The Effect of Mindfulness Practice on Salivary Cortisol Levels in A Patient Population Undergoing Rotator Cuff Repair

Sanya Kathuria, “The Effect of Mindfulness Practice on Salivary Cortisol Levels in A Patient Population Undergoing Rotator Cuff Repair”
Mentors: Elizabeth Liedhegner and Bhagwant Singh Sindhu, Biomedical Sciences
Oral Presentation Block 2

Shoulder pain is a prevalent problem amongst adults and is manifested by injuries to the tendons. Despite physical therapy and other non-invasive interventions, 20% of those afflicted with rotator cuff complaints will require surgical repair to restore functionality and reduce pain. Unfortunately, only slight improvement 1 year post surgery has been reported in patients who suffer through psychological distress and pain. Physiologically, stress is regulated by the hypothalamic-pituitary-adrenal (HPA) axis via production of cortisol. Distress occurs when stress levels impair health and hampers day to day activities. Factors that cause psychological distress can be hospitalization, surgical outcomes, recovery period, financial burden, social support, and absence from work. Since stress is negatively correlated with rotator cuff disorder outcomes, methods to reduce patient stress could improve shoulder surgery recovery. One such method is mindfulness practice where a person uses meditation techniques to attune one’s focus to the present moment. Indeed, a meta-analysis of mindfulness-based stress reduction (MBSR) studies showed a small, positive effect on patients experiencing depression, anxiety, and psychological distress. Thus, our central hypothesis is that mindfulness-based interventions will help reduce overall stress and improve surgical outcomes in patients undergoing rotator cuff surgery. We plan to test this hypothesis by prescribing mindfulness through the app, Headspace to half of our patient population chosen at a random basis. We will assess surgical outcomes via pain analysis and stress levels via self-report and salivary cortisol analysis at 4 time points throughout the surgical intervention and recovery. We predict that mindfulness will decrease overall stress leading to a reduction in cortisol levels which can be correlated with reduction in self-reported stress. We predict reduction in overall stress will improve patient-reported pain and ultimately be positively correlated with surgical outcomes.