Mindfulness Based Intervention in Acute Rehabilitation of Spinal Cord Injury: A Pilot Study

Research Objectives To assess the feasibility, acceptability, and preliminary mood, pain and sleep outcomes of a mindfulness-based intervention administered to patients with spinal cord injuries (SCI) in acute inpatient rehabilitation. Design This is a pilot study utilizing retrospective data analysis of a Performance Improvement project, looking at the feasibility and acceptability of a mindfulness meditation program in acute rehabilitation of patients with SCI in a before-after design. Setting Acute inpatient rehabilitation facility. Participants Eight patients with acute SCI volunteered to participate in the study. Three patients withdrew due to schedule conflicts. Inclusion criteria included (1) individuals with SCI in acute rehabilitation, and (2) basic knowledge of English (as the mindfulness meditation program was in English). Interventions Intervention included 10 minutes of recorded guided mindfulness meditation twice a day for two weeks delivered on an iPad. Main Outcome Measures The main study outcomes included self-report measures of mood, pain, and sleep administered at the beginning, middle and end of the study. These included the Patient Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Positive and Negative Affect Schedule Short Form (PANAS-SF), Insomnia Severity Index (ISI), Numeric Pain Rating Scale (NPRS), and Pain Catastrophizing Scale (PCS). In addition, 10-point Likert scales assessing levels of anxiety, depression, and pain were administered before and after each session. Finally, a survey assessing feasibility and acceptability was delivered at the end of the study. Results Overall, participants (n=5) enjoyed the intervention and reported subjective improvements in mood, pain, participation in rehabilitation activities, and overall progress. Findings demonstrated post-session improvements in mood and pain (Depression 2.84 vs. 2.43, Anxiety 2.70 vs. 2.02, Pain 3.59 vs. 3.06). In terms of pre-and-post study measures, the greatest differences were observed in anxiety (GAD-7; 10.75 vs. 7.75) and sleep (ISI; 18.5 vs. 9.75). Conclusions Guided mindfulness meditation may be beneficial for mood, sleep and pain management in patients living with SCI undergoing acute rehabilitation. A larger randomized controlled trial is needed to better assess the clinical utility of the intervention in this patient population. Author(s) Disclosures None. To assess the feasibility, acceptability, and preliminary mood, pain and sleep outcomes of a mindfulness-based intervention administered to patients with spinal cord injuries (SCI) in acute inpatient rehabilitation. This is a pilot study utilizing retrospective data analysis of a Performance Improvement project, looking at the feasibility and acceptability of a mindfulness meditation program in acute rehabilitation of patients with SCI in a before-after design. Acute inpatient rehabilitation facility. Eight patients with acute SCI volunteered to participate in the study. Three patients withdrew due to schedule conflicts. Inclusion criteria included (1) individuals with SCI in acute rehabilitation, and (2) basic knowledge of English (as the mindfulness meditation program was in English). Intervention included 10 minutes of recorded guided mindfulness meditation twice a day for two weeks delivered on an iPad. The main study outcomes included self-report measures of mood, pain, and sleep administered at the beginning, middle and end of the study. These included the Patient Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Positive and Negative Affect Schedule Short Form (PANAS-SF), Insomnia Severity Index (ISI), Numeric Pain Rating Scale (NPRS), and Pain Catastrophizing Scale (PCS). In addition, 10-point Likert scales assessing levels of anxiety, depression, and pain were administered before and after each session. Finally, a survey assessing feasibility and acceptability was delivered at the end of the study. Overall, participants (n=5) enjoyed the intervention and reported subjective improvements in mood, pain, participation in rehabilitation activities, and overall progress. Findings demonstrated post-session improvements in mood and pain (Depression 2.84 vs. 2.43, Anxiety 2.70 vs. 2.02, Pain 3.59 vs. 3.06). In terms of pre-and-post study measures, the greatest differences were observed in anxiety (GAD-7; 10.75 vs. 7.75) and sleep (ISI; 18.5 vs. 9.75). Guided mindfulness meditation may be beneficial for mood, sleep and pain management in patients living with SCI undergoing acute rehabilitation. A larger randomized controlled trial is needed to better assess the clinical utility of the intervention in this patient population.