Acupuncture, Reflexology, Hypnotherapy and Yoga

[NIGEL COCKLE <100777.2503@xxxxxxxxxxxxxx>]

Report on  the Initial  Trials of  Alternative Therapies as a Treatment
for Parkinson's  Disease  by  the  Chester  Branch  of  the Parkinson's
Disease Society, Chester, UK.

By Robert French



Background

At the  January 1994  meeting of  the Chester Branch of the Parkinson's
Disease Society, it was  proposed to  undertake a  feasibility study of
'alternative' therapies for Parkinson's Disease sufferers.

A  sub    committee  of  four  met and discussed the proposed study and
concluded that a scientific and clinically controlled trial  was beyond
the capabilities  of the branch membership nor would funds be available
from  the  branch  to  employ  the  scientific  and  medical  personnel
required.

Enquiries of  headquarters revealed no such studies had been undertaken
by them or, to their knowledge, any other branch.


At a further meeting,  which  Beverley  Shember,  Area  Officer  of the
Society,  attended,  it  was  agreed to make preliminary enquiries into
therapies available locally and the cost of therapy sessions

>From  the  information  received,  it  was  proposed    that  we  would
investigate  the  feasibility  of  a  course  of  therapies which could
realistically be funded and managed by th branch.

The above decision was determined by the receipt of a generous donation
of #1500 specifically for the alternative therapies project or 'special
project' as it became known.

Four therapies  were  considered  for  investigation  and  all sufferer
members  were  requested  to  complete  a  questionnaire, seeking their
preparedness to take part in the project.

As a result of the enquiries we were able to  determine which therapies
would be investigated and how many members were prepared to take part.

With  the  information  obtained,  further enquiries were made of local
therapists and  from  the  data  received,  a  proposed  branch managed
project was submitted to the Chester Branch Committee.

The project  would consist of some 20 members of the branch undertaking
10 weekly sessions of either Acupuncture,  Hypnotherapy, Reflexology or
Yoga at  a cost of #300 per week at the Chester Clinic of Complementary
Medicine.

The proposed project was approved by the Branch  Committee but  the sub
committee was advised to prepare a feasibility report in order to raise
the additional funds required to meet the full costs.


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Close consultation and good liaison  enabled  the  project  to progress
most  satisfactorily,  starting    on  the  10th  of March 1995. The 10
sessions to be interrupted by Easter after week 5.

Considering the difficulties Parkinson's  Disease patients  endure, the
co-operation of  the clinic's  staff and  the sub  committee was vital.
This was ably demonstrated by the clinic's ability  to enable  a number
of patients to undertake more than one therapy.

Considering  the  non  clinical  nature  of  the  project  and to bring
uniformity of assessment,  each  patient  was  required  to  maintain a
'diary' during  the period  of the  course. A  method of evaluating the
response  to  the  treatment   was  designed   by  the   sub  committee
specifically for the trial.

Difficulty  was  experienced  by  some  patients  in  completion of the
diaries and the method of evaluation was not easily understood.

The trials undertaken over a period of 11  weeks inevitably  meant that
some patients  were unable  to complete  their 10  sessions and in some
instances patients withdrew for various reasons during the period.

The advantage of the clinic being  able to  provide some  patients with
additional therapies  enabled the  addition of non Parkinson members to
take part as 'control' patients.

Additionally,  the  Chairman  of  the  Project,  who  acted  as liaison
throughout the trial undertook sample sessions of each therapy.

A  particularly  encouraging  result  of carrying out the therapies, at
the clinic, was the bringing  together  of  patients  and  carers  in a
friendly  environment  and  the  opportunity  to  compare  notes of the
Parkinson's problems.  It also  promoted a  sense of  common purpose in
sharing the  projects experience,  made evident by their enthusiasm for
an 'end of term' get together on the completion of the trials.

This enthusiasm could be of considerable benefit should  it be possible
to revitalise it in some way.

On  completion    of  the  trials,  some  difficulty was experienced in
obtaining the completed diaries and not all the  diaries were completed
as required  but the following report on each of the therapies is drawn
from the diaries submitted.







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ACUPUNCTURE

This therapy was undertaken  by Mr  Charles Buck,  Head of  the Chester
clinic  and  7  patients  had  a  total of 42 Acupuncture sessions. Two
patients did not complete their course of treatment or medical reasons.
Listed below is a brief resume identified by Case Number of each of the
patients taking part.

