Abstract
Background In Parkinson's disease (PD) patients, fluctuations in symptoms commonly occur after many years of dopamine replacement therapy. The so-called wearing-off phenomenon exists of both motor and non-motor symptoms, such as rigidity and anxiety. Current treatment options are limited and an integrated approach is needed to address the complex interactions between motor and non-motor symptoms. Since wearing-off is eventually inevitable, treatment needs to focus on coping, acceptance and self-efficacy. We developed the body awareness training, named BEWARE, combining physical therapy with acceptance and commitment therapy to help PD patients deal better with wearing-off related anxiety (WRA). Methods This was an investigator-blinded randomized controlled trial. Forty PD patients with WRA were randomly assigned to the BEWARE or to the treatment as usual (TAU) condition. Assessments were performed prior to and immediately after the treatment period, and at 3-months follow up. The primary outcome was self-efficacy, secondary outcomes focused on mobility, daily functioning, anxiety, depression and quality of life. Results There was no significant improvement in self-efficacy in the BEWARE treatment condition when compared to TAU. However, standing balance and emotional wellbeing showed a significant improvement, and feelings of stigmatization showed a trend-significant decrease in the BEWARE condition. Conclusions We consider the BEWARE training to be a promising therapeutic approach to address WRA. Improvement points from the participants included 1) less frequent but longer therapy sessions; 2) active involvement of caregivers; and 3) the development of a supportive workbook. The optimized treatment protocol needs further evaluation in a phase III RCT. Trial registration: ClinicalTrials.gov identifier: NCT02054845
Original language | English |
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Pages (from-to) | 1-8 |
Number of pages | 8 |
Journal | Journal of Psychosomatic Research |
Volume | 103 |
DOIs | |
Publication status | Published - 1 Dec 2017 |
Funding
This project has been financially supported by the Dutch Parkinson Patient Association ( Parkinson Vereniging (MvhH/110-2013/MvhH) and Project number: 2013-R16, awarded to Dr. E.E.H. van Wegen and Prof. Dr. O.A. van den Heuvel).
Funders | Funder number |
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Dutch Parkinson Patient Association | MvhH/110-2013/MvhH, 2013-R16 |
Keywords
- Anxiety
- Body awareness
- Parkinson's disease
- Randomized controlled trial
- Self-efficacy
- Wearing-off