Yoga Improves Balance and Low-Back Pain, but Not Anxiety, in People with Parkinson's Disease

Abstract

Individuals with Parkinson's disease (PD) experience postural instability, low-back pain (LBP), and anxiety. These symptoms increase the risk of falls and decrease quality of life. Research shows yoga improves balance and decreases LBP and anxiety in healthy adults, but its effects in PD are poorly understood. All participants were part of a larger intervention study. Participants received pretest and posttest evaluations, including the Balance Evaluation Systems Test (BESTest), Beck Anxiety Inventory (BAI), and Revised Oswestry Disability Index (ROSW). Total scores for each measure, as well as individual balance system section scores from the BESTest (biomechanical constraints, stability limits/verticality, transitions/anticipatory, reactive, sensory orientation, and stability in gait) were compared within groups pre- to posttest. Participants in the yoga group (n = 13) completed a twice-weekly 12-week yoga interve n t i o n , whereas controls (n = 13) continued their usual routines for 12 weeks. Both the yoga (Z = -3.20, p = 0.001) and control (Z = -2.10, p = 0.040) groups improved on the BESTest total score. The control group showed no changes in individual balance systems, whereas the yoga group improved in stability limits/verticality (Z = -2.3, p = 0.020), transitions/ anticipatory (Z = -2.50, p = 0.010), reactive (Z = -2.70, p = 0.008), and sensory orientation (Z = -2.30, p = 0.020). ROSW decreased in the yoga group only (Z = -2.10, p = 0.030). BAI did not change in either group. Yoga is a nonpharmacological intervention that can improve balance and LBP in people with PD. This study demonstrated that yoga is feasible for people with PD, and participants reported high levels of enjoyment and intent to practice yoga after the study.

Keywords: Parkinson’s disease; anxiety; low-back pain; postural instability; yoga.

Figure 1.

Yoga intervention outline. The middle column indicates the focus of each week’s classes. New poses were integrated with poses from previous weeks, building up to a beginner level vinyasa class. Class outlines for weeks one, six, and twelve are shown in the boxes.

Figure 2.

Box and whisker plots for changes in outcomes from pre- to post-test. For the Balance Evaluation Systems Test (BESTest) and its system sections, a positive change denotes improvement. For Revised Oswestry Disability Index (ROSW), a negative change denotes reduced disability. For the Beck Anxiety Inventory (BAI), a negative change denotes reduced anxiety. The bottom two rows show the different balance systems within the BESTest. +indicates mean value.