notwendigen) Begriffsdifferenzierung. Tycho de Brahe Jahrbuch für Goetheanismus. Niefern-Öschelbronn: Tycho Brahe Verlag GdbR.2003: 38-54. German.
10 Smith KW, Avis NE, Assmann SF.Distinguishing between quality of life and health status in quality of life research: a meta-analysis.Qual Life Res. 1999; 8(5): 447-459.
11 Kröz M, Broder von Laue HB, Zerm R, Brauer D, Reif M, Girke M, Matthes H, Heckmann C. Reduction of endogenous regulation in internal medicine patients. Forsch Komplementarmed Klass Naturheilkd.2005; 12(6): 333- 341. German.
12 Kröz M, Feder G, von Laue HB, Zerm R, Reif M, Girke M, Matthes H, Gutenbrunner C, Heckmann C. Validation of a questionnaire measuring the regulation of autonomic function.BMC Complement Altern Med. 2008; 8: 26.
13 Halberg F, Cornélissen G, Katinas G, Watanabe Y, Otsuka K, Maggioni C, Perfetto F, Tarquini R, Schwartzkopff O, Bakken EE.Feedsidewards: intermodulation (strictly) among time structures, chronomes, in and around us, and cosmo-vasculo-neuroimmunity. About ten-yearly changes: what Galileo missed and Schwabe found.Ann N Y Acad Sci. 2000; 917: 348-375.
14 Steiner R. Geisteswissenschaft und Medizin. Dornach: Rudolf Steiner Verlag.1990: 96-116. German.
15 Weckenmann M, Kitschmann M, Rauch E, Trageser K, Möllenbruck G, Wormsbecher M. Pilotstudie über die Anamnesefragen R. Steiners und ihre Beziehungen zu klinischen Bildern, Teil V. Der Merkurstab.1995; 48(5): 417-424. German.
16 Kröz M, von Laue HB, Zerm R, Girke M. Development of a questionnaire for endogenous regulation—a contribution for salutogenesis research. Forsch Komplementarmed Klass Naturheilkd.2003; 10(2): 70-77. German.
17 Kröz M, Zerm R, Schad F, Reif M, von Laue HB, Storch T, Brinkhaus B, Willich SN, Girke M. State Version zur autonomen Regulation, ein neuer Ansatz zur Unterscheidung zwischen vegetativer Konstitution und Regulationsverlust in Bezug auf Chemo-und Misteltherapie- Sensitivität. In: Scheer R, Alban S, Becker H, Stange R, Matthes H. Die Mistel in der Tumortherapie-3, Aktueller Stand der Forschung und klinische Anwendung. Essen: KVC-Verlag. 2013: 427-437. German.
18 Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation.Value Health. 2005; 8(2): 94-104.
19 Kröz M, Schad F, Reif M, von Laue HB, Feder G, Zerm R, Willich SN, Girke M, Brinkhaus B. Validation of the state version questionnaire on autonomic regulation (State-aR) for cancer patients.Eur J Med Res. 2011; 16(10): 457-468.
20 Baars EW, Ponstein A, Kok ET, Heybroek R, Van der Veen W, Kröz M, de Bruin A. Validation of the Dutch state version of the autonomic regulation (State-aR) questionnaire in a group of patients and a group of healthy persons.Eur J Integr Med. 2015; 7(Suppl 1): 52.
21 Feder G, Ramsay J, Gangahar D, Varsani D, Rutterford C, Kröz M. Validation of three functional scales for people with cancer. (2009) [2016-04-26]. 2009) [2016-04-26]. http://www.uksbm.org. uk/cardiff-2016/meeting/southampton-2009/.
22 Kröz M, Linke J, Gutenbrunner CH, Girke M, Hecht K, Bockelbrink A, Dimeo F, Matthes H.Cancer fatigue, disturbed rest/activity regulation and sleep disturbances with female patients with non-metastatic breast cancer— a pilot study.Phys Med Rehab Kuror. 2010; 20(3): 152-157.
23 Kröz M, Reif M, Bartsch C, Heckmann C, Zerm R, Schad F, Girke M.Impact of autonomic and self-regulation on cancer-related fatigue and distress in breast cancer patients—a prospective observational study.J Cancer Surviv. 2014; 8(2): 319-328.
