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Blacker DJ, Fazio R, Tucak C, Beranek P, Pollard C, Shelley T, Rajandran S, Holbeche G, Turner M, Cruickshank T. FIGHT-PD: A feasibility study of periodized boxing training for Parkinson disease. PM R 2024; 16:36-46. [PMID: 37071916 DOI: 10.1002/pmrj.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Boxing training has become a popular form of exercise for people with Parkinson disease (PD). There is a dearth of high-quality feasibility, safety, and efficacy data on boxing training for PD. Feasibility of Instituting Graduated High-intensity Training (FIGHT-PD) aimed to examine these features in a periodized boxing training program featuring high-intensity physical and cognitive demands. OBJECTIVE To conduct a feasibility study, aiming to address deficiencies in the current knowledge base and to provide data for future studies. DESIGN Single-arm, open-label feasibility. SETTING University department and medical research institute. PARTICIPANTS Ten people with early stage PD without contraindications to intense exercise, identified from a database of participants interested in boxing training. INTERVENTIONS A 15-week exercise program with three 1-hour sessions per week, with each session including warmup and then rounds of noncontact boxing using a training device. Three distinct blocks of 5 weeks including active rest. Boxers Development: focus on training technique Boxers Cardio: increasing intensity, including high-intensity interval training Boxers Brain: focus on cognitively challenging dual task training MAIN OUTCOME MEASURES: Process, resource, and management measures including recruitment and retention rates, timelines and costs, and compliance with prescribed exercise targets. Clinical outcomes were safety (adverse events), training intensity (using heart rate and perceived exertion monitoring), tolerability (pain, fatigue, and sleep scores), and pre- and postprogram Unified Parkinson Disease Rating Scale (UPDRS-III). RESULTS Among 10 participants from a pool of 82 (recruitment rate = 12%), there were no withdrawals; 348/360 workouts were completed (adherence = 97.7%); 4/348 (1.1%) workouts were missed due to minor injury. Nine of 10 participants showed improvement in UPDRS motor score. CONCLUSIONS FIGHT-PD provides a depth of feasibility and safety data, methodological detail, and preliminary results that is not described elsewhere and could provide a useful basis for future studies of boxing training for PD.
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Affiliation(s)
- David J Blacker
- Perron Institute for Neurological and Translational Science, Dept of Neurology, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, Australia
| | - Raimondo Fazio
- Perron Institute for Neurological and Translational Science, Nedlands, Australia
| | - Claire Tucak
- Department of Physiotherapy, Sir Charles Gairdner Hospital, Perron Institute for Neurological and Translational Science, Nedlands, Australia
| | - Phillip Beranek
- Centre for Precision Health, Edith Cowan University, Joondalup, Australia
| | | | | | | | - Georgina Holbeche
- Perron Institute for Neurological and Translational Science, Nedlands, Australia
| | - Mitchell Turner
- Centre for Precision Health, Edith Cowan University, Joondalup, Australia
| | - Travis Cruickshank
- Centre for Precision Health, Edith Cowan University, Perron Institute for Neurological and Translational Science, Nedlands, Australia
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Savoie FA, Benoit S, Riesco E, Tanguay A. Long-term impact of a community-based adapted boxing program on physical functioning and quality of life of individuals with Parkinson's disease. NeuroRehabilitation 2024; 54:473-484. [PMID: 38640181 DOI: 10.3233/nre-230382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
BACKGROUND Adapted boxing can help improve the physical functioning and health-related quality of life (HRQoL) of individuals with Parkinson's disease (PD). Whether these benefits persist longitudinally is unclear. OBJECTIVE The purpose of this retrospective study was to evaluate the impact of a community-based adapted boxing program on the physical functioning and HRQoL of individuals with PD over 1-1.5 years. METHODS Twenty-six individuals with PD agreed to share their results on tests administered upon enrollment in the program (PRE) and ∼431 days later (POST). The tests included the Fullerton Advanced Balance scale, (FAB), the Timed Up-and-Go test (TUG), the 30-second Sit-to-Stand test (30-STS), and the PD questionnaire-39 (PDQ-39). RESULTS From PRE to POST, performance significantly improved on the TUG and 30-STS tests (both p < 0.001), but not on the FAB (p = 0.79). Over the same period, PDQ-39 scores significantly increased (p = 0.05). No PRE to POST changes surpassed the minimal detectable change threshold. CONCLUSION The results of this study suggest that adapted boxing is at worst non-detrimental and at best potentially beneficial for muscle strength, endurance, and functional mobility in individuals with PD. However, adapted boxing probably cannot fully counteract the HRQoL decrements that accompany PD progression.
