Yoga and Mind-Body Exercises Improve Wellbeing For Those With Parkinson’s
Parkinson’s disease (PD) affects 1-2% of the population over 65 years of age, making it one of the most widely diagnosed neurodegenerative disorders. To date, its causes remain unknown, and there is no cure. Given that the prevalence of PD is estimated to double by 2050, considerable efforts are underway to better understand and treat PD. A new review and meta-analysis of existing research finds that mind-body interventions like yoga, dance, and tai chi hold great promise for alleviating PD symptoms.
As PD progresses it often leads to debilitating motor symptoms including tremor, stiffness, impaired movement, and postural instability, as well as psychological problems like anxiety and depression and cognitive impairment. Physical exercise is one of the key recommendations for alleviating these symptoms.
Due to the multidimensional nature of PD, and its impact on both physical and psychological outcomes, treatments that address both mind and body, such as yoga, tai chi, and even dance, are believed to be uniquely impactful. To test this premise, researchers in Hong Kong examined all of the published research in which these mind-body interventions were used to improve physical and emotional wellbeing.
A total of nine studies in which individuals with idiopathic PD of any disease stage or level of severity (tai chi = 5; yoga = 2; dance = 2) were examined. Only papers that considered mind-body exercise as the primary intervention compared to a control group were included. Sample sizes ranged from 13-80 participants, between the ages of 60.8-74.9 years. Males comprised 64% of the samples. Most of the individuals included had mild to moderate, PD-related functional impairment.
The studies included in the meta-analysis were judged to be moderate to weak due to methodological limitations such as small sample size, missing information regarding recruitment, eligibility criteria, sample characteristics and retention rates, and other key methodological parameters.
Data from each of the studies were looked at in two ways: comparing mind-body interventions to a control group, and comparing differences between yoga, tai chi and dance when possible.
Mind-body Interventions Improve Motor Control, Postural Stability and Functional Mobility
All nine of the studies considered examined motor control as an outcome variable. Overall, mind-body interventions significantly improved motor symptoms in individuals with PD. These effects were large for yoga and dance, and moderate for tai chi. Generally speaking, treatment sessions were 60 min in duration, and were offered once to three times per week. Programs ranging from 10 to 16 weeks in duration appeared to have the greatest impact on improving motor symptoms.
Six of the nine studies compared changes in postural stability between mind-body intervention and control groups. Participants attending mind-body programs yielded large and significant improvements on all measures of postural stability compared to controls. No significant differences between yoga, tai chi or dance were found.
Similarly, of the three studies that reported on changes in functional mobility, participants receiving mind-body interventions showed significant improvements compared to those in the control group, with yoga, tai chi and dance showing comparable levels of benefits.
Mind-body Interventions May Improve Psychological Wellbeing
Results across all studies for psychological variables were less definitive. While some studies showed improvements in self-reported depression symptoms and quality of life variables at the end of an intervention period, other studies failed to detect any differences between intervention and control groups.
Feasibility of Mind-body Interventions for PD is Mixed
Only half of the nine studies reported information regarding intervention adherence and participant attrition. For those studies using longer interventions (16 weeks to 1 year), adherence rates were relatively low (56.4-66.7% of participants adhered), and dropout rates were moderately high (6.3-20.8% of participants dropped out). Adherence and dropout rates were significantly better for interventions of shorter duration (73.3-92.9% and 0-16.7% respectively). The most commonly cited reasons for dropping out were medical issues, lack of transportation support, and lack of commitment to the intervention.
Although these data raise some questions regarding the feasibility of mind-body interventions for those with PD, authors of the study suggest that moderate doses of 60 min, twice per week for 10 weeks may yield the greatest benefits for physical symptoms. They attribute this finding to participant’s uncertainty about the future and lack of confidence in committing to a long-term intervention, and recommend the addition of home-based practice be used to alleviate some of these barriers or concerns.
On the whole, yoga, dance, and tai chi interventions yielded consistent beneficial effects in the domains of motor symptoms, postural stability, and functional mobility, and were found to be safe and beneficial for those experiencing mild to moderate symptoms of PD.
Kwok, JYY, Chow, CK, Lai, CHY (2016). Effects of mind-body exercises on the physiological and psychological well-being of individuals with Parkinson’s disease: A systematic review and meta-analysis. Complementary Therapies in Medicine, 29, 121-131.