Anxiety, Depression, Fatigue, and Quality of Life Outcomes Following a Movement-Based Mindfulness or Social Group Program for Chronic Stroke: A Sub-Study of a Phase II Feasibility Randomised Controlled Trial

Objectives: Movement-based mindfulness may be beneficial for mental health and health-related quality of life (HRQoL) post-stroke. We assessed changes in anxiety, depression, fatigue, and HRQoL in survivors of stroke participating in movement-based mindfulness intervention against an attention control (social group). 

Method: Participants were between 3- and 18-months post-stroke and randomised 1:1 to the movement-based mindfulness intervention or social group (15-20 min lifestyle education then socialisation). Each program was delivered as group-based, 1-hr classes over 12 weeks. Anxiety, depression, fatigue, and HRQoL were measured at baseline and post-intervention (13–15 weeks post-baseline). Within-group changes were analysed using Cohen’s d. The magnitude of change was classified as small (d = 0.2), medium (d = 0.50), or large (d = 0.80). Between-group differences were assessed using generalised linear mixed models. 

Results: Thirty-eight participants were randomised, and 36 completed follow-up (72% male, median age 70 years). Movement-based mindfulness showed greater within-group effects than attention control for HRQoL (d = 0.22 vs d = 0.18) and aspects of HRQoL (e.g. memory (d = 0.31 vs d = 0.06), and mobility (d = 0.45 vs d = 0.37). Movement-based mindfulness showed smaller within-group effect than attention control for anxiety (d = 0.25 vs d = 0.46), depression (d = 0.11 vs d = 0.48), and aspects of HRQoL (e.g. communication (d = 0.01 vs d = 0.46), usual activities (d = 0.11 vs d = 0.40), hand function (d = 0.04 vs d = 0.43), and utility score (d = 0.02 vs d = 0.34)). No between-group differences were found. 

Conclusions: Movement-based mindfulness or social group classes provide small-to-medium favourable changes in various health domains within 3–18 months of stroke. These findings support further investigation of these programs.