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Affiliation(s)
- Félix-Antoine Savoie
- Departement des Sciences de la Santé, Université du Québec à Rimouski, Rimouski, QC, Canada
- Centre de Recherche sur le Vieillissement, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Simon Benoit
- Faculté des Sciences de l'Activité Physique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Eléonor Riesco
- Centre de Recherche sur le Vieillissement, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculté des Sciences de l'Activité Physique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Andréanne Tanguay
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
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Brito SAFD, Scianni AA, Peniche PDC, Faria CDCDM. Measurement properties of outcome measures used in neurological telerehabilitation: A systematic review using COSMIN checklist. Clin Rehabil 2023; 37:415-435. [PMID: 36448251 DOI: 10.1177/02692155221129834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To summarize the measurement properties (reliability, validity, and responsiveness) and the clinical utility of measurement tools used in telerehabilitation in individuals with neurological conditions. DESIGN Systematic review. SUBJECTS Individuals with neurological conditions. INTERVENTION Not applicable. MAIN MEASURES The methodological quality of the studies using the COSMIN Risk of Bias Checklist, the quality of the measurement properties using the criteria for good measurement properties, and the clinical utility of the measurements using the Tyson & Connell scale. RESULTS From the 22,188 identified studies, 47 were included. Forty-three measurement tools were identified. The main modes of administration were telephone and videoconference. Studies involved mostly individuals with stroke, multiple sclerosis, and Alzheimer's disease. Criterion validity and reliability were the most investigated measurement properties. None of the tools had their responsiveness investigated. Twenty-two measurement tools have at least one measurement property evaluated as "sufficient" in a study with appropriate methodological quality ("very good" or "adequate"). Nineteen measurement tools showed adequate clinical utility. Eight measurement tools, investigated in individuals with stroke, spinal cord injury or Alzheimer's disease, all administered by telephone, were recommended. CONCLUSION The present results can be used to assist in choosing appropriate measurement tools, both in research and clinical practice, during telerehabilitation in individuals with neurological conditions. Measurement error, content validity, structural validity, and responsiveness need to be further investigated. In addition, the measurement properties of tools used in telerehabilitation in other neurological conditions, such as Huntington's disease, should also be investigated. REGISTRATION NUMBER CRD42021257662.
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Affiliation(s)
| | - Aline Alvim Scianni
- Department of Physical Therapy, 28114Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paula da Cruz Peniche
- Department of Physical Therapy, 28114Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Kruszewski A. From Ancient Patterns of Hand-to-Hand Combat to a Unique Therapy of the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3553. [PMID: 36834248 PMCID: PMC9960953 DOI: 10.3390/ijerph20043553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this publication is to provide generalized knowledge of the area of changes that took place over past centuries in relation to health, social and cultural conditions. In Greek mythology, it was necessary to nurture both body and spirit to be a perfect human being. This link between the concepts of physical beauty and goodness can be also found in later works dedicated to ancient Greek history. Particularly in Greek myths, and in Greek education in general, it was believed that both physical and spiritual excellence were necessary to raise men to achieve their true form. Some of the main forms of implementing this idea were hand-to-hand combat exercises (wrestling, boxing and pankration). Ideas characteristic of the world of ancient Greece, in a general sense, can be observed in the culture of the Far East. The main difference is the fact that these principles did not survive in Western culture as a result of transformation into a consumer society focused on the rejection of moral principles. The brutalisation of the forms of the Roman Games meant that the ideals of the ancient world were forgotten for more than 1500 years. The modern Olympic Games were resurrected in the 19th century. Inspired by the ancient Greek cult of health of body and spirit, they gave rise to a movement known as Olympism. In the Olympic Charter written by Coubertin, Olympism was called "a philosophy of life exalting and combining in a balanced whole the qualities of body, will and mind". The combat sports disciplines have had their place there since the beginning of the modern Olympic Games. The evolution of hand-to-hand combat disciplines, including numerous scientific studies indicating a very broad impact in the area of health, led to this type of physical activity being reached for as an essential element in supporting the health-promoting behaviour of society. Nowadays, physical activity in the area of exercise with elements of hand-to-hand combat, combat sports, or martial arts is an indissoluble link in the prevention and treatment of 21st century diseases. For Parkinson's disease patients, drug treatment is an essential resource for continuing to function in society, but it will not be completely effective without supporting the treatment with appropriate and attractive physical activity (e.g., "Rock Steady Boxing"). Of similar importance is the prevention of dangerous falls, which are common in this population as well as among the elderly or those affected by other diseases of civilisation. Implementing the principles and techniques of safe falling in the teaching of the young population significantly increases the likelihood of applying appropriate responses to these individuals in adulthood and old age. Actions that should be taken now for prevention can be implemented through social programmes, such as "Active today for a healthy future".
