The Effects of Yoga and Power Training on Mindfulness, Psychological Wellbeing, and Functional Ability of Individuals With Parkinson's Disease.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Miami
- Enrollment
- 35
- Locations
- 1
- Primary Endpoint
- Parkinson's Disease Questionnaire (PDQ-39)
Study Overview
Brief Summary
The investigators propose to compare the effects of a 16-week specially designed yoga program to a power-based resistance training program on affect trait mindfulness, anxiety, depression, functionality, and quality of life. As secondary measures, we propose to compare the effects of these exercise programs on measures of executive function (EF), sleep, disease stage, motor symptoms, muscle quality, rigidity, strength, power, and mobility.
Detailed Description
Yoga has long been recognized as a therapeutic intervention for improving mindfulness and psychological well-being. Yoga represents a unique exercise activity that employs mindfulness-based practices and various balance postures to improve physical and mental health. Yoga is a gentle form of exercise that can be easily adapted to populations suffering from physical and mental limitations and has been shown to improve physical and psychological functioning in individuals with PD. Though research continues to support the positive psychological effects of yoga, it is unclear whether this is due to the unique mindfulness-rooted approach of yoga or general increases in physical activity.
Power-based resistance training has had promising results in the PD community. Improvements in balance, gait, and increases in leg muscle power and strength have been shown in PD patients after power training interventions. Although power training is a beneficial exercise modality in the treatment of motor symptoms, the effects of power training on nonmotor symptoms have yet to be established.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
Assessors will be masked concerning the intervention provided.
Eligibility Criteria
- Ages
- 30 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •diagnosed with mild to moderate PD [Hoehn and Yahr (H&Y) stage 1-3];
- •over 50 years of age;
- •stable use of medication;
- •able to walk 15 m independently with or without an assistive device;
- •the ability to get up and down from the floor with minimal assistance;
- •not currently participating in yoga or resistance training more than one time per week;
- •able to understand and communicate in English; and,
- •able to provide informed consent.
Exclusion Criteria
- •cognitive impairment as designated by a score of less than 23 on the Montreal Cognitive Assessment (MoCA)]; and,
- •any clinically significant medical condition, such as cardiopulmonary disease and musculoskeletal problems. Subjects providing affirmative answers on a Physical Activity Readiness Questionnaire (PAR-Q) or Health Status Questionnaire related to cardiopulmonary disease or musculoskeletal impairments will be required to present a physical activity clearance from their physician.
Arms & Interventions
Standard Hatha Yoga
A yoga program adapted for those with PD will be used in the current study. It will be conducted over a 16-week period and consists of twice-weekly sessions lasting approximately one hour. The program will be based on principles of Hatha yoga which incorporate longer holds and deep breathing. Each session will include a warm-up, three yoga flows, a balance training section, and a cooldown phase. The first four weeks will emphasize proper alignment, breathing, and technique. Additionally, the classes will be led by a certified yoga instructor and include multiple on-site assistants to ensure a safe training environment. Participants will also be provided with assistive devices (i.e. chairs, yoga blocks, and blankets) if they are required.
Intervention: Yoga (Other)
Power Resisatnce Training
: A high-velocity resistance (power) will be conducted over a 16-week period and consists of twice-weekly sessions lasting approximately one hour. Each training session will begin with a brief warm-up. Each session will consist of three sets of 10 repetitions each with 1.5 to 2- to minute rest periods between sets. Participants will be instructed to control the concentric and eccentric velocity of each exercise, with each phase lasting approximately two to three seconds. Exercise order will be randomized during each session and upper and lower body exercises will be alternated whenever possible.
Intervention: High-speed Resistance Training (Other)
Outcomes
Primary Outcomes
Parkinson's Disease Questionnaire (PDQ-39)
Time Frame: 15 minutes
The PDQ-39 is one of the most widely used self-reported questionnaires designed to assess QoL in Parkinson's patients. It is composed of 39 items which are distributed over 8 separate scales including mobility, activities of daily living, emotional wellbeing, stigma, social support, cognition, communication, and bodily discomfort (Jenkinson et al., 1997). All items are answered on a 5-point Likert type scale (0= never, 1=occasionally, 2=sometimes, 3=often, 4=always). In addition, a summary index can be computed to assess the overall impact of PD on the responder.
Parkinson Anxiety Scale (PAS)
Time Frame: 2 minutes
The Parkinson Anxiety Scale (PAS) is a frequently used observer or patient-rated anxiety measurement tool designed specifically for PD patients. The exam consists of three sub-scales for persistent anxiety (dimension A), episodic anxiety (dimension B), and avoidance behavior (dimension C), with 5, 4, and 3 items, respectively. All items are scored on a 5-point Likert type scale (0=not or never, 4=severe or almost always). A cut-off point of 14 is optimal to detect anxiety. Self-administered, the test takes approximately 2 minutes.
Beck Depression Inventory
Time Frame: 5 minutes
The Beck Depression Inventory is a widely used self-report inventory to assess the severity of depressive symptoms in adults in the past two weeks. The BDI-II has been validated in patients with PD. It includes both cognitive and somatic symptoms of depression and consists of 21 items using a 4-point Likert scale. A maximum score is 63 with 0-13 indicating none or minimal range depression, 14-19 mild, 20-28 moderate, and 29-63 severe.
Mindful Attention Awareness Scale (MAAS)
Time Frame: 5 minutes
The Mindful Attention Awareness Scale is a single-factor measure of trait mindfulness comprised of 15 items. The scale evaluates attentiveness and awareness of the present moment with higher scores indicating a greater degree of mindfulness trait. All questions are answered on a 6-point Likert scale with a range from 1 to 6. The total possible score is 90 points with a minimum score of 15
Secondary Outcomes
- Actigraphy(168 hours)
- Power Testing(15 minutes)
- One-repetition maximum (1RM) testing(10 minutes)
- Timed Up & Go (TUG)(3 minutes)
- Ultrasound(20 minutes)
- The Stroop Color Word Test(5 minutes)
- Quantitative Gait Assessment(5 minutes)
- Isokinetic Testing(30 minutes)
- Trail-making Test (TNT)(5 minutes)
- Home Sleep Testing(8 hours)
Investigators
Joseph Signorile
Professor
University of Miami