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Chrysagis N, Trompouki G, Petropaulis D, Koumantakis GA, Krekoukias G, Theotokatos G, Skordilis E, Sakellari V. Effect of Boxing Exercises on the Functional Ability and Quality of Life of Individuals with Parkinson's Disease: A Systematic Review. Eur J Investig Health Psychol Educ 2024; 14:1295-1310. [PMID: 38785583 PMCID: PMC11119617 DOI: 10.3390/ejihpe14050085] [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: 03/11/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Parkinson's disease (PD) is a neurological disorder caused by the loss of dopamine-producing cells in the substantia nigra and characterized by motor and non-motor symptoms. Boxing is a type of complementary therapy to improve symptoms in PD. The purpose of the present study was to examine the effect of boxing training on the functionality and quality of life of patients with PD. The literature search was performed on PubMed, Scopus, PEDro, Cochrane Library, and Google Scholar search engines. The PEDro scale was used to assess the methodological quality of the studies. This systematic review included three studies that examined disease severity, mobility, physical activity, balance, and quality of life. According to the PEDro scale criteria, the three articles included were of high methodological quality. Statistically significant improvements after the implementation of boxing training was shown for balance and quality of life in contrast to the other variables. Boxing training intervention programs had a positive effect on balance and quality of life in patients with PD; however, the results are conflicting regarding certain functionality variables. Therefore, it is necessary to conduct further research to examine the effectiveness of boxing training on the functionality and quality of life of patients with Parkinson's disease.
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Affiliation(s)
- Nikolaos Chrysagis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
| | - Georgia Trompouki
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
| | - Dimitris Petropaulis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
| | - George A. Koumantakis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
| | - Georgios Krekoukias
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
| | - Georgios Theotokatos
- School of Physical Education and Sport Science, National and Kapodestrian University of Athens, Ethniki Antistaseos 41, 17237 Dapne, Greece; (G.T.); (E.S.)
| | - Emmanouil Skordilis
- School of Physical Education and Sport Science, National and Kapodestrian University of Athens, Ethniki Antistaseos 41, 17237 Dapne, Greece; (G.T.); (E.S.)
| | - Vasiliki Sakellari
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
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Lin YJ, Hsu WC, Wang KC, Tseng WY, Liao YY. Interactive boxing-cycling on frailty and activity limitations in frail and prefrail older adults: A randomized controlled trial. Ann Phys Rehabil Med 2024; 67:101819. [PMID: 38479253 DOI: 10.1016/j.rehab.2024.101819] [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] [Received: 02/28/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND Frailty is common among older adults, often associated with activity limitations during physical and walking tasks. The interactive boxing-cycling combination has the potential to be an innovative and efficient training method, and our hypothesis was that interactive boxing-cycling would be superior to stationary cycling in improving frailty and activity limitations in frail and prefrail older adults. OBJECTIVE To examine the impact of interactive boxing-cycling on frailty and activity limitations in frail and prefrail older adults compared to stationary cycling. MATERIALS AND METHODS A single-blinded randomized controlled trial. Forty-five participants who met at least one frailty phenotype criteria were randomly assigned to receive either interactive boxing-cycling (n = 23) or stationary-cycling (n = 22) for 36 sessions over 12 weeks. The interactive boxing-cycling was performed on a cycle boxer bike with an interactive boxing panel fixed in front of the bike. The primary outcomes were frailty status, including score and phenotypes. Secondary outcomes included activity limitations during physical and walking tasks. The pre- and post-intervention data of both groups were analyzed using a repeated measures two-way ANOVA. RESULTS Both types of cycling significantly improved frailty scores (p<0.001). Interactive boxing-cycling was more effective than stationary cycling in reversing the frailty phenotype of muscle weakness (p = 0.03, odds ratio 9.19) and demonstrated greater improvements than stationary cycling in arm curl (p = 0.002, η2=0.20), functional reach (p = 0.001, η2=0.22), and grip strength (p = 0.02, η2=0.12) tests. Additionally, interactive boxing-cycling exhibited a greater effect on gait speed (p = 0.02, η2=0.13) and gait variability (p = 0.01, η2=0.14) during dual-task walking. CONCLUSION In frail and prefrail older adults, interactive boxing-cycling effectively improves frailty but is not superior to stationary cycling. However, it is more effective at improving certain activity limitations. REGISTRATION NUMBER TCTR20220328001.
