parkinson 's disease ( pd ) affects neurological , physiological and psychological functions and quality of life ( qol ) . physical contributors such as dyskinesias , decreased mobility , fatigue and motor complications worsen qol . psychological variables like depression correlate with reduced qol . although treatments target motor symptoms , proper identification and subsequent treatment for psychological measures may be overlooked . compromised pulmonary function may also lead to impairment in activities of daily living ( adls ) and physical function and affect exercise tolerance , causing fatigue and thereby reducing qol . several forms of exercise show improvement in adls , perceived health status , fall risk , qol and motor performance . yoga also improves respiratory pressure , while yogic breathing techniques have an immediate effect on lowering blood pressure in healthy people . the purpose of this study was to discern if physiological and qol - related benefits of yoga exist in individuals with pd . because overall function measured by the unified parkinson 's disease rating scale ( updrs ) was investigated , we wanted to discern whether yoga affects the non - motor aspects of pd . this pilot study presents additional findings . medical information and self - reported symptoms included time of pd diagnosis , current medications , pd - related symptoms , physical and social activity levels , and fall incidents . if there was a major medication change , participants were allowed to complete yoga training but data were not used after the medication change . health - related qol measures included the modified falls efficacy scale ( fes ) , the geriatric depression scale ( gds ) and the sf-36 . physiological measures included weight , resting heart rate , respiratory rate , blood pressure and standard pulmonary function tests calculated by a puritan - bennett renaissance ii spirometer ( covidien - puritan bennett , boulder , co , usa ) . data were analyzed using the sigma plot 11.0 ( systat software , san jose , ca , usa ) . the primary analysis used independent t - tests to assess the baseline group differences and one - way repeated measures anova to measure change over time , with p = 0.05 considered statistically significant . gender recruitment was fairly even , but random allocation into groups divided males predominantly into the control group and more females into the yoga group . the only baseline group differences existed in bodily pain ( p = 0.006 ) and role limitations due to emotional problems ( p = 0.038 ) sub - scales of the sf-36 . participant characteristics the updrs showed a significant improvement in the yoga group over time , with the largest gain in the first 6 weeks of intervention [ figure 1a ] . although updrs mentation , behavior and mood subsection scores improved with yoga , they were not significantly different in either group [ figure 1b ] . at baseline , one control and two yoga participants had reached the ceiling on the modified fes . at the final assessment , , no control participants displayed depression measured by the gds . only three yoga participants displayed mild depression . at the final evaluation , the baseline group differences in the two domains of the sf-36 were no longer significant at the final assessment ( p = 0.435 and p = 0.724 ) . there was a significant reduction in diastolic blood pressure in the yoga group only ( p = 0.036 ) . all participants had mild pulmonary obstruction as interpreted from flow volume graphs and volume time graphs . the only pulmonary function test , average forced vital capacity ( fvc ) , showed significant improvement in the yoga group ( p = 0.03 ) . there was also a trend of improved forced expiratory volume in 1 s over time in the yoga group ( p = 0.059 ) but not in the control group ( p = 0.962 ) . ( a ) updrs score improved significantly with the yoga group ( * ) over time ( p = 0.006 , f = 7.593 , df = 2 ) but not the control group ( p = 0.876 ) . both groups showed minimal symptoms in this subsection , with 0 being no symptoms and 12 being severe symptoms medical information and self - reported symptoms are summarized in table 2 . at baseline , the yoga group reported swallowing difficulties and disinterest or loss of initiative in activities , while the control group reported none . the yoga group more commonly reported hand shaking , stiffness , clumsiness , falling , sensory disturbances or pain , lack of energy or exhaustion and forgetfulness than the control group . between 20 and 40% of the control group reported worsening of seven symptoms over time (  ) . sleep disturbances , lack of energy , shaking hands , stiffness and clumsiness showed mixed results in improvement in the yoga group . self - report of symptoms and activity in the medical questionnaire yoga participants reported more energy and visible tremor reduction lasting several hours immediately following yoga plus more relaxation with less fatigue , positive social relationship building , improved overall mood and paying more attention to body signals . the purpose of this study was to determine the potential effects of yoga on non - motor symptoms , specifically depression , qol and physiological measures . certain qol and physiological measures resulted in improvement or maintenance in activity and exercise tolerance , suggesting that positive effects of yoga may be possible . because of the progressive nature of pd , lack of deterioration of yoga participants ' self - reported