Improve Coping with Brain Injury with Mindfulness

Improve Coping with Brain Injury with Mindfulness

 

By John M. de Castro, Ph.D.

 

For many brain injury survivors, mindfulness is an essential practice that helps to regulate their mental health, mood changes, and memory.” – Headway

 

Brain damage is permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Although the brain tissues that are destroyed are permanently lost, we know that people can recover to some extent from brain injury. How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, new behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function. Rehabilitation for brain injury patients usually involves strategies to promote these recovery mechanisms. These include mindfulness training which has been found to be helpful in recovery from brain injury.

 

In today’s Research News article “Grieving a disrupted biography: an interpretative phenomenological analysis exploring barriers to the use of mindfulness after neurological injury or impairment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386048/ ) Finlay and colleagues recruited adult mindfulness teachers who had a neurological injury including sensory loss. They completed a mindfulness measure and a semi-structured interview exploring their experiences with mindfulness. Transcript of the interviews were assessed for descriptive, linguistic, and conceptual themes.

 

Two overarching themes emerged in the analysis of the interviews, overcoming a disrupted biography and proactive self-management. The first theme involved adjusting to a new identity and the changed health status and sensory loss. This included coping with their grief over the loss. This was facilitated by mindfulness practices of self-compassion, acceptance, and focusing on the present moment. This heled them to overcome the desire to return to their previous selves, accept themselves as the currently are, and manage their emotions. The second theme of proactive self-management involved using mindfulness practice to regain autonomy and take responsibility for the needed adjustments to their lives. This involved not diffusing responsibility to healthcare providers. It also involved using mindfulness to manage the physical and emotional suffering resulting from the injury including pain and emotional agony.

 

It was clear from the participants descriptions of their journeys to adapt to their changed realities that the adaptations were greatly facilitated by mindfulness practice. It allowed them to accept things as they are and take responsibility for their own management of the symptoms. The study involved highly experienced mindfulness practitioners. It is not clear that training in mindfulness after neurological injury in non-practitioners would have the same benefits. But the descriptions revealed that the core skills produced by mindfulness training were essential in accepting and adjusting to their altered selves. So, it would be expected that mindfulness training would be beneficial to everyone after neurological injury.

 

So, improve coping with brain injury with mindfulness.

 

TBI is a complex diagnosis involving many components. One significant component is the stress response after having this type of injury. Mindfulness meditation appears to have a strong relaxing and stress reduction quality for patients, which is tremendously beneficial for overall recovery from injury.”  – Heechin Chae

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Finlay, K. A., Hearn, J. H., & Chater, A. (2021). Grieving a disrupted biography: an interpretative phenomenological analysis exploring barriers to the use of mindfulness after neurological injury or impairment. BMC psychology, 9(1), 124. https://doi.org/10.1186/s40359-021-00628-0

 

Abstract

Background

Mindfulness has demonstrated strong utility for enhancing self-management and health outcomes in chronic illness. However, sensation-focused mindfulness techniques may not be appropriate for clinical populations with neurological injury. This study aimed to identify how expert mindfulness teachers with sensory loss/impairment naturalistically adapt and experience mindfulness. We aimed to highlight the rationale for and barriers to mindfulness practice when living with sensory loss.

Methods

A qualitative, semi-structured interview design was used, analysed via Interpretative Phenomenological Analysis (IPA). Eight (5 females, 3 males) mindfulness teachers with neurological injury were recruited via a national registry of Mindfulness for Health teachers. Interviews (range: 50–93 min) were completed, transcribed verbatim and analysed idiographically for descriptive, linguistic and conceptual themes, before a cross-case analysis was completed.

Results

Two superordinate themes were identified: (1) Overcoming a disrupted biography; and (2) Proactive self-management. These themes considered the challenge of reconciling, through grief, a past health status with the present reality of living with sensory loss due to Spinal Cord Injury, Multiple Sclerosis or Functional Neurological Disorder. Mindfulness was experienced as a method by which proactive choices could be made to maintain control and autonomy in health, reducing perceptions of suffering, psychological distress, cognitive reactivity and rumination.

