Mindfulness in Motion: A Mindfulness Based Intervention in Pulmonary Rehabilitation to Improve Self-Efficacy in Chronic Respiratory Disease

ABSTRACT

Rationale Patients with chronic lung disease experience dyspnea and other symptoms that significantly affect quality of life and can result in elevated rates of depression and anxiety. Concomitant anxiety and depression can often result in poorer outcomes in these patients and can hinder their confidence in self-management of their disease. Mindfulness involves non-judgmental attention to a person's surroundings and experiences cultivates the ability to be aware of the present moment. A formal mindfulness-based intervention developed at Ohio State University called Mindfulness in Motion offered within the established structure of a pulmonary rehabilitation program was implemented in both virtual and in-person format to promote disease self-efficacy, reduce stress and improve symptoms of anxiety and depression that often accompany chronic symptomatic lung disease. Methods: This is a prospective feasibility/pilot study pre/post-test design with an intervention and control wait list groups. All new adult patients enrolling in pulmonary rehabilitation were eligible. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention that is offered in a group format for 1hr/week/8 weeks combined with 10-20 online audio and video programs to facilitate individual mindfulness practice. The Mindfulness in Motion program relaced one of the usual 1 hour pulmonary rehabilitation education sessions. One round of the intervention was done virtually via Microsoft Teams due to the restrictions of the Covid-19 pandemic and an additional in-person round of this program is currently ongoing. The primary outcome is the PROMIS Self-Efficacy for Managing Chronic Conditions-Symptoms. Breath counts pre and post intervention are of interest as well. Secondary outcomes are PROMIS Percieved Stress Scale, PROMIS Anxiety Short Form, PROMIS Depression short form and Respiratory Rate. These measures were collected pre-intervention, post-intervention, 6 months and 1 year. Results: Data collection and analysis of primary and secondary endpoints is currently ongoing. However, early analysis shows a decrease in respiratory rate immediately post-intervention. In initial 4 subjects in which respiratory rate data was recorded, 3 out of 4 patients showed significant consistent reduction in respiratory rate from the beginning to the end of each session in the 7 weeks of the intervention already completed (see Table 1). Conclusion: Mindfulness in Motion is a mindfulness intervention that is implementable within the existing structure of pulmonary rehabilitation. Further, it may be effective at slowing breathing rate in these patients prior to exercising which may be beneficial to participation. Further investigation with a larger randomized control trial would be feasible and warranted for further study. (Table Presented).