Telehealth mindful yoga for balance in Parkinson’s disease: A randomised controlled trial

Background

Impaired balance affects about 80% of people with Parkinson’s disease (PD), leading to falls, injury and reduced quality of life (QoL). Motor and non‑motor deficits (e.g. cognitive decline, anxiety) impair balance control. Mind–body modalities such as mindfulness and yoga may address both domains by improving coordination and stress. This study evaluated the effects of a telehealth home-based mindful yoga program on balance in PD.

Methods

An assessor-blinded, randomised waitlist-controlled trial enrolled 139 people with PD and balance impairment. Participants were randomised to a 12-week Zoom-delivered mindful yoga program(n = 69) or usual care(n = 70). Primary outcome was functional balance (Berg Balance Scale, BBS). Secondary outcomes included freezing of gait, balance confidence, motor symptoms, anxiety, depression, mindfulness, QoL, and gait assessed using a validated smartphone‑based 3-m Timed Up & Go. Assessments were conducted at baseline, 3 months, and 6 months. Linear mixed models were applied (intention-to-treat).

Results

Mean age was 65 years; 49.5% were male and 72.9% had moderate disease severity. Adherence was 81.7%. At 3 months, the yoga group showed significantly greater improvements in balance (mean difference[MD]1.75), with larger gains in high-risk participants (BBS≤50; MD 4.67)(p<.001). Balance confidence (MD 7.10–10.60), motor symptoms (MD − 5.04), and depression (MD − 1.19) also improved (p<.001). At 6 months, improvements in balance, motor symptoms, and depression were sustained, including in high-risk participants (MD 2.72, p=.046). Delayed gains in gait were observed in 3‑m Timed Up & Go, with increased cadence (MD 8.745 steps/min) and reduced mediolateral (MD − 0.013m) and anteroposterior sway (MD − 0.007m)(p≤.02).

Conclusions

Telehealth mindful yoga produced sustained improvements in balance, motor and psychological outcomes in PD. High adherence supports digital delivery of mind-body interventions to improve balance and reduce fall risk.

Key messages

• A 12-week home-based mindfulness yoga programme improved balance, motor symptoms, depression, and gait patterns in people with Parkinson’s disease.

• Telehealth delivery achieved 81.7% adherence and sustained 6-month benefits, supporting scalable public health rehabilitation for patients with balance impairment at high fall risk.