Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis

Abstract

Background: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief.Objective: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries.Materials and Methods: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke.Results: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17).Conclusion: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

The Effect of Group Mindfulness-based Stress Reduction and Consciousness Yoga Program on Quality of Life and Fatigue Severity in Patients with MS

“…Lack of significant difference in social functioning subscale between experimental and control group can be affected by different factors such as family relationships, culture, attitude and economic condition in individuals. Like our study, Henderson et al, 32 Carletto et al, 33 and Ulrichsen et al, 34 showed that the treatment of MBSR highly affected on the quality of life, well-being, and hope in Traumatic Brain Injury and MS samples and significantly in reducing subscales of depression, anxiety, and hostility.…”

A Pilot Mobile-Based Mindfulness Intervention for Cancer Patients and Their Informal Caregivers

“…We successfully recruited men, non-whites, and patients with different types of cancer; 32% of patients were male, 20% were non-white, and over 60% of patients had cancers other than breast. Previous mindfulness studies for cancer patients overwhelmingly consisted of white, early stage breast cancer patients who had completed all of their initial treatment (Piet et al, 2012; Ulrichsen et al, 2016). Few mindfulness studies have focused on patients who are actively undergoing chemotherapy or patients with more advanced stages (Chambers et al, 2017; Lengacher et al, 2012).…”

Mind and body practices for fatigue reduction in patients with cancer and hematopoietic stem cell transplant recipients: A systematic review and meta-analysis

“…These results are consistent with a systematic review that concluded that mindfulness was effective in women with breast cancer at improving fatigue, quality of life and sleep. [25] Other systematic reviews have suggested that mindfulness may reduce fatigue in traumatic brain injury, [26] stroke [27] and multiple sclerosis. [27] We also found that relaxation techniques were effective at improving fatigue symptoms, consistent with a review that evaluated exercise and nonpharmaceutical interventions for CRF and used indirect comparisons to conclude that relaxation was the highest ranked intervention for fatigue reduction.…”

“…[25] Other systematic reviews have suggested that mindfulness may reduce fatigue in traumatic brain injury, [26] stroke [27] and multiple sclerosis. [27] We also found that relaxation techniques were effective at improving fatigue symptoms, consistent with a review that evaluated exercise and nonpharmaceutical interventions for CRF and used indirect comparisons to conclude that relaxation was the highest ranked intervention for fatigue reduction. [28] Other systematic reviews have also suggested that relaxation techniques may reduce fatigue in osteoarthritis, [29] heart failure [30] and kidney disease.…”