Background and Purpose:
Despite the high prevalence of post-stroke depression (PSD) and negative impact on stroke survivors (SS) and their informal caregivers ([IC]; e.g., unpaid spouses), treatment of PSD is inadequate. Meditation has been associated with improved psychological outcomes. The purpose of this study was to establish the feasibility and acceptability of a 12-week randomized controlled trial (RCT) of a meditation intervention with SS and IC. Secondary objectives were to explore the effects of the intervention on symptoms of PSD, anxiety, and pain.
Methods:
Participants were randomized to the 4-week meditation intervention (n=27 SS; n=16 IC) or expressive writing control (n=14 SS; n=7 IC). Descriptive statistics were used to examine feasibility. Acceptability data included interviews and field notes. Repeated measures analysis with linear mixed models were used to test for change over time in Center for Epidemiological Studies Depression Scale (CES-D), State-Trait Anxiety Inventory (STAI), and Brief Pain Inventory (BPI) Severity and Intensity subscale scores.
Results:
Of the 92 eligible, 71 (77%) enrolled. Of the 64 randomized (7 were lost-to-follow-up or withdrawn due to ineligibility prior to randomization), 25 (39%) completed the study. The mean intervention attendance rate was 55%. Assessment completion rate for the intervention was 96%. For intervention SS, BPI severity scores were significantly lower at 8 weeks (p=.0270), while non-significant reductions across CES-D and STAI scores were noted. For intervention IC, a significant reduction in STAI-Trait scores was noted at 4 weeks (p=.0262). Data indicated distance was a primary barrier; however, the majority voiced favorable responses to the meditation.
Conclusions:
A meditation RCT in the post-stroke environment is acceptable; however, consideration needs to be given to the feasibility of an in-person, multiple-visit intervention. Further efficacy testing is needed in a larger RCT.
A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression
