{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:31:18Z","timestamp":1790767878817,"version":"4.1.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:00:00Z","timestamp":1650672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Association of Hong Kong Nursing Staff","award":["PDF040416"],"award-info":[{"award-number":["PDF040416"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although several studies have reported positive effects of mind-body exercises on symptom management and health-related quality of life (HRQOL) of people living with Parkinson\u2019s disease (PD), it is not known whether these effects are attributable to a change in anxiety and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the effects of mindfulness yoga to conventional stretching exercises in a randomized controlled trial while examining potentially mediating effects of anxiety and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>138 adults with PD were randomized to eight weekly yoga (n = 71) or stretching (n = 67) sessions. Symptom experiences, anxiety and depression, and HRQOL outcomes were assessed at baseline, immediate post-intervention, and 3-month post-intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Generalized estimating equation analyses revealed that, compared to stretching, yoga significantly improved patients\u2019 nonmotor (time-by-group interaction, T1:\u03b2 = \u22121.99, p = .008; T2:\u03b2 = \u22122.86, p &amp;lt; .001) and motor (time-by-group interaction, T1:\u03b2 = \u22121.77, p = .03) symptom experiences. The mediation analysis found that the changes in anxiety and depression were the mediators in the associations between non-motor experience and HRQOL; while only the changes in depression were found to be the mediator in the relationship between motor experience and HRQOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Yoga is superior to conventional stretching exercises in improving nonmotor and motor symptoms in daily living. Reduced anxiety and depression play a role in mediating the positive effects of the mindfulness yoga intervention. To optimize HRQOL, rehabilitation should reinforce psychological care in addition to pharmacological treatments and physical relief of PD symptoms. Future studies are needed to identify strategies for facilitating the implementation and sustainability of mind-body rehabilitation to enhance the quality of care for PD.<\/jats:p><\/jats:sec>","DOI":"10.1093\/abm\/kaac005","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T12:26:59Z","timestamp":1650716819000},"page":"1068-1081","source":"Crossref","is-referenced-by-count":35,"title":["Effects of Mindfulness Yoga Versus Conventional Physical Exercises on Symptom Experiences and Health-related Quality of Life in People with Parkinson\u2019s Disease: The Potential Mediating Roles of Anxiety and Depression"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7444-6935","authenticated-orcid":false,"given":"Jojo Yan Yan","family":"Kwok","sequence":"first","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Pukfulam, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-3540","authenticated-orcid":false,"given":"Edmond Pui Hang","family":"Choi","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Pukfulam, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9704-2116","authenticated-orcid":false,"given":"Jung Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Pukfulam, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3227-0799","authenticated-orcid":false,"given":"Kris Yuet Wan","family":"Lok","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Pukfulam, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie Cheuk Yin","family":"Kwan","sequence":"additional","affiliation":[{"name":"The Hong Kong Society for Rehabilitation , Kowloon, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Chung Tong","family":"Mok","sequence":"additional","affiliation":[{"name":"Department of Medicine, Pamela Youde Nethersole Eastern Hospital , Chai Wan, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Auyeung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Center for Prevention of Dementia, Gerald Choa Neuroscience Centre, Faculty of Medicine, The Chinese University of Hong Kong , Shatin, Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,23]]},"reference":[{"issue":"3","key":"2022100313311072100_CIT0001","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1002\/mds.25292","article-title":"The current and projected economic burden of Parkinson\u2019s disease in the United States","volume":"28","author":"Kowal","year":"2013","journal-title":"Mov Disord."},{"issue":"4","key":"2022100313311072100_CIT0002","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1002\/mds.23499","article-title":"The patients\u2019 perception of prodromal symptoms before the initial diagnosis of Parkinson\u2019s disease","volume":"26","author":"Gaenslen","year":"2011","journal-title":"Mov Disord."},{"issue":"6","key":"2022100313311072100_CIT0003","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S1474-4422(18)30127-3","article-title":"Risk factors for non-motor symptoms in Parkinson\u2019s disease","volume":"17","author":"Marinus","year":"2018","journal-title":"Lancet Neurol."},{"issue":"1","key":"2022100313311072100_CIT0004","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/0973-6131.146070","article-title":"A randomized controlled pilot study of the therapeutic effects of yoga in people with Parkinson\u2019s disease","volume":"8","author":"Sharma","year":"2015","journal-title":"Int J Yoga"},{"issue":"6","key":"2022100313311072100_CIT0005","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1002\/1531-8257(200011)15:6<1112::AID-MDS1008>3.0.CO;2-A","article-title":"How does Parkinson\u2019s disease affect quality of life? 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