Effects of Mind-Body Exercises for Mood and Functional Capabilities in Patients with Stroke: An Analytical Review of Randomized Controlled Trials

Abstract

Objective: The effects of stroke are both physical and mental in nature and may have serious implications on the overall well-being of stroke survivors. This analytical review aims to critically evaluate and statistically synthesize the existing literature regarding the effects of mind-body (MB) exercises on mood and functional capabilities in patients with stroke. Methods: A structured literature review was performed in both English (PubMed, PEDro, and Cochrane Library) and Chinese (Wanfang and CNKI (Chinese National Knowledge Information Database)) databases. Sixteen randomized controlled trials were considered eligible for meta-analysis. Based on the random effects model, we used the pooled effect size to determine the magnitude of rehabilitative effect of MB exercise intervention on depression, anxiety, activities of daily living, and functional mobility among stroke survivors. The sum PEDro score ranged from five to nine points (fair-to-good methodological quality), but the absence of concealed allocation and blinded assessors were reported in most studies. Results: The aggregated results showed that MB exercise intervention is associated with significantly improved ADL (Hedges’ g = 1.31, 95% CI 0.85 to 1.77, p < 0.001, I2 = 79.82%) and mobility (Hedges’ g = 0.67, 95% CI 0.25 to 1.09, p < 0.001, I2 = 69.65%), and reduced depression (Hedges’ g = −0.76, 95% CI −1.16 to −0.35, p < 0.001, I2 = 74.84%). Conclusions: as add-on treatments, the MB exercises may potentially improve depression, activities of daily living, and mobility of these post-stroke patients. Future studies with more robust methodology will be needed to provide a more definitive conclusion.

Effectiveness of Motivational Interviewing in Regard to Activities of Daily Living and Motivation for Rehabilitation among Stroke Patients

“…The focus of post-stroke care was recovery of limb function in an attempt to restore physical function as soon as possible to achieve the goal of having independent self-care capabilities [11]. Studies showed that approximately 50% of stroke patients had difficulties performing daily activities in the chronic phase (>6 months) [24], and evidence-based research showed that stroke patients were unable to integrate upper limb function into daily life 6 months after stroke and that the dependence of IADLs was influenced 2-3 years after stroke [4,5]. The participants in this study were first-stroke patients who were recruited within 3 months after the stroke.…”

“…Motivation for rehabilitation is very important in stroke patients, and it is mainly associated with the convenience of daily life, work, quality of life, and other such factors [24]. MI enables patients to actively understand information related to the disease and improves their confidence, making them want to try to face and solve the pain or frustration experienced in the rehabilitation process and strengthening their motivation to receive rehabilitation information [5,24]. In the present study, the 6-week MI intervention improved the motivation for rehabilitation among first-stroke patients, and the difference was significant.…”

“…It has been found that self-care tasks of first-time stroke patients are affected and that mobility (walking) and stair climbing are the most affected [4]. Because of the limitations with regard to physical activity, stroke patients often sit for a long time (75%), and only 0.5% of stroke patients perform moderate-to-severe physical activities and 1.3 h of IADLs every day [5]. Patients should receive long-term and continuous rehabilitation therapy to reduce disability and dysfunction to recover activities of daily living [5,6].…”

“…Because of the limitations with regard to physical activity, stroke patients often sit for a long time (75%), and only 0.5% of stroke patients perform moderate-to-severe physical activities and 1.3 h of IADLs every day [5]. Patients should receive long-term and continuous rehabilitation therapy to reduce disability and dysfunction to recover activities of daily living [5,6]. Studies have shown that the greatest difficulty for stroke patients is facing changes in activities of daily living, and early rehabilitation therapy has been shown to significantly improve activities of daily living (BI and IADLs) among acute stroke patients with limb hemiplegia [3,4,6].…”

Mind-Body (Baduanjin) Exercise Prescription for Chronic Obstructive Pulmonary Disease:A Systematic Review with Meta-Analysis

“…Note-worthily, exercise as one of the rehabilitation modalities has been gradually recognized to be effective for symptomatic management of COPD, specifically alleviating the clinical symptoms, preventing the exacerbation of lung functions, and improving quality of life of the COPD patients [15]. Baduanjin exercise is one of ancient Chinese health-Qigong exercise [16][17][18], which involves training of musculoskeletal relaxation and stretching, breathing control, and mental focus at a slow pace [19,20]. Because Baduanjin exercise is a mild-to-moderate intensity exercise and consists of eight simple movements [21], it has been commonly prescribed for patients with chronic diseases who have low exercise tolerance at Chinese medicine hospitals [22].…”