Relaxation guided imagery reduces motor fluctuations in Parkinson's disease.

BACKGROUND: Motor fluctuations in Parkinson's disease (PD) cause major disabling symptoms. OBJECTIVE: We aimed to assess the efficacy of relaxation guided imagery in PD patients with motor fluctuation. METHODS: In a prospective pilot, case cohort, PD patients underwent (i) a relaxation session with relaxation guided imagery, and (ii) a control session of relaxing music. Three-day diaries were completed at baseline and after each intervention. Subsequently, patients received discs for home listening-a relaxation guided imagery disc and a relaxing music disc. After three months the patients were interviewed by phone. RESULTS: Twenty one PD patients participated and 19 completed this study. There was a significant increase in the percent of "on" time after listening to the relaxation guided imagery disc as compared with baseline (from 47.7% to 62.8%, 95% CI 5.26-25.03, p = 0.005). Relaxing music caused no significant change in percent of "on" time from baseline (from 47.7% to 53.0%, p = 0.161). Although all sessions were performed in "on" state, there was a significant decrease in UPDRS motor subscores after each of the two sessions as compared with the UPDRS score before the session (relaxation guided imagery mean reduction -3.81 p = 0.0002 and after relaxing music mean reduction -1.95, p = 0.001), significantly more so after the relaxation guided imagery (p = 0.020). After 3 months listening to the relaxation guided imagery disc increased "on" time from baseline by 12.6% (95% CI 3.19-28.39, p = 0.111) but this did not reach statistical significance. CONCLUSION: In this pilot study we showed that relaxation guided imagery is a promising treatment for PD.

Parkinson's disease tremor is diminished with relaxation guided imagery.

Patients with Parkinson's disease (PD) may have pronounced tremor that exacerbates during stress. To determine whether PD tremor improves with relaxation guided imagery (RGI) and relaxing music. Twenty patients with PD with moderate to severe tremor participated in sessions where relaxation techniques were implemented. Tremor was objectively monitored using an accelerometer. RGI dramatically decreased tremor in all 20 patients (baseline 270.38 +/- 85.82 vs. RGI 35.57 +/- 43.90 movements per minute P < 0.0001). In 15 patients, RGI completely abolished tremor for 1-13 min. Average tremor activity remained significantly below baseline both 15 min and 30 min after RGI was discontinued (P < 0.001). Patients reported improvement lasting 2-14 hours (mean 6.8 +/- 3.8). Relaxing music significantly reduced tremor but to a lesser degree than RGI (220.04 +/- 106.53 movements per minute P = 0.01). Self-relaxation had no significant effect on tremor. RGI can supplement conventional medical treatments for tremor in patients with PD on best medical treatment.