Objective: To determine if one session per week of Rock Steady Boxing (RSB) for 12 to 36 weeks resulted in improved cognition, mental health, activities of daily living, and quality of life.

Background: Current medications for PD can provide relief of motor symptoms, but non-motor symptoms are less responsive. Therefore, adjunctive therapies are needed. Rock Steady Boxing is a group exercise program tailored specifically for people with Parkinson’s disease (PD). Studies have shown improvements in motor symptoms and quality of life (QOL) after participation in a program. However, it is not known if RSB has an impact on cognitive function, mental health, or ability to participate in daily activities.

Method: One hundred people with PD were evaluated for the RSB program at NYIT’s College of Osteopathic Medicine using the Montreal Cognitive Assessment, Unified Parkinson’s Disease Rating Scale (UPDRS) parts I and II, the PHQ-9 and PDQ-39.  Participants in the study voluntarily agreed to attend a minimum of 1 boxing class a week for a minimum of 12 weeks, and up to 36 weeks.  Statistical analysis were performed using IBM SPSS Version 23.

Results: Forty-four individuals with PD (33 males, 11 females, mean age 71 years; H&Y stage 1-3) participated in the study.  Separate paired samples t-tests were conducted comparing baseline to re-assessments.  Results were significant for the PHQ-9 between baseline and 12 weeks (t=1.796, df=27, p=0.04), 24 weeks (t=2.966, df=11, p=0.01), and 36 weeks (t=2.727, df=11, p=0.01). The UPDRS-II showed a difference between baseline and 12 weeks (t = -2.132, df = 28, p= 0.02) and 36 weeks (t=-2.569, df=38, p=0.01). The PDQ-39 showed a difference between baseline and 24 weeks (t=4.34, df=11, p < 0.000).

Conclusion: Currently, there are no known guidelines regarding intensity, frequency, or modality of exercise to improve mental health and activities of daily living in people with PD.  Results of this study indicate that participation in RSB one session per week for 12-36 weeks may result in improvements in these aspects of life that are adversely affected in people with PD.  Future research should include a larger sample size and increased frequency of weekly attendance which may yield an improvement in cognition as well.

References: Mattay, V., & Casey, D. (2002). Neuroleptic-Induced Acute Extrapyramidal Syndromes and Tardive Dyskinesia. Schizophrenia,552-572. doi:10.1002/9780470987353.ch28 D. Larson, D. Bega, E. Johnson, L. Slowey. Effects of Rock Steady Boxing on Activities of Daily Living and Motor Symptoms of Parkinson’s Disease [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/effects-of-rock-steady-boxing-on-activities-of-daily-living-and-motor-symptoms-of-parkinsons-disease/. Accessed March 1, 2019. Combs SA, Diehl MD, Staples WH, et al. “Boxing Training for Patients With Parkinson Disease: A Case Series.” Physical Therapy 2011; 91: 132-142. Chou, C., Hwang, C., & Wu, Y. (2012). Effect of Exercise on Physical Function, Daily Living Activities, and Quality of Life in the Frail Older Adults: A Meta-Analysis. Archives of Physical Medicine and Rehabilitation,93(2), 237-244. doi:10.1016/j.apmr.2011.08.042

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-non-contact-boxing-on-non-motor-symptoms-in-parkinsons-disease/