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Affiliation(s)
- Yi-Jia Lin
- Graduate Institute of A.I. Cross-disciplinary Tech, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wei-Chun Hsu
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Kai Chen Wang
- Department of Neurology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wan-Yan Tseng
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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Nahum L, Ptak R. Rehabilitation of hemianopia and visuospatial hemineglect with a mixed intervention including adapted boxing therapy: An exploratory case study. Neuropsychol Rehabil 2024:1-18. [PMID: 38506693 DOI: 10.1080/09602011.2024.2329379] [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: 09/27/2023] [Accepted: 03/03/2024] [Indexed: 03/21/2024]
Abstract
Visual field loss and visuospatial neglect are frequent consequences of cerebral stroke. They often have a strong impact on independence in many daily activities. Rehabilitation aiming to decrease these disabilities is therefore important, and several techniques have been proposed to foster awareness, compensation, or restitution of the impaired visual field. We here describe a rehabilitation intervention using adapted boxing therapy that was part of a pluridisciplinary intervention tailored for a particular case. A 58-year-old man with left homonymous hemianopia (HH) and mild visuospatial hemineglect participated in 36 sessions of boxing therapy six months after a right temporo-occipital stroke. Repeated stimulation of his blind and neglected hemifield, and training to compensate for his deficits through improved use of his healthy hemifield were performed through boxing exercises. The patient showed a stable HH before the beginning of the training. After six months of boxing therapy, he reported improved awareness of his visual environment. Critically, his HH had evolved to a left superior quadrantanopia and spatial attention for left-sided stimuli had improved. Several cognitive functions and his mood also showed improvement. We conclude that boxing therapy has the potential to improve the compensation of visuospatial impairments in individual patients with visual field loss.
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Affiliation(s)
- Louis Nahum
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland
| | - Radek Ptak
- Laboratory of Cognitive Neurorehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland
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Langeskov-Christensen M, Franzén E, Grøndahl Hvid L, Dalgas U. Exercise as medicine in Parkinson's disease. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-332974. [PMID: 38418216 DOI: 10.1136/jnnp-2023-332974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
Parkinson's disease (PD) is an incurable and progressive neurological disorder leading to deleterious motor and non-motor consequences. Presently, no pharmacological agents can prevent PD evolution or progression, while pharmacological symptomatic treatments have limited effects in certain domains and cause side effects. Identification of interventions that prevent, slow, halt or mitigate the disease is therefore pivotal. Exercise is safe and represents a cornerstone in PD rehabilitation, but exercise may have even more fundamental benefits that could change clinical practice. In PD, the existing knowledge base supports exercise as (1) a protective lifestyle factor preventing the disease (ie, primary prevention), (2) a potential disease-modifying therapy (ie, secondary prevention) and (3) an effective symptomatic treatment (ie, tertiary prevention). Based on current evidence, a paradigm shift is proposed, stating that exercise should be individually prescribed as medicine to persons with PD at an early disease stage, alongside conventional medical treatment.
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Affiliation(s)
- Martin Langeskov-Christensen
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurology, Viborg Regional Hospital, Viborg, Denmark
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Grøndahl Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
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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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Goldman JG, Volpe D, Ellis TD, Hirsch MA, Johnson J, Wood J, Aragon A, Biundo R, Di Rocco A, Kasman GS, Iansek R, Miyasaki J, McConvey VM, Munneke M, Pinto S, St. Clair KA, Toledo S, York MK, Todaro R, Yarab N, Wallock K. Delivering Multidisciplinary Rehabilitation Care in Parkinson's Disease: An International Consensus Statement. JOURNAL OF PARKINSON'S DISEASE 2024; 14:135-166. [PMID: 38277303 PMCID: PMC10836578 DOI: 10.3233/jpd-230117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD. OBJECTIVE The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care. METHODS The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions. RESULTS The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages. CONCLUSIONS Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.