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Affiliation(s)
- Artur Kruszewski
- Department of Individual Sports, Jozef Pilsudski University of Physical Education in Warsaw, 01-813 Warsaw, Poland
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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; 107:64-67. [PMID: 36512938 DOI: 10.1016/j.jocn.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Community-based exercise programs for Parkinson's disease (PD) have gained popularity. Our understanding of such programs on non-motor features is limited. We characterized the effect of a 12-week community-based boxing exercise program on motor and non-motor symptoms in people with Parkinson's disease (PwPD). METHODS In this prospective observational study, PwPD underwent a 12-week community-based boxing program (2 sessions per week, for a total of 24 sessions). The following assessments were performed by a movement disorders neurologist at baseline and after completion of the program: MDS-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) in a modified version since assessments were performed virtually due to COVID-19 pandemic, MDS Non-Motor Rating Scale (MDS-NMS), Hamilton Depression Rating Scale (HDRS), Lilli Apathy Rating Scale (LARS), Parkinson's Disease Questionaire-39 (PDQ-39), and Schwab and England Activities of Daily Living scale (SE-ADL). Pre- and post-assessments were compared using Wilcoxon signed rank test; only participants who completed the program and both assessments were analyzed. RESULTS A total of 14 PwPD agreed to be a part of the study and completed assessments. All participants were ambulatory and functionally independent at baseline. Total non-motor feature severity (MDS-NMS, p = 0.0031), depression (HDRS, p = 0.015), and motor features (MDS-UPDRS PART 3 modified, p = 0.023) all improved significantly after the intervention. Scales on apathy (LARS, p = 0.29), Parkinson's disease-specific health related quality (PDQ-39, p = 0.093), and activities of daily living (SE-ADL, p = 0.32) did not demonstrate significant change. CONCLUSION PwPD who participated in a community-based, pilot boxing program showed improvements in motor exam and non-motor symptoms.
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Affiliation(s)
- Roshni Abee Patel
- Rush University Medical Center, Dept of Neurological Sciences, 1725 W Harrison Ave Ste 755, Chicago, IL 60612, USA; Jesse Brown VA Medical Center, Neurology Service, 820 S Damen Ave, Chicago, IL 60612, USA
| | - Lucia Blasucci
- Rush University Medical Center, Dept of Neurological Sciences, 1725 W Harrison Ave Ste 755, Chicago, IL 60612, USA
| | - Abhimanyu Mahajan
- Rush University Medical Center, Dept of Neurological Sciences, 1725 W Harrison Ave Ste 755, Chicago, IL 60612, USA.
