Mindfulness- and acceptance-based interventions for people with spinal cord injury : a scoping review

Abstract

Study design: Scoping review. Objective: To synthesize the effects of mindfulness- and acceptance-based interventions (MABIs) on health-related outcomes of individuals with spinal cord injury. Setting: The included studies were conducted across four countries: The United States, Iran, China, and The United Kingdom. Methods: This review followed the Arksey and O’Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Seven databases were searched until November 2024 to identify studies published in English-language that evaluated MABIs’ effects on health-related outcomes in people with spinal cord injury. Literature screening, data extraction, and quality assessment were conducted by two reviewers independently. A narrative data synthesis was conducted. Results: Of 2389 records, nine studies were included with designs of randomized controlled trials (n = 4), quasi-experimental studies (n = 3), and case studies (n = 2). Acceptance commitment therapy (n = 4) and mindfulness-based interventions (n = 5) were employed. MABIs demonstrated significant improvements in psychological health outcomes (depression, n = 3; anxiety, n = 3; stress, n = 2) with medium-to-large effect sizes (n2p = 0.112 - 0.223) and other health-related outcomes (chronic pain, n = 1; functional independence, n = 1; engagement in meaningful activities, n = 1; and quality of life, n = 1). Participants found the MABIs to be acceptable and satisfactory. Study quality varied from weak (n = 6) to strong (n = 2). Conclusions: The findings generally support the acceptability and effectiveness of MABIs for improving the overall well-being of individuals with SCI. Future research directions regarding designing MABIs and exploring effectiveness mechanisms were recommended for maximizing its benefits.