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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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Does a 60 Seconds Personalized Mindfulness Exercise Improve Pain and Emotional Outcomes in Patients With Upper Extremity Illness? A Single Blinded Randomized Control Trial
Ritsaart Frederik Westenberg, MD; Emily Lynn Zale, MSc; Tessa Heinhuis, BSc; Sezai ÷zkan, MD; Adam Nazzal, MD; Sang-Gil Lee, MD; Neal C Chen, MD; Ana-Maria Vranceanu, MSc, PhD; Massachusetts General Hospital/Harvard Medical School, Boston, MA

Introduction

Mindfulness interventions have been found to be feasible, acceptable, and useful in reducing symptoms of pain, anxiety, and fatigue in pain patients, but are resource intensive, lengthy and not amenable to busy orthopedic practices. We tested the primary null-hypotheses that a 60-second Personalized Mindfulness Based Video Exercise (MBVE): 1) is not feasible and acceptable; and 2) does not reduce pain and psychological distress over and above a sham control in patients presenting to a hand surgery practice.

Methods

A hundred-twenty-five participants were randomized to MBVE or sham control in the form of Educational Pamphlet (Table 1). Patients completed validated measurement tools for pain and psychological distress before and after the interventions. Post-intervention, patients also completed the Client Satisfaction Questionairre-3 (CSQ-3) to assess the acceptability. Analysis of covariance (ANCOVA) was used to test comparatively improvement in pain and distress after controlling for baseline scores.

Results

93% of patients who were approached agreed to participate in the research study. The intervention was feasible and acceptable, such that 100% of enrolled patients complete the intervention. Both MBVE and sham control had comparable and high acceptability rates (21 out of 32 max). Patients in the MBVE improved significantly more than those in the sham control on self-reported pain intensity, anxiety, state anxiety, depression and anger (P <0.05). There were no significant differences in improvement on distress between the MBVE and sham control. (Table 2).

Conclusion

• MBVE seems feasible for use in busy surgical practices.

• MBVE is effective in improving pain, anger, anxiety and depression outcomes in patients with hand and upper extremity illness.

• MBVE is a cost effective tool for orthopedic surgical practices, which bypasses many barriers associated with typical mindfulness based interventions.

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