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Affiliation(s)
- Jennifer G. Goldman
- JPG Enterprises LLC, Medical Division, Chicago, IL, USA
- ^Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniele Volpe
- Fresco Parkinson Institute, Fiesole, Italy
- Fresco Parkinson Center Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
- NYU Grossman School of Medicine, New York, NY, USA
| | - Terry D. Ellis
- Boston University Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA
| | - Mark A. Hirsch
- Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, NC, USA
| | - Julia Johnson
- Kings College Hospital NHS Foundation Trust, London, UK
| | - Julia Wood
- Lewy Body Dementia Association, Lilburn, GA, USA
| | - Ana Aragon
- Independent Consultant Occupational Therapist, Bath, UK
| | | | | | | | | | | | | | - Marten Munneke
- Radboudumc Center of Expertise for Movement Disorders, Nijmegen, Netherlands
| | - Serge Pinto
- The French National Centre for Scientific Research, Aix-Marseille University, Aix-en-Provence, France
| | | | - Santiago Toledo
- ^Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Ronnie Todaro
- Voz Advisors, New York, NY, USA
- ^Parkinson’s Foundation, New York, NY, USA
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Padilha C, Souza R, Grossl FS, Gauer APM, de Sá CA, Rodrigues-Junior SA. Physical exercise and its effects on people with Parkinson's disease: Umbrella review. PLoS One 2023; 18:e0293826. [PMID: 37917715 PMCID: PMC10621990 DOI: 10.1371/journal.pone.0293826] [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: 07/13/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Parkinson's disease is neurodegenerative, complex and progressive, manifesting in a slow and irreversible way. Physical exercise has been proposed as therapeutic alternative to people with Parkinson´s disease. OBJECTIVE To synthesize knowledge about the effects of physical exercise on people with Parkinson´s Disease as presented by published systematic reviews. METHODS Nine electronic databases and two grey literature databases were searched for systematic reviews reporting the effects of physical exercises on people with Parkinson´s Disease. Searches involved a two-phase process, by, at least, two independent reviewers. Methodological quality of the included systematic reviews was assessed using AMSTAR-2. RESULTS From 2,122 systematic reviews, 139 were included. Motor outcomes were assessed in 91% of the studies, with balance being the most studied. Non-motor outcomes were assessed in 68% of the studies, with emphasis on quality of life. Physical exercises were classified into five categories: aerobic exercises, strength, combined, sensorimotor activities and other activity protocols. Findings of the systematic reviews suggest that all exercise categories can be prescribed to improve balance and mobility, while combined exercises, strength, and specific activities improve both motor and non-motor outcomes, and aerobic exercise and sensorimotor activities improve motor outcomes. CONCLUSION Current evidence from systematic reviews suggests that physical exercises impacts both motor and non-motor outcomes in people with Parkinson´s Disease. Limits in evidence provided by the systematic reviews were related to methodological issues and to the description of the interventions and must be considered to improve decision-making and clinical application.
