Objective: This study aimed to determine the feasibility of using a non-pharmacologic intervention (mindfulness training; MT) administered with a wearable tracker to alleviate anxiety through controlled breathing.

Background: Anxiety is a common non-motor symptom in Parkinson’s disease (PD), which significantly impairs quality of life. MT and controlled breathing are simple yet cost-effective interventions for primary anxiety disorders and anxiety secondary to chronic illnesses. Brief self-guided and home-based MT can be integrated into daily activities, without significant time commitment.

Method: This single-blinded, randomized controlled study asked participants to use a commercially available biofeedback device (Spire) for at least 8 hours/day over 6 weeks. The device tracks respiration patterns and physical activity, providing biofeedback and MT exercises. Patients in the intervention group were asked to engage in guided MT twice daily, while controls did not participate in guided MT. Compliance was monitored by intrinsic device data and weekly surveys. Anxiety was measured using the Parkinson’s Anxiety Scale.

Results: Thirteen PD patients (69.2% females, 30.7% males; mean age 63.7 +/-10.7 years) were randomized into the guided MT and control groups from the Movement Disorders Centers at the University of Louisville and University of Cincinnati over eighteen months. Two patients dropped out before completion. There was a trend towards reduction of anxiety in the intervention group (p=0.06), but compliance was poor, and subjects reported difficulty with device usage.

Conclusion: This six-week pilot study showed a trend towards subjective improvement in anxiety in PD patients using biofeedback and guided MT. While the intervention seemed promising, feasibility was compromised by poor patient recruitment and retention. Patients’ comfort level with, and adaptability into daily living of, mobile health technology should be taken into account for future studies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mindfulness-training-to-reduce-anxiety-in-parkinsons-disease-a-cautionary-tale-about-wearable-technology/