Category: Parkinson’s Disease: Clinical Trials
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.
To cite this abstract in AMA style:J. Fleisher, K. Woo, B. Sennott, J. O'Keefe, C. Gill, S. Anderson, N. Purcell, B. Ouyang, J. Chodosh. Randomized, waitlist-controlled trial of Karate Intervention to Change Kinematic Outcomes in PD (KICK OUT PD) [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/randomized-waitlist-controlled-trial-of-karate-intervention-to-change-kinematic-outcomes-in-pd-kick-out-pd/. Accessed September 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/