Effects of Mindfulness Yoga Versus Conventional Physical Exercises on Symptom Experiences and Health-related Quality of Life in People with Parkinson’s Disease: The Potential Mediating Roles of Anxiety and Depression

Abstract

Background Although several studies have reported positive effects of mind-body exercises on symptom management and health-related quality of life (HRQOL) of people living with Parkinson’s disease (PD), it is not known whether these effects are attributable to a change in anxiety and depression. Purpose To compare the effects of mindfulness yoga to conventional stretching exercises in a randomized controlled trial while examining potentially mediating effects of anxiety and depression. Methods 138 adults with PD were randomized to eight weekly yoga (n = 71) or stretching (n = 67) sessions. Symptom experiences, anxiety and depression, and HRQOL outcomes were assessed at baseline, immediate post-intervention, and 3-month post-intervention. Results Generalized estimating equation analyses revealed that, compared to stretching, yoga significantly improved patients’ nonmotor (time-by-group interaction, T1:β = −1.99, p = .008; T2:β = −2.86, p < .001) and motor (time-by-group interaction, T1:β = −1.77, p = .03) symptom experiences. The mediation analysis found that the changes in anxiety and depression were the mediators in the associations between non-motor experience and HRQOL; while only the changes in depression were found to be the mediator in the relationship between motor experience and HRQOL. Conclusions Yoga is superior to conventional stretching exercises in improving nonmotor and motor symptoms in daily living. Reduced anxiety and depression play a role in mediating the positive effects of the mindfulness yoga intervention. To optimize HRQOL, rehabilitation should reinforce psychological care in addition to pharmacological treatments and physical relief of PD symptoms. Future studies are needed to identify strategies for facilitating the implementation and sustainability of mind-body rehabilitation to enhance the quality of care for PD.

A randomized clinical trial of mindfulness meditation versus exercise in Parkinson’s disease during social unrest

“…Compared to our previous clinical trial of mindfulness yoga, there was inconsistency in the evidence of its effects on anxiety, motor symptoms, and HRQOL 12 , 20 , 21 . Such discrepancies might be due to the different teaching/training approaches of mindfulness practices, as well as confounding factors related to the external stressors.…”

Whether mindfulness-guided therapy can be a new direction for the rehabilitation of patients with Parkinson’s disease: a network meta-analysis of non-pharmacological alternative motor-/sensory-based interventions

“…After selection, 58 studies ( Chaiwanichsiri et al, 2011 ; Duncan and Earhart, 2012 , 2014 ; Li et al, 2012 , 2018 , 2021 , 2022 ; Amano et al, 2013 ; Cheon et al, 2013 ; Corcos et al, 2013 ; Hye-Jung et al, 2013 ; Nocera et al, 2013 ; Volpe et al, 2013 ; Gao et al, 2014 ; Chen et al, 2015 ; Hashimoto et al, 2015 ; Rios Romenets et al, 2015 ; Sharma et al, 2015 ; Zhang et al, 2015 ; Choi, 2016 ; Kluger et al, 2016 ; Pantelyat et al, 2016 ; Ventura et al, 2016 ; Wong-Yu and Mak, 2016 ; Xiao and Zhuang, 2016 ; Kunkel et al, 2017 ; Lou et al, 2017 ; Cheung et al, 2018 ; Kong et al, 2018 ; Kurt et al, 2018 ; Lee et al, 2018 ; Michels et al, 2018 ; Van Puymbroeck et al, 2018 ; Vergara-Diaz et al, 2018 ; Kalyani et al, 2019 , 2020 ; Kwok et al, 2019 , 2022 ; Poier et al, 2019 ; Rawson et al, 2019 ; Solla et al, 2019 ; Wroblewska et al, 2019 ; Burt et al, 2020 ; Cancela et al, 2020 ; Dos Santos Delabary et al, 2020 ; Elangovan et al, 2020 ; Jang et al, 2020 ; Khuzema et al, 2020 ; Moon et al, 2020 ; Pohl et al, 2020 ; Cherup et al, 2021 ; Fodor et al, 2021 ; Frisaldi et al, 2021 ; Shen et al, 2021 ; Brandin-de la Cruz et al, 2022 ; ...…”

The impact of mindfulness-based stress reduction on psychological health among patients with chronic diseases during COVID-19 outbreak lockdown

“…While the majority of the literature has focused on the benefits of group-based mindfulness programs, mindfulness programs based on smartphone applications offer more feasibility and training benefits regardless of time or space barriers that could hinder in-person classes. This digital approach also applies in special circumstances, such as during the pandemic social distancing and the lockdown because of safety concerns [ 30 , 31 ].…”