24 Bartsch C, Bartsch H, Flüchter SH, Mecke D, Lippert TH.Diminished pineal function coincides with disturbed circadian endocrine rhythmicity in untreated primary cancer patients. Consequence of premature aging or of tumor growth?Ann N Y Acad Sci. 1994; 719: 502-525.
25 Miller AH, Ancoli-Israel S, Bower JE, Capuron L, Irwin MR.Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer.J Clin Oncol. 2008; 26(6): 971-982.
26 Kröz M, Fink M, Reif M, Grobbecker S, Zerm R, Quetz M, Frühwirth M, Brinkhaus B, Bartsch C, Girke M, Gutenbrunner C.Multimodal therapy concept and aerobic training in breast cancer patients with chronic cancer-related fatigue.Integr Cancer Ther. 2013; 12(4): 301-311.
27 Kröz M, Reif M, Zerm R, Winter K, Schad F, Gutenbrunner C, Girke M, Bartsch C.Do we have predictors of therapy responsiveness for a multimodal therapy concept and aerobic training in breast cancer survivors with chronic cancer-related fatigue?Eur J Cancer Care (Engl). 2015; 24(5): 707-717.
28 Kröz M, Reif M, Büssing A, Zerm R, Feder G, Bockelbrink A, von Laue HB, Matthes HH, Willich SN, Girke M. Does self-regulation and autonomic regulation have an influence on survival in breast and colon carcinoma patients? results of a prospective outcome study.Health Qual Life Outcomes. 2011; 9: 85.
29 Zerm R, Jecht M, Pranga D, Girke M, Kröz M.Autonomic regulation in type-2 diabetes with and without concomitant obstructive sleep apnea syndrome.Eur J Integr Med. 2015; 7(Suppl 1): 52.
30 Schrauth M. Histrionisch-dissoziative Symptome bei psychiatrischen Patienten und ihre Behandlung im Rahmen eines naturkundlich-anthroposophischen Ansatzes mit einem Extrakt aus Citrus limon und Cydonia oblonga (Gencydo). Freiburg: Albert-Ludwigs-Universität.2005. German.
31 Jabeen S.Effect of sleep/wake cycle on autonomic regulation.J Coll Physicians Surg Pak. 2015; 25(6): 434-437.
32 Zerm R, Kröz M, Cysarz D, Frühwirth M, Moser M, Jecht M, Heckmann C, Girke M.Cardiovascular risk in diabetic patients determined by a newly developed questionnaire of autonomic regulation (aR). In: Lewis BS, Halon DA, Flugelman MY. New horizons in coronary artery disease. Venedig: Medimond. 2007: 281-285.
33 Paaschen D. Gesundheit im Senium, endogene Regulation und vegetative Konstitution bei hochbetagten Frauen. Witten/Herdecke: Universität Witten/Herdecke.2005. German.
34 Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro MI, van der Meer JW, Schnabel P, Smith R, van Weel C, Smid H. How should we define health?BMJ. 2011; 343: d4163.
35 Kröz M. Die Anamnesefragen rudolf steiners, ihre bedeutung für die endogene regulation und erste ergebnisse zum diabetes mellitus. Der Merkurstab.2002; 55: 30-38. German.
36 Kröz M. Psychometrische Methoden zur Evaluation der Integrativen Medizin. Witten/Herdecke: Universität Witten/ Herdecke.2014. German.
37 Büssing A, Girke M, Heckmann C, Schad F, Ostermann T, Kröz M.Validation of the self regulation questionnaire as a measure of health in quality of life research.Eur J Med Res. 2009; 14(5): 223-227.
38 Kröz M, Büssing A, von Laue HB, Reif M, Feder G, Schad F, Girke M, Matthes H. Reliability and validity of a new scale on internal coherence (ICS) of cancer patients. HealthQual Life Outcomes. 2009; 7: 59.
39 Kröz M, Zerm R, Reif M, von Laue HB, Zander A, Schad F, Brinkhaus B, Matthes H, Girke M. Are autonomic regulation (aR) and self-regulation predictors for internal coherence (ICS) and distress in internal medicine patients?Eur J Integr Med. 2012; 4(Suppl 1): 118.
40 Linke J. Cancer Fatigue und gestörte Ruhe/Aktivitäts- Regulation bei Mammakarzinom-Patientinnen—Eine explorative Fall-Kontroll-Studie. Berlin: Charité— Universitätsmedizin Berlin.2009. German.

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