Abstract
BACKGROUND: Sleep disorders are prevalent in Parkinson's disease (PD) patients, significantly impacting their quality of life and rehabilitation outcomes. This controlled trial aimed to investigate the impact of Yijinjing-inspired exercises on sleep disorders in PD patients, utilizing functional near-infrared spectroscopy (fNIRS) to assess neurophysiological changes. METHODS: Ninety-six PD patients were allocated to control, exercise, or music therapy groups for eight weeks. The Pittsburgh Sleep Quality Index (PSQI), along with the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Unified Parkinson's Disease Rating Scale (UPDRS), and Parkinson's Disease Questionnaire (PDQ-39) were used to assess outcomes. fNIRS measured neurophysiological changes post-intervention. RESULTS: The exercise group demonstrated substantial improvement in sleep quality after Bonferroni correction (PSQI: mean Δ = -1.78 ± 0.99, P < 0.001; Cohen's d = 1.45). Moderate effect sizes were observed in cognition (MoCA: d = 0.43) and motor function (UPDRS: d = 0.40), though these did not retain statistical significance after correction. Between-group analysis revealed greater PSQI reduction in exercise versus control (Δ = -1.19 ± 0.85 vs. -0.19 ± 1.53; P = 0.001 after Bonferroni adjustment, Cohen's d = 0.87), but not versus music therapy (P = 0.018 > 0.0167). fNIRS confirmed cortical reorganization in dorsolateral prefrontal cortex (Brodmann Area 9; Channel 3) and primary motor cortex (Brodmann Area 4; Channel 9) at FDR-corrected P < 0.05. The control group showed no statistically significant changes post-correction (all P > 0.01). DISCUSSION: Yijinjing training may improve sleep quality in Parkinson's disease patients, with preliminary evidence of neuroplastic adaptation. Consideration could be given to exploring its integration into comprehensive rehabilitation approaches.