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

点击翻译按钮获取中文摘要

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.