Importance Patients with long-term neurological conditions, such as Parkinson’s disease (PD), are particularly vulnerable to the public health measures taken to combat the COVID-19 pandemic. The inaccessibility of center-based rehabilitation further aggravated their motor dysfunctions as well as mental distress, leading to exacerbation of motor and non-motor symptoms, high healthcare utilization and worsened health-related quality of life (HRQOL). Objective This study aimed to evaluate the feasibility, safety, and preliminary effects of the mHealth-delivered home-based mindfulness yoga program on functional balance, motor symptoms, mental health and HRQOL in patients with PD. Design, setting and participants This prospective, single-arm, non-randomized feasibility study adopted a sequential explanatory mixed-method design. Adults (aged ≥ 18) with a clinical diagnosis of idiopathic Parkinson’s disease (Hoehn and Yahr stage I to III) who were able to stand unaided and walk with or without an assistive device were enrolled via convenience sampling. Intervention Home-based mindfulness yoga training were delivered via video-conferencing software (Zoom) in eight bi-weekly 90-min sessions. Main outcomes and measures This current study measured functional balance, motor symptoms, perceived balance confidence, perceived freezing of gait symptoms, anxiety and depression, mindfulness and HRQOL using a tele-assessment approach at baseline and 1-week post-intervention. All participants were invited to attend qualitative individual interviews to explore their experience of using online mindfulness yoga program as a lifestyle intervention for PD rehabilitation. Results Among the ten patients, 80% completed the program with an adherence rate of 98.4%. All participants were able to learn and practice mindfulness yoga following the eight bi-weekly online mindfulness yoga training sessions, without any significant adverse events. Tele-assessment of outcomes were feasible and uneventful. Qualitative feedback revealed participants had a high preference of using the tele-rehabilitation approach to stay mindful and being active, both physically and socially, while confronting the changes brought by COVID-19 pandemic. Conclusions and relevance The mHealth-delivered home-based mindfulness yoga intervention was feasible, safe, and well-accepted among people with PD to relieve the burden brought by COVID-19 pandemic. Future studies should adopt a design with enhanced rigor, a comparison group, and enlarged sample size to evaluate the efficacy of the program in patients with long-term neurological conditions and/or physical impairments. We recommend a longer intervention duration of at least 8 weeks to enhance the psychophysiological effects.
【저자키워드】 yoga, mindfulness, mHealth, rehabilitation, Parkinson’s disease, Physical exercise, Quality of life, psychological support, Home-based, Symptom management, 【초록키워드】 Efficacy, Anxiety, Depression, feasibility, mental health, COVID-19 pandemic, Intervention, outcome, Symptoms, adverse events, healthcare, Patient, Motor symptoms, Qualitative, Clinical diagnosis, change, patients, Parkinson’s disease, distress, neurological, Safe, convenience sampling, dysfunction, public health measure, Sample size, balance confidence, measure, participant, Future, Effect, Mental, Effects, approach, objective, physical, single-arm, ENhance, post-intervention, Result, enrolled, evaluate, physically, eight, functional, condition, non-randomized, adopted, feasible, conditions, Importance, All participant, baseline, worsened, 【제목키워드】 coronavirus, feasibility, Parkinson’s disease,