Pilot Study of Mindfulness Training on the Self-Awareness of Motor Symptoms in Parkinson’s Disease – A Randomized Controlled Trial
Open accessAbstract
Objective:This study aims to evaluate feasibility and effects of a newly developed mindfulness intervention tailored to specific needs of patients with Parkinson’s disease (PD). Background:The phenomenon of impaired self-awareness of motor symptoms (ISAm) in PD might be reduced by increasing patients’ mindfulness. A PD-specific mindfulness intervention has been developed and evaluated as a potential treatment option: IPSUM (“Insight into Parkinson’s Disease Symptoms by using Mindfulness”). Methods:IPSUM’s effectiveness is evaluated by comparing an intervention with a waitlist-control group. Applying a pre-post design, patients were assessed before, directly after and 8weeks after treatment. The primary outcome was the change in a quantitative ISAm score from baseline to post-assessment. Secondary outcome measures were PD-related affective changes and neuropsychological test performance. Feasibility was evaluated via feedback forms. Results:In total, 30 non-depressed and non-demented PD patients were included (intervention:n=14, waitlist-control:n=16). ISAm score did not change significantly, but the training group showed greater performance in sustained attention and language tasks over time. Additional changes included greater mindfulness as well as less sleeping problems and anxiety. Cognitive disturbances, apathy, and sleeping problems worsened only in the waitlist-control group. Patients’ feedback regarding the training concept and material was excellent. Conclusion:Insight into Parkinson’s Disease Symptoms by using Mindfulness has not been capable of reducing ISAm in PD patients but appears to be a feasible and effective concept to, among others, support mental health in the mid-term. It has to be noted though that the study was stopped beforehand because of the SARS CoV-2 pandemic. The lack of findings might therefore be caused by a lack of statistical power. The need for further research to better understand the mechanisms of ISAm and its connection to mindfulness in PD is highlighted.
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One pilot study of IPSUM vs TAU found a significant reduction in the State-Trait Anxiety Inventory (STAI), but not depression measured by BDI-II.
“one pilot study of IPSUM vs TAU (Buchwitz et al., 2021) found a significant reduction in the State-Trait Anxiety Inventory (STAI), but not depression, measured by the Becks Depression Inventory (BDI)-II.”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
The Results section reports a significant reduction in STAI trait anxiety in the IPSUM group, but not the control group; state anxiety did not change. It also reports no significant change in depression scores, measured with BDI-2. The claim omits the important qualification that the anxiety finding applies to the trait subscale, not STAI as a whole. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn Buchwitz et al. (2021), anxiety scores continuously reduced over time, but only the change from baseline to follow-up assessment was significant.
“Anxiety scores continuously reduced over time, but only the change from baseline to follow-up assessment turned out to be significant (z = 0.964, p = .011,r = 0.26).”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
In Buchwitz et al. (2021), trait anxiety was significantly reduced in the training group, but not the control group, over the course of the study.
“Trait anxiety was significantly reduced in the training group, but not the control group, over the course of the study [χ2 (2) = 8.591, p = .014].”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
In Buchwitz et al. (2021), there was no significant change in dysexecutive functioning or quality of life total or subscale scores at any point in time.
“There was no significant change of dysexecutive functioning or quality of life total or subscale scores at any point in time.”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
In Buchwitz et al. (2021), state anxiety did not change within groups at any point.
“State anxiety did not change within groups at any point.”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
In Buchwitz et al. (2021), neither depression scores nor perceived stress total or subscale scores changed significantly in any group.
“Neither depression scores, nor perceived stress total or subscale scores did change significantly in any group.”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
IPSUM consisted of mindfulness training which included several PD-specific adaptations: the theoretical component was reduced to accommodate potential cognitive impairment; potential mobility concerns were addressed by carrying out yoga whilst seated; mild movement was added in the guided sitting meditation to keep the participant from falling asleep.
“IPSUM (Buchwitz et al. (2021) consisted of mindfulness training which included several PD-specific adaptations: The theoretical component was reduced to accommodate potential cognitive impairment; potential mobility concerns were addressed by carrying out yoga whilst seated; mild movement was added in the guided sitting meditation to keep the participant from falling asleep.”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al., 2021
Buchwitz et al. (2021) is a pilot study.
“This is a pilot study.”
From A Systematic Review of Third-Wave Therapies to Reduce Distress and Improve Wellbeing and Quality of Life in People with Parkinson's Disease. (2025) · cites this paper as Buchwitz et al. (2021)
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“Other teams sought to improve awareness of motor symptoms by using mindfulness or a novel body awareness training (BEWARE) that combined physical therapy with acceptance and commitment therapy elements (Buchwitz et al., 2021; Ghielen et al., 2017).”
