Six-month follow-up of a mindfulness yoga program, MiYoga, on attention, executive function, behaviour and physical outcomes in cerebral palsy

A randomised controlled trial (RCT) of a mindfulness-based yoga program, MiYoga, for cerebral palsy (CP) demonstrated improved attention in children and decreased mindfulness in parents post-intervention. This paper evaluates the retention of treatment effects at 6-months follow-up. 42 children with CP and their parents participated in a RCT with two groups MiYoga (<i>n</i> = 21) and Waitlist control group (<i>n</i> = 21). Waitlist control participants were offered MiYoga following the post-intervention assessment. 23 out of 42 child-parent dyads from both groups completed follow-up assessment 6-months after completing MiYoga. This paper evaluates and reports data from both groups collapsed (<i>n</i> = 23; MiYoga <i>n</i> = 11; and waitlist control <i>n</i> = 12; 47.8% male; mean age = 9:10 ± 2.4 years) to assess retention from post-MiYoga to follow-up and pre-MiYoga to follow-up. The primary outcome was attention, measured by Conner’s Continuous Performance Test II (CCPT). Secondary outcomes included child executive function, physical function, behaviour, quality of life, child and parent mindfulness, personal wellbeing, psychological wellbeing and parent-child relationship. Paired <i>t</i>-tests showed no significant changes between post-MiYoga to follow-up and pre-MiYoga to follow-up for variables that showed an intervention effect immediately after MiYoga, namely, children’s attention variables and parent’s mindfulness. Paired <i>t</i>-tests showed that children’s executive function and physical function and parent’s wellbeing improved significantly from pre-MiYoga to 6-months follow-up which may potentially reflect sleeper or delayed effects of MiYoga. This study identified possible delayed or sleeper effects in children’s executive function and physical function and parent’s well-being.Implications for rehabilitation6-month follow-up evidence for retention of effects of MiYoga on children’s attention was inconsistent; therefore, booster sessions or continued practice of MiYoga as a lifestyle option are needed to maintain an effect on attention.Because MiYoga can be practised during daily activities, it may provide additional support for children with CP, complementing standard rehabilitation options.By embedding mindfulness in children and parents’ daily activities, MiYoga, could provide families with accessible and time-efficient means of learning and practicing mindfulness. 6-month follow-up evidence for retention of effects of MiYoga on children’s attention was inconsistent; therefore, booster sessions or continued practice of MiYoga as a lifestyle option are needed to maintain an effect on attention. Because MiYoga can be practised during daily activities, it may provide additional support for children with CP, complementing standard rehabilitation options. By embedding mindfulness in children and parents’ daily activities, MiYoga, could provide families with accessible and time-efficient means of learning and practicing mindfulness.

一项针对脑瘫（cerebral palsy, CP）患者的正念瑜伽项目MiYoga的随机对照试验（randomised controlled trial, RCT）结果显示，干预后儿童的注意力得到改善，而家长的正念水平有所下降。本研究旨在评估干预后6个月随访时的治疗效应留存情况。本RCT共纳入42名脑瘫儿童及其家长，分为两组：MiYoga组（样本量n=21）与等待列表对照组（样本量n=21）。等待列表对照组参与者在干预后评估阶段结束后可参与MiYoga项目。两组中共23对亲子完成了MiYoga结束后6个月的随访评估。本研究对合并两组的数据（总样本量n=23；其中MiYoga组n=11，等待列表对照组n=12；男性占比47.8%；平均年龄9岁10个月±2.4岁）进行分析，以评估从MiYoga干预后至随访阶段，以及从MiYoga干预前至随访阶段的效应留存情况。
主要结局指标为注意力，采用康纳斯持续操作测试II（Conner’s Continuous Performance Test II, CCPT）进行评估。次要结局指标包括儿童执行功能、躯体功能、行为问题、生活质量、儿童与家长的正念水平、个人幸福感、心理幸福感以及亲子关系。
配对t检验结果显示，对于MiYoga干预后即刻出现干预效应的指标，即儿童注意力相关变量与家长的正念水平，在MiYoga干预后至随访阶段，以及干预前至随访阶段均未出现显著变化。而配对t检验结果表明，儿童的执行功能、躯体功能以及家长的幸福感在从MiYoga干预前至6个月随访阶段均得到显著改善，这可能反映了MiYoga的睡眠者效应（sleeper effect，延迟效应）。本研究证实了MiYoga在儿童执行功能、躯体功能以及家长幸福感方面存在潜在的延迟效应或睡眠者效应。
康复领域启示：
关于MiYoga对儿童注意力的效应留存情况，6个月随访的相关证据并不一致，因此需要通过强化疗程或作为生活方式持续开展MiYoga练习，以维持对注意力的改善效果。由于MiYoga可在日常活动中进行，其可为脑瘫儿童提供额外支持，作为标准康复方案的补充。通过将正念练习融入儿童与家长的日常活动，MiYoga可为家庭提供便捷且省时的正念学习与实践途径。
6个月随访的相关证据并不一致，因此需要通过强化疗程或作为生活方式持续开展MiYoga练习，以维持对注意力的改善效果。由于MiYoga可在日常活动中进行，其可为脑瘫儿童提供额外支持，作为标准康复方案的补充。通过将正念练习融入儿童与家长的日常活动，MiYoga可为家庭提供便捷且省时的正念学习与实践途径。