Movement-based mindfulness versus lifestyle education for managing physiological risk factors in stroke survivors: a phase II study.

Abstract

Background: Movement-based mindfulness interventions (MBI) have the potential to reduce cardiovascular risk in people living with stroke. Aim(s): Compare potential changes in physiological risk factors between participants in a novel MBI program and an attention control group. Method(s): Participants 3-18 months post-stroke were recruited from the Australian Stroke Clinical Registry over four periods (between April 2021 and July 2023). Eligible participants were randomised (1:1) into a MBI (tailored yoga and meditation) or attention control group (lifestyle classes and socialisation). All participants attended weekly 60-minute in-person classes for 12 weeks. Baseline and post-intervention assessments included blood pressure and stress (perceived stress scale and hair cortisol). When funding became available, for participants in the third and fourth periods, glycated haemoglobin (HbA1c) and lipid profiles were also measured. Cohen's d (within-group change) and generalised linear modelling (betweengroup differences) were conducted. Result(s): Overall, thirty-six participants completed the trial (mean age: 69 years, male: 72%). Within-group differences: small to moderate non-significant effect sizes observed for blood pressure with greater magnitude for MBI group (systolic: 0.35 vs 0.10; diastolic: 0.41 vs 0.11). Similar results observed for highdensity lipoprotein (0.73 vs 0.14), low-density lipoprotein (1.3 vs 0.02) and stress (perceived stress scale: 0.12 vs 0; hair cortisol 0.52 vs 0.34). Conversely, effect size (non-significant) was lower in MBI for total cholesterol (0.15 vs 0.31), and no changes observed for HbA1C (n=17). No between-group differences were observed. Conclusion(s): Our MBI program may moderate physiological risk factors in survivors post-stroke. Larger, well-powered studies are needed to confirm these findings.