symptoms and improvement in clinical outcome measures suggest that yoga is potentially an effective intervention to maintain the current activity level . updrs scores were significantly improved , especially during the initial 6 weeks of yoga training . the 95% confidence intervals indicate that clinical benefit is likely to result from the intervention . improvement in updrs scores could be explained by improved motor symptoms , but it is possible that non - motor symptoms could cumulatively contribute to the score . it is possible that with more participants , improvements would have been noted in other sf-36 domains or the group gender discrepancy could alter these perceptions . our results resemble aerobic and strengthening exercise interventions where emotional reactions , social interactions , physical activity and qol scores improve in pd participants . depression has a major impact on the symptoms of pd and is often overlooked and undertreated . yoga practice shows improvements in memory , stress , depression and anxiety in a healthy population , possibly due to improved cortisol levels . people with chronic pain who participated in yoga demonstrate improvements in depression , anxiety , fatigue and pain , while yoga in those with multiple sclerosis has a significant impact on qol , fatigue and cognition . our results of improved fvc after 6 weeks is consistent with another study showing that as little as 8 weeks of yoga in inactive older adults improves respiratory function , blood pressure and aspects of mental wellbeing . improvement in cardiorespiratory fitness , specifically pulmonary function parameters , rate of perceived exertion and exercise tolerance after aerobic exercise training has been reported in pd . it is known that different types of yoga breathing techniques have different effects on blood pressure . healthy participants increase absolute and relative maximal oxygen uptake in addition to improved strength and flexibility , showing health - related improvement in physical fitness . our results support these findings and those that found improvements in blood pressure , but changes in blood pressure may be confounded by the existence of multiple comorbidities and medications . yoga may contribute to efficacy via improvement in physiological and psychological variables associated with pd . a proposed mechanism of mental and physical health benefits has been postulated through the down - regulation of the hypothalamic - pituitary - adrenal axis . differences in stress responses between novice and expert yoga practitioners allude to this pathway as having health benefits . improved mood with decreased anxiety was correlated with acute changes in thalamic gaba levels in a healthy yoga group , which was different than a metabolically matched walking group . studies are needed to confirm the psycho - neuro immunological hypotheses in neurological disease . given the pilot nature of this study , there are a number of limitations : small sample size , coin toss randomization method , no control for social interaction , confounding variables like comorbidities , no correction for multiple comparisons between outcome measures and the measures selected may not have captured important changes in other relevant non - motor symptoms that might be positively impacted by yoga . yoga appears to improve physiological and non - motor factors that can affect qol over a relatively short period of time for pd participants . it is important to determine conservative intervention to treat physiological functions and clinical outcomes contributing to qol in pd for which yoga appears to be a viable intervention .
background : exercise can be beneficial for cardiopulmonary , musculoskeletal or neurological systems , and other factors including mood , and may be beneficial in reducing fall risks , dementia and variables associated with quality of life ( qol ) . 
 parkinson 's disease ( pd ) produces progressive motor and cognitive deterioration that may leave those inflicted unable to participate in standard exercise programs . 
 alternative forms of exercise such as yoga may be successful in improving physical function , qol and physiological variables for overall well-being.aim:this randomized controlled pilot study investigated the effectiveness of yoga intervention on physiological and health - related qol measures in people with pd.methods and materials : thirteen people with stage 1 - 2 pd were randomized to either a yoga ( n = 8) or a control group ( n = 5 ) . 
 the yoga group participated in twice - weekly yoga sessions for 12 weeks . 
 participants were tested at baseline , and at 6 and 12 weeks using the unified parkinson 's disease rating scale ( updrs ) , clinical measures of health - related qol and physiological measures.results:significant improvement in updrs scores ( p = .006 ) , diastolic blood pressure ( p = 0.036 ) and average forced vital capacity ( p = 0.03 ) was noted in the yoga group over time . 
 changes between groups were also noted in two sf-36 subscales . 
 positive trends of improvement were noted in depression scores ( p = 0.056 ) , body weight ( p = 0.056 ) and forced expiratory volume ( p = 0.059 ) . 
 yoga participants reported more positive symptom changes including immediate tremor reduction.conclusions:the results suggest that yoga may improve aspects of qol and physiological functions in stages 1 - 2 pd . 
 future larger studies are needed to confirm and extend our findings of the effects of yoga in pd .