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Danoudis M, Iansek R. A long-term community gym program for people with Parkinson's disease: a feasibility study of the Monash Health "Health and Fitness" model. Disabil Rehabil 2022; 44:7330-7338. [PMID: 34546146 DOI: 10.1080/09638288.2021.1977396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To investigate the feasibility and acceptability of the Health and Fitness Program (HFP), a long-term community gym program for people with mild to moderate Parkinson's disease (PD). METHODS Physiotherapists, with PD expertise, developed individualised exercise programs for new HFP members in consultation with them. Gym instructors, with PD training, supervised the HFP sessions. Exercises included progressive strength training, aerobic, balance, and stretching. Participants who had been enrolled in the HFP for 12 months, were recruited to a single group pre/post design study to test the program's feasibility and acceptability. Feasibility included safety, retention, attendance, and compliance data and acceptability measured using a customised questionnaire. RESULTS 17 of the 20 HFP members enrolled maintained membership for 12 months and participated in this study. The program was shown to be feasible with no falls reported during sessions, only one participant reported pain from exercising lasting more than 48 h, retention was high (85%) and most members complied with their program. Overall satisfaction with the program was high, with seven somewhat satisfied and 10 very satisfied. CONCLUSION The HFP demonstrated that a PD community gym program is feasible and acceptable when physiotherapists and PD-trained instructors collaborate to provide individualized exercise programs.IMPLICATIONS FOR REHABILITATIONPeople with Parkinson's disease need support to maintain long-term adherence to regular exercise which can be achieved with supervised community-based gym programs.A community-based PD-specific exercise program can be safe and acceptable to people with PD when PD specialist physiotherapists are involved in planning participants' exercise programs and PD-trained gym instructors supervise the exercise sessions.Members are satisfied with programs that have strategies in place to minimise barriers to participation, such as keeping costs to members low, providing a quality service, having supportive trained staff, and creating opportunities for social interaction between members.Evidence-based community exercise programs may result in improved strength and aerobic fitness and maintain quality of life in people with mild to moderate PD however further research using an RCT study is needed.
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Affiliation(s)
- Mary Danoudis
- Clinical Research Centre for Movement Disorders and Gait, Parkinson's Foundation Center of Excellence, Monash Health, Kingston Centre, Melbourne, Australia.,Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, Parkinson's Foundation Center of Excellence, Monash Health, Kingston Centre, Melbourne, Australia.,Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, Australia
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Domingos J, Dean J, Fernandes JB, Massano J, Godinho C. Community Exercise: A New Tool for Personalized Parkinson’s Care or Just an Addition to Formal Care? Front Syst Neurosci 2022; 16:916237. [PMID: 35844246 PMCID: PMC9280427 DOI: 10.3389/fnsys.2022.916237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Physiotherapy and exercise are associated with motor and non-motor benefits in Parkinson’s disease (PD). Community exercise programs may increase ongoing exercise participation and help people with Parkinson’s disease actively participate in their health management. But there is still limited knowledge about these programs regarding their benefits, safety, implications over the long-term, and effective implementation. These questions could hold relevant clinical implications. In this perspective article, we identify the current challenges and reflect upon potential solutions to help community exercise to be implemented as an additional anchor to personalize management models for Parkinson’s disease.
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Affiliation(s)
- Josefa Domingos
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- Triad Health AI, Aurora, CO, United States
- Young Parkies, Porto, Portugal
- *Correspondence: Josefa Domingos
| | - John Dean
- Triad Health AI, Aurora, CO, United States
| | - Júlio Belo Fernandes
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
| | - João Massano
- Young Parkies, Porto, Portugal
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
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Mustafa H, Harrison A, Sun Y, Pearcey GEP, Follmer B, Nazaroff BM, Rhodes RE, Zehr EP. Five weeks of Yuishinkai karate training improves balance and neuromuscular function in older adults: a preliminary study. BMC Sports Sci Med Rehabil 2022; 14:65. [PMID: 35410626 PMCID: PMC8997192 DOI: 10.1186/s13102-022-00458-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 03/30/2022] [Indexed: 12/03/2022]
Abstract
Background Martial arts training has shown positive impacts on balance and physiological measurements. Further investigation of the contents and feasibility of an effective therapeutic assessment of martial arts is needed in older adults, mainly for future applications and real-world implementation. Methods Sixteen older adults (8 male, 8 female, age 59–90 years), with or without chronic conditions, participated in a preliminary study using 5-weeks of karate training and a triple baseline control procedure. Group and single subject data analyses were conducted for dynamic balance, Timed Up and Go (TUG), hand grip, ankle plantarflexion force, and spinal cord excitability (via the soleus H-reflex) pre- and post-training. Results On average, participants completed a total of 2437 steps, 1762 turns, 3585 stance changes, 2047 punches, 2757 blocks, and 1253 strikes. Karate training improved dynamic balance performance such that the group average time was reduced (time to target (−13.6%, p = 0.020) and time to center (−8.3%, p = 0.010)). TUG was unchanged when considering the entire group (p = 0.779), but six participants displayed significant changes. Left handgrip (7.9%, p = 0.037), and plantarflexion force in the right (28.8%, p = 0.045) and left leg (13.3%, p = 0.024) increased for the group. Spinal cord excitability remained unchanged in group data analysis but 5 individuals had modulated Hmax/Mmax ratios. Conclusion 5-weeks of karate training delivered in a fashion to mimic generally accessible community-level programs improved balance and strength in older adults. Whole-body movement embodied in karate training enhanced neuromuscular function and postural control. We met the overriding goal of this preliminary study to emphasize and assess feasibility and safety for the generalizability of martial arts interventions to real-world communities to impact health outcomes. Further quantitative work should explore threshold dose and development of martial arts training interventions as potential “exercise is medicine” functional fitness for older adults.
