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| The effect of a mindfulness and motivational interviewing-oriented physical-psychological integrative intervention for community-dwelling spinal cord injury survivors: a mixed-methods randomized controlled trial [with consumer summary] |
| Li Y, Li M, Bressington D, Li K, Wong A, Chung WM, Molasiotis A, Ma CZ-H, Kor PPK, Yeung WF |
| Archives of Physical Medicine and Rehabilitation 2024 Sep;105(9):1632-1641 |
| clinical trial |
| 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To evaluate the feasibility, acceptability, and efficacy of a mindfulness and motivational interviewing-oriented physical-psychological integrated intervention in community-dwelling spinal cord injury (SCI) survivors. DESIGN: A mixed-methods randomized controlled trial. SETTING: Local organizations of handicapped in Hong Kong. PARTICIPANTS: Community-dwelling adults with SCI (N = 72). INTERVENTIONS: Participants in the intervention group (n = 36) received video-guided exercise for daily practice and online group psychological (mindfulness and motivational interviewing-oriented) weekly sessions for eight weeks. Participants in the control group (n = 36) received an eight-week online group didactic education on lifestyle discussions and general health suggestions. MAIN OUTCOMES MEASURES: Primary outcomes included quality of life, physical activity, depression, and chronic pain. Secondary outcomes included exercise self-efficacy and mindfulness. Outcomes were measured at baseline, post-intervention, and three-month follow-up. Focus-group interviews were conducted post-intervention. RESULTS: The recruitment, retention, and adherence rates were 84.7%, 100%, and 98.6%, respectively. The intervention showed significant positive effects on preventing declines in quality of life at three-month follow-up (Cohen's d 0.70 (0.22 to 1.18)). Positive trends manifested in physical activity, depression, chronic pain, and exercise self-efficacy. Three qualitative categories were identified: subjective improvements in exercise, physical, and social well-being; perceived changes in mindfulness and mental well-being; and intervention facilitators and barriers. CONCLUSIONS: The mindfulness and motivational interviewing-oriented physical-psychological integrated intervention is feasible and acceptable. The significant prolonged effect in maintaining quality of life and positive impacts on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors.
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