Effects of Mind-Body Exercises for Mood and Functional Capabilities in Patients with Stroke: An Analytical Review of Randomized Controlled Trials

Abstract

Objective: The effects of stroke are both physical and mental in nature and may have serious implications on the overall well-being of stroke survivors. This analytical review aims to critically evaluate and statistically synthesize the existing literature regarding the effects of mind-body (MB) exercises on mood and functional capabilities in patients with stroke. Methods: A structured literature review was performed in both English (PubMed, PEDro, and Cochrane Library) and Chinese (Wanfang and CNKI (Chinese National Knowledge Information Database)) databases. Sixteen randomized controlled trials were considered eligible for meta-analysis. Based on the random effects model, we used the pooled effect size to determine the magnitude of rehabilitative effect of MB exercise intervention on depression, anxiety, activities of daily living, and functional mobility among stroke survivors. The sum PEDro score ranged from five to nine points (fair-to-good methodological quality), but the absence of concealed allocation and blinded assessors were reported in most studies. Results: The aggregated results showed that MB exercise intervention is associated with significantly improved ADL (Hedges' g = 1.31, 95% CI 0.85 to 1.77, p < 0.001, I² = 79.82%) and mobility (Hedges' g = 0.67, 95% CI 0.25 to 1.09, p < 0.001, I² = 69.65%), and reduced depression (Hedges' g = -0.76, 95% CI -1.16 to -0.35, p < 0.001, I² = 74.84%). Conclusions: as add-on treatments, the MB exercises may potentially improve depression, activities of daily living, and mobility of these post-stroke patients. Future studies with more robust methodology will be needed to provide a more definitive conclusion.

Keywords: mind-body exercise; rehabilitation; stroke; tai chi.

Figure 1

Flowchart showing the retrieval of studies for review (PEDro = Physiotherapy Evidence Database; CNKI = Chinese National Knowledge Information Database).

Figure 2

Effect of mind-body exercises on depression. (Circled symbol represents the effect size of each individual study and squared symbol represents an overall/pooled effect size of all studies on each outcome).

Figure 3

Effect of mind-body exercises on activities of daily living. ADL: activities of daily living. (Circled symbol represents the effect size of each individual study and squared symbol represents an overall/pooled effect size of all studies on each outcome).

Figure 4

Effect of mind-body exercises on mobility function. (Circled symbol represents the effect size of each individual study and squared symbol represents an overall/pooled effect size of all studies on each outcome).