Conclusions

Mindfulness was found to support the self-management of health after neurological injury/impairment. Mindfulness meditation presented an initial challenge as trauma and grief processes were (re-)activated during mindfulness sessions. However, mindfulness was found to support the resolution of these grief processes and encourage adaptive approach-based coping and acceptance of health and neurological impairment/injury.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386048/

 

Improve Well-Being of Traumatic Brain Injury Patients with Mindfulness

Improve Well-Being of Traumatic Brain Injury Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

TBI is a complex diagnosis involving many components.”One significant component is the stress response after having this type of injury. Mindfulness meditation appears to have a strong relaxing and stress reduction quality for patients, which is tremendously beneficial for overall recovery from injury.” – Heechin Chae

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Brain Injury is caused by a number of different events including a violent blow to the head (Traumatic Brain Injury, TBI). In the United States it is estimated that annually 1.7 million people sustain Traumatic Brain Injury. Although the brain tissues that are destroyed are permanently lost, we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function. Rehabilitation for brain injury patients usually involves strategies to promote these recovery mechanisms. Mindfulness training has been found to be helpful in recovery from Traumatic Brain Injury.

 

In today’s Research News article “Comparison of the effects of transcranial direct current stimulation and mindfulness-based stress reduction on mental fatigue, quality of life and aggression in mild traumatic brain injury patients: a randomized clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207739/ ) and Shirvani colleagues recruited adult patients with traumatic brain injury and randomly assigned them to either no treatment or to receive a once a week for 2 hours for 8 weeks program of Mindfulness-Based Stress Reduction (MBSR) or 3 sessions of 20 minutes per week for 10 total sessions of transcranial direct current stimulation (tDCS). They were measured before and after training and 2 months later for mental fatigue, quality of life, physical aggression, verbal aggression, anger, and hostility.

 

They found that in comparison to baseline and the control group both the Mindfulness-Based Stress Reduction (MBSR) and transcranial direct current stimulation (tDCS) groups had significantly lower levels of mental fatigue and aggression both after treatment and 2 month later but the MBSR group has a significantly greater improvement than the tDCS group in mental fatigue but not aggression. They report that only the MBSR group has a significantly greater improvement in quality of life.

 

In the present study mental fatigue, quality of life, and aggressive behaviors were improved immediately after treatment and 2 month later by both Mindfulness-Based Stress Reduction (MBSR) and transcranial direct current stimulation (tDCS). But MBSR produced greater improvement in mental fatigue and only MBSR produced a significant improvement in quality of life. Mindfulness has been shown in prior research to produce improvements in fatigue, aggression, and quality of life. The present study extends these benefits to patients with traumatic brain injury.

 

Traumatic brain injury patients are particularly difficult to treat. But the present findings suggest that mindfulness training may not only be effective but be the best treatment to improve the behavior and cognitive ability of patients with traumatic brain injury. Importantly, the improvements are relatively long lasting.

 

So, improve well-being of traumatic brain injury patients with mindfulness.

 

Mindfulness is a technique used to concentrate on your immediate surroundings, focusing on what happens moment by moment. It can be transformative for some and allow them to feel more aware of the situations around them, which can be particularly helpful for brain injury survivors.” – Headway

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Shirvani, S., Davoudi, M., Shirvani, M., Koleini, P., Hojat Panah, S., Shoshtari, F., & Omidi, A. (2021). Comparison of the effects of transcranial direct current stimulation and mindfulness-based stress reduction on mental fatigue, quality of life and aggression in mild traumatic brain injury patients: a randomized clinical trial. Annals of general psychiatry, 20(1), 33. https://doi.org/10.1186/s12991-021-00355-1

 

Abstract

Background

The rate of traumatic brain injuries (TBIs) due to the accidents is high around the world. Patients with mild TBIs may suffer from some psychological disorders, including aggression, and mental fatigue, and thus their quality of life decreased. Among different treatments for TBI, two treatments, namely transcranial direct current stimulation (tDCS), and mindfulness-based stress reduction (MBSR) have shown to be effective. Therefore, this study aimed to compare the effects of these two treatments on mental fatigue, aggression and quality of life in mTBI patients.

Materials and methods

This randomized controlled trial study was conducted on 48 TBI patients referred to emergency and neurosurgery departments of Shahid Beheshti Hospital, Kashan, Iran. They were selected using the convenience sampling method. Data were collected using the mental fatigue scale, the World Health Organization Quality of Life-BREF (short version), and the Buss–Perry Aggression Questionnaires. Then, the data were analyzed using a Mixed Repeated Measures ANOVAs, and the Levene and Kolmogorov–Smirnov tests by SPSS-23 software.

