Improve Parkinson’s Disease with Group Tai Chi Practice

Improve Parkinson’s Disease with Group Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Tai chi, an ancient martial art characterized by slow, flowing movement and meditation, helps improve balance and movement control for people with Parkinson’s disease.” – Tara Parker-Pope

 

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. 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.

 

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 which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients. Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. In addition, Qigong  has been shown to improve the symptoms of Parkinson’s Disease. Hence, Tai Chi and Qigong may be an excellent treatment for the symptoms of Parkinson’s Disease.

 

The parameters of Tai Chi and Qigong practice that maximize its benefits for the relief of the symptoms of Parkinson’s Disease have not been explored. In today’s Research News article “The Effects of Group-Based versus Individual-Based Tai Chi Training on Nonmotor Symptoms in Patients with Mild to Moderate Parkinson’s Disease: A Randomized Controlled Pilot Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546134/, Yang and colleagues investigate the relative effectiveness of Tai Chi practiced alone or in group contexts. They recruited patients with Parkinson’s Disease and randomly assigned them to practice Tai Chi for 45 minutes, 3 times per week, for 13 weeks either alone or in a group of 6 to 7 participants. Home practice was also prescribed. They were measured before and after training for cognitive ability, depression, and the non-motor symptoms of Parkinson’s Disease including cardiovascular, sleep/fatigue, mood/cognition, perceptual problems, attention/memory, gastrointestinal, urinary, and sexual function.

 

They found that after training both groups showed significant improvement in the overall non-motor symptoms of Parkinson’s Disease and particularly in sleep. Only the group Tai Chi practice participants, however, showed a significant improvement in cognitive (thinking) performance. In addition, the group Tai Chi practice participants had significantly greater compliance with home practice. Hence, Tai Chi regardless of whether practiced in groups of individually improved the non-motor symptoms of Parkinson’s Disease, but practicing it in groups appears to produce an additional improvement in the ability of the patients to process information (Cognition) and improve their likelihood of practicing at home.

 

The present results, as prior research, make it clear that Tai Chi practice is helpful in relieving the symptoms of Parkinson’s Disease. But, the results also make it clear that practicing in a group may be superior to practicing alone. Group Tai Chi practice may be more fun and engaging, potentiating its effectiveness. Its effectiveness for cognition is particularly important as cognitive decline is a common symptom of the progression of Parkinson’s Disease and complicates the patient’s ability to carry on normal life functions.

 

So, improve Parkinson’s Disease with group Tai Chi practice.

 

“Falls are common in people with Parkinson’s, and they can cause serious injuries, including fractures and concussions. Studies show falls are the main cause of hospitalizations in Parkinson’s patients. People in the tai chi group reported half the number of falls compared to those who were taking resistance training and two-thirds fewer falls than people who were doing light stretching exercises.” – Brenda Goodman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yang, J. H., Wang, Y. Q., Ye, S. Q., Cheng, Y. G., Chen, Y., & Feng, X. Z. (2017). The Effects of Group-Based versus Individual-Based Tai Chi Training on Nonmotor Symptoms in Patients with Mild to Moderate Parkinson’s Disease: A Randomized Controlled Pilot Trial. Parkinson’s Disease, 2017, 8562867. http://doi.org/10.1155/2017/8562867

 

Abstract

Objective

To compare the effects of group-based and individual-based Tai Chi training on nonmotor symptoms in patients with mild to moderate Parkinson’s disease.

Design

Randomized controlled pilot study.

Methods

36 community-dwelling patients with Parkinson’s disease (PD) were randomly assigned to either group-based training group (n = 19) or individual-based group (n = 17). Both groups received same content of Tai Chi training 3 times a week for 13 weeks. Participants were also asked to perform home exercises daily. The Non-Motor Symptoms Scale was used to assess global nonmotor symptoms change. Sleep quality, depression, and cognition were evaluated by Parkinson’s Disease Sleep Scale, Hamilton Depression Scale, and Beijing version-Montreal Cognitive Assessment, respectively. Home exercise compliance was recorded.

