The effects of a mindfulness-based lifestyle program for adults with Parkinson's disease: a mixed methods, wait list controlled randomised control study.
The effects of a mindfulness-based lifestyle program for adults with Parkinson's disease: a mixed methods, wait list controlled randomised control study.
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基于正念的生活方式计划对帕金森氏病的成年人的影响：一种混合方法，等待清单受控的随机对照研究。
DOI：
10.1186/s12883-016-0685-1
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发表时间：
2016-09-08
期刊：
影响因子：
2.6
通讯作者：
Russell G
中科院分区：
文献类型：
--
作者：
Advocat J;Enticott J;Vandenberg B;Hassed C;Hester J;Russell G
帕金森病（Parkinson's disease，PD）是发达国家第二常见的神经退行性疾病。目前对PD的治疗是非常集中的，并且可能具有显著的副作用。人们对包括正念在内的整体方法越来越感兴趣，以帮助管理与PD相关的挑战。我们假设参与者在参加了为期6周的正念生活方式计划后，PD相关功能和健康状况会有所改善，并且这些改善在6个月内是可持续的。我们的主要目标是确定与PD相关的功能和健康变化。在2012-2013年进行了一项探索性前瞻性、混合方法、随机对照试验，采用了前后设计和等待列表对照，并包含了嵌入式定性成分。参与者包括符合H&Y第2阶段PD的社区生活残疾成年人，年龄在18-75岁之间，英语口语和书面流利，能够参加该计划的六次会议中的至少四次。参与者被随机分配到两个地点的干预组或等待名单对照组。等待名单控制组的所有参与者最终都接受了干预。为每个位置创建两个随机化代码。干预或等待列表对照的分配通过随机数生成。项目主持人和参与者对参与者数据不知情。第一组包括35名参与者，第二组（候补名单对照）包括37名参与者。分析了24名（第1组）和33名（第2组）参与者的数据。根据PDQ-39 SI的报告，与等待名单对照组相比，干预组在计划后立即（t评分=-0.59）和干预后6个月（t评分=-1.42）与PD相关的功能和健康状况略有改善。然而，这一发现并不显著（分别为p = 0.56和0.16）。干预后6个月，第1组报告了PDQ-39 ADL的小但显著的效应量（β = 0.23）。这显示了第1组在6个月后报告的ADL的积极改善（t评分-1.8，p = 0.04）。报告了四项次要措施。我们的研究结果表明，基于正念的生活方式计划有可能帮助参与者管理与帕金森病等神经系统疾病相关的持续困难。重要的是，我们的研究显示了这些计划的长期利益。干预后6个月，参与者日常生活和正念活动的改善得到保留。应该在更大样本的PD患者中进行更明确的研究，以进一步探讨这些发现及其对减轻PD患者压力和焦虑的影响。澳大利亚和新西兰临床试验注册中心（ANZCTR）ACTRN 12612000440820，2012年4月17日。
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. 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. 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. 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. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12612000440820, 17th April 2012.
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