Effects of mind-body training on upper-limb function in stroke patients: a multilevel dose-response meta-analysis

Area of Science:

• Neurorehabilitation
• Physical Therapy
• Integrative Medicine

Background:

• Stroke is a leading cause of long-term disability, often impairing upper-limb function.
• Mind-body training (MBT) encompasses practices like meditation and Tai Chi, showing potential for neurological recovery.
• Optimizing MBT dosage and identifying key influencing factors are crucial for effective stroke rehabilitation.

Purpose of the Study:

• To systematically review and meta-analyze the effects of MBT on upper-limb function in stroke patients.
• To determine the optimal intervention dosage for MBT using Bayesian dose-response modeling.
• To identify key factors influencing MBT outcomes in stroke rehabilitation through XGBoost-SHAP analysis.

Main Methods:

• Systematic search of major databases (PubMed, Web of Science, PsycINFO, Cochrane) for randomized controlled trials (RCTs).
• Meta-analysis of 16 RCTs (769 participants) using standardized mean differences (SMDs) and Bayesian dose-response modeling.
• Exploratory analysis of predictors using XGBoost-SHAP and assessment of evidence certainty using GRADE.

Main Results:

• MBT significantly improved upper-limb function in stroke patients (SMD = 0.65).
• An optimal cumulative intervention duration of approximately 33.5 hours was identified, showing an inverted U-shaped dose-response relationship.
• Subgroup analyses indicated potentially larger effects in subacute patients and with Tai Chi interventions.

Conclusions:

• Moderate-certainty evidence supports MBT's efficacy in enhancing upper-limb function post-stroke.
• A recommended intervention schedule is 30-minute sessions, five times weekly for 14-15 weeks, totaling ~33.5 hours.
• Further research is needed to confirm findings in stage-stratified RCTs, particularly for subacute patients.