Mindfulness training during brief periods of hospitalization in multiple sclerosis (MS): beneficial alterations in fatigue and the mediating role of depression

Abstract

Objectives Persons with MS (PwMS) are frequently affected by fatigue and depression. Mindfulness-based interventions may reduce these symptoms in PwMS and consequently their application has been extended to various settings. Only few efforts have been made to explore effects of short-term mindfulness training during brief periods of hospitalization. In the current study, the feasibility and potential effects of short-term mindfulness training on depression, fatigue, rumination and cognition were explored in PwMS in an acute-care hospital setting. Based on previous work, it was further examined whether the relation between trait mindfulness and fatigue prior to and following the intervention was mediated by depression and whether a mediation effect was also observable throughout the intervention. Methods A short-term mindfulness training protocol was developed, tailored to the requirements of the acute-care setting. Subsequently, 30 PwMS were recruited sequentially and received mindfulness training during the routine clinical process (median duration in hospital: eight days, number of sessions: four). Participants completed relevant self-report measures (depression, fatigue, rumination) and a neuropsychological assessment before and after training. Results Participants reported significantly increased trait mindfulness and decreased depression and fatigue following the intervention. Respective change scores were highly correlated so that increased trait mindfulness was associated with decreased symptoms. In the rumination domain, patients reported a tendency for an increased adaptive ability to engage in distractive behavior during arising negative mood. Other measures of trait rumination and cognition remained relatively stable. Results of the mediation analyses indicated that depression mediated the negative relationship between trait mindfulness and fatigue symptoms at pre and post assessments. With regards to the change scores, an association between mindfulness and cognitive fatigue ceased to be significant when depression was controlled, albeit in this case, the mediation effect did not reach significance. Conclusion Results of the current study indicate that short-term mindfulness training during brief periods of hospitalization may be beneficial for PwMS. They further complement previous work by identifying depression as a potential mediator of the antagonistic relationship between mindfulness and fatigue. Based on the current exploratory study, future trials are warranted to address this mechanism of mindfulness training in more detail.

Effectiveness of acupuncture for fatigue in patients with relapsing-remitting multiple sclerosis: a randomized controlled trial

“…31 Other therapeutic interventions include physical exercise, cognitive behavioral therapy, mindfulness training and energy conservation education. [32][33][34] Complementary and alternative medicine has been used by 58% of people with MS around the world, and acupuncture has been shown to have therapeutic effects on MS-associated fatigue. 14 In the current trial, we investigated the effectiveness of acupuncture plus amantadine on fatigue and quality of life of individuals with RRMS.…”

The role of worry in exercise and physical activity behavior of people with multiple sclerosis

“…These results do relate to the work of exposure therapy research in that worry, in this context, could be tied to exposure to fatigue or physical activity in this sample. Mindfulness training has also demonstrated benefit in people with MS, particularly by encouraging self-acceptance of the presence of emotions like worry (Burschka et al, 2014 ; Sauder et al, 2021 ). Combinations of exercise interventions and mindfulness interventions that encourage acceptance of worry could be tailored to help overcome worry and long-term physical activity or exercise behavior.…”

Stability of sensor-based gait parameters reassessed after a period of one year in people with multiple sclerosis

“…Therefore, these sensor-based gait parameters can be identified as clinically relevant markers to evaluate treatment effects over a longer period of time (e.g. the effect of mindfulness training [24] or a six-month Tai Chi training on balance and coordination in PwMS; [2]). Looking at the MS subgroups, the ICCs were slightly higher in MS subgroup 2 (EDSS 2.0-5.0) than those in MS subgroup 1 (EDSS 0.0-1.5) and healthy controls.…”