Evaluation of mindfulness-based interventions for pain, anxiety, and depression in spinal cord injury patients: A systematic review and meta-analysis

Abstract

Objective

Rehabilitative measures following spinal cord injury (SCI) typically fail to mitigate the psychological symptoms that might heighten pain levels. Mindfulness-based interventions (MBI) have been proposed to address such concerns. We aim to review the literature on MBI used for pain, anxiety, and depression in SCI.

Methods

A systematic literature search for studies using MBI in patients with pain and psychological symptoms following SCI was conducted. Primary outcomes were pain, assessed by Numeric Pain Rating Scale (NPR) and Brief Pain Inventory (BPI), anxiety, and depression, assessed by the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes included stress and quality of life, as measured by the Perceived Stress Scale (PSS) and World Health Organization Quality of Life (WHO-QOL). Only comparative studies were included.

Results

Seven studies (n = 419) were included pertaining to yoga, mental imagery, biofeedback, and mindfulness meditation. Five studies (n = 260) reported NPR pain. The mean post-treatment difference comparing the control and MBI groups was −1.26 (95 %CI: [-2.44; −0.07]), with MBI showing significant pain reduction (p = 0.04). The intergroup difference was not significant but trended favoring treatment. Three studies included HADS (n = 282) and BPI (n = 203), with neither reaching significance in post-treatment comparisons, but showing improvements favoring MBI for both. Further, changes for MBI groups revealed marginal mood benefits. Secondary outcomes were not statistically analyzed.

Conclusions

A significant difference was observed regarding NPR post-treatment scores. The results of this study trend positively towards the treatment groups, showing possible benefits in utilizing MBI for patients with SCI suffering from pain and psychological concerns.