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HEADS:UP: The mindfulness course for stroke survivors

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Approximately one third of stroke survivors report experiencing some emotional problems after their stroke. And as well as impacting on survivors’ general quality of life, mental ill-health can seriously hinder their rehab prospects or even lead to another stroke.

Professor Maggie Lawrence has an extensive background in stroke prevention and recovery research. And since 2017, the Glasgow Caledonian University academic has been working on the innovative HEADS:UP research project.

“When we started this, we decided that we needed to find a way to help people manage their anxiety and depression so they could both engage with their rehab and have better relationships,” Prof. Lawrence tells Stroke Rehab Times.

“In the long term, we hope HEADS:UP will help people take those steps towards preventing another stroke from happening. But in the short term, it’s about helping people to manage anxiety and depression symptoms better.”

The course has been developed around Mindfulness Based Stress Reduction (MBSR). Techniques in the course include meditation, mindful breathing and mindful movement.

Prof. Lawrence and her team worked with stroke survivors to adapt the course.

“One the things we know about MBSR is that it’s generally effective if people can follow the eight-week course and commit to regular personal practice.

“Those things aren’t easy for the general population, let alone after stroke.

“Survivors are having to deal with so many things that can significantly impact their ability to follow a course, read a manual or whatever it may be. We wanted to make it easier for people to stick with and to learn how to do.”

As well as daily home practice, participants work with an experienced MBSR therapist to develop their mindfulness skills. The content gets progressively more challenging over time as the participants acquire the skills and understanding to change their attitudes.

HEADS:UP also includes an introductory session, where the team can answer any questions as participants can get to know one another.

“We also invite people to tell their stroke story because that’s so important.

“As well as helping the individual themselves, it hopefully helps the group to bond and may give the trainer some insight into the particular needs of individuals within the group.”

The research project has now entered the randomised controlled trial (RCT) phase, with 64 people recruited into one of two groups: half will following the HEADS:UP course and the other half will act as a control.

“I think clinicians and charitable organisations are keen to use HEADS:UP as an intervention that they can consider rolling out.

“Our problem is that the study is too small to show that the treatment is effective.

“But you could argue that we already know that MBSR is effective. This was just more about how can we make it more accessible for people who have had a stroke.

“Ideally, we would want to do a big multicentre, RCT, but that that takes years. And it’s really frustrating for people who just want to get going with something.

“We’re just starting discussions about how best we can take it forward, sometime towards the end of this year or maybe next year.”

Maggie admits that mindfulness is not for everyone. But those people who do connect with it have been sticking with it.

For every 10 people doing the course, maybe eight have seen through all eight weeks, which is almost unheard of, she says.

“And interestingly, some of the participants have been using WhatsApp or email to stay in touch and a couple have even gone on to become mindfulness trainers. It’s great to see that it’s impacting people in that way.”

You can stay up-to-date with Maggie’s research by signing up to the HEADS:UP mailing list.

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