Objective

To examine the effects of mindfulness- and acceptance-based interventions (MABIs) on reducing symptoms in individuals with multiple sclerosis (MS).

Data Sources

A comprehensive search was conducted within the PubMed, CINAHL, PsycINFO, and SCOPUS databases for articles published from inception to July 3, 2020.

Study Selection

Randomized controlled trials (RCTs) were included if MABIs were provided to individuals with MS exclusively, with reported pre-and posttest results in symptoms of depression, anxiety, stress, fatigue, or pain.

Data Extraction

Characteristics of the included RCTs and data for meta-analysis were extracted. The quality of the included RCTs was assessed using the Cochrane Collaboration risk of bias tool.

Data Synthesis

A random effects model with the inverse variance method was used with effect size reported as standardized mean difference. Heterogeneity was assessed using the I² statistic.

Results

Twenty-three RCTs met the eligibility criteria. Meta-analyses found large effects of MABIs on reducing depressive symptoms, anxiety, stress, and pain, as well as a moderate effect of MABIs on reducing fatigue at the immediate posttest. Large effects of MABIs on reducing depressive symptoms, anxiety, and stress at follow-up were also found, whereas a moderate effect on reducing fatigue was found at follow-up. There was no significant effect of MABIs on reducing pain at follow-up.

Conclusions

Fewer studies were included in meta-analyses for pain at the immediate posttest and follow-up and stress and fatigue at follow-up. The overall risk of bias was unclear. Future high-quality studies with follow-up evaluations are needed to support effects of MABIs on reducing symptoms in individuals with MS and examine intervention features that increase and maintain effects.

中文翻译：

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以正念和接受为基础的干预措施以减轻多发性硬化症患者的症状：系统评价和荟萃分析

客观的

研究基于正念和接受的干预措施 (MABI) 对减轻多发性硬化症 (MS) 患者症状的影响。

数据源

在 PubMed、CINAHL、PsycINFO 和 SCOPUS 数据库中对从开始到 2020 年 7 月 3 日发表的文章进行了全面搜索。

研究选择

如果 MABI 仅提供给 MS 患者，并且报告的测试前和测试后结果出现抑郁、焦虑、压力、疲劳或疼痛症状，则纳入随机对照试验 (RCT)。

数据提取

提取了纳入 RCT 的特征和用于荟萃分析的数据。使用 Cochrane Collaboration 偏倚风险工具评估纳入的 RCT 的质量。

数据综合

使用具有逆方差方法的随机效应模型，效应大小报告为标准化平均差。使用I ² 统计量评估异质性。

结果

23 项 RCT 符合纳入标准。荟萃分析发现 MABI 对减轻抑郁症状、焦虑、压力和疼痛有很大的影响，以及 MABI 在立即后测中对减轻疲劳的中等影响。还发现 MABI 对减少随访时的抑郁症状、焦虑和压力有很大影响，而在随访时发现对减轻疲劳有中等作用。MABI 对减轻随访疼痛没有显着影响。

结论

较少的研究被纳入对立即后测和随访时的疼痛以及随访时的压力和疲劳的荟萃分析。偏倚的总体风险尚不清楚。未来需要进行后续评估的高质量研究来支持 MABI 对减轻 MS 患者症状的影响，并检查增加和维持效果的干预特征。