Results

There was no significant difference between two groups at baseline. After 13 weeks, there were no statistical significance between two groups. However, the within-group effect was different. Participants in group-based and individual-based groups showed a significant improvement on global nonmotor symptoms (P < 0.001, P = 0.004) and sleep (P < 0.001, P < 0.001). But only group-based training patients presented a significant improvement in cognitive impairment compared with baseline (P = 0.002, P − 0.116). For depression, no group gained a significant improvement(P = 0.123, P = 0.170). Group-based participants had a higher home-exercise compliance rate (HeCR) than individual-based participants did (P = 0.019), and HeCR showed a moderate correlation with MoCA-BJ and NMSS scores changes in this study.

Conclusion

Group-based Tai Chi training is considered to be a more effective and a more labor-saving method in the clinical settings, and patients tend to have a higher compliance rate in their home exercise program

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546134/

Improve Parkinson’s Disease with Mindfulness

Improve Parkinson’s Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A practical and powerful way to reduce stress is to become more mindful which, simply put, means being present in the moment rather than agonizing over the past or anticipating the future. Once stress levels are well under control, symptoms of Parkinson’s will have enormous difficulty presenting themselves. When people experience stress, their symptoms get much worse. When stress levels are under control, symptoms subside.” – Robert Rogers

 

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. 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.

 

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 which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially anxiety and depression. All of these symptoms result in a marked reduction in the quality of life.

 

Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients. In addition, stress is known to exacerbate the symptoms of PD. So, it would make sense that Mindfulness-Based Stress Reduction (MBSR), a mindfulness training that was developed specifically for stress reduction, would be effective for relieving some of the symptoms of PD. In today’s Research News article “Mindfulness-based stress reduction in Parkinson’s disease: a systematic review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433018/, McLean and colleagues review the published research literature on the effectiveness of an 8-week program of  MBSR for patients with PD.

 

As it turns out, the research is sparse. They were only able to identify 3 published articles which described 2 controlled trials, both of small size and with non-active control groups. The studies reported that MBSR participants, in comparison to controls, had improved motor ability, mindfulness, and quality of life with PD, and decreases in depression. One study found potentially beneficial changes in the patients’ brains in the MBSR group.

 

The scarce published research to date is promising and suggests that MBSR may be a beneficial treatment for patients with Parkinson’s Disease (PD) producing improvements in motor ability, psychological well-being, and quality of life. There is obviously a need for larger and better controlled trials. But, the research suggests that such research is warranted. Mindfulness training may be helpful in easing some of the symptom burden that plagues PD sufferers.

 

So, improve Parkinson’s disease with mindfulness.

 

“Mindfulness training, as taught by qualified and experienced teachers, may offer a more participatory medicine, empowering the individual by engagement to learn how to strengthen internal resources to help cope with chronic disease. Mindfulness training may help to restore some degree of self-determination in the experience of living with PD.” – Margaret Tuchman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

McLean, G., Lawrence, M., Simpson, R., & Mercer, S. W. (2017). Mindfulness-based stress reduction in Parkinson’s disease: a systematic review. BMC Neurology, 17, 92. http://doi.org/10.1186/s12883-017-0876-4

 

Abstract

Background

Mindfulness based stress reduction (MBSR) is increasingly being used to improve outcomes such as stress and depression in a range of long-term conditions (LTCs). While systematic reviews on MBSR have taken place for a number of conditions there remains limited information on its impact on individuals with Parkinson’s disease (PD).

Methods

Medline, Central, Embase, Amed, CINAHAL were searched in March 2016. These databases were searched using a combination of MeSH subject headings where available and keywords in the title and abstracts. We also searched the reference lists of related reviews. Study quality was assessed based on questions from the Cochrane Collaboration risk of bias tool.

Results

Two interventions and three papers with a total of 66 participants were included. The interventions were undertaken in Belgium (n = 27) and the USA (n = 39). One study reported significantly increased grey matter density (GMD) in the brains of the MBSR group compared to the usual care group. Significant improvements were reported in one study for a number of outcomes including PD outcomes, depression, mindfulness, and quality of life indicators. Only one intervention was of reasonable quality and both interventions failed to control for potential confounders in the analysis. Adverse events and reasons for drop-outs were not reported. There was also no reporting on the costs/benefits of the intervention or how they affected health service utilisation.

