Effects of guided aerobic exercise and mindfulness after acquired brain injury: a pilot study

"Hidden gains"? Measuring the impact of mindfulness-based interventions for people with mild traumatic brain injury: a scoping review

BACKGROUND

Mindfulness-based interventions can support recovery from mild traumatic brain injury (mTBI). Although measurement is a key determinant of outcomes, there is no comprehensive assessment of measurement approaches used to capture outcomes of these programs. Here, we review the domains targeted, measurement techniques used, and domains and techniques most affected by mindfulness-based interventions for mTBI.

METHODS

We conducted a scoping review. After screening and full-text review, we included 29 articles and extracted data related to measurement domains, techniques, and results.

RESULTS

We identified 8 outcome domains, each with multiple subdomains. The most common domains were cognitive symptoms and general health/quality of life. No quantitative studies directly assessed sleep, physical-function, or pain-catastrophizing. Self-report was the most common measurement technique, followed by performance-based methods. Coping, somatic symptoms, emotional symptoms, stress response, and domains of cognition (particularly attention) were the most frequently improved domains. Qualitative results described benefits across all domains and suggested novel areas of benefit. Biomarkers did not reflect significant change.

CONCLUSIONS

Mindfulness-based interventions for mTBI impact a range of clinical domains and are best captured with a combination of measurement approaches. Using qualitative methods and expanding the breadth of outcomes may help capture underexplored effects of mindfulness-based interventions for mTBI.

Therapeutic Effects of Meditation, Yoga, and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis

BACKGROUND

Chronic symptoms of mild traumatic brain injury (mTBI) vary greatly and are difficult to treat; we investigate the impact of meditation, yoga, and mindfulness-based interventions on this treatment group.

METHOD

Search included four databases, allowing studies of any design containing pre/post outcomes for meditation, yoga, or mindfulness-based interventions in people suffering from brain injury acquired by mechanical force. Analyses used robust variance estimation to assess overall effects and random-effects models for selected outcomes; we evaluated both between- and within-group changes.

RESULTS

Twenty studies (N = 539) were included. Results revealed significant improvement of overall symptoms compared to controls (d = 0.41; 95% CI [0.04, 0.77]; τ²  = 0.06), with significant within-group improvements in mental health (d = 0.39), physical health (d = 0.39), cognitive performance (d = 0.24), quality of life (d = 0.39), and self-related processing (d = 0.38). Symptoms showing greatest improvement were fatigue (d = 0.96) and depression (d = 0.40). Findings were homogeneous across studies. Study quality concerns include lack of randomisation, blinding, and recording of adverse events.

CONCLUSIONS

This first-ever meta-analysis on meditation, yoga, and mindfulness-based interventions for chronic symptoms of mTBI offers hope but highlights the need for rigorous new trials to advance clinical applications and to explore mechanistic pathways.