Results

The mean age of patients in the three groups of MBSR, tDCS and control were 69.38 + 6.11 (25% male), 25.40 + 12.11 (25% male) and 69.37 + 0.2 (18.8% male), respectively. There was no significant difference between the three groups in terms of mental fatigue, quality of life and aggression (P < 0.05). In addition, the results showed that there was a significant difference between the main effect of time and the interaction between time and group (P < 0.001).

Conclusions

Both MBSR and tDCS methods are effective in reducing the mental fatigue and aggression and increasing quality of life of mTBI patients; MBSR treatment, as indicated in the present study, can be more effective than tDCS in patients with mTBI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207739/

 

Tai Chi Practice Improves the Symptoms of Multiple Diseases

Tai Chi Practice Improves the Symptoms of Multiple Diseases

 

By John M. de Castro, Ph.D.

 

“In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects.” Peter Wayne

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving the symptoms of many different diseases. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of different Tai Chi practices for different disease conditions.

 

In today’s Research News article “.Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/ ) Huang and colleagues review and summarize the published randomized controlled trials on the effectiveness of different Tai Chi practices for different disease conditions. They identified 139 published randomized controlled trials utilizing a number of different Tai Chi styles and numbers of forms. Yang style was by far the most frequent style and 24 forms was the most frequent number of forms employed.

 

They report that the published research found that Tai Chi practice produced significant improvement in the symptoms of musculoskeletal system or connective tissue diseases such as osteoarthritis, fibromyalgia, and chronic low back pain.; on circulatory system diseases such as hypertension, stroke, coronary heart disease, and chronic heart failure; on mental and behavioral disorders such as depression, cognitive impairment, and intellectual disabilities; on nervous system diseases such as Parkinson’s disease, dementia, and sleep disorders; on chronic obstructive pulmonary disease (COPD); on endocrine, nutritional, or metabolic diseases such as type 2 diabetes and metabolic syndrome; on the physical and mental state of cancer patients, and on traumatic brain injury and urinary tract disorders; on balance control and flexibility and falls in older adults.

 

These are remarkable findings. Tai Chi practice appears to be a safe and effective treatment for the symptoms of a wide variety of diseases. It doesn’t cure the disease. Rather if alleviates the symptoms. It is not known the mechanisms by which Tai Chi has these benefits. Future research needs to further explore what facets or effects of Tai Chi practice are responsible for the disease symptom improvements.

 

So, Tai Chi practice improves the symptoms of multiple diseases.

 

Tai Chi and Qigong are evidence-based approaches to improve health-related quality of life, and they may be effective for a range of physical health conditions.” – Ryan Abbott

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huang, J., Wang, D., & Wang, J. (2021). Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM, 2021, 5558805. https://doi.org/10.1155/2021/5558805

 

Abstract

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972853/

 

The Default Mode Network of the Brain Underlies Mind Wandering

The Default Mode Network of the Brain Underlies Mind Wandering

 

By John M. de Castro, Ph.D.

 

“the brain appears to support mind wandering by disrupting some of the brain processes that are involved in responding to our surrounding external environment.” – Julia Kam

 

We spend a tremendous amount of waking time with our minds wandering and not on the present environment or the task at hand. We daydream, plan for the future, review the past, ruminate on our failures, exalt in our successes. In fact, we spend almost half of our waking hours off task with our mind wandering. A system of the brain known as the Default Mode Network (DMN) becomes active during wind wandering and relatively quiet during focused on task behavior. Meditation is known to reduce the size, connectivity, and activity of the Default Mode Network (DMN).

 

In today’s Research News article “Lesion network mapping demonstrates that mind-wandering is associated with the default mode network.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704688/ ) Philippi and colleagues recruited patients with circumscribed brain injuries (lesions) and age and education matched non-brain damaged comparison participants. They all underwent brain scanning with Magnetic Resonance Imaging (MRI). They completed a self-report measure of mind wandering.

 

They found that the brain damaged patients had lower frequencies of mind wandering than the healthy comparison participants. They then examined the specific brain areas damaged in the patients lesions and related it to their reduced mind wandering scores. They found that reduced mind wandering was associated with structures in the Default Mode Network (DMN), including the medial prefrontal cortex, parietal lobe, and inferior frontal gyrus.

