Objective: The purpose of this intervention was to assess the impact of boxing on non-motor symptoms (NMS) in PD.

Background: ​​​​​​For persons with Parkinson’s Disease (PD), motor and NMS significantly impact health-related quality of life.[1,2] Exercise is a common intervention that could modify PD symptoms[3] by decreasing the rate of disease progression and magnitude of symptoms.[4] Community based boxing training (CBBT), provides high- intensity workouts focused on strength, coordination and dual task activities. Positive aspects of CBBT include improvements in cardiovascular capacity, functional strength, balance, and postural control.[5,6] CBBT may improve the non-physical impairments from PD via stress relief, increased confidence, and fostering a sense of community.[5-7]

Method: 14 individuals (13 M; 1 F) were consented and participated in 8 weeks of boxing (2 classes/week). Inclusion criteria: PD diagnosis by licensed physician, H&Y 1-3, following 2-3 step commands, age<85. Classes were led by a PT who was a former amateur fighter. PT students were volunteer instructors. Classes included a warm-up, 10 rounds of station work (3 minutes activity/1 minute rest) with stationary punching bags, footwork drills, and strengthening exercises; then, a cool-down. Outcome measures were taken pre/post the program: 1) Patient-Reported Outcomes Measurement Information System (P-29): assess functioning and well-being in physical/mental/social domains of health, 2) Inventory of Depressive Symptomatology-Self Report (IDS-SR): depression inventory, 3) Non-Motor Symptoms Questionnaire (NMSQ): PD non-motor symptoms.

Results: Results are shown in two categories, “Responders” and “Non-Responders.” Responders had ≥ three positive changes in 10 sub-categories (IDS-SR score, NMSQ score, and the 8 domains of the P-29). Responders: 75% had improvement in depression vs.16.7% non-responders. Responders: 75% reported improvements on P-29 sleep vs. 50% in non-responders. Responders: 50% noted improvements in each category (NMSQ and P-29 Anxiety/fatigue/social/pain sections) vs. 33% of non-responders in social section. See [TABLE 1].

Conclusion: CBBT may be an effective intervention to impact NMS in PD. Individuals with the best program outcomes had more falls, higher levels of depression, and NMSQ scores at baseline. Clinical questions remain regarding the best exercise prescription to elicit changes in the majority of individuals with PD.

TABLE 1

References: 1. Gökçal, E., Gür, V. E., Selvitop, R., Yildiz, G. B., & Talip, A. S. İ. L. (2017). Motor and non-motor symptoms in Parkinson’s disease: effects on quality of life. Archives of Neuropsychiatry, 54(2), 143.
2. Kuhlman, G. D., Flanigan, J. L., Sperling, S. A., & Barrett, M. J. (2019). Predictors of health-related quality of life in Parkinson’s disease. Parkinsonism & related disorders, 65, 86-90.
3. Ahlskog, J. E. (2018). Aerobic exercise: evidence for a direct brain effect to slow parkinson disease progression. In Mayo Clinic Proceedings (Vol. 93, No. 3, pp. 360-372). Elsevier.
4. Tsukita, K., Sakamaki-Tsukita, H., & Takahashi, R. (2022). Long-term effect of regular physical activity and exercise habits in patients with early Parkinson disease. Neurology, 98(8), e859-e871.
5. Dawson, R. A., Sayadi, J., Kapust, L., Anderson, L., Lee, S., Latulippe, A., & Simon, D. K. (2020). Boxing exercises as therapy for Parkinson disease. Topics in Geriatric Rehabilitation, 36(3), 160-165.
6. Sonne, J. W., Joslyn, K., Reus, K., Angulo, M., Guettler, S., & Beato, M. C. (2021). A retrospective analysis of group-based boxing exercise on measures of physical mobility in patients with Parkinson disease. American Journal of Lifestyle Medicine, 15598276211028144.
7. Larson, D., Yeh, C., Rafferty, M., & Bega, D. (2022). High satisfaction and improved quality of life with Rock Steady Boxing in Parkinson’s disease: results of a large-scale survey. Disability and Rehabilitation, 44(20), 6034-6041.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-community-boxing-program-on-non-motor-symptoms-in-individuals-with-parkinsons-disease/