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Affiliation(s)
- Hajer Mustafa
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
| | - Aimee Harrison
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.,Behavioural Medicine Laboratory, University of Victoria, Victoria, BC, Canada
| | - Yao Sun
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
| | - Gregory E P Pearcey
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.,Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Bruno Follmer
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
| | - Benjamin M Nazaroff
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.,Behavioural Medicine Laboratory, University of Victoria, Victoria, BC, Canada
| | - E Paul Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria, Room 172, McKinnon Building, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada. .,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada. .,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada. .,Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada. .,Division of Medical Sciences, University of Victoria, Victoria, BC, Canada.
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de Brito SAF, Scianni AA, Peniche PDC, Faria CDCDM. Measurement properties of outcome measures used in neurological telerehabilitation: A systematic review protocol. PLoS One 2022; 17:e0265841. [PMID: 35312708 PMCID: PMC8936471 DOI: 10.1371/journal.pone.0265841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Several measurement tools commonly used in face-to-face neurological rehabilitation have been used in telerehabilitation. However, it is not known whether these tools have adequate measurement properties and clinical utility. This systematic review aims to investigate the measurement properties and the clinical utility of measurement tools used in telerehabilitation in individuals with neurological diseases. A systematic review to investigate the measurement properties and clinical utility of measurement tools used in telerehabilitation in individuals with neurological conditions will be conducted. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. this systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 28 May 2021 (registration number: CRD42021257662). Electronic searches will be performed in following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE Ovid), Excerpta Medica Database (Embase Classic + Embase Ovid), Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (Scielo), and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Two trained independent reviewers will select the studies according to the inclusion criteria, and will also extract the data, evaluate the clinical utility and methodological quality. The relevant data such as design, participants, settings, and mode of administration, measurement properties, and clinical utility will be summarized. Disagreements between reviewers will be resolved by consensus or by the decision of a third independent reviewer. Hand searches of other relevant studies will be employed. The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the clinical utility scale will be used to assess the methodological quality and clinical utility of these tools, respectively. This systematic review will provide information regarding the measurement properties and the clinical utility of the measurement tools used in neurological telerehabilitation. This information will be useful to assist health professionals in choosing adequate measurement tools and planning new research studies.
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Affiliation(s)
| | - Aline Alvim Scianni
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paula da Cruz Peniche
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Domingos J, de Lima ALS, Steenbakkers-van der Pol T, Godinho C, Bloem BR, de Vries NM. Boxing with and without Kicking Techniques for People with Parkinson's Disease: An Explorative Pilot Randomized Controlled Trial. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2585-2593. [PMID: 36245387 PMCID: PMC9837687 DOI: 10.3233/jpd-223447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND People with Parkinson's disease (PD) benefit from boxing exercise. Adding kicking variations to the boxing may provide additional benefit to improve balance. However, the benefits and adherence to such trainings is unknown. OBJECTIVE To explore the feasibility, safety, and benefits on balance of boxing training combined with kicking techniques in comparison to boxing without kicking in PD. METHODS Participants were randomized to group-based boxing training with kicking techniques (BK) or to group-based boxing alone training (BO). Both groups trained for one hour, once a week, for a period of 10 weeks. Participants were assessed at baseline and ten weeks post-intervention for difference in balance, fear of falling, balance confidence, walking ability, and quality of life. RESULTS Twenty-nine people with PD (median age 64 years; median disease duration 5 years) participated. Both interventions were feasible and acceptable for all participants. No adverse events occurred. Most participants (BK 80%; BO 75%) were satisfied with the training. We found no significant between group difference on either the primary (Mini-BEST) or secondary outcomes. The within group comparison showed that balance improved in both groups after the intervention (BK 22.60 (2.7) to 25.33 (2.64) p = 0.02; BO 23.09 (3.44) to 25.80 (2.39); p = 0.01 on the Mini BEST test). CONCLUSION Both types of boxing seem to be feasible and safe. Adding kicking techniques to boxing does not improve balance significantly more than boxing alone. Incorporation of kicking may be a valuable addition to the exercise therapy repertoire.