 

The results are simple and straightforward and suggest that damage to the Default Mode Network (DMN) reduces mind wandering. This finding taken together with the findings that the DMN becomes more active during mind wandering makes a clear case that the DMN is responsible for mind wandering.

 

So, the default mode network of the brain underlies mind wandering.

 

mind-wandering was associated with increased DMN activity and increased DMN-VS connectivity.“ – Xinqi Zhou

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Philippi, C. L., Bruss, J., Boes, A. D., Albazron, F. M., Deifelt Streese, C., Ciaramelli, E., Rudrauf, D., & Tranel, D. (2021). Lesion network mapping demonstrates that mind-wandering is associated with the default mode network. Journal of neuroscience research, 99(1), 361–373. https://doi.org/10.1002/jnr.24648

 

Abstract

Functional neuroimaging research has consistently associated brain structures within the default mode network (DMN) and frontoparietal network (FPN) with mind-wandering. Targeted lesion research has documented impairments in mind-wandering after damage to the medial prefrontal cortex (mPFC) and hippocampal regions associated with the DMN. However, no lesion studies to date have applied lesion network mapping to identify common networks associated with deficits in mind-wandering. In lesion network mapping, resting-state functional connectivity data from healthy participants are used to infer which brain regions are functionally connected to each lesion location from a sample with brain injury. In the current study, we conducted a lesion network mapping analysis to test the hypothesis that lesions affecting the DMN and FPN would be associated with diminished mind-wandering. We assessed mind-wandering frequency on the Imaginal Processes Inventory (IPI) in participants with brain injury (n = 29) and healthy comparison participants without brain injury (n = 19). Lesion network mapping analyses showed the strongest association of reduced mind-wandering with the left inferior parietal lobule within the DMN. In addition, traditional lesion symptom mapping results revealed that reduced mind-wandering was associated with lesions of the dorsal, ventral, and anterior sectors of mPFC, parietal lobule, and inferior frontal gyrus in the DMN (p < 0.05 uncorrected). These findings provide novel lesion support for the role of the DMN in mind-wandering and contribute to a burgeoning literature on the neural correlates of spontaneous cognition.

Significance

Adults spend up to 50% of their waking day mind-wandering, which is the process of turning one’s attention inward to focus on self-generated thoughts or feelings. Mind-wandering can have both costs and benefits, such as increased negative mood or enhanced creative problem-solving. In this study, we report novel findings linking reduced mind-wandering with brain injury located within the default mode network. This work is important because it can help us to determine which brain networks are necessary for self-generated cognition, which may improve our understanding of neuropsychiatric conditions associated with altered self-focused thought.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704688/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

Movement-Based Therapies are Affective for Rehabilitation from Disease

 

By John M. de Castro, Ph.D.

 

Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

 

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

 

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

 

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

 

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

 

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

 

So,  movement-based therapies are affective for rehabilitation from disease.

 

Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

 

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

  • Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
  • Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
  • Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
  • Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
  • Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/

 

Improve Well-Being and Relaxation of Patients Undergoing Rehabilitation for Acquired Brain Injuries with Yoga Practice

Improve Well-Being and Relaxation of Patients Undergoing Rehabilitation for Acquired Brain Injuries with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“One of the things about yoga that is different from traditional rehabilitation exercises is that it is more whole-body focused. It helps people learn to take their nervous systems to a more calm and relaxed state, which helps with healing.” –Kristine Miller

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Brain Injury is caused by a number of different events from a violent blow to the head (Traumatic Brain Injury, TBI), to interruption of the blood supply to the brain (strokes), and to demyelinating diseases such as Multiple Sclerosis (MS). These neurological diseases are common and disabling. In the United States it is estimated that annually 1.7 million people sustain Traumatic Brain Injury, while 400,000 people are diagnosed with Multiple Sclerosis, and about 800,000 people have strokes.

 

Regardless of the cause, the brain is damaged, and the tissues that are destroyed are permanently lost. But we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function.

 

Rehabilitation for brain injury patients usually involves strategies to promote these recovery mechanisms. Mindfulness training has been found to be helpful in recover from Traumatic Brain InjuryMultiple Sclerosis, and stroke. Yoga is both a mindfulness practice and an exercise making it a potentially ideal practice to promote rehabilitation from brain injury.

