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冥想、瑜伽和正念干预对轻度创伤性脑损伤慢性症状的治疗效果:系统评价和荟萃分析。

Therapeutic Effects of Meditation, Yoga, and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

机构信息

University of Connecticut, USA.

出版信息

Appl Psychol Health Well Being. 2021 Feb;13(1):34-62. doi: 10.1111/aphw.12244. Epub 2020 Nov 2.

Abstract

BACKGROUND

Chronic symptoms of mild traumatic brain injury (mTBI) vary greatly and are difficult to treat; we investigate the impact of meditation, yoga, and mindfulness-based interventions on this treatment group.

METHOD

Search included four databases, allowing studies of any design containing pre/post outcomes for meditation, yoga, or mindfulness-based interventions in people suffering from brain injury acquired by mechanical force. Analyses used robust variance estimation to assess overall effects and random-effects models for selected outcomes; we evaluated both between- and within-group changes.

RESULTS

Twenty studies (N = 539) were included. Results revealed significant improvement of overall symptoms compared to controls (d = 0.41; 95% CI [0.04, 0.77]; τ  = 0.06), with significant within-group improvements in mental health (d = 0.39), physical health (d = 0.39), cognitive performance (d = 0.24), quality of life (d = 0.39), and self-related processing (d = 0.38). Symptoms showing greatest improvement were fatigue (d = 0.96) and depression (d = 0.40). Findings were homogeneous across studies. Study quality concerns include lack of randomisation, blinding, and recording of adverse events.

CONCLUSIONS

This first-ever meta-analysis on meditation, yoga, and mindfulness-based interventions for chronic symptoms of mTBI offers hope but highlights the need for rigorous new trials to advance clinical applications and to explore mechanistic pathways.

摘要

背景

轻度创伤性脑损伤(mTBI)的慢性症状差异很大,且难以治疗;我们调查了冥想、瑜伽和正念干预对该治疗组的影响。

方法

搜索包括四个数据库,允许对任何设计的研究进行包含冥想、瑜伽或正念干预的研究,这些研究针对的是因机械力而遭受脑损伤的人,包含预先/事后结果。分析采用稳健方差估计来评估总体效果,并对选定的结果采用随机效应模型;我们评估了组间和组内的变化。

结果

共纳入 20 项研究(N=539)。结果显示,与对照组相比,总体症状有显著改善(d=0.41;95%置信区间[0.04,0.77];τ=0.06),心理健康(d=0.39)、身体健康(d=0.39)、认知表现(d=0.24)、生活质量(d=0.39)和自我相关处理(d=0.38)等方面的组内改善也具有统计学意义。改善最明显的症状是疲劳(d=0.96)和抑郁(d=0.40)。研究结果在各研究间具有同质性。研究质量方面的担忧包括缺乏随机分组、盲法和不良事件的记录。

结论

这是首次针对冥想、瑜伽和正念干预治疗 mTBI 慢性症状的荟萃分析,为治疗提供了希望,但也强调需要开展严格的新试验,以推进临床应用并探索其机制途径。

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