Abstract
Objectives
This systematic review aims to gain a comprehensive understanding of the feasibility,
acceptability, and efficacy of mindfulness-based interventions (MBIs) on depression,
anxiety, fatigue, and health-related quality of life among individuals with upper
motor neuron disorders (UMND).
Data Sources
PubMed, PsycINFO, EMBASE, and CINAHL were searched for relevant studies published
between Jan 2001 and June 2021.
Study selection
Clinical trials published in English evaluating MBIs in adults with the four most
common UMND (multiple sclerosis, brain injury including stroke, spinal cord injury,
and amyotrophic lateral sclerosis) were included.
Data Extraction
Two reviewers independently performed the risk of bias assessment using standardized
tools and extracted desired data electronically.
Data Synthesis
A total of 44 studies were included: 26 randomized control trials, 10 non-randomized
control trials, and 8 pre-post intervention studies. The average (SD) duration of
MBIs was 8 (2) weeks. On average (SD), 85% (14%) of participants completed the MBI,
and the retention rate at follow-up was 80% (16%). Only 14% of the studies delivered
MBIs virtually, and feasibility metrics were similar to in-person studies. Among studies
reporting acceptability data, most participants reported satisfaction with the MBI.
Randomized control trials which evaluated the effects of MBI on depression, anxiety,
fatigue, and quality of life revealed greater relative improvement in these outcomes
among MBI participants compared to controls, with differences greater when compared
to passive control than active control participants. None of the studies included
in this review studied dose-response.
Conclusion
Based on current data, MBIs are feasible and offer a promising approach to address
the biopsychosocial needs of individuals with UMNDs. MBIs are associated with a high
acceptance rate among participants with notable improvements in depression, anxiety,
fatigue, and quality of life post-intervention. Future studies are needed to evaluate
alternate models of delivery of MBIs and the dose-response relationship.
Keywords
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Article Info
Publication History
Accepted:
May 12,
2022
Received in revised form:
May 3,
2022
Received:
September 27,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
Acknowledgment: None
Conflicts of interests: None
Abbreviations: ACT: Acceptance and commitment therapy, ALS: Amyotrophic lateral sclerosis, BI: Brain injury, CBT: Cognitive-based therapy, CINAHL: Cumulative Index to Nursing and Allied Health Literature, EMBASE: Excerpta Medica Database, IQR: Interquartile range, MBI: Mindfulness-based intervention, MS: Multiple sclerosis, NI: No information, PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses, QOL: Quality of life, RCT: Randomized control trial, SCI: Spinal cord injury, UMN: Upper motor neuron, UMND: Upper motor neuron disorder
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
