Efficacy of Yijinjing-Inspired Exercises on Sleep Disorders in Parkinson's Disease: a Controlled fNIRS Study

Zekai Hu¹Jing Shi²Yiting Xue³Jinyan Wang¹Ting Liu⁴Yujia Li⁵Han Xue⁵Xueming Jin⁵Xinhao LIU^5*Jie Wang^1*Jun Hu^1*

• ¹The Second Rehabilitation Hospital of Shanghai, Shanghai, China
• ²The Baoshan Branch of the Renji Hospital affiliated with the Shanghai Jiao Tong University School of Medicine, Shanghai, China
• ³Shanghai Pudong Hospital, Shanghai, Shanghai Municipality, China
• ⁴Shanghai Baoshan Luodian Hospital, Shanghai, China
• ⁵School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China

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 nearinfrared spectroscopy (fNIRS) to assess neurophysiological changes.: 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 Bonferroniadjustment, 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.