CN1  A sufferer of some nine years, lost a relative during  week 4
     resulting in two weeks loss of treatment. Her biggest problem
     was sleeping difficulties which by week 9 had  improved but a
     change in routine set this improvement back.

CN2  A  patient  recently  diagnosed  as  a Parkinson sufferer (18
     months) but suffering  marked  symptoms  of  PD, particularly
     tremor.  On   completion  of   her  eight  sessions  she  had
     experienced progressive improvement and was able  to resume a
     much busier life style.

CN3  A sufferer of some two years with little obvious symptoms but
     reporting depression. This improved during treatment  but her
     mental state made it difficult to assess progress.

CN7  A sufferer  of 13  years also suffered a number of additional
     complaints , making it  difficult  to  isolate  a Parkinson's
     Disease  response.   Following  the  weekly  treatment,  this
     patient experienced initial discomfort which was  followed by
     an improvement  in  her general health.  During the course of
     treatment she sustained  a  rib  injury  which  set  back her
     progress but  by the  end of the trial sleep and mobility had
     improved.

CN4  Retired  from  the  project   after   only   three  sessions.
     Unfortunately,having   experienced   some   discomfort  after
     treatment, chose to ignore advice to discuss the problem with
     the therapist and did not keep any more appointments.

CN6  Was  forced  to  retire  from  the  trial after four sessions
     following an accident. She was one of the non PD patients

CN22 Another control  patient, attended  four   sessions with very
     positive  results.  Suffering  from  a digestive disorder and
     receiving medication, after treatment  experienced no further
     problems and the medication was discontinued.




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REFLEXOLOGY

This treatment  was carried out by therapist Kate Quartermaine for most
of the course. Eight patients were involved, five of whom were men.

CN8  A  sufferer  for  three   years,  undertook   both  yoga  and
     reflexology and  at the  same time  underwent a  change in PD
     medication. As he describes in his  diaries, it  is difficult
     to identify the cause but some general improvement was noted.

CN9  A  long  term  sufferer  with particularly intense tremor and
     serious mobility problems,  he  was  unable  to  complete the
     course of treatment for medical reasons.

CN7  Also   undergoing   Acupuncture,  attended  nine  Reflexology
     sessions but due to the severity of her non related illnesses
     found    it    difficult    to   identify   PD   improvement.
     Significantly,  Reflexology   treatment  by   her  carer  had
     successfully relieved involuntary movement

CN10 Undergoing  Yoga  (8  sessions  in  all) in addition to seven
     sessions of Reflexology. Unfortunately, the diaries  were not
     very detailed  but benefit  in the form of greater relaxation
     had improved both speech and mobility.

CN11 This patient is giving some concern, not only  with regard to
     this  project  but  also  to  the branch. The patient had six
     sessions  but  communication  with   the  patient   was  very
     difficult and  it is  impossible to assess any progress. That
     the  patient  and  his  carer  overcame  the  difficulties in
     attending the clinic is highly commended.

CN17 A  control  patient  who  had  undertaken  four  sessions  of
     Hypnotherapy  and   three  sessions   of  Reflexology.  Other
     clinical conditions suffered by the patient made it difficult
     to assess the efficacy of the treatment.

CN12 Taking  part  in  nine  Yoga  sessions  in  addition  to  six
     Reflexology   treatments.   The   combined   effect  of  both
     therapies was to provide  improvement  in  tremor  and sleep.
     The therapies  appear to  be complimentary because early Yoga
     sessions caused some discomfort  which may  have ben relieved
     by subsequent Reflexology treatment.

CN22 Another  control  patient  undertook  an  single  session  of
     Reflexology to appreciate the treatment, with  a surprisingly
     accurate diagnosis of the patient's health.



                                                  4


HYPNOTHERAPY

This  course  of  therapy  was  conducted  by  Hypnotherapist,  Mr Noel
Glendon. Seven patients were involved, four of them men.

CN13 A PD sufferer for the past eight years and currently a victim
     of  sciatica   which  has   made  Hypnotherapy  difficult  to
     administer. He reported an  awareness obtained  of relaxation
     techniques  and   the  powers  of  auto  suggestion  and  its
     potential but no PD symptoms appear affected.