 

In today’s Research News article “The Lived Experience and Patient-reported Benefits of Yoga Participation in an Inpatient Brain Injury Rehabilitation Setting.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937874/), Seeney and Griffin recruited adults with acquired brain injuries who were inpatients in a brain injury rehabilitation unit. They participated in once weekly 1-hour Hatha yoga classes that were modified for brain injury patients. They were measured before and after each yoga class for relaxation, well-being, and satisfaction with the class. After the second yoga class they completed a semi-structured interview on their lived experience while in rehabilitation.

 

They found that over each class and over the first 3 classes compared to baseline there were significant improvements in the relaxation and well-being of the patients. Qualitative analysis of the semi-structured interviews revealed that the participants found that participation in the yoga classes improved their levels of relaxation, their physical well-being including flexibility and movements, present moment awareness, and self-awareness.

 

Although this study was small, short-term, and lacked a control group, the results suggest that yoga training can be successfully implemented in a brain injury rehabilitation unit. It suggests that yoga practice is seen as beneficial by the patients with acquired brain injuries and it improved their well-being and relaxation. Although not investigated, it would be expected that this would improve their rehabilitation.

 

So, improve well-being and relaxation of patients undergoing rehabilitation for acquired brain injuries with yoga practice.

 

A growing science is showing that the dynamic and multifaceted nature of yoga has tremendous potential to foster healing from brain injury. Not only does yoga offer a pathway to improved strength, attention control, and stress management, it can also provide people with powerful opportunities to look inward, connect with themselves more deeply, and discover their capacity to move forward.” – Kyla Pearce

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Seeney, R., & Griffin, J. (2020). The Lived Experience and Patient-reported Benefits of Yoga Participation in an Inpatient Brain Injury Rehabilitation Setting. International journal of yoga, 13(1), 25–31. https://doi.org/10.4103/ijoy.IJOY_46_19

 

Abstract

Context:

The multifactorial benefits of yoga have been well documented in the literature, with the integration of yoga therapy into healthcare being an emerging field. In general, yoga therapy programs are utilized in the community as an adjunct to other therapy. At present, limited rehabilitation units routinely incorporate integrative therapy options within a hospital environment.

Aims:

The aim of this study is to explore the lived experience and patient-reported benefits of yoga in an inpatient brain injury rehabilitation setting.

Settings and Design:

Thirty-one participants were recruited to the study after voluntarily participating in a yoga class within an inpatient brain injury rehabilitation unit of a major metropolitan hospital. Yoga sessions were held weekly for 60 min and consisted of a modified Hatha yoga style. This was a mixed-methods, quasi-experimental one-group pretest–posttest study.

Methodology:

Quantitative data were collected to measure perceptions of relaxation and well-being before and after yoga classes, along with the satisfaction of the class. Semi-structured interviews were utilized to collect qualitative data of experiences and perceptions associated with yoga participation.

Statistical Analysis Used:

Thematic analysis was completed for qualitative data. Quantitative data were analyzed using nonparametric statistical methods, and descriptive statistics were also provided.

Results:

The benefits described by participants are reported in this paper. These include improved relaxation, physical well-being, emotional well-being, being present, and self-awareness.

Conclusions:

This study describes the personal benefits experienced from regular yoga participation within an inpatient rehabilitation setting.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937874/

 

Do Spiritual Experiences Reveal Ultimate Truth or Merely Brain Activity?

Do Spiritual Experiences Reveal Ultimate Truth or Merely Brain Activity?

 

By John M. de Castro, Ph.D.

 

Spiritual experiences, be they called awakenings, mystical experiences, or enlightenments, involve a shift in how the individual perceives reality. This could be viewed as a spiritual revelation. But it could also be viewed as a change in the neural systems integrating and interpreting experiences. So, are spiritual awakenings revelations of a reality beyond physical reality or are they simply hallucinatory experience evoked by changes in the nervous system?

 

One way of investigating this question is to study the brain-spirituality connection. Research along these lines has revealed that there is a clear association between spirituality and the brain. Modern neuroscience has developed methods, such as neuroimaging, to investigate the relationship. Applying these techniques it has been demonstrated that spirituality is associated with changes in the size, activity, and connectivity of the frontal and parietal lobes of the brain (see http://contemplative-studies.org/wp/index.php/2015/07/19/spirituality-mindfulness-and-the-brain/). So spirituality and changes in neural systems co-occur. But, this does not demonstrate a causal connection, whether spirituality alters the brain or brain alteration causes spirituality, or some third factor is responsible for both.