BackgroundTreatment of Apathy in Parkinson’s Disease and Implications for Underlying Pathophysiology
Maher, S., Donlon, E., Mullane, G., Walsh, R. A., Lynch, T., & Fearon, C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082216 · Cited by 22 · see citing works
“Another pilot study examined a group-based mindfulness training intervention involving 14 PD patients, but no significant difference in apathy levels was demonstrated in their post-intervention assessment [79].”
BackgroundYi, M., Zhang, W., Zhao, B., & Wang, Z.-W. (2024) · Clinical Gerontologist · doi:10.1080/07317115.2024.2314192 · Cited by 11 · see citing works
“The measurements used varied between studies; eight studies (Advocat et al. 2016, Buchwitz et al., 2021, Dissanayaka et al., 2016, Koh et al., 2022, Kwok et al., 2019, Kwok et al., 2022, Kwok et al., 2023, Rodgers et al., 2019) used PDQ-related scales (e.g. PDQ-8, PDQ-39).”
InfluentialTang, R., Gong, S., Li, J., Hu, W., Liu, J., & Liao, C. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1337616 · Cited by 10 · see citing works
Christodoulou, D., Reeves, S., Carvalho, N. P., Stellman, J., & Gould, R. L. (2025) · Clinical Gerontologist · doi:10.1080/07317115.2025.2511957 · Cited by 4 · see citing works
“IPSUM (Buchwitz et al. (2021) consisted of mindfulness training which included several PD-specific adaptations: The theoretical component was reduced to accommodate potential cognitive impairment; potential mobility concerns were addressed by carrying out yoga whilst seated; mild movement was added…”
InfluentialRezayi, S., Rahmani-Katigari, M., Shahmoradi, L., & Nilashi, M. (2023) · Parkinson's Disease · doi:10.1155/2023/6272982 · Cited by 3 · see citing works
Zhang, M.-W., Zhang, Y., Zhang, Z., Jia, X.-Y., Lei, S., Bu, N., Wang, Y.-L., Bai, Y., & Wang, S. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1860499 · Cited by 1 · see citing works
“23 articles were related to PD (27, 38–59), PD involved 9 outcome measures: UPDRS-III, TUG, BBS, MoCA, MMSE, BDI, PDSS, ADL, and PDQ-39.”
Siarkos, K., Politis, A. M., Politis, A. A., Smyrnis, N., Papageorgiou, C., Prentakis, A. G., Gournellis, R. J., Katirtzoglou, E. A., & Theleritis, C. G. (2026) · Brain Sciences · doi:10.3390/brainsci16070687 · Cited by 1 · see citing works
“Buchwitz et al. [72] evaluated IPSUM mindfulness training in 30 PD participants, where the training group held apathy stable while waitlist controls significantly worsened ( p = 0.01).”
InfluentialBogahawatta, P., Wijekoon, A., Harini, S., & Wettasinghe, A. H. (2026) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2026.2725697
Gwak, J., & Park, J. (2026) · BMC Psychology · doi:10.1186/s40359-026-05436-y · Cited by 1 · see citing works
Liu, Z., An, S., Liu, S.-H., Wang, Q., & Jiang, B. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1764300
“(Buchwitz et al., 2021; Calabrò et al., 2019; Cheung et al., 2018; Frisaldi et al., 2021; Kwok et al., 2022, 2019; Lee et al., 2015; Michels et al., 2018; Ni et al., 2016; Paolo et al., 2019; Pohl et al., 2020; Rios Romenets et al., 2015; Rodgers et al., 2019; Shanahan et al., 2017; Vitale et al.,…”
Liu, Z., Liu, S.-H., Hui, C., Wang, R., & Ye, W. (2026) · Geriatric Nursing · doi:10.1016/j.gerinurse.2026.104050
- Authors
- Buchwitz, T. M., Maier, F., Greuel, A., Thieken, F., Steidel, K., Jakobs, V., & Eggers, C.
- Affiliations
- Universitätsklinikum Gießen und Marburg (DE)
- University Hospital Cologne (DE)
- Corresponding author
- Buchwitz, Timo Marcel
- ORCID
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2021-11-30
- Volume
- 12
- Pages
- 763350-763350
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC8670006
- OpenAlex
- W3215245941
- Cited by
- 15
- References
- 66
- Citations by year
- 2026: 7 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Parkinson Vereniging
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Keywords
- Parkinson's disease, mindfulness training, feasibility, sustained attention, language performance, sleep disorders, anxiety, apathy, cognitive disorders, mental health
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