Pilot clinical trial of a clinical meditation and imagery intervention for chronic pain after spinal cord injury

Abstract

Objective

To assess the feasibility and potential benefits of clinical meditation and imagery (CMI) for people with chronic spinal cord injury (SCI) and chronic pain.

Design

Pilot randomized, controlled trial.

Setting

Outpatients with SCI in the United States.

Participants

24 adults with chronic SCI (>1 year) and a >3 month history of pain rated ≥4/10 on average over the last week.

Interventions

4-week program of once-weekly 2-hour group classes, offered in-person and online. CMI group participants were taught mindfulness, mantra meditation, and guided imagery practices. Control group participants received education on topics related to health and function after SCI.

Outcome Measures

Pain interference (primary outcome), pain cognitions, pain intensity/unpleasantness, depressive symptomology, perceived stress.

Results

Pain interference decreased to a greater extent in the control group at both Day 42 and Day 70, with a large effect size (d > 1.0). Several secondary outcome measures showed changes consistent with more favorable outcomes in the CMI group at both Day 42 and Day 70, with a large effect size d > 0.80, including worst pain intensity over the last week, depressive symptomology, belief in pain as a sign of harm and perceived control over pain. Perceived stress improved to a greater extent in the control group (d = 1.16 at Day 42, d = .20 at Day 70).

Conclusion

CMI is feasible and acceptable to implement with people with SCI and chronic pain. Further study is warranted to assess potential benefits for pain-related outcomes.

Trial registration:

• NCT02262234

Keywords:

• Chronic pain
• Imagery
• Meditation
• Rehabilitation
• Spinal cord injury

Acknowledgements

This work was supported by the Craig H. Neilsen Foundation under grant number 288925. The authors acknowledge the contributions of Jeanette Centeno, RN, Ashleigh Quinn, Richard Schaub, PhD, Bonney Gulino Schaub, MS, RN, PMHCNS, NC-BC, Bob Su, PhD, and Jeffrey Zhang, PhD. We appreciate the time and effort of all those with SCI who participated in this project.

Disclaimer statements

Contributors None.

Funding This work was supported by the Craig H. Neilsen Foundation [grant number 288925].

Conflicts of interest Authors have no conflict of interests to declare.