Comparison of yoga and physiotherapy on motor neuropsychiatric symptoms and quality of life in Parkinson’s disease

Abstract

Background: Motor and neuropsychiatric symptoms are the manifestations of Parkinson’s disease (PD), leading to poor quality of life of patients. Aim: This study aims to compare the benefits of yoga versus physiotherapy on motor and neuropsychiatric symptoms and health-related quality of life in patients with PD. Materials and Methods: Twenty-four patients with PD, Hoehn and Yahr disease severity rating scale of I–III, score of <3 on a pull test, and walking ability for 10 meters participated in this observer-blinded randomized clinical trial. The yoga group practiced asanas (postures), pranayama (breathing), and meditation. The comparator group underwent physiotherapy. All participants performed 60-minute training sessions a day, with two sessions per week for 12 weeks. The Parkinson’s Disease Questionnaire-39 (PDQ-39), Addenbrooke Cognitive Examination (ACE-R), Beck’s Depression Inventory (BDI), Unified Parkinson’s Disease Rating Scale (UPDRS) motor experiences, and Balance Evaluation System Test (BESTest) were the outcome measurements. Results: On comparing the groups using the Mann–Whitney U test, a statistical significance was observed in the overall quality of life (p = 0.008), emotional well-being (p = 0.008), and stigma (p = 0.048) domains of PDQ-39 and the memory (p = 0.025) and fluency (p = 0.003) domains of ACE-R, which were favorable for yoga. The BDI, UPDRS motor experiences, and BESTest measures were statistically significant (p < 0.05) for both the yoga and physiotherapy groups, only on within-group analysis. Conclusion: Psycho-spiritual yoga practice appears to promote emotional well-being and alleviate the stigma attached to PD; therefore, it improves the quality of life of PD patients compared to physical exercises. In addition, it is noted that patients taking antidepressants may experience less depressive symptoms, warranting a multi-arm parallel-group randomized trial. In conclusion, both yoga and physiotherapy appear to exhibit therapeutic potential in alleviating the motor and neuropsychiatric symptoms of PD and enhancing the balance performance in patients.