Conclusion

This systematic review found limited and inconclusive evidence of the effectiveness of MBSR for PD patients. Both of the included interventions claimed positive effects for PD patients but significant outcomes were often contradicted by other results. Further trials with larger sample sizes, control groups and longer follow-ups are needed before the evidence for MBSR in PD can be conclusively judged.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433018/

Improve Parkinson’s Disease Symptoms with Qigong

Image may contain: one or more people and closeup

Improve Parkinson’s Disease Symptoms with Qigong

 

By John M. de Castro, Ph.D.

 

“Through Tai Chi, I get a sense of accomplishment and well being, knowing that I can still function relatively well and, in some cases better, than a person with no physical limitations. It has given me an acute awareness of my body, which parts are not aligned and how to bring them back into the whole of the body so that it functions as one unit.  Tai Chi has helped me to cope with Parkinson’s and has heightened my enjoyment of life.” – Daniel Loney

 

Parkinson’s Disease (PD) has received public attention because of its occurrence in a number of celebrities such as Mohammed Ali, Michael J Fox, and Linda Ronstadt. 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.

 

Parkinson’s Disease (PD) itself is not fatal but is often associated with related complications which 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. But, since PD is a movement disorder that requires physical therapy for treatment, a mindful movement practice such as Qigong and Tai Chi may be particularly effective. Qigong is ancient mindful movement practices that has been found to produce beneficial effects for a large range of physical and psychological problems. Since, it is a very gentle and safe practice, it is particularly appropriate for the elderly. In addition, falling is the most common cause of injury and death in PD patients and Qigong and Tai Chi have been found to be very effective in lowering the risk of falling. In today’s Research News article “Effects of Health Qigong Exercises on Relieving Symptoms of Parkinson’s Disease.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1472686966088558/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116525/

Liu and colleagues investigate the effectiveness of Qigong practice for the elderly with Parkinson’s Disease (PD). They recruited patients with mild to moderate PD and randomly assigned them to receive either treatment as usual or treatment as usual combined with Qigong practice, 1-hour per day, 5 days per week, for 10 weeks. They were measured for muscle hardness and elasticity, physical stability, and coordination, prior to, during and after the 10-week practice period.

 

They found that in comparison to treatment as usual, Qigong practice produced a significant (10%) decrease in muscle hardness on both sides at the interim assessment which continued to improve to 20% at the post treatment assessment. The practice also produced a significant 11% improvement in hand eye coordination at interim and 22% at post-test and a significant 30% improvement in balance at interim and 50% at post-test. Hence, Qigong practice produced marked improvements in muscle elasticity, coordination, and balance in PD patients.

 

These results are striking and clinically significant. Qigong practice would appear to be an important therapy to be used in addition to traditional drug therapy. It should be noted that there was no another exercise condition tested. So, it cannot be determined if any type of gentle exercise would be as effective as Qigong. Regardless, it is clear that Qigong practice helps to ameliorate the motor deterioration produced by Parkinson’s Disease. Since, it is safe, even for use with the frail elderly, it would appear to be an excellent choice for the treatment of PD.

 

So, improve Parkinson’s disease symptoms with qigong.

 

“Tai chi engages both mind and body; you might call it “mindful movement.” It may help patients use undamaged parts of their brains to compensate for the areas that normally control automatic movements such as walking.” – Peter Wayne

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

and on Twitter @MindfulResearch

 

Study Summary

Liu, X. L., Chen, S., & Wang, Y. (2016). Effects of Health Qigong Exercises on Relieving Symptoms of Parkinson’s Disease. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 5935782. http://doi.org/10.1155/2016/5935782

 