 

A better way to demonstrate if brain activity cause spiritual experiences is to investigate what happens to spirituality when the brain changes. One place to look at this is with accidental brain injuries incurred by humans that afford an opportunity to glimpses associations between brain change and spirituality. In general people who have incurred damage to the right inferior parietal area show an increase in spirituality. So, brain alteration affects spirituality. But, increased spiritual beliefs and spiritual seeking is not the same thing as spiritual experiences. So, we cannot conclude that these changes in the brain are responsible for awakening experiences.

 

Another manipulation of the brain occurs with drugs. Indeed, various hallucinogenic drugs such as mescaline, LSD, psilocybin, etc. have been shown to produce experiences that are extremely similar to spiritual experiences. These drugs have been shown to alter the activity in specific neurochemical systems in the brain and when that happens, experiences that are very similar to spiritual awakenings are evoked. Many people who have used these drugs are altered spiritually but vast numbers of people find hallucinatory drugs as fun recreation but are not affected spiritually.

 

Spiritual seekers who have used psychedelic substances report that they experience something like but not the same as spiritual awakening experiences. The following quote from Alan Watts is illustrative.

“Psychedelic experience is only a glimpse of genuine mystical insight, but a glimpse         which can be matured and deepened by the various ways of meditation in which drugs           are no longer necessary or useful. If you get the message, hang up the phone. For         psychedelic drugs are simply instruments, like microscopes, telescopes, and telephones.       The biologist does not sit with eye permanently glued to the microscope, he goes away      and works on what he has seen…”

Also a quote from Ralph Metzner

            “While psychedelic use is all about altered states, Buddhism is all about altered traits,     and one does not necessarily lead to the other.”

Hence, it appears that although there are great similarities between manipulation of brain chemistry with drugs and the experiences occurring with spiritual awakenings, they are in fact quite different.

 

So, what should we conclude regarding the clear relationship between the brain and spiritual experiences? It has been established that spirituality changes the brain and that changes in the brain are associated with spiritual experiences. Does this indicate that spirituality is nothing but a brain function? This would suggest that spirituality and spiritual experiences are nothing but physical events and don’t represent experience of true transcendence or an indication of a god. If this were true then it would suggest that there is nothing beyond the physical, that spiritual awakenings are nothing other than evoked changes in the nervous system.

 

It should be noted that reported spiritual experiences most frequently involve changes in sensory experiences. We know that sensory experiences are produced by the nervous system. So, it would be expected that if a spiritual experience occurs then there would be changes in the nervous system. As a result it is not surprising that nervous system changes would accompany spiritual experiences.

 

Neural changes may represent the effects of spiritual experiences on the physical body. After all, when we become aware of any kind of remarkable occurrence we react emotionally, physically, and thoughtfully. This would imply that the neural changes occur after the spiritual experience and not before it as a causal relationship would demand. In addition, changing the brain with drugs may simply induce the same effects as the sequela of spiritual experience and not the spiritual experiences themselves.

 

The most common report of spiritual experience is that everything is perceived as one. This oneness experience is not reported to be a change in the actual sensory information, but rather as a perception of the interconnectedness of all things such that they are seen as all a part of a singular entity, like seeing individual waves as all being part of one ocean. The more modern science studies events and their interconnections the more that the truth of oneness is revealed. The entire science of ecology has developed to study the interconnectedness among biological entities, meteorology has determined that atmospheric conditions over the entire planet are interconnected, and geology has revealed the interconnectedness of all movement of the planet’s surface and interior. Just think how interconnected everything is with sunlight. Without this energy, life could not exist and even the weather would not be changing. Everything about us and our planet is interconnected to the sun’s energy.

 

So, perhaps the oneness revealed in spiritual experiences may actually be a more accurate glimpse of the truth of existence. Perhaps, the changes observed in the brain may simply be the effect of this revelation rather than the cause. At this point we cannot reach a clear conclusion as to whether spiritual experiences are material and physical or true revelation of a non-physical reality. But the research is exciting and will continue to explore these ultimate questions regarding existence.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Relieve Fatigue Accompanying Neurologic Disease with Mindfulness

By John M. de Castro, Ph.D.

