Internet-delivered mindfulness for people with depression and chronic pain following spinal cord injury; a randomised, controlled feasibility trial

Study Design: Between-subjects, randomised controlled feasibility study. Objectives: Populations with reduced sensory and motor function are at increased risk of depression, anxiety, and pain, and may be less geographically mobile. This study explored the efficacy and feasibility of web-based mindfulness training for people with spinal cord injury (SCI). Setting: UK community sample. Methods: Participants were randomly allocated to an eight-week online mindfulness intervention (N = 36), or to internet-delivered psychoeducation (N = 31). Depression symptom severity was the primary outcome. Secondary outcomes included anxiety, quality of life (QoL), pain perception, pain catastrophising, and mindfulness. Measures were taken before (T1), at completion of, (T2), and three months following the intervention (T3). Results: At T2, ten participants discontinued mindfulness training, and five discontinued psychoeducation. Dropouts were of significantly older age. Nine participants were lost to follow-up. Mindfulness reduced depression significantly more than psychoeducation at T2 (mean difference = -1.50, 95% CI [-2.43, -.58]) and T3 (mean difference = -2.34, 95% CI [-3.62, -1.10]). Anxiety, pain unpleasantness, and catastrophising were significantly reduced compared with psychoeducation. Total mindfulness scores, and all facets of mindfulness except observing were significantly higher following mindfulness training. At follow-up, reductions in anxiety and catastrophising persisted. Conclusions: Internet-delivered mindfulness training offers unique benefits and is viable for people with reduced sensory awareness. Future work should explore the feasibility of combined education and mindfulness training. The use of brief interventions shows promise in maximizing participant retention