A randomized clinical trial of mindfulness meditation versus exercise in Parkinson's disease during social unrest

Author: Jojo Yan Yan Kwok1, Edmond Pui Hang Choi2, Janet Yuen Ha Wong3, Kris Yuet Wan Lok2, Mu-Hsing Ho2, Daniel Yee Tak Fong2, Jackie Cheuk Yin Kwan4, Shirley Yin Yu Pang5, Man Auyeung6
1 School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. jojo.yykwok@gmail.com.
2 School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
3 Hong Kong Metropolitan University, Hong Kong SAR, China.
4 The Hong Kong Society for Rehabilitation, Hong Kong SAR, China.
5 Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
6 Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China.
Conference/Journal: NPJ Parkinsons Dis
Date published: 2023 Jan 21
Other: Volume ID: 9 , Issue ID: 1 , Pages: 7 , Special Notes: doi: 10.1038/s41531-023-00452-w. , Word Count: 209

Clinical practice guidelines support resilience training and exercise for patients with Parkinson's disease (PD). This assessor-blinded, randomized clinical trial aimed to compare the effects of a modified mindfulness meditation program versus stretching and resistance training exercise (SRTE) in patients with mild-to-moderate PD. A total of 126 potential participants were enrolled via convenience sampling, of which 68 eligible participants were randomized 1:1 to receive eight weekly 90-min sessions of mindfulness meditation or SRTE. Compared to the SRTE group, generalized estimating equation analyses revealed that the mindfulness group had significantly better improvement in outcomes, particularly for improving depressive symptoms (d, -1.66; 95% CI, -3.31 to -0.02) at week 8 and maintaining emotional non-reactivity at week 20 (d, 2.08; 95% CI, 0.59 to 3.56). Both groups demonstrated significant immediate, small-moderate effects on cognition (effect size [d] = 0.36-0.37, p = 0.006-0.011). Compared with the SRTE, mindfulness meditation appeared to be a feasible and promising strategy for managing depressive symptoms and maintaining emotional stability, with comparable benefits on cognitive performance. To combat the psychospiritual and cognitive sequelae of social unrest and COVID-19 pandemic, the integration of mindfulness training into motor-oriented PD rehabilitation protocols is recommended to strengthen the resilience and minimize the psycho-cognitive comorbidities among patients with mild-to-moderate PD.Trial Registration: HKU Clinical Trials Registry identifier: HKUCTR-2681.

PMID: 36681670 PMCID: PMC9862216 DOI: 10.1038/s41531-023-00452-w