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Affiliation(s)
- Cristiano Padilha
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Renan Souza
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Fernando Schorr Grossl
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Ana Paula Maihack Gauer
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
| | - Clodoaldo Antônio de Sá
- Health Sciences Post-Graduate Program, Universidade Comunitária da Região de Chapecó–Unochapecó, Chapecó, Santa Catarina, Brazil
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Moreno Rodríguez RM, Solas Gómez B, Gallego Marcuello L, Diaz Martinez MDC, Fernández del Palacio E, Santiago-Sáez A. Observational Prospective Study to Determine the Efficacy of 'Non-Slip Socks' vs. 'Adequate Footwear' Regarding the Number of Falls Observed among Admitted Patients. Healthcare (Basel) 2023; 11:2605. [PMID: 37830642 PMCID: PMC10572164 DOI: 10.3390/healthcare11192605] [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: 06/26/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Fall prevention is an important indicator of the quality of patient care. Prevention includes the use of adequate footwear. Our objective is to determine the differences in the number of falls between patients with "adequate footwear" and "non slip socks", and their associated consequences, to support their use in the prevention of falls among hospitalized patients. METHODS This is an observational prospective study on inpatient falls. Patient characteristics, fall circumstances, and injuries were collected through Clinical Report Forms, a review of fall reports, and medical records. Admitted patients over 18 years old were recruited from Geriatric and Internal Medicine Units over a brief period of 3 months. RESULTS A total of 158 hospitalized patients were recruited. In total, 77 patients (48.73%) were assigned to the non-slip socks group, and 81 (51.27%) were assigned to the adequate footwear group. There were 21 falls during the study period, all of which were experienced by the adequate footwear group (p < 0.0001). The mean age of the patients who fell was 83.14 (range 60-100) years old. The most frequent reasons for admission among the patients who fell were COVID-19 infection (19%) and oncological complications (19%). Overall, 61.9% of patients had a high risk of falling. Most falls (76.1%) occurred in patient rooms, and most of these occurred while wandering around. The most frequent reason for falls was slipping (14/21). For 16 of 21 patients, falls did not have immediate consequences, while 5 had contusions and 1 suffered a wound. Nobody needed to be admitted to the ER or suffered external hemorrhages or loss of consciousness. CONCLUSIONS Non-slip socks represent an adequate alternative to well-fitting rubber-soled footwear. It seems that non-slip socks could prevent falls among hospitalized patients; nevertheless, further studies are necessary to clarify their role in preventing hospital falls and reducing injury rates.
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Affiliation(s)
- Rosa M. Moreno Rodríguez
- Nursing Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (B.S.G.); (L.G.M.); (E.F.d.P.)
| | - Beatriz Solas Gómez
- Nursing Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (B.S.G.); (L.G.M.); (E.F.d.P.)
| | - Laura Gallego Marcuello
- Nursing Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (B.S.G.); (L.G.M.); (E.F.d.P.)
| | | | | | - Andrés Santiago-Sáez
- Head of Legal Medicine Department, Hospital Clínico San Carlos, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Yun SJ, Hyun SE, Oh BM, Seo HG. Fully immersive virtual reality exergames with dual-task components for patients with Parkinson's disease: a feasibility study. J Neuroeng Rehabil 2023; 20:92. [PMID: 37464349 PMCID: PMC10355082 DOI: 10.1186/s12984-023-01215-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Dual-task training in Parkinson's disease (PD) improves spatiotemporal gait parameters, cognition, and quality of life. Virtual reality (VR) has been used as a therapeutic tool for patients to participate in activities in a safe environment, engage in multisensory experiences, and improve motivation and interest in rehabilitation. This study aimed to investigate the feasibility of fully immersive VR exergames with dual-task components in patients with PD. METHODS We developed VR exergames (go/no-go punch game, go/no-go stepping game, and number punch game) to improve habitual behavior control using motor-cognitive dual-task performance in patients with PD. The participants underwent 10 sessions 2-3 times a week, consisting of 30 min per session. The Unified Parkinson's Disease Rating Scale, Timed Up and Go test (TUG) under single- and dual-task (cognitive and physical) conditions, Berg balance scale (BBS), Stroop test, trail-making test, and digit span were evaluated before and after intervention. The Simulator Sickness Questionnaire (SSQ) was used to assess VR cybersickness. Usability was assessed using a self-reported questionnaire. RESULTS Twelve patients were enrolled and completed the entire training session. The mean age of participants was 73.83 ± 6.09 years; mean disease duration was 128.83 ± 76.96 months. The Hoehn and Yahr stages were 2.5 in seven patients and 3 in five patients. A significant improvement was observed in BBS and Stroop color-word test (p = 0.047 and p = 0.003, respectively). TUG time and dual-task interferences showed positive changes, but these changes were not statistically significant. The median SSQ total score was 28.05 (IQR: 29.92), 13.09 (IQR: 11.22), and 35.53 (IQR: 52.36) before, after the first session, and after the final session, respectively; the differences were not significant. Overall satisfaction with the intervention was 6.0 (IQR: 1.25) on a 7-point Likert-type scale. CONCLUSIONS Fully immersive VR exergames combined with physical and cognitive tasks may be used for rehabilitation of patients with PD without causing serious adverse effects. Furthermore, the exergames using dual-task components improved executive function and balance. Further development of VR training content may be needed to improve motor and dual-task performances. Trial registration NCT04787549 ( https://clinicaltrials.gov/ct2/show/NCT04787549 ).