 

“Mindfulness meditation — or mentally focusing on being in the present moment — has also proven an effective tool to help people with cognitive and behavioral issues after TBI. With meditation of all kinds — from chanting to visual imagery — people can make peace with their new self and not get swept up in the constant maelstrom of mental obsessions.” – Victoria Tilney McDonough

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Brain Injury is caused by a number of different events from a violent blow to the head (Traumatic Brain Injury, TBI), to interruption of the blood supply to the brain (strokes), and to demyelinating diseases such as Multiple Sclerosis (MS). These neurological diseases are common and disabling. In the United States it is estimated that annually 1.7 million people sustain Traumatic Brain Injury, while 400,000 people are diagnosed with Multiple Sclerosis, and about 800,000 people have strokes.

 

Regardless of the cause, the brain is damaged, and the tissues that are destroyed are permanently lost. But, we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function. Rehabilitation usually involves strategies to promote these recovery mechanisms.

 

Each of these neurologic diseases are accompanied by a profound fatigue. This disrupts rehabilitation as it makes it difficult for the patients to engage in the needed activities. In fact, the depth of fatigue is associated with lower levels of quality of life, everyday functioning, and life expectancy. So, it is important to find methods to reduce fatigue in patients with neurologic diseases. Mindfulness training has been found to be helpful in recover from Traumatic Brain Injury, Multiple Sclerosis, and stroke. It would seem likely then that mindfulness training reduces fatigue.

 

In today’s Research News article “Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1327481707275752/?type=3&theater

or see summary below or view the full text of the study at:

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00912/full

Ulrichsen and colleagues review the published research literature on the effects on fatigue of mindfulness training on adult patients with neurologic diseases. In all of the studies 8-weeks of either Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) were employed as therapy. They found that mindfulness training significantly reduced fatigue with moderate effect size.

 

These are encouraging results as fatigue plays such a crucial role in the disease and its reduction is needed for other rehabilitation activities to be effective. It isn’t clear exactly how mindfulness training reduces fatigue. It is possible that by improving present moment awareness, especially of the patient’s physical state, that worry and rumination that contribute to the feelings of fatigue may be lowered or that the improved attentional mechanisms allows the patients to perform well in spite of fatigue.

 

Regardless, relieve fatigue accompanying neurologic disease with mindfulness.

 

“Imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity. Many say that they barely notice it at all.” – Danny Penman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Ulrichsen KM, Kaufmann T, Dørum ES, Kolskår KK, Richard G, Alnæs D, Arneberg TJ, Westlye LT and Nordvik JE (2016) Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis. Front. Psychol. 7:912. doi: 10.3389/fpsyg.2016.00912

 

Abstract

BACKGROUND: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief.

OBJECTIVE: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries.

MATERIALS AND METHODS: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke.

RESULTS: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17).

CONCLUSION: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00912/full

 

Reduce Fatigue After Brain Injury with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation — or mentally focusing on being in the present moment — has also proven an effective tool to help people with cognitive and behavioral issues after TBI. With meditation of all kinds — from chanting to visual imagery — people can make peace with their new self and not get swept up in the constant maelstrom of mental obsessions.” – Victoria Tilney McDonough

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. There are a number of causes of brain damage including Traumatic Brain Injury, stroke, and Multiple Sclerosis. TBI has many causes of this including car accidents, warfare, violent disputes, etc.. A stroke results from an interruption of the blood supply to the brain, depriving it of needed oxygen and nutrients. This can result in the death of brain cells and depending on the extent of the damage produce profound loss of function. Multiple Sclerosis is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with brain injuries in general is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality.

 

Regardless of the cause, the brain is damaged, and the areas that are destroyed are permanently lost. But, people can recover to some extent from brain injury. Fatigue is the common symptom of all of these neurological disorders and it interferes with treatment and recovery. These patients frequently lack the energy to adhere to their therapeutic regimens. So, there is a pressing need to find treatments that can reduce or eliminate fatigue in these patients. Mindfulness practices have been shown to be helpful in recovery from Traumatic Brain Injury, stroke, and Multiple Sclerosis. They have also been shown to be effective in reducing fatigue due to environmental and medical causes. Hence, mindfulness training may be an effective treatment for the fatigue following brain injury.

