Objective: To test the adherence to and efficacy of twice-weekly karate classes for people with mild to moderate Parkinson’s Disease (PD) on quality of life and individual goal attainment over 6 months, and maintenance of karate practice at 12 months, compared to individuals randomized to a waitlist.

Background: Karate combines aerobic, strength, resistance, and mindfulness training, each individually conferring benefits in PD. In our earlier pilot of PD-specific karate classes, we demonstrated high retention (79%), adherence (87%), and 18% improvement in quality of life over ten weeks. To rigorously test these findings, we designed a randomized, waitlist-controlled trial, with 12-month follow-up.

Method: We recruited and 1:1 randomized individuals with Hoehn & Yahr (HY) stages 1-3 to six months of twice weekly, 60-minute, no-cost, PD-specific karate classes or a waitlist control. We gathered baseline demographics, MDS-UPDRS motor score, quality of life, and individual goals. We assessed attendance, quality of life (PDQ-8), individual goal attainment at six months, and continued karate practice in the active group at 12 months.

Results: Fifty-two individuals were randomized with no baseline differences between groups (mean age 65.7 years, 61.5% male, mean PD duration: 7.8 years, 88.5% HY 2, and mean MDS-UPDRS III: 29). Mean attendance was 92.5% of 48 classes, with 70% retention of active participants and 74% retention of waitlist participants. Active participants had a clinically significant improvement in quality of life (PDQ-8 within-group change: 24.2 vs. 15.0, p = 0.002) while the waitlist control group did not change (p = 0.12). Both groups had motor improvement in MDS-UPDRS III (effect size 0.52-0.59, p = 0.02-0.03) without a between-group difference (effect size 0.29, p = 0.38). Among active participants, 84% achieved their individual goal, 100% would recommend KICK OUT PD to others, and 94% planned to continue karate. By 12 months, 63% of the active group continued attending karate classes.

Conclusion: In this randomized, controlled trial, twice-weekly karate improved PD-specific quality of life, and led to high individual goal attainment, adherence, and sustained 12-month participation. Future investigations into this promising intervention are needed.

Portions of this abstract will be presented at the American Academy of Neurology Annual Meeting, April 23, 2023.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/randomized-waitlist-controlled-trial-of-karate-intervention-to-change-kinematic-outcomes-in-pd-kick-out-pd/