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Affiliation(s)
- Seo Jung Yun
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Eun Hyun
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
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Morris ME, McConvey V, Wittwer JE, Slade SC, Blackberry I, Hackney ME, Haines S, Brown L, Collin E. Dancing for Parkinson's Disease Online: Clinical Trial Process Evaluation. Healthcare (Basel) 2023; 11:healthcare11040604. [PMID: 36833138 PMCID: PMC9957486 DOI: 10.3390/healthcare11040604] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/22/2023] Open
Abstract
Background: Dancing is an engaging physical activity for people living with Parkinson's disease (PD). We conducted a process evaluation for a PD trial on online dancing. Methods: "ParkinDANCE Online" was co-produced by people with PD, healthcare professionals, dance instructors, and a PD organisation. The evaluation mapped the following inputs: (i) stakeholder steering group to oversee program design, processes, and outcomes; (ii) co-design of online classes, based on a research evidence synthesis, expert advice, and stakeholder recommendations; (iii) trial fidelity. The key activities were (i) the co-design of classes and instruction manuals, (ii) the education of dance teachers, (iii) fidelity checking, (iv) online surveys, (v) and post-trial focus groups and interviews with participants. The outputs pertained to: (i) recruitment, (ii) retention, (iii) adverse events, (iv) fidelity, (v) protocol variations, and (vi) participant feedback. Results: Twelve people with PD, four dance instructors and two physiotherapists, participated in a 6-week online dance program. There was no attrition, nor were there any adverse events. Program fidelity was strong with few protocol variations. Classes were delivered as planned, with 100% attendance. Dancers valued skills mastery. Dance teachers found digital delivery to be engaging and practical. The safety of online testing was facilitated by careful screening and a home safety checklist. Conclusions: It is feasible to deliver online dancing to people with early PD.
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Affiliation(s)
- Meg E. Morris
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, VIC 3150, Australia
- Correspondence:
| | - Victor McConvey
- Fight Parkinson’s, Surrey Hills, Melbourne, VIC 3086, Australia
| | - Joanne E. Wittwer
- Physiotherapy Department, La Trobe University, Melbourne, VIC 3086, Australia
| | - Susan C. Slade
- Physiotherapy Department, Monash University, Melbourne, VIC 3086, Australia
| | - Irene Blackberry
- CERI and John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, VIC 3086, Australia
| | - Madeleine E. Hackney
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA 30329, USA
- Atlanta Veterans Affairs Center for Visual and Neurocognitive Rehabilitation, Decatur, GA 30033, USA
| | - Simon Haines
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
| | - Lydia Brown
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
| | - Emma Collin
- Fight Parkinson’s, Surrey Hills, Melbourne, VIC 3086, Australia
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11
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Khubetova I. Complex Rehabilitation of Patients with Parkinson’s Disease. ACTA BALNEOLOGICA 2023. [DOI: 10.36740/abal202301102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Aim: To assess the clinical effectiveness of a comprehensive rehabilitation program for patients with Parkinson’s disease Materials and Methods: The study was conducted in the regional center for movement disorders (Odesa, Ukraine). 90 patients with 1-2.5 Hoehn-Yahr stage were examined. Patients were randomly assigned to three groups (I (n=30) – standard drug therapy, II (n=30) – standard drug therapy +physical therapy, III (n=30) – standard drug therapy +physical therapy+ art therapy). The effectiveness of the therapy was assessed using the UPDRS questionnaires, Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), and Pegboard Test. The follow-up period was 12 months.
