The effects of a mindfulness-based lifestyle program for adults with Parkinson's disease: a mixed methods, wait list controlled randomised control study.
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.


BACKGROUND
Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12612000440820 , 17(th) April 2012.
Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Bldg 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia. jenny.advocat@monash.edu.
Jenny
J
Advocat
Department of Psychiatry, Southern Synergy, Monash University, 126-128 Cleeland Street, Dandenong, Victoria, 3175, Australia.
Joanne
J
Enticott
School of Primary Health Care, Monash University, Bldg 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia.
Brooke
B
Vandenberg
Department of General Practice, School of Primary Health Care, Monash University, Bldg 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia.
Craig
C
Hassed
Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Bldg 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia.|Brotherhood of St Laurence, Melbourne, Australia.
Jennifer
J
Hester
Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Bldg 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia.|Department of General Practice, School of Primary Health Care, Monash University, Bldg 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia.|Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
Grant
G
Russell
D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D064866:Mindfulness / Q000379:methods*; D009520:New Zealand; D010300:Parkinson Disease / Q000534:rehabilitation*; D011446:Prospective Studies
Group program; Meditation; Mindfulness; Neurological disorder; Parkinson’s disease