title: Relaxation guided imagery reduces motor fluctuations in Parkinson's disease.
abstract: BACKGROUND
  Motor fluctuations in Parkinson's disease (PD) cause major disabling symptoms.
  
  
  OBJECTIVE
  We aimed to assess the efficacy of relaxation guided imagery in PD patients with motor fluctuation.
  
  
  METHODS
  In a prospective pilot, case cohort, PD patients underwent (i) a relaxation session with relaxation guided imagery, and (ii) a control session of relaxing music. Three-day diaries were completed at baseline and after each intervention. Subsequently, patients received discs for home listening-a relaxation guided imagery disc and a relaxing music disc. After three months the patients were interviewed by phone.
  
  
  RESULTS
  Twenty one PD patients participated and 19 completed this study. There was a significant increase in the percent of "on" time after listening to the relaxation guided imagery disc as compared with baseline (from 47.7% to 62.8%, 95% CI 5.26-25.03, p = 0.005). Relaxing music caused no significant change in percent of "on" time from baseline (from 47.7% to 53.0%, p = 0.161). Although all sessions were performed in "on" state, there was a significant decrease in UPDRS motor subscores after each of the two sessions as compared with the UPDRS score before the session (relaxation guided imagery mean reduction -3.81 p = 0.0002 and after relaxing music mean reduction -1.95, p = 0.001), significantly more so after the relaxation guided imagery (p = 0.020). After 3 months listening to the relaxation guided imagery disc increased "on" time from baseline by 12.6% (95% CI 3.19-28.39, p = 0.111) but this did not reach statistical significance.
  
  
  CONCLUSIONS
  In this pilot study we showed that relaxation guided imagery is a promising treatment for PD.
authors.affiliation: Department of Neurology, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Ilana
authors.initials: I
authors.lastname: Schlesinger
authors.affiliation: Internal Medicine Division, Haifa, Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Benyakov
authors.affiliation: Department of Neurology, Haifa, Israel.
authors.forename: Ilana
authors.initials: I
authors.lastname: Erikh
authors.affiliation: Department of Neurology, Haifa, Israel.
authors.forename: Maria
authors.initials: M
authors.lastname: Nassar
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009147:Music Therapy; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012064:Relaxation Therapy; D016896:Treatment Outcome
keywords: Parkinson's disease; guided imagery; motor fluctuations; relaxation; treatment