CN14 A PD sufferer  for  10  years  with  pronounced  mobility and
     speech  difficulties.  This  patient  was however, a very co-
     operative member of  the  project  with  an  interest  in its
     progress. He  reported an  improvement in mobility and sleep.
     On week 4 of the  course,  undertook  additional  sessions of
     Yoga.  Half  way  through  the  course an annual visit to his
     Consultant  neurologist   showed   an   improvement   in  his
     condition, but  difficulty in  identifying the  cause as some
     dietary changes had also taken place.

CN15 A Parkinson sufferer for the past six years and aged 79. This
     patient  is  unique  in  the  trial  insofar  as he is not in
     receipt of any medication for PD. Slow of gait but still very
     capable, The hypnotherapy was beginning to show some positive
     results with a reduction  in tremor  and general improvement.
     This was,  however, severely set back after a near miss while
     driving home from the fifth session.  He subsequently stopped
     driving but managed to complete the course of 10 sessions and
     recovered the ground  lost.  This  patient  was  an excellent
     example of what can be achieved with a positive attitude.

CN16 This  member  is  not  a  Parkinson sufferer and was a useful
     control patient. Suffering the effects of a neck  injury  and
     acute stress,  the initial  session brought a big improvement
     which was consolidated over the rest of the course.

CN17 Another control patient, four  sessions were  undertaken. The
     patient was  receiving treatment  for stress and some dietary
     problems. The first session  produced a  profound improvement
     which was  maintained through  the second  session but by the
     fourth session the improvement had been lost.

CN23 This control patient undertook  two sessions  but this proved
     to be of considerable help in relieving stress.





                                                  5


YOGA

Conducted by  Mr John  Clark. Nine  members took part, six of whom were
men. Although members had low expectations  of  yoga    the  course was
popular and  if larger  accommodation had  been available, more members
would have taken part.  This popularity  may have  been due  to a wider
understanding of this therapy.

CN18 Was the  only long  term   patient who undertook Yoga with no
     other therapy.  He enjoyed the  eight sessions  and whilst no
     improvement  in  his  PD  symptoms  occurred,  the  course of
     treatment led to an improvement  in  his  general  health and
     sense of wellbeing. He intends to continue the therapy.

CN12 Undertook nine sessions and after the third, started a course
     of  reflexology.  Enthusiasm   caused   some   problems  with
     stiffness and  an aching  neck and  limbs which was helped by
     the reflexology.

CN21 This PD patient found the exercise too strenuous and withdrew
     after 3 sessions.

CN19 The carer of CN21, also withdrew after 3 sessions

CN10 In a  similar way to CN12, a combination of eight sessions of
     Yoga and seven sessions of Reflexology, enabled this patient,
     despite  severe   PD  problems,   to  obtain  improvement  in
     mobility and speech.

CN8  See reflexology, this patient has been diagnosed a PD sufferer for
     three years  and in  good general  health. A combination of 9 Yoga
     sessions and  10 reflexology  provided this  patient with balanced
     treatment as with CN10 and CN12.

CN14 THis  PD   sufferer  found   the  seven  Yoga  sessions  very
     difficult but considering his  poor mobility  and involuntary
     movement  his  tenacity  in  undertaking this treatment is an
     example of what can be achieved.

CN20 A non PD sufferer, this subject was forced to retire by a pre-
     existing neck problem.







                                                  6


SUMMARY

A  distinctive  feature  of  Parkinsons  Disease  is the different ways
sufferers respond both to the disease and the  treatments. Age, natural
health, gender, length of time diagnosed, environment and care all play
a part in  influencing  the  Parkinson's  Disease  patient's lifestyle.
Given  so  many  variables    and  the  limitations  imposed by using a
'layman's approach', the project has been (with one  or two exceptions)
a rewarding experience.

There is  not sufficient  evidence to  warrant the additional cost of a
medically qualified opinion of each patient  at this  stage. Sufficient
experience  has  been  gained  to make further trials worthwhile should
further funds be available.

In conclusion, a total of 185  therapy sessions  were achieved, through
the co-operation  of all who took part. The sub committee would like to
thank Marianne and the staff of the Clinic who provided the fullest co-
operation  and  helped  to  create  a congenial atmosphere which was an
important factor throughout the whole project.

There is a growing awareness of  the potential  of alternative medicine
and our  first enquiry into their efficacy has proved, for some, a very
worthwhile experience. It would be wrong having invested  members tom,e
and funds  in our  first tentative efforts at investigation to turn our
backs on the advantages that could be gained for our membership.

Robert A French.






















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