Objective: To determine the effectiveness of boxing vs. conventional physiotherapy techniques in improving the quality of movement, motor, cognitive functions in patients with PD.

Background: PD is a neurodegenerative disorder with an estimated prevalence of 1% in people over 65 years of age (1). Exercise is one of the protective factors for PD (2). PD patients benefit from continuous exercise such as boxing (3). limited number of RCT in the literature, Combs and colleagues (2011,2013) studied the effects of multiple sessions of Rock Steady boxing on short- and long-term changes on balance, mobility, gait, and QOL in PD(4,5,6,7).

Method: In this randomized controlled study, 14  PD participants  were randomized into two groups; boxing (n = 7) or conventional techniques (n = 7).The patients with the following conditions are excluded from the study : MOCA score <23, patients with other neurological/orthopedic conditions affecting their gait and balance, patients with recent drug adjustment or on medications that might interfere with their quality of movement or level of attention ,patients with H&Y stage (5). Participants in the experimental group will receive boxing training only, which will be practiced in a static and dynamic manner using punch mitts. Participants in the control group will receive conventional exercises for training their balance, quality of movement, and coordination, including reaching activities, fine-motor training, ball exercises. Participants were assessed at baseline and after six weeks of follow up using MoCA, MDS-UPDRS (8), mini-BESTest (9),and 6-Metre Timed Walk (6MTW) (10).

Results: Fourteen PD patients with a mean age of 58.5 y participated in this trial, statistical analysis showed a significant reduction in UPDRS in both groups , a non-significant improvement in MoCA for both groups. A significant reduction in MDS-UPDRS was detected in both groups . mini-BESTest and 6MTW, showed an improvement in both, which was of a statistically significant in 6MTW. However no significant difference was detected between the two groups in all of the outcomes evaluated.

Conclusion: Boxing is as beneficial as conventional physiotherapy techniques in improving the quality of movement, motor, cognitive functions, and balance in patients with PD.

References: 1-Chaudhuri KR, Healy DG, Schapira AH, National Institute for Clinical E. Non motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 2006;5:235-245.
2-Ascherio A, Schwarzschild MA. The epidemiology of Parkinson’s disease: risk factors and prevention. Lancet Neurol 2016;15:1257-1272.
3 – Domingos J, Radder D, Riggare S, Godinho C, Dean J, Graziano M, de Vries NM, Ferreira J, Bloem BR. Implementation of a Community-Based Exercise Program for Parkinson’s Patients: Using Boxing as an Example. J Parkinsons Dis. 2019;9(3):615-623. doi: 10.3233/JPD-191616. PMID: 31282426; PMCID: PMC6839476
4- Combs SA, Diehl MD, Staples WH, Conn L, Davis K, Lewis N, Schaneman K. Boxing training for patients with Parkinson disease: a case series. Phys Ther. 2011 Jan;91(1):132-42. doi: 10.2522/ptj.20100142. Epub 2010 Nov 18. PMID: 21088118.
5- Combs SA, Diehl MD, Chrzastowski C, Didrick N, McCoin B, Mox N, Staples WH, Wayman J. Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. NeuroRehabilitation. 2013;32(1):117-24. doi: 10.3233/NRE-130828. PMID: 23422464
6-MacCosham, B., Webb, E., Oey, J., & Gravelle, F. (2019). A Qualitative Phenomenological Exploration of the Experiences of Individuals with Parkinson’s Disease Engaged in a Boxing Program. The Qualitative Report, 24(6), 1460-1477. https://doi.org/10.46743/2160-3715/2019.3570.
7-Patel RA, Blasucci L, Mahajan A. A pilot study of a 12-week community-based boxing program for Parkinson’s disease. J Clin Neurosci. 2023 Jan;107:64-67. doi: 10.1016/j.jocn.2022.12.006. Epub 2022 Dec 10. PMID: 36512938.
8-Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stern MB, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, van Hilten JJ, LaPelle N; Movement Disorder Society UPDRS Revision Task Force. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008 Nov 15;23(15):2129-70. doi: 10.1002/mds.22340. PMID: 19025984.
9-Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 2010 Apr;42(4):323-31. doi: 10.2340/16501977-0537. PMID: 20461334; PMCID: PMC3228839.
10-Lam HS, Lau FW, Chan GK, Sykes K. The validity and reliability of a 6-Metre Timed Walk for the functional assessment of patients with stroke. Physiother Theory Pract. 2010 May;26(4):251-5. doi: 10.3109/09593980903015235. PMID: 20397859

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-boxing-and-conventional-physiotherapy-techniques-in-patients-with-pd-a-randomized-control-study/