Yoga may help ease mood disorders in Parkinson's patients

FILE PHOTO - People take part in a group yoga practice on the morning of the summer solstice in New York's Times Square, June 21, 2013. REUTERS/Eric Thayer

By Lisa Rapaport (Reuters Health) - People with Parkinson's disease may have less anxiety and depression when they practice yoga focused on mindfulness and breathing exercises, a small experiment suggests. 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. 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: JAMA Neurology, online April 8, 2019.