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Affiliation(s)
- Josefa Domingos
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal
| | - Ana Ligia Silva de Lima
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
| | - Tessa Steenbakkers-van der Pol
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Monte de Caparica, Portugal
| | - Bastiaan R. Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
| | - Nienke M. de Vries
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
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Domingos J, Dean J, Cruickshank TM, Śmiłowska K, Fernandes JB, Godinho C. A Novel Boot Camp Program to Help Guide Personalized Exercise in People with Parkinson Disease. J Pers Med 2021; 11:jpm11090938. [PMID: 34575715 PMCID: PMC8467248 DOI: 10.3390/jpm11090938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022] Open
Abstract
Given the variety of exercise programs available for people with Parkinson's disease (PD), such individuals may struggle to make decisions about what exercise to perform. The objective of this study was to assess the usefulness, satisfaction, and preferences regarding participation in a PD-personalized educational and exercise boot camp program. Attendees participated in a four-day program consisting of exercise sessions, workshops, and social activities. We collected demographic and clinical information. We assessed satisfaction and preferences immediately after. At one-month follow-up, participants assessed usefulness and changes in exercise habits. Eight individuals diagnosed with PD, with a mean age of 59.5 ± 6.8 years, participated. All participants felt "very satisfied" and likely to attend future events. The two favorite sessions were: cognitive stepping and dance-based movements. At one-month follow-up, participants considered the program "very useful" and reported changes in their exercise routine. Our results suggest that the boot camp program was considered useful and capable of influencing participants' exercise habits.
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Affiliation(s)
- Josefa Domingos
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands;
- Triad Solutions, Aurora, CO 80012, USA;
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal;
| | - John Dean
- Triad Solutions, Aurora, CO 80012, USA;
| | - Travis M. Cruickshank
- Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027, Australia;
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
| | - Katarzyna Śmiłowska
- Department of Neurology, Silesian Center of Neurology, 40-055 Katowice, Poland;
| | - Júlio Belo Fernandes
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal;
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC)—Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Escola Superior de Saúde Egas Moniz, Caparica, 2829-511 Almada, Portugal;
- Correspondence: ; Tel.: +351-91-007-7492
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12
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Sangarapillai K, Norman BM, Almeida QJ. Boxing vs Sensory Exercise for Parkinson's Disease: A Double-Blinded Randomized Controlled Trial. Neurorehabil Neural Repair 2021; 35:769-777. [PMID: 34121511 PMCID: PMC8414806 DOI: 10.1177/15459683211023197] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson's disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson's Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.
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Affiliation(s)
- Kishoree Sangarapillai
- Movement Disorders Research and
Rehabilitation Centre, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Benjamin M. Norman
- Movement Disorders Research and
Rehabilitation Centre, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Quincy J. Almeida
- Movement Disorders Research and
Rehabilitation Centre, Wilfrid Laurier University, Waterloo, ON, Canada
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13
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Horbinski C, Zumpf KB, McCortney K, Eoannou D. Longitudinal observational study of boxing therapy in Parkinson's disease, including adverse impacts of the COVID-19 lockdown. BMC Neurol 2021; 21:326. [PMID: 34429075 PMCID: PMC8382938 DOI: 10.1186/s12883-021-02359-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/14/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Parkinson's Disease (PD) is a highly prevalent neurodegenerative disease whose incidence is increasing with an aging population. One of the most serious manifestations of PD is gait instability, leading to falls and subsequent complications that can be debilitating, even fatal. Boxing therapy (BT) uses gait and balance exercises to improve ambulation in people with PD, though its efficacy has not yet been fully proven. METHODS In the current longitudinal observational study, 98 participants with idiopathic PD underwent twice-weekly BT sessions. Primary outcome was self-reported falls per month; secondary outcomes were quantitative and semi-quantitative gait and balance performance evaluations. Statistical methods included segmented generalized estimating equation with an independent correlation structure, binomial distribution, and log link. RESULTS The average number of self-reported falls per month per participant decreased by 87%, from 0.86 ± 3.58 prior to BT, to 0.11 ± 0.26 during BT. During the lockdown imposed by COVID-19, this increased to 0.26 ± 0.48 falls per month. Females and those > 65 years old reported the greatest increase in falls during the lockdown period. Post-lockdown resumption of BT resulted in another decline in falls, to 0.14 ± 0.33. Quantitative performance metrics, including standing from a seated position and standing on one leg, largely mirrored the pattern of falls pre-and post-lockdown. CONCLUSIONS BT may be an effective option for many PD patients.
