Effects of mindfulness and exercise on cognition and emotion in adults with mild deficits in the chronic post-stroke phase: A randomized controlled trial.
Por:
Bermudo-Gallaguet A, Ariza M, Agudelo D, Camins-Vila N, Boldó M, Ferrer-Uris B, Busquets A, Pera G, Cáceres C, Gomis M, Dacosta-Aguayo R, Clemente I, García-Molina A, Mata MJD, Torán-Monserrat P, Erickson KI and Mataró-Serrat M
Publicada:
1 oct 2025
Ahead of Print:
21 ago 2025
Resumen:
BACKGROUND: Individuals with stroke often face cognitive and emotional challenges. Mindfulness-based stress reduction (MBSR), physical exercise (PE), and computerized cognitive training (CCT) are promising approaches to incorporate into post-stroke rehabilitation. OBJECTIVES: To determine whether adding MBSR or PE to CCT improves cognition and mental health more than CCT alone, and whether any benefits are mediated by gains in mindfulness or fitness. METHODS: The MindFit Project was a single-blind, parallel, 3-arm randomized controlled trial enrolling participants with chronic stroke, assigned to MBSR+CCT, PE+CCT, or CCT-only (1:1:1). All 12-week, home-based interventions were delivered online, with 5 sessions per week. The primary outcomes included 3 cognitive and 2 mental health measures; mindfulness and physical fitness were also assessed. Analyses used per-protocol and intention-to-treat approaches. RESULTS: A total of 141 individuals (mean [SD] age 57.7 [11.2] years; 40 % women) were randomly assigned to 3 groups (47 each). Participants were 28.54 (20.35) months post-stroke with a mean modified Rankin Scale score of 2.23 (1.04). Of these, 78 % (39 in MBSR+CCT, 34 in PE+CCT, and 37 in CCT-only) achieved an adherence rate of =80 % and were included in the per-protocol analysis. No significant between-group differences were found in primary outcomes (all P > 0.05). For secondary outcomes, the PE+CCT group showed significantly greater gains in leg strength than the others (F = 7.50, adjusted P = 0.009). These results were consistent with the intention-to-treat analysis. In the per-protocol sample, improvements in mindfulness significantly mediated emotional outcomes in the MBSR+CCT group (B = -1.08; 95 % bootstrapped CI, -2.77 to -0.01). CONCLUSIONS: In participants with predominantly mild chronic post-stroke deficits, adding MBSR or PE to CCT did not improve primary cognitive or emotional outcomes beyond CCT alone. However, PE+CCT increased fitness, and MBSR+CCT yielded mindfulness-mediated emotional gains. Future studies involving larger and more severe stroke samples are needed. TRIAL REGISTRATION: NCT04759950 (www. CLINICALTRIALS: gov).
Filiaciones:
Bermudo-Gallaguet A:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
Ariza M:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), 08035 Barcelona, Spain
Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa (CST), 08227 Terrassa, Spain
Agudelo D:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), 08035 Barcelona, Spain
Camins-Vila N:
Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain
Boldó M:
Servei de Rehabilitació, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
Institut de Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
Ferrer-Uris B:
Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain
Busquets A:
Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain
Pera G:
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, 08303 Mataró, Spain
Cáceres C:
Institut de Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
Department of Neurosciences, Servei de Neurologia, Hospital Universitari Germans Trias i Pujol, Universitat Auntònoma de Barcelona, 08916 Badalona, Spain
Gomis M:
Institut de Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
Department of Neurosciences, Servei de Neurologia, Hospital Universitari Germans Trias i Pujol, Universitat Auntònoma de Barcelona, 08916 Badalona, Spain
Dacosta-Aguayo R:
Institut de Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
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, 08303 Mataró, Spain
Clemente I:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
García-Molina A:
Institut Guttmann, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
Mata MJD:
Servei de Rehabilitació, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
Institut de Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
Torán-Monserrat P:
Institut de Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
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, 08303 Mataró, Spain
Grup de REcerca Multidisciplinar en Salut i Societat (GREMSAS), 08303 Mataró, Spain
Department of Medicine, Faculty of Medicine, Universitat de Girona, 17003, Girona, Spain
Erickson KI:
Advent Health Research Institute, Neuroscience, Orlando, FL 32803, USA
Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
Mataró-Serrat M:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
Green Submitted, hybrid
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