Understanding and enhancing post-stroke recovery: Insights from an nested qualitative study within the MindFit Project randomized clinical trial.

Computerized cognitive training Mindfulness Physical exercise Qualitative interview Stroke

Journal

Complementary therapies in medicine
ISSN: 1873-6963
Titre abrégé: Complement Ther Med
Pays: Scotland
ID NLM: 9308777

Informations de publication

Date de publication:
11 Oct 2024
Historique:
received: 17 04 2024
revised: 25 07 2024
accepted: 08 10 2024
medline: 14 10 2024
pubmed: 14 10 2024
entrez: 13 10 2024
Statut: aheadofprint

Résumé

Stroke survivors experience a wide range of physical, cognitive, and emotional challenges. In the MindFit Project, a randomized clinical trial, 141 chronic stroke patients were divided into three groups: mindfulness-based stress reduction (MBSR) with computerized cognitive training (CCT), physical exercise (PE) with CCT, and CCT alone. The interventions were conducted remotely over 12 weeks, including online group and individual sessions. This exploratory nested qualitative study aimed to investigate chronic stroke survivors' experiences, opinions, and perceived changes due to the interventions within the MindFit Project. The secondary objective was to describe the broader experience of their recovery journey. Twenty-seven participants were recruited through purposive sampling and engaged in semi-structured one-on-one interviews. Twelve received MBSR+CCT, nine received PE+CCT, and six received CCT-only. The interviews were recorded, transcribed, and analyzed using thematic analysis. Participants shared insights into their lives after stroke, including emotional and physical challenges, coping mechanisms, and the impact of societal perceptions. The interventions were generally positively valued, with MBSR aiding in emotional regulation, PE enhancing physical capabilities, and CCT improving cognition. The group setting provided valuable peer support and motivation, although some participants noted challenges owing to the heterogeneity. The telematic format was also appreciated for its accessibility, although it posed challenges to personal interaction and intervention supervision. Our study emphasizes the complexity of stroke recovery and the importance of holistic, patient-centered rehabilitation approaches. It also highlights the value of combining physical and non-physical interventions in a group setting, along with the potential of remote platforms to enhance the accessibility of rehabilitation programs. These findings generate hypotheses for future randomized clinical trials aimed at improving post-stroke recovery interventions.

Sections du résumé

BACKGROUND BACKGROUND
Stroke survivors experience a wide range of physical, cognitive, and emotional challenges. In the MindFit Project, a randomized clinical trial, 141 chronic stroke patients were divided into three groups: mindfulness-based stress reduction (MBSR) with computerized cognitive training (CCT), physical exercise (PE) with CCT, and CCT alone. The interventions were conducted remotely over 12 weeks, including online group and individual sessions.
OBJECTIVE OBJECTIVE
This exploratory nested qualitative study aimed to investigate chronic stroke survivors' experiences, opinions, and perceived changes due to the interventions within the MindFit Project. The secondary objective was to describe the broader experience of their recovery journey.
METHODS METHODS
Twenty-seven participants were recruited through purposive sampling and engaged in semi-structured one-on-one interviews. Twelve received MBSR+CCT, nine received PE+CCT, and six received CCT-only. The interviews were recorded, transcribed, and analyzed using thematic analysis.
RESULTS RESULTS
Participants shared insights into their lives after stroke, including emotional and physical challenges, coping mechanisms, and the impact of societal perceptions. The interventions were generally positively valued, with MBSR aiding in emotional regulation, PE enhancing physical capabilities, and CCT improving cognition. The group setting provided valuable peer support and motivation, although some participants noted challenges owing to the heterogeneity. The telematic format was also appreciated for its accessibility, although it posed challenges to personal interaction and intervention supervision.
CONCLUSIONS CONCLUSIONS
Our study emphasizes the complexity of stroke recovery and the importance of holistic, patient-centered rehabilitation approaches. It also highlights the value of combining physical and non-physical interventions in a group setting, along with the potential of remote platforms to enhance the accessibility of rehabilitation programs. These findings generate hypotheses for future randomized clinical trials aimed at improving post-stroke recovery interventions.

Identifiants

pubmed: 39396801
pii: S0965-2299(24)00088-8
doi: 10.1016/j.ctim.2024.103100
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103100

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Conflict of interest None.

Auteurs

Adrià Bermudo-Gallaguet (A)

Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institut de Recerca Sant Joan de Déu. Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain. Electronic address: abermudo@ub.edu.

Jofre Bielsa-Pascual (J)

Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain. Electronic address: jbielsap.mn.ics@gencat.cat.

Rosa García-Sierra (R)

Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain; Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), 2021 SGR 01484, Mataró, Barcelona, Spain; Department of Nursing. Faculty of Medicine. Universitat Autònoma de Barcelona, Bellaterra, Spain; Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, Badalona, Barcelona, Spain. Electronic address: rgarciasi.mn.ics@gencat.cat.

Maria Feijoo-Cid (M)

Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), 2021 SGR 01484, Mataró, Barcelona, Spain; Department of Nursing. Faculty of Medicine. Universitat Autònoma de Barcelona, Bellaterra, Spain. Electronic address: maria.feijoo@uab.cat.

Antonia Arreciado Marañon (AA)

Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), 2021 SGR 01484, Mataró, Barcelona, Spain; Department of Nursing. Faculty of Medicine. Universitat Autònoma de Barcelona, Bellaterra, Spain. Electronic address: antonia.arreciado@uab.cat.

Mar Ariza (M)

Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa (CST), Terrassa, Spain; Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain. Electronic address: mariza@ub.edu.

Daniela Agudelo (D)

Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain. Electronic address: daniela.agudelo@ub.edu.

Neus Camins-Vila (N)

Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain. Electronic address: ncaminvi16@alumnes.ub.edu.

Maria Boldó (M)

Servei de Rehabilitació, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain. Electronic address: mboldo.ics@gencat.cat.

Maria José Durà Mata (MJD)

Servei de Rehabilitació, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain. Electronic address: mjdura.germanstrias@gencat.cat.

Alberto García-Molina (A)

Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, Badalona, Barcelona, Spain; Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Badalona, Spain. Electronic address: agarciam@guttmann.com.

Pere Torán-Monserrat (P)

Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain; Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), 2021 SGR 01484, Mataró, Barcelona, Spain; Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, Badalona, Barcelona, Spain; Department of Medicine, Faculty of Medicine, Universitat de Girona, Girona, Spain. Electronic address: ptoran.bnm.ics@gencat.cat.

Maria Mataró (M)

Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institut de Recerca Sant Joan de Déu. Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain. Electronic address: mmataro@ub.edu.

Classifications MeSH