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Affiliation(s)
- Craig Horbinski
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
- Department of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
- Northwestern University, SQ6-518, 303 East Superior Street, Chicago, IL, 60630, USA.
| | - Katelyn B Zumpf
- Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Kathleen McCortney
- Department of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
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14
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Moore A, Yee E, Willis BW, Prost EL, Gray AD, Mann JB. A Community-based Boxing Program is Associated with Improved Balance in Individuals with Parkinson's Disease. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:876-884. [PMID: 35096235 PMCID: PMC8758155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In alignment with efforts to mitigate the negative health consequences of Parkinson's Disease (PD), the purpose of this investigation was to examine if participation in a community-based boxing program (CBP) was associated with improvements in balance and fall risk reduction among individuals with PD. In this retrospective cross-sectional study, de-identified data from 12 individuals with PD participating in a CBP was examined. Participants included those with a Hoehn and Yahr stage between 1 and 3, averaging 2.8 ± 0.8 CBP sessions per week for 6.1 ± 0.8 months between testing. Baseline and re-evaluation testing included the Fullerton Advanced Balance (FAB) Scale and Timed Up and Go (TUG) to quantify balance and fall risk. Sessions were 90-minutes in length involving a warm-up, boxing drills, strength and endurance exercises, and cool down. Sessions included multiple bouts of 30-60 second high-intensity exercise intervals (RPE between 15/20 to 17/20). Paired t-tests were used to determine if differences existed between the FAB and TUG from baseline to re-evaluation, with statistical significance accepted at p < 0.05 and > 0.8 interpreted as a large effect using Cohen's d. Results indicated a statistically significant increase and large effect in FAB performance, with a mean increase in score above previously reported minimal detectable change (MDC). While participation in CBP was associated with a statistically significant improvement and medium effect in the TUG, this did not demonstrate a population specific MDC. This study found that participation in a CBP was associated with improved balance among clients with PD.
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Affiliation(s)
- Abbie Moore
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Enoch Yee
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Brad W Willis
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Evan L Prost
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Aaron D Gray
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
| | - J Bryan Mann
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
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15
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Horbinski C, Zumpf KB, McCortney K, Eoannou D. Longitudinal Study of Boxing Therapy in Parkinson's Disease, Including Adverse Impacts of the COVID-19 Lockdown. RESEARCH SQUARE 2021. [PMID: 33851151 PMCID: PMC8043465 DOI: 10.21203/rs.3.rs-355283/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Parkinson’s Disease (PD) is a highly prevalent neurodegenerative disease whose incidence is increasing with an aging population. One of the most serious manifestations of PD is gait instability, leading to falls and subsequent complications that can be debilitating, even fatal. Boxing therapy (BT) uses gait and balance exercises to improve ambulation in people with PD, though its efficacy has not yet been fully proven. Methods: In the current longitudinal observational study, 98 participants with idiopathic PD underwent twice-weekly BT sessions. Primary outcome was self-reported falls per month; secondary outcomes were quantitative and semi-quantitative gait and balance performance evaluations. Statistical methods included segmented generalized estimating equation with an independent correlation structure, binomial distribution, and log link. Results: The average number of self-reported falls per month per participant decreased by 87%, from 0.86 ± 3.58 prior to BT, to 0.11 ± 0.26 during BT. During the lockdown imposed by COVID-19, this increased to 0.26 ± 0.48 falls per month. Females and those > 65 years old reported the greatest increase in falls during the lockdown period. Post-lockdown resumption of BT resulted in another decline in falls, to 0.14 ± 0.33. Quantitative performance metrics, including standing from a seated position and standing on one leg, largely mirrored the pattern of falls pre- and post-lockdown. Conclusions: BT may be an effective option for many PD patients.
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