Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease

Abstract

IMPORTANCE Clinical practice guidelines support exercise for patients with Parkinson disease (PD), but to our knowledge, no randomized clinical trials have tested whether yoga is superior to conventional physical exercises for stress and symptom management.OBJECTIVE To compare the effects of a mindfulness yoga program vs stretching and resistance training exercise (SRTE) on psychological distress, physical health, spiritual well-being, and health-related quality of life (HRQOL) in patients with mild-to-moderate PD.DESIGN, SETTING, AND PARTICIPANTS An assessor-masked, randomized clinical trial using the intention-to-treat principle was conducted at 4 community rehabilitation centers in Hong Kong between December 1, 2016, and May 31, 2017. A total of 187 adults (aged Ն18 years) with a clinical diagnosis of idiopathic PD who were able to stand unaided and walk with or without an assistive device were enrolled via convenience sampling. Eligible participants were randomized 1:1 to mindfulness yoga or SRTE. INTERVENTIONS Mindfulness yoga was delivered in 90-minute groups and SRTE were delivered in 60-minute groups for 8 weeks. MAIN OUTCOMES AND MEASURES Primary outcomes included anxiety and depressive symptoms assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes included severity of motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale [MDS-UPDRS], Part III motor score), mobility, spiritual well-being in terms of perceived hardship and equanimity, and HRQOL. Assessments were done at baseline, 8 weeks (T1), and 20 weeks (T2). RESULTSThe 138 participants included 65 men (47.1%) with a mean (SD) age of 63.7 (8.7) years and a mean (SD) MDS-UPDRS score of 33.3 (15.3). Generalized estimating equation analyses revealed that the yoga group had significantly better improvement in outcomes than the SRTE group, particularly for anxiety (time-by-group

Sensory focused exercise improves anxiety in Parkinson’s disease: A randomized controlled trial

“…Whilst there have been few, if any, pharmacological randomized controlled trials with anxiety as the primary outcome in PD, there has been a small number of non-pharmacological studies. A recent study demonstrated that a weekly mindfulness yoga intervention that lasted 8 weeks reduced anxiety in PD (measured by the Hospital Anxiety and Depression Scale), whereas a weekly stretching and resistance exercise intervention did not [62]. Similar to our study, the reduction in anxiety was both statistically and clinically significant.…”

Role of yoga in Parkinson’s disease-A comprehensive update of the literature

“…The improvements in the yoga group were moderate to large. However both groups in the study showed similar signi icant improvement in motor symptoms and mobility [11]. Several other studies also found yoga as a feasible and acceptable complementary therapy in improving motor function in PD [17,18,24].…”

The Impact of the COVID-19 Pandemic on Parkinson’s Disease: Hidden Sorrows and Emerging Opportunities

“…It is also good to mention the availability of specific treatments that can reduce stress, such as mindfulness-based interventions. Several recent studies have shown that mindfulness can reduce depression and anxiety, and even improve motor symptoms [17]. These courses are usually given in groups of patients, but they may also be offered through online platforms.…”