 

In today’s Research News article “Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1306292806061309/?type=3&theater

or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917545/  Ulrichsen and colleagues review the published research literature investigating the usefulness of mindfulness treatments for fatigue following brain injury. They report that the summarized results from four studies indicate that mindfulness training reduces fatigue after brain injury with a moderate but clinically significant effect size (.37). In other words, mindfulness treatment reduces fatigue, but doesn’t eliminate it.

 

These are promising results suggesting that one way that mindfulness training may help improve the recovery after brain injury is by reducing the fatigue that typically accompanies brain injury. This is very important as fatigue is at the center of the reduced quality of life after brain injury. Fatigue also interferes with the patient’s ability to fully engage in their rehabilitation therapy regimens. Additionally, mindfulness training is a safe treatment with no know negative side effects and many additional positive physical and psychological effects on the patients. Hence, these results suggest that mindfulness training should be employed to assist in recovery after brain injury.

 

So, reduce fatigue after brain injury with mindfulness.

 

“It seems then that exploring the benefits of mindfulness and meditation after brain injury can be worthwhile for people living with brain injury, family and supporters.  It can reduce stress and focus concentration and attention.” –  Melanie Atkins

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Ulrichsen, K. M., Kaufmann, T., Dørum, E. S., Kolskår, K. K., Richard, G., Alnæs, D., … Nordvik, J. E. (2016). Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis. Frontiers in Psychology, 7, 912. http://doi.org/10.3389/fpsyg.2016.00912

 

Abstract

Background: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief.

Objective: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries.

Materials and Methods: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke.

Results: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17).

Conclusion: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917545/

 

Improve Physical Rehabilitation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

 

Mindfulness practices have been shown to be effective in promoting physical and psychological health. As a result of mindfulness’ ability to reduce the physiological and psychological responses to stress these practices have been found to be helpful in treating a number of medical disorders. In addition, because of mindfulness’ ability to improve emotion regulation and reduce worry and rumination these practices have been found to be helpful in treating a number of psychological disorders. There is such a wide variety of benefits that the application of mindfulness training is being explored for an ever expanding list of conditions.

 

In today’s Research News article “Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1284023361621587/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

Hardison and colleagues examine the effectiveness of mindfulness training in assisting rehabilitation from a variety of physical disorders. To do this, they reviewed the published research literature on the effects of mindfulness training on recovery from any illness, injury, or disability of the neurological, musculoskeletal, or other body system that could be treated within a medical or rehabilitation setting. A number of different mindfulness practices were employed in the studies including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy, and General Mindfulness.

 

They found that, in general the literature reported that mindfulness training was effective in treating musculoskeletal and pain disorders such as chronic musculoskeletal pain, work-related musculoskeletal injury, and knee surgery. These studies reported mixed results regarding mindfulness training effects on reducing the pain accompanying these disorders, but they routinely found that mindfulness produced significant improvements in acceptance of pain and functioning with pain, and reduced distress. They also found that, in general the published research found that mindfulness training was effective in treating recovery from traumatic brain injury (TBI). Mindfulness training improved the patients’ cognitive functioning, physical health, self-efficacy, quality of life, vitality, emotionality and mental health and reduced the distress produced by the TBI symptoms.

 

These results are potentially very important and suggest that mindfulness training is effective in improving the process of rehabilitation from a number of musculoskeletal and pain disorders and traumatic brain injury. This adds to the already extensive list of applications of mindfulness training to assist in prevention and recovery from medical disorders. It is not known exactly what effects of mindfulness training might be responsible for these benefits. But, it is reasonable to speculate that improvements in stress responses, emotion regulation, and worry and rumination are involved.

 

So, the published research literature suggests that mindfulness training should be included in the interventions recommended for rehabilitation from physical disorders.

 

“From the broadest vantage point, mindful clinical practice holds possibilities when used in conjunction with other strategies. It helps patients to take a step back, assess their experiences and move toward compassionate self-care. We owe it to our patients to help them discover their own pockets of rest, relief and comfort.” – Reji Mathew

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Hardison, M. E., & Roll, S. C. (2016). Mindfulness Interventions in Physical Rehabilitation: A Scoping Review. The American Journal of Occupational Therapy, 70(3), 7003290030p1–7003290030p9. http://doi.org/10.5014/ajot.2016.018069

 

Abstract

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association’s Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/