Abstract

The purpose of this study was to investigate the effects of Health Qigong on the treatment and releasing symptoms of Parkinson’s disease (PD). Fifty-four moderate PD patients (N = 54) were randomly divided into experimental and control groups. Twenty-eight PD patients were placed in the experimental group in which the prescribed medication plus Health Qigong exercise will be used as intervention. The other 26 PD patients as the control group were treated only with regular medication. Ten-week intervention had been conducted for the study, and participants completed the scheduled exercises 5 times per week for 60 minutes each time (10 minutes for warm-up, 40 minutes for the exercise, and 10 minutes for cooldown). Data which included the muscle hardness, one-legged blind balance, physical coordination, and stability was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the Repeated Measures ANOVA. The results showed that PD patients demonstrate a significant improvement in muscle hardness, the timed “up and go,” balance, and hand-eye coordination (the turn-over-jars test). There were no significant differences between the two groups in gender, age, and course of differences (P < 0.05). The study concluded that Health Qigong exercises could reduce the symptoms of Parkinson’s disease and improve the body functions of PD patients in both the mild and moderate stages. It can be added as an effective treatment of rehabilitation therapy for PD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116525/

 

Be Mindful with Parkinson’s Disease

mindfulness-parkinsons2-advocat

 

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:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1354151734608749/?type=3&theater

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 

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

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/

 

Improve Symptoms of Parkinson’s Disease with Mindfulness

By John M. de Castro, Ph.D.

 

“Stress is a primary instigator of symptoms associated with Parkinson’s Disease. A practical and powerful way to reduce stress is to become more mindful which, simply put, means we are present in the moment rather than agonizing over the past or anticipating the future.” – Robert Rodgers

 

Parkinson’s Disease (PD) has received public attention because of its occurrence in a number of celebrities such as Mohammed Ali, Michael J Fox, and Linda Ronstadt. PD is an incurable disease of the central nervous system that attacks the dopamine neurotransmitter system in the brain. 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.

 

PD is an incurable progressive degenerative disease. 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.

 

Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients. But, because PD is caused exclusively by a physiological degeneration it would be surprising if mindfulness practice can help improve the physical symptoms. But, in today’s Research News article “Mindfulness for Motor and Nonmotor Dysfunctions in Parkinson’s Disease.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1236994512991139/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842053/

Dissanayaka and colleagues investigated if mindfulness training could improve not only the psychological symptoms and the quality of life but also the physical symptoms of Parkinson’s Disease (PD). They treated PD patients for 8 weeks with a version of the Mindfulness Based Stress Reduction (MBSR) program that was adapted for PD. Measurements of physical and psychological symptoms were obtained before and after treatment and 6 months later.

 

They found that after mindfulness training there was a significant improvement in anxiety, depression and psychological distress. Cognitive ability also improved including improvements in memory and verbal fluency. These results are compatible with these shown in previous research on mindfulness training for PD patients. These are important effects as they reduce quality of life and can lead to suicidal thoughts. It can be speculated that these effects on psychological well-being were due to the known effects of mindfulness training on emotion regulation. These involve the full experience and recognition of the emotions, but with adaptive responses to them. So, the patients don’t deny how they feel but do not react to them negatively, instead cope with the feelings and act positively.

 

Of the physical symptoms, they observed improvement in postural instability gait dysfunction but not tremor. This is surprising as these motor symptoms are due to direct deterioration of the neural systems underlying movement. It is possible that the yoga component of MBSR may have improved strength, balance, and flexibility and thereby improved the posture and gait of the PD patients even though the underlying brain degeneration was not affected.

 

The psychological and motor improvements that were present immediately after mindfulness training were no longer present six months later. But, it should be noted that PD is a progressive disorder, with symptoms getting worse over time, which could have obscured the improvements detected after treatment. The study lacked an untreated control condition, so it is impossible to determine whether the continued deterioration produced the lack of effects at the 6-month follow-up. It should also be noted, however, that the lack of a control condition limits the conclusion that the mindfulness training was responsible for the improvements and not another confounding variable such as a placebo effect or experimenter bias.

 

Regardless, it is clear that both the psychological and motor symptoms of Parkinson’s Disease can be improve with mindfulness training.

