Domain-specific responsiveness to mindfulness and cognitive rehabilitation in chronic ischemic stroke survivors

BACKGROUND: Chronic ischemic stroke survivors experience cognitive, emotional, and participation-related limitations that affect reintegration into the community and life satisfaction. Mindfulness-Based Stress Reduction (MBSR) and Cognitive Rehabilitation Therapy (CRT) may aid in the recovery process of stroke survivors. These rehabilitation programs may act through different mechanisms. However, little is known about the domain-specific responsiveness of stroke survivors to these rehabilitation programs. OBJECTIVES: The objectives of this study were to investigate the domain-specific functional responsiveness of stroke survivors with chronic ischemic stroke to both mindfulness-based and cognitive rehabilitation programs, especially in terms of participation, communication, and cognitive outcomes. METHODS: This controlled longitudinal study consisted of 36 stroke survivors with chronic ischemic stroke who were randomly assigned to one of the three groups: MBSR, cognitive rehabilitation based on Powell's protocol, or a control group. Participants underwent the Stroke Impact Scale (SIS) assessment. Changes in SIS domain scores from baseline to post-intervention and two-month follow-up were evaluated using repeated measures analysis of variance. RESULTS: The results revealed that the patterns of domain-specific responsiveness varied between the interventions. It was noted that the mindfulness-based intervention showed better recovery in cognitive-affective domains, especially memory, thinking, and participation/role function. Conversely, cognitive rehabilitation showed better recovery in communication-related outcomes. No significant recovery was noted in the control group for any of the domains. CONCLUSIONS: The study suggests that both mindfulness-based and cognitive rehabilitation interventions facilitate recovery through unique pathways in chronic ischemic stroke survivors. Domain-specific responsiveness may be a valuable tool for providing clinically relevant information for tailoring rehabilitation approaches according to individual patient characteristics.