Benefits of mindfulness-based interventions for stroke care: a systematic review

Background: Problems in physical, mental and social well-being are common in survivors of stroke. Mindfulness-based interventions have been shown to be effective in people with chronic illnesses and have the potential to address many of the unmet needs reported by survivors of stroke. Aims: To systematically evaluate published evidence, using the Cochrane methods for systematic review, on the effectiveness of mindfulness-based interventions on the physical, mental and social well-being of survivors of stroke. Methods: The Ovid Medline, PubMed, Cochrane Central Register of controlled trials, and Google Scholar databases were searched from 1990 to 2014 for studies examining the effectiveness of mindfulness-based interventions in stroke populations. Papers where the results of randomized controlled trials and pre-post design studies were reported were eligible for inclusion. The methodological quality of extracted manuscripts was assessed and results collated. Results: Seven eligible papers were identified and reviewed (5 randomized controlled trials (RCT); 2 pre-post studies); with 1/7 studies judged as low risk of bias. The overall quality of evidence, using the GRADE approach, was moderate. Interpretation of results was limited by heterogeneity between studies (e.g. dosage, frequency), and small samples. Nonetheless, the mindfulness-based interventions showed consistent indicators of effectiveness for improving mental well-being, quality of life cognitive function and a range of physiological or functional improvements. No adverse events were reported. Retention rates exceed >75% for most interventions. Conclusion: Mindfulness-based interventions may be effective for ameliorating the long-term consequences of stroke. Large well designed RCTs are needed to confirm these findings in survivors of stroke.