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 Parkinson's disease is one of the most common chronic
neurodegenerative diseases. Classic motor symptoms include tremors,
rigidity, slowed movements, and postural instability - but patients
with Parkinson's can also experience a variety of cognitive problems
as well as psychiatric disorders like depression and anxiety,
researchers note in JAMA Neurology.
For the study, researchers randomly assigned 138 adults with
Parkinson's to participate in eight weeks of either a mindfulness
yoga program or an exercise program focused on stretching and
resistance training to improve mobility and stability. All of the
participants could stand and walk without canes or walkers.
Yoga was just as effective as stretching and resistance training for
improving motor dysfunction and mobility, the study found.
But people who did yoga experienced greater reductions in anxiety,
depression, and perceived hardship related to their illness.
Patients in the yoga group also reported greater improvements in
what's known as health-related quality of life, or how well they're
able to function in daily activities despite their disease.
"Before the study, we knew that mind-body exercises such as yoga and
stretching improve the physical health of patients with Parkinson's
disease (PD), however the benefit to their mental health was not
known," said lead study author Jojo Kwok of the University of Hong
Kong.
"This study concludes that mindfulness yoga alleviates psychological
distress, improves spiritual well-being and quality of life, not to
mention motor symptoms and mobility," Kwok said by email. "What is
exciting, is that yoga has now been proven to be a better strategy
than just stretching."
Each week during the study, people in the stretching and resistance
training group had one weekly 60-minute group session. They were
also encouraged to practice exercises at home for 20 minutes twice a
week.
People in the yoga group had one weekly 90-minute session of hatha
yoga, which focuses on breathing and meditation in addition to
specific poses. They, too, were told to practice at home for 20
minutes twice a week.
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Mindfulness-based training programs are designed to help people
focus on the present moment and accept any pain or discomfort they
may be feeling. This may involve meditation techniques to cultivate
awareness of the present moment during ordinary daily activities
such as driving or eating, or breathing exercises and practices such
as yoga to help encourage body awareness and focus on the present.
Four participants in the yoga group reported temporary mild knee
pain, as did two people in the stretching and resistance training
group. None of the patients had more serious side effects.
One limitation of the study is that many participants dropped out.
And, it's also possible results might be different for Parkinson's
patients with more mobility limitations, who were excluded from the
trial.
Still, the results add to the evidence that hatha and other forms of
yoga may be beneficial for Parkinson's patients, said Catherine
Justice, an integrative physical therapist at Hennepin Healthcare in
Minneapolis, Minnesota.
Particularly with the motor symptoms of Parkinson's, however, it's
crucial that people with this condition discuss it with their yoga
instructor before trying a class to minimize their risk of injury,
Justice advised.
"Risk of falls could be quite high in standing or balancing poses or
when transitioning to and from the floor," Justice said. "For this
reason, I recommend that anyone with Parkinson's practice yoga next
to a wall, with a sturdy chair positioned within reach with at least
2 feet of the chair on the mat."
Parkinson's patients may still benefit from both the physical and
mental activity of yoga practice, said Dr. Martha Nance, medical
director of the Park Nicollet-Struthers Parkinson's Center in
Minneapolis.
If yoga isn't available where patients live, "it is still useful to
exercise 150 minutes weekly, and other forms of
mindfulness/meditation are likely to help with emotional (health)
too," Nance, who wasn't involved in the study, said by email.
SOURCE: http://bit.ly/2G5GUDN JAMA Neurology, online April 8, 2019.
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