Clinical Trial Finds Anxiety Coaching Ineffective for Reducing Freezing of Gait in Parkinson's Patients

The study involved a small sample size and was conducted to assess the impact of a brief, personalized intervention on managing anxiety linked to FOG. Participants engaged in weekly counseling sessions with a neuropsychologist over the span of about one month, aimed at elucidating the relationship between anxiety and FOG, and developing strategies to mitigate freezing episodes.

Despite initial analyses indicating some benefits—such as reductions in the time spent frozen, anxiety, and stress—these outcomes could not be definitively attributed to the intervention due to the lack of a control group after the intervention phase. The researchers concluded that the intervention did not produce a significant decrease in FOG compared to the control group.

“Contrary to our hypothesis, the intervention did not result in a greater reduction in FOG compared to the control group,” the researchers stated, emphasizing the limitations of the study’s size and duration. They noted, however, that future research is necessary to explore effective treatments for anxiety-related FOG in Parkinson’s patients.

The trial, titled “Managing the mental state to tackle anxiety-related freezing of gait in people with Parkinson’s disease: a randomized controlled trial,” was published in the journal npj Parkinson’s Disease. It enrolled 41 participants, who reported multiple daily episodes of FOG exacerbated by anxiety or stress.

Participants were divided into two groups: one received the anxiety coaching intervention immediately, while the other spent four weeks on a waitlist before receiving the same intervention. Both groups showed similar rates of FOG during the initial analysis, with no statistically significant difference between them. However, after all participants completed the intervention, exploratory analyses revealed a mean reduction of 8.5 percentage points in the time spent frozen, along with improved reports of anxiety and perceived stress over time.

Despite these findings, the researchers cautioned against drawing firm conclusions. Subsequent improvements could have been influenced by repeated assessments or other factors unrelated to the intervention. The authors suggested that the brief nature of the sessions may have limited their effectiveness, pointing out that cognitive behavioral therapy for anxiety in Parkinson’s typically comprises more sessions. They also noted the absence of physical therapy components, which are pivotal in addressing balance and fall-related anxiety in Parkinson's patients.