Moving Mindfully: A MBSR-Centered Approach to Freezing in Parkinson Disease

摘要 这项计划拨款申请是为了响应由国家补充和综合健康中心（NCCIH）赞助的R34资助机会，该中心名为NCCIH高优先研究主题的身心干预可行性临床试验，PAR-18 - 417。在这里，我们将修改和评估帕金森病（PD）和步态冻结（FOG）患者的正念干预的可行性。FOG是一种严重的运动障碍，可使人们无法正常行走，并与焦虑、沮丧、久坐行为、生活质量下降和福尔斯有关。正念减压（MBSR）是一种以证据为基础的实践，通过增加有意识的意识和自我同情来创造一种减少压力和焦虑的文化。在这项研究中，我们建议开发一种基于正念的步行干预，以解决构成FOG的心理健康和移动性挑战。 该R34包括三个目标，以允许在PD患者中开发FOG的身心方法。在目标1中，我们将组建一个由研究团队成员、物理治疗师、正念导师和患者利益相关者组成的咨询小组。该咨询小组将调整目前的正念减压疗法，以开发和提供一种基于正念的治疗方法，该方法强调步行冥想，对PD和FOG患者安全适用。在目标2中，我们开放了修改后的程序，基于正念的步行疗法（MBWT）。MBWT将根据讲师和参与者的反馈进行修改。目标2的最终结果将是一个标准化的MBWT程序。在目标3中，我们将在一项个体随机分组治疗试验中试行标准化MBWT计划。经历FOG的人将随机接受MBWT或常规护理。康复护理将包括关于步态冻结的医疗管理和教育。在目标2和目标3期间，将收集满足招募、随机化、保留、满意度、提供干预、依从性和结局负担相关基准的可行性参数。

ABSTRACT This planning grant application is in response to the R34 funding opportunity sponsored by the National Center for Complementary and Integrative Health (NCCIH) titled Feasibility Clinical Trials of Mind and Body Interventions for NCCIH High Priority Research Topics, PAR-18-417. Here we will modify and evaluate the feasibility of a mindfulness intervention among people living with Parkinson disease (PD) and freezing of gait (FOG). FOG is a severe motor disturbance that prevents people from stepping normally and is associated with anxiety, frustration, sedentary behaviors, poorer quality of life, and falls. Mindfulness-Based Stress Reduction (MBSR) is an evidence-based practice that creates a culture to reduce stress and anxiety by increasing conscious awareness and self-compassion. In this study, we propose developing a mindfulness-based walking intervention to address both mental health and mobility challenges that constitute FOG. This R34 includes three aims to permit the development of a mind and body approach for FOG among people living with PD. In Aim 1 we will form an advisory group of study team members, physical therapists, mindfulness instructors, and patient stakeholders. The advisory group will adapt the current MBSR Program to develop and deliver a mindfulness-based treatment that emphasizes walking meditations and is safe and applicable for people living with PD and FOG. In Aim 2 we open pilot the modified program, Mindfulness-Based Walking Therapy (MBWT). MBWT will be modified per feedback from instructors and participants. The end result of Aim 2 will be a standardized MBWT program. In Aim 3 we will pilot the standardized MBWT program in an individually randomized group treatment trial. People who experience FOG will be randomized to receive MBWT or usual care. Usual care will include medical management and education regarding freezing of gait. Feasibility parameters to meet benchmarks regarding recruitment, randomization, retention, satisfaction, delivery of intervention, adherence, and burden of outcomes will be collected during both Aim 2 and Aim 3.