Results: Patients of the II and III groups noted an improvement in mood after physical exertion. They observed a decrease in daytime sleepiness, a decrease in tremors, and a decrease in the intensity of anxiety and fear. During the observation period, signs of disease progression were observed only in 4 (13.3%) patients of group II, in 2 (6.7%) patients of group III and in 12 (40.0%) ) patients of the control group (respectively, χ2 = 4.18 p = 0.04 and χ2 = 7.55 p = 0.006)
Conclusions: 1. The use of complex rehabilitation allows to reduce the severity of motor and non-motor manifestations of Parkinson's disease.
2. The inclusion of art therapy in the complex rehabilitation program allows to halve the number of cases of disease progression. 3. The positive effect of the use of comprehensive rehabilitation is maintained throughout the observation period.
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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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Lin YA, Chen LH, Chen FP, Wong AMK, Hsu CC, Chen JY. The Effectiveness of a Group Kickboxing Training Program on Sarcopenia and Osteoporosis Parameters in Community-Dwelling Adults Aged 50-85 Years. Front Med (Lausanne) 2022; 9:815342. [PMID: 35547204 PMCID: PMC9081979 DOI: 10.3389/fmed.2022.815342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Sarcopenia and osteoporosis are important health issues faced by older people. These are often associated with each other and share common risk factors and pathologic mechanisms. In the recently revised consensus of the European Working Group on Sarcopenia in Older People, low muscle strength has been defined as the first characteristic of sarcopenia rather than a loss in muscle mass, and walking speed has been stated as an indicator of the severity of sarcopenia. It is believed that these markers of muscle function can be potentially reversed via exercise-based interventions. The purpose of this study was to evaluate the effects of kickboxing exercise training on the parameters of sarcopenia and osteoporosis in community-dwelling adults. Methods In total, one hundred eligible subjects were randomized into an intervention group (n = 50) with 76% women and control group (n = 50) with 86% women. Both the intervention and control groups were provided with classroom lectures and personal consultations pertaining to sarcopenia and osteoporosis, whereas a 12-week kickboxing exercise training was arranged only for the intervention group. All anthropometric, physical performance, body composition, and bone mineral density measurements along with participant completed questionnaires were conducted before and after the training period. Results After 12 weeks, 41 participants in the intervention group and 34 participants in the control group completed the final assessments. There was no difference between the intervention and control groups in terms of basic demographic data. The BMI (+1.14%) of the control group increased significantly during the study period. The waist circumference (−6.54%), waist-to-height ratio (−6.57%), waist–to–hip ratio (−4.36%), total body fat (−1.09%), and visceral fat area (−4.6%) decreased significantly in the intervention group. Handgrip strength (+5.46%) and gait speed (+5.71%) improved significantly in the intervention group. The lean body mass increased by 0.35% in the intervention group and by 0.9% in the control group. The femoral neck bone mineral density (−1.45%) and T score (−3.72%) of the control group decreased significantly. The intervention group had more improvement in the status of sarcopenia (OR 1.91) and osteoporosis over the control group. Finally, the intervention group had less deterioration in the status of sarcopenia (OR 0.2) and osteoporosis (OR 0.86) compared with the control group. Conclusion Our study demonstrated that a 12-week kickboxing exercise training program is effective for improving sarcopenic parameters of muscle strength and function, but not muscle mass in adults, aged 50–85 years. Furthermore, markers of osteoporosis also showed improvement. These findings suggest that a 12-week kickboxing program is effective for muscle and bone health among community-dwelling older individuals.
