Objective: Can participation in a Rock Study Boxing program improve procedural memory in people with Parkinson’s disease (PD)?

Background: Procedural memory is important for daily function, such as when riding a bicycle.  Studies show that people with PD have deficits in procedural memory, in particular, motor procedural memory. In addition, there is a known relationship between procedural memory and exercise. Rock Steady Boxing (RSB) is a group exercise program geared specifically for people with Parkinson’s disease. A case series by Combs et al. shows improvements in quality of life, balance and gait after participation in RSB. However, the impact of RSB on memory, particular, procedural memory, has not been investigated.

Method: People with PD were divided into experimental; those who planned to attend RSB, and control groups; those who did not attend RSB.  To assess procedural learning, a modified Serial Reaction Time Task (modified script of Inquisit 5 Lab©) was used.  The task timed participants as they correctly identified 7 blocks of 10 stimuli. Determination of procedural learning was assessed by comparing reduction in response time over four identical “Learning” blocks, with response time when exposed to a random “Transfer” block. To date, re-assessments were performed pre and post 6 months, with planned re-assessments at 1 year.

Results: Twenty-eight participants with PD; experimental (n= 14), control (n=14), participated in the study. Results show that in boxers, when exposed to random stimuli, a decrease in median reaction time of 27.3ms was found.  In non-boxing participants, an average 93.5ms increase in median reaction time was found.

Conclusion: Participants in a RSB program showed improvements in reaction time during a procedural memory task when compared to non-boxers. This improvement might be attributed to the repetitive nature of RSB which involves committing a boxing punch combination to memory, then recalling and executing the combination.  Improvements in procedural learning may help people with PD in their daily function as many daily activities utilize procedural memories.  Future research should include a longer time frame for re-evaluation and a larger sample size.  A large randomized controlled trial would better evaluate the impact of RSB on procedural learning and its link to function.

References: Mochizuki-Kawai H. “Neural Basis of Procedural Memory” Brain and Nerve. (2008), 60(7):825-832 Mang, C. S., Snow, N. J., Wadden, K. P., Campbell, K. L., Boyd, L. A. “High-intensity aerobic exercise enhances motor memory retrieval.” Medicine and Science in Sports and Exercise 2016; 48: 2477-2486 Combs SA, Diehl MD, Staples WH, et al. “Boxing Training for Patients With Parkinson Disease: A Case Series.” Physical Therapy 2011; 91: 132-142. Massano, J., and K. P. Bhatia. “Clinical Approach to Parkinson’s Disease: Features, Diagnosis, and Principles of Management.” Cold Spring Harbor Perspectives in Medicine (2012): Web. D. Muslimović, B. Post, J. D. Speelman, B. Schmand; “Motor procedural learning in Parkinson’s disease.” Brain 2007; 11: 2887–2897 Nieuwboer, A., Rochester, L., Muncks, L. & Swinnen, S. P. “Motor learning in Parkinson’s disease: limitations and potential for rehabilitation.” Parkinsonism Relat. Disord. 2009; 15: S53–S58 Squire LR, Dede AJO. “Conscious and Unconscious Memory Systems.” Cold Spring Harbor Perspectives in Biology (2015): Web. Graybiel AM, Grafton ST. “The Striatum: Where Skills and Habits Meet.” Cold Spring Harbor Perspectives in Biology (2015): Web. P. Damier, E. C. Hirsch, Y. Agid, A. M. Graybiel. “The substantia nigra of the human brain: II. Patterns of loss of dopamine-containing neurons in Parkinson’s disease.” Brain 1999; 1437–1448 Clark, G. M., Lum, J. A. G., & Ullman, M. T. “A meta-analysis and meta-regression of serial reaction time task performance in Parkinson’s disease.” Neuropsychology 2014; 28: 945-958. Robertson E. M. “The serial reaction time task: implicit motor skill learning?” J. Neurosci. 2007; 27: 10073–10075.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/procedural-memory-changes-of-parkinsons-disease-patients-post-participation-in-boxing/