Effect of mindfulness-based cognitive therapy on rumination and post-traumatic growth in patients with acute cerebral infarction: A randomized controlled trial

• Published in: Medicine (Baltimore) Vol. 104; no. 22; p. e42570
• Main Authors: Zhang, Zuoju, Dong, Yanhong, Sun, Yuxin
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 30.05.2025
• Subjects: Aged; Anxiety - etiology; Anxiety - therapy; Cerebral Infarction - complications; Cerebral Infarction - psychology; Cerebral Infarction - therapy; Clinical Trial/Experimental Study; Cognitive Behavioral Therapy - methods; Depression - etiology; Depression - therapy; Female; Humans; Male; Middle Aged; Mindfulness - methods; Muscle Strength; Rumination, Cognitive; Single-Blind Method; Treatment Outcome; anxiety; acute cerebral infarction; mindfulness-based cognitive therapy; nursing; depression; rumination; randomized controlled trial
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000042570

Background: The prevention and management of cerebrovascular diseases, particularly cerebral infarction - the most prevalent type of cerebrovascular disease - pose significant challenges, severely affecting patients' physical and mental health. Mindfulness-based cognitive therapy (MBCT) has been shown to be effective in treating various mental and chronic conditions. However, there is limited evidence on its effectiveness for treating rumination in patients with acute cerebral infarction (ACI). This study examines the effects of MBCT on rumination, anxiety and depression symptoms, post-traumatic growth, self-care ability, limb motor function, and muscle strength in patients with ACI. Methods: In this randomized, single-blind, parallel, single-center controlled trial, participants were recruited from the Department of Neurology and allocated randomly to either 6 weeks of mindfulness cognitive therapy or standard care. The outcomes were assessed at baseline and post-intervention (6 weeks) using the simplified Chinese event-related rumination inventory, the hospital anxiety and depression scale, the simplified Chinese post-traumatic growth inventory, the modified Barthel index (MBI), Brunnstrom hemiplegic motor function assessment, and the Lovett Muscle strength scale. Results: Ninety-five subjects were randomly sorted into either the intervention (n = 48) or control group (n = 47). During the study, 5 (5.26%) participants were lost to follow-up, leaving 90 (94.74%) to complete the intervention. Post-intervention, both groups exhibited increased total and purposive rumination scores, with the intervention group scoring higher (P < .05). Intrusive rumination decreased in both groups, with a more significant reduction observed in the intervention group (P < .05). Both groups showed reduced hospital anxiety and depression scores, though the intervention group had lower scores (P < .05). The intervention group also had higher total and subscale scores for post-traumatic growth than the control (P < .05). The MBI scores improved in both groups, with the intervention group showing higher scores (P < .05). However, no significant difference was observed in the improvement of limb motor function or muscle strength between the intervention and conventional care groups (P > .05). Conclusion: MBCT can improve the purposeful rumination and self-care ability of patients with ACI, alleviate anxiety and depression symptoms, and foster post-traumatic growth. However, it did not significantly improve limb motor function or muscle strength.