The Potential of a Mindfulness-Enhanced, Integrative Neuro-psychotherapy Program for Treating Fatigue Following Stroke: A Preliminary Study

Abstract

Fatigue is a frequently reported symptom after a stroke. Although the phenomenology of poststroke fatigue is well known, clear definitions as well as diagnostic and therapeutic guidelines are missing. Poststroke fatigue can be regarded as a multidimensional phenomenon that might be influenced by neurological, physical, psychological, and cognitive factors. It can range from mild to severe and can affect every area of the activities of daily life. The objective of our preliminary study was to outline aspects of a specific treatment program for the management of poststroke fatigue. Eight patients were recruited for a mindfulnessenhanced, integrative neuropsychotherapy program. The treatment was a combination of neuropsychological interventions, psychoeducation, cognitive-behavioral therapy, and mindfulness techniques. The main treatment foci were (a) to facilitate an increased awareness of fatigue symptoms, (b) to help the patient detect and manage triggers of fatigue, and (c) to equip the patient with multiple self-help tools. Measures were assessed at the beginning, during, and at the end of treatment using self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries. Significant pre-to post-assessment differences were observed. These findings suggest that patients may benefit from a specific treatment program in order to better adapt to poststroke fatigue. These findings encourage further investigation of this integrative treatment in larger samples that include adequate control treatments.

Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review

“…In total ten studies were identified meeting the inclusion and exclusion criteria. Out of ten studies, five were randomized control studies [21, 25, 28, 31, 33, 34], four were single case report studies [26, 27, 30, 32], and one was a qualitative study [29]. These studies were conducted in USA ( n = 5), Canada ( n = 1), Switzerland ( n = 1), Saudi Arabia ( n = 1), and Australia ( n = 2) between 2003 and 2013.…”

“…Improved performance for this participant was maintained at a 1-month followup for all but one goal, yoga [30]. Finally, Hofer et al [32] applied a treatment for stroke, which was a combination of neuropsychological interventions, psychoeducation, cognitive-behavioral therapy, and mindfulness techniques. For the patients with poststroke fatigue (PSF), the central goal was to learn better coping skills regarding their increased vulnerability to fatigue.…”

Nursing Interventions for Poststroke Fatigue

“…36 A combination of cognitive-behavioral therapy and graded activity training(COGRAT) 37 and cognitive-behavioral therapy with mindfulness techniques appear to be effective in alleviating PSF. 38 Regular exercise and increasing daily step count in the early stage of stroke, were reported to decrease fatigue at 6 and 12 months, 39 and walking and water aerobics were perceived by patients as helpful in relieving PSF. 40 Therefore, nurses should recommend physical exercise for patients with PSF that always take into consideration individualized needs pertaining to their condition, age, and resources.…”

An Integrative Neuro-Psychotherapy Treatment to Foster the Adjustment in Acquired Brain Injury Patients—A Randomized Controlled Study

“…In the Standard PLUS treatment, neuropsychological interventions were combined with evidence-based psychotherapeutic interventions [ 46 , 67 ]. The psychotherapeutic interventions were adapted from cognitive–behavioral, emotion-focused, process-experiential as well as interpersonal psychotherapies [ 68 , 69 , 70 ].…”

“…According to power considerations based on previous studies [ 67 , 71 ], we planned to include 72 patients to show a difference of three points on the BDI-II reaching the level of significance ( p < 0.05). Due to the much slower than anticipated recruitment rate over time, the recruitment had to finish before reaching this target.…”