By John M. de Castro, Ph.D.
“For the person with Parkinson’s, mindfulness might be considered as a method to help with issues of denial and acceptance, loss of independence, and the many frustrations that accompany a disease over which a person has no control and can help him or her feel more connected to body, mind, and spirit in ways that enhance self-understanding and personal insight.”
Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications can reduce life expectancy, such as falls, choking, and cardiovascular problems. There are also psychological effects, especially anxiety and depression. All of these symptoms result in a marked reduction in the quality of life. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.
Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients. In today’s Research News article “The effects of a mindfulness-based lifestyle program for adults with Parkinson’s disease: a mixed methods, wait list controlled randomised control study.” See:
or see summary below or view the full text of the study at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016929/
Advocat and colleagues investigate the effectiveness of mindfulness training on the symptoms of Parkinson’s Disease (PD). They randomly assigned Parkinson’s Disease patients to either receive a modified 6-week, 2-hour per week, mindfulness program or remain with treatment as usual on a wait list. Mindfulness training participants were also provided materials to practice at home. As part of the intervention, they also received education on PD management, stress managements, spirituality, exercise, nutrition, available support, and environmental issues. The participants were measured before and after treatment and 6 months later for PD symptoms, mindfulness, depression, anxiety, locus of control, exercise, and nutrition.
They found that the immediately after the intervention the mindfulness group in comparison to controls had a significant increase in mindfulness and perceived internal locus of control. At the 6-month follow up the mindfulness group had a significant increase in mindfulness, decrease in stress, and an improvement in their diet. On the average, but not significant, were improvements in in Parkinson’s Disease symptoms overall and with activities of daily living.
These results are disappointing and did not replicate previous findings of a positive effect of mindfulness training on PD. The study however, was small, with only 23 patients completing the intervention and thereby did not have sufficient statistical power to detect small differences. The mindfulness training also only lasted for 6-weeks and contained only 5-20 minutes per week of mindfulness training which may have been insufficient to be effective. In addition, follow up measures of adherence to the program were neutral suggesting that the participants were not particularly diligent in their practice. This suggests that future interventions should have a larger number of participants, contain more intensive mindfulness training, and include methods to insure compliance with the practice instructions.
Regardless of these disappointing findings, mindfulness training holds promise to help relieve the suffering of patients with Parkinson’s Disease. It is not a cure and it does not even delay the progression of the disease, but it can be helpful in improving the patient’s quality of life and ability to deal with PD. So, be mindful with parkinson’s disease.
CMCS – Center for Mindfulness and Contemplative Studies
“Long-term mindfulness practitioners increase the working capacity of the brain and connections within the brain, and increase brain matter than non-practitioners. This suggests mindfulness may keep brains young and healthy.“ – Terry Gebhardt
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Study Summary
Advocat, J., Enticott, J., Vandenberg, B., Hassed, C., Hester, J., & Russell, G. (2016). The effects of a mindfulness-based lifestyle program for adults with Parkinson’s disease: a mixed methods, wait list controlled randomised control study. BMC Neurology, 16(1), 166. http://doi.org/10.1186/s12883-016-0685-1
Abstract
Background: Parkinson’s disease (PD) is the second commonest neurodegenerative disease in developed countries. Current treatment for PD is pharmacologically focused and can have significant side-effects. There is increasing interest in holistic approaches including mindfulness to help manage the challenges associated with living with PD. We hypothesised that there would be an improvement in PD associated function and wellbeing in participants after participating in a 6-week mindfulness-based lifestyle program, and that these improvements would be sustainable at 6 months. Our primary objective was to determine changes in function and wellbeing associated with PD.
Methods: An exploratory prospective, mixed-method, randomised control trial incorporating a before and after design with a waitlist control, with an embedded qualitative component was conducted in 2012–2013. Participants included community living adults with disability congruent to H&Y Stage 2 PD, aged 18–75, fluent in spoken and written English and able to attend at least four of six sessions of the program. Participants were randomised to the intervention or wait-list control groups at two locations. All participants in the wait-list control group eventually received the intervention. Two randomisation codes were created for each location. Allocation to the intervention or wait-list control was by random number generation. The program facilitator and participants were blinded to participant data.
Results: Group 1 included 35 participants and group 2 (the waitlist control), 37. Data was analysed from 24 (group 1) and 33 (group 2) participants. The intervention group, compared to the waitlist control, showed a small improvement in function and wellbeing associated with PD immediately after the program (t-score = −0.59) and at 6-month post intervention (t-score = −1.42) as reported by the PDQ-39 SI. However this finding was not significant (p = 0.56 and 0.16 respectively). A small yet significant effect size (β = 0.23) in PDQ-39 ADL was reported in group 1 after 6-months post-intervention. This showed a positive improvement in the ADL as reported by group 1 after 6-months (t-score −1.8, p = 0.04). Four secondary measures are reported.
Conclusions: Our findings suggest mindfulness-based lifestyle programs have potential to assist participants in managing the ongoing difficulties associated with a neurological condition such as Parkinson’s disease. Importantly, our study shows promise for the long term benefits of such programs. Improvements to participant activities in daily living and mindfulness were retained at 6-months post intervention. A more definitive study should be conducted in a larger sample of PD patients to further explore these findings and their impact on reducing stress and anxiety in PD patients.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016929/