 

“You would expect mindfulness-based interventions to alleviate the psychological symptoms of Parkinson’s – mindfulness has proved its worth at reducing both anxiety and depression – but a recent study suggests mindfulness training could also address some of the physical changes in the brain. An eight-week course of mindfulness training seemed to increase the density of grey matter in two areas of the brain associated with the disease.” – Plastic Brain

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Dissanayaka, N. N. W., Idu Jion, F., Pachana, N. A., O’Sullivan, J. D., Marsh, R., Byrne, G. J., & Harnett, P. (2016). Mindfulness for Motor and Nonmotor Dysfunctions in Parkinson’s Disease. Parkinson’s Disease, 2016, 7109052. http://doi.org/10.1155/2016/7109052

 

Abstract

Background. Motor and nonmotor symptoms negatively influence Parkinson’s disease (PD) patients’ quality of life. Mindfulness interventions have been a recent focus in PD. The present study explores effectiveness of a manualized group mindfulness intervention tailored for PD in improving both motor and neuropsychiatric deficits in PD. Methods. Fourteen PD patients completed an 8-week mindfulness intervention that included 6 sessions. The Five Facet Mindfulness Questionnaire (FFMQ), Geriatric Anxiety Inventory, Hamilton Depression Rating Scale, PD Cognitive Rating Scale, Unified PD Rating Scale, PD Quality of Life Questionnaire, and Outcome Questionnaire (OQ-45) were administered before and after the intervention. Participants also completed the FFMQ-15 at each session. Gains at postassessment and at 6-month follow-up were compared to baseline using paired t-tests and Wilcoxon nonparametric tests. Results. A significant increase in FFMQ-Observe subscale, a reduction in anxiety, depression, and OQ-45 symptom distress, an increase in PDCRS-Subcortical scores, and an improvement in postural instability, gait, and rigidity motor symptoms were observed at postassessment. Gains for the PDCRS were sustained at follow-up. Conclusion. The mindfulness intervention tailored for PD is associated with reduced anxiety and depression and improved cognitive and motor functioning. A randomised controlled trial using a large sample of PD patients is warranted.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842053/

 

Mindfulness Treatment for Parkinson’s Disease

Parkinson’s Disease (PD) has received public attention because of its occurrence in a number of celebrities such as Mohammed Ali, Michael J Fox, and Linda Ronstadt. PD is a disease of the central nervous system that attacks the dopamine neurotransmitter system in the brain. There are around 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.

PD is a progressive degenerative disease. Its 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.

Because PD is exclusively a physiological disorder it is surprising that mindfulness practice can help improve the symptoms. But it can as shown in today’s Research News article “Mindfulness Training among Individuals with Parkinson’s Disease: Neurobehavioral Effects.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1048400695183856/?type=1&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460233/

Pickut and colleagues demonstrate that mindfulness training improves motor performance and quality of life but increases pain in PD patients.

These are exciting and remarkable findings that a simple practice like mindfulness training could relieve the symptoms that result from degeneration of a neural system. But this just goes to illustrate that the separation of mind and body is far less than we assume. What are the mechanisms by which mindfulness training might improve PD symptoms?

A key mechanism might be via stress reduction that is so emblematic of mindfulness training. There is a clear relationship between stress and PD symptoms. When PD sufferers experience stress their symptoms get worse and when stress is lowered the symptoms improve. So, the stress reduction produced by mindfulness may well be responsible for the improvements.

Mindfulness training is known to produce significant changes directly in the nervous system. It has been shown that mindfulness training in PD patients increases grey matter density in the hippocampus and the amygdala. The same thing was found in areas of the right and left caudate nucleus, left occipital lobe, and left thalamus. These areas are known to be damaged in PD. So mindfulness training may act by improving brain areas that deteriorate in PD thus reducing symptoms.

Remarkably, mindfulness training has not been shown to produce improvements in the cerebellum, a structure responsible for motor coordination. The cerebellum increases in size by the usual care for PD. This may suggest that mindfulness training acts in a different way than directly working on the motor systems, perhaps by accentuating the activity of structures that take over and compensate for lost abilities.

One rather surprising finding was that mindfulness training actually increased pain perception in PD patients. This is exactly the opposite of its normally pain reducing properties. Pickut and colleagues, however, observed a marked increase in mindful observing in the trained PD patients. Buy becoming better at observing their bodies these patients may be becoming better at noting their pain levels.

So, mindfulness should be employed to help patients with Parkinson’s Disease.

CMCS