Objective: To examine the impact of a community boxing program on gait, functional mobility, and motor skills for persons living with PD.

Background: Higher intensity exercise may influence disease progression in PD (1). Boxing training can provide higher-intensity exercise, movement in multiple planes, and emphasizes both upper and lower extremity activities (UE/LE) [1]. Additionally, group exercise has had better outcomes and improve compliance more than individual home programs [2]. Further investigation is necessary to understand the comprehensive impact and physical benefits of boxing in PD.

Method: 20 individuals living with PD participated in a community boxing program for 12 weeks, 2 times a week, 1 hour per session. Classes included stationary punch bag, cone and footwork drills, and strengthening with a focus on the LE and core. Exercises focused on high repetition, large amplitude, velocity and power. Outcome measures: 1. UE gross and fine motor skills (Box and Blocks, 9-Hole Peg Test); 2. Temporal and spatial gait parameters (Zeno Mat – Self-selected gait velocity with and without a Dual Task Condition); 4. Functional Strength (Supine to Stand – from floor) 5. Multi-directional dynamic balance (4 Square Step Test).

Results: Participation in the boxing program resulted in statistically significant difference in pre-post scores for the Box and Blocks (p=0.000); Self-selected gait speed (p=0.007), gait with Dual Task (p=0.017); Supine to Stand (p=0.042); and 4 Square Step Test (p=0.054). There was no significant difference for the 9 Hole Peg Test (p=0.268).

Conclusion: These results support that a community boxing program positively impacts both physical and dual task motor functions in individuals with PD. This data is especially relevant in terms of the impact boxing had on dual task abilities and dynamic balance which relate to safety and falls [3-4].  Additionally, the changes to functional strength identified in this cohort may indicate critical improvements as studies have found the ability on floor transfers to predict serious fall injuries and failing health in older adults [5]. There was also a specificity of impact on the gross motor skills (Box and Blocks) but not on the fine motor skills (9-Hole Peg Test) which likely correlates with the type of exercises being performed in boxing. Further study is needed to compare treatment types.

References: [1] Combs, S. A., Diehl, M. D., Staples, W. H., Conn, L., Davis, K., Lewis, N., & Schaneman, K. (2011). Boxing training for patients with Parkinson disease: a case series. Physical therapy, 91(1), 132-142. [2] Yang, J. H., Wang, Y. Q., Ye, S. Q., Cheng, Y. G., Chen, Y., & Feng, X. Z. (2017). The effects of group-based versus individual-based tai chi training on nonmotor symptoms in patients with mild to moderate Parkinson’s disease: a randomized controlled pilot trial. Parkinson’s Disease, 2017. [3] Heinzel, S., Maechtel, M., Hasmann, S. E., Hobert, M. A., Heger, T., Berg, D., & Maetzler, W. (2016). Motor dual-tasking deficits predict falls in Parkinson’s disease: a prospective study. Parkinsonism & related disorders, 26, 73-77. [4] Cleary, K., & Skornyakov, E. (2017). Predicting falls in older adults using the four square step test. Physiotherapy theory and practice, 33(10), 766-771. [5] Bergland, A., & Laake, K. (2005). Concurrent and predictive validity of “getting up from lying on the floor”. Aging clinical and experimental research, 17(3), 181-185.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-community-boxing-program-on-motor-impairments-of-parkinsons-disease-pd-including-gait-functional-mobility-dual-task-and-coordination/