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 languageEnglish
Pages (from-to)1-8
Number of pages8
JournalJournal of Psychosomatic Research
Volume103
DOIs
Publication statusPublished - 1 Dec 2017

Cite this

@article{591b7577fe6744d0a78a211599fa8662,
title = "Body awareness training in the treatment of wearing-off related anxiety in patients with Parkinson's disease: Results from a pilot randomized controlled trial",
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",
keywords = "Anxiety, Body awareness, Parkinson's disease, Randomized controlled trial, Self-efficacy, Wearing-off",
author = "Ires Ghielen and {van Wegen}, {Erwin E.H.} and Sonja Rutten and {de Goede}, {Cees J.T.} and {Houniet-de Gier}, Marieke and Collette, {Emma H.} and Burgers-Bots, {Ingrid A.L.} and Twisk, {Jos W.R.} and Gert Kwakkel and Kees Vermunt and {van Vliet}, Bep and Berendse, {Henk W.} and {van den Heuvel}, {Odile A.}",
year = "2017",
month = "12",
day = "1",
doi = "10.1016/j.jpsychores.2017.09.008",
language = "English",
volume = "103",
pages = "1--8",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Body awareness training in the treatment of wearing-off related anxiety in patients with Parkinson's disease

T2 - Results from a pilot randomized controlled trial

AU - Ghielen, Ires

AU - van Wegen, Erwin E.H.

AU - Rutten, Sonja

AU - de Goede, Cees J.T.

AU - Houniet-de Gier, Marieke

AU - Collette, Emma H.

AU - Burgers-Bots, Ingrid A.L.

AU - Twisk, Jos W.R.

AU - Kwakkel, Gert

AU - Vermunt, Kees

AU - van Vliet, Bep

AU - Berendse, Henk W.

AU - van den Heuvel, Odile A.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - 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

AB - 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

KW - Anxiety

KW - Body awareness

KW - Parkinson's disease

KW - Randomized controlled trial

KW - Self-efficacy

KW - Wearing-off

UR - http://www.scopus.com/inward/record.url?scp=85030473866&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychores.2017.09.008

DO - 10.1016/j.jpsychores.2017.09.008

M3 - Article

VL - 103

SP - 1

EP - 8

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

ER -