The effect of mindfulness movement therapy on arm and hand function in people with and without stroke

Upper extremity motor deficit is a big issue in patients with stroke. Mindfulness meditation may have potential to improve arm and hand function in stroke patients. However, there is no mindfulness programme specifically concerned with motor performance. Therefore, this thesis proposed a new protocol of a mindfulness movement therapy programme (MMTP) for improving arm and hand function in patients with stroke. There were 4 phases to this thesis, phase I; a systematic review of meditation for motor function in patients with stroke, phase II; a preliminary study in older adults, phase III; a randomised single-blind controlled trial in healthy older adults, and phase IV; a preliminary study in patients with stroke. In phase I, 13 studies were included for qualitative synthesis but no studies focused on the primary outcome of motor function. In phase II, MMTP improved motor performance speed of the upper limbs for both hands, especially in the trained upper limb (p=0.008) and affected mood (p=0.033) accompanied by improved sensorimotor and attentional functioning in the brain. In phase III, MMTP increased nerve conduction velocity (p=0.018) with no changes in the active control group. Moreover, motor performance speed improved in the trained upper limb (p<0.0001). In the last phase, MMTP improved spasticity of the elbow flexor (p=0.025) and finger flexors (p=0.034), mindfulness (p=0.027), and quality of life (p=0.043). It was concluded that MMTP might have the potential to add to the standard rehabilitation programme for improving motor performance of the upper limb in people with and without stroke. While this thesis provides promising evidence, larger clinical trials are needed to confirm the effects of MMTP as a new intervention for improving arm and hand function in patients with stroke.