Depression and anxiety are common following spinal cord injury (SCI) and can worsen pain and negatively impact quality of life. Researchers at UHN’s KITE Research Institute (KITE) are exploring how adapting the language and content of mindfulness-based interventions—programs that teach present-moment awareness and acceptance—can improve psychological well-being and recovery for individuals with SCI.
Mindfulness-based interventions are proven to reduce pain and improve mood in those with chronic pain. However, most interventions were designed for individuals without motor or sensory impairments. Standard exercises such as mindfulness walks or instructions like “feel your feet on the ground” can be frustrating or impossible for those with limited mobility or altered sensation. Without adaptation, these practices may feel inaccessible and discourage participation.
To explore how mindfulness-based interventions could be made more inclusive, KITE researchers interviewed 22 individuals with SCI to identify motivators and barriers to practicing mindfulness. Participants noted physical challenges—such as pain, stress, and poor sleep—as key motivators. They also reported perceived benefits, including reduced anxiety and depression, improved emotional regulation, and feeling more present in relationships.
Barriers included misconceptions about how hard it is to fit mindfulness into daily life and a lack of accessibility in the language used during exercises. Emphasis on specific body postures or traditional mindfulness practices, such as walking meditations, made participation challenging.
Adapting mindfulness-based interventions with more inclusive language, flexible options for body positioning, and improved education around mindfulness could greatly increase program accessibility. Removing these barriers could support more patient-centred care for individuals with SCI.
Dorothy Luong, first author of the study, is a Research Associate at UHN’s KITE Research Institute in the lab of Dr. Sarah Munce.
Dr. Sarah Munce, senior author of the study, is an Affiliate Scientist at UHN’s KITE Research Institute and an Implementation Scientist at the Holland Bloorview Kids Rehabilitation Hospital. At the University of Toronto, Dr. Munce is an Associate Professor at the Institute of Health Policy, Management, and Evaluation and is cross appointed at the Rehabilitation Sciences Institute.
This work was supported by Crain H. Neilsen Foundation and UHN Foundation.
Luong D, Lee TJ, Simpson R, Fetterly MJ, Jaglal S, Allin S, Craven C, Hearn J, Webster F, Munce S. How do individuals with spinal cord injury practice mindfulness? Barriers & facilitators to practicing mindfulness and considerations for tailoring programs. Disabil Rehabil. 2025 Oct 29. doi: 10.1080/09638288.2025.2580297. Epub ahead of print.