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Affiliation(s)
- Yen-An Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Lee-Hwa Chen
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Fang-Ping Chen
- Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Alice May-Kuen Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan City, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
| | - Chih-Chan Hsu
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan City, Taiwan
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15
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Terrens AF, Soh SE, Morgan P. What web-based information is available for people with Parkinson's disease interested in aquatic physiotherapy? A social listening study. BMC Neurol 2022; 22:170. [PMID: 35513789 PMCID: PMC9069763 DOI: 10.1186/s12883-022-02669-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Aquatic physiotherapy is becoming a more frequently utilised treatment for people with Parkinson’s Disease (PD). Consumers are increasingly accessing information regarding health choices online, and it is not known what type or quality of information regarding aquatic physiotherapy is available. Methods Web-based platforms (Facebook™, Twitter™, YouTube™, Instagram™, blogs and the web) were searched using the Awario© social listening software. Webpages had to be in English, mention PD, aquatic physiotherapy and its effects. Quality of webpages was assessed using a modified DISCERN tool and content analysis summarised reported effects. Results Awario© identified 2992 entries, with 133 assessed using the modified DISCERN tool. A small number (n = 31, 24%) described the effects of aquatic physiotherapy for people with PD. Quality of webpages was low, with many lacking information regarding clear sources of information, contraindications to aquatic physiotherapy and descriptions of the therapeutic environment. Content analysis showed several themes; general physical, PD-specific and psychosocial effects. More than a third of webpages indicated that aquatic physiotherapy would improve strength, balance, pain and aid relaxation. A large number (n = 96, 72%) described at least one hydrodynamic or hydrostatic property of water, most commonly buoyancy (n-83, 62%). Conclusions Overall quality of information was poor, and it is recommended that webpages list all potential contraindications to aquatic physiotherapy and direct consumers to discuss potential participation with their healthcare professionals. Webpages also should include information regarding the therapeutic environment, disclose sources of information and focus on enablers to exercise to improve engagement of people with PD in aquatic physiotherapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02669-3.
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Affiliation(s)
- Aan Fleur Terrens
- Movement Disorder Program, Peninsula Health, VIC, Australia. .,Department of Physiotherapy, Monash University, VIC, Australia.
| | - Sze-Ee Soh
- Department of Physiotherapy, Monash University, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, VIC, Australia
| | - Prue Morgan
- Department of Physiotherapy, Monash University, VIC, Australia
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16
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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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Xu W, Liang HN, Baghaei N, Ma X, Yu K, Meng X, Wen S. Effects of an Immersive Virtual Reality Exergame on University Students' Anxiety, Depression, and Perceived Stress: Pilot Feasibility and Usability Study. JMIR Serious Games 2021; 9:e29330. [PMID: 34813487 PMCID: PMC8663481 DOI: 10.2196/29330] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/07/2021] [Accepted: 08/25/2021] [Indexed: 01/20/2023] Open
Abstract
Background In recent years, there has been an increase in the number of students with depression, anxiety, and perceived stress. A solution that has been increasingly used for improving health and well-being is exergaming. The effects and acceptability of exergames have been studied widely but mostly with older adults. The feasibility and usability of exergames among university students, especially those of immersive virtual reality (iVR) exergames, remain unexplored. Objective This study aimed to explore the feasibility of a 6-week iVR exergame–based intervention in reducing anxiety, depression, and perceived stress among university students and to examine the usability and acceptability of such games. Methods A total of 31 university students were recruited to participate in a 6-week study in which they needed to play a boxing-style iVR exergame called FitXR (FitXR Limited) twice per week (30 minutes per session). Their anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), and perceived stress (Perceived Stress Scale) levels were measured before and after intervention. Results A total of 15 participants completed the 6-week study. Our results suggested that participants’ mean depression scores decreased significantly from 8.33 (SD 5.98) to 5.40 (SD 5.14) after the intervention (P=.01). In addition, most participants (14/15, 93%) believed that the iVR exergame has good usability. Furthermore, most participants (14/15, 93%) were satisfied with the iVR gameplay experience and would play the iVR exergame again in the future. Of the 15 participants, 11 (73%) would recommend the iVR exergame to their friends. Conclusions The results gained from this study show that the iVR exergame has good usability, is highly acceptable, and has the potential to reduce depression levels among university students.
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Affiliation(s)
- Wenge Xu
- Digital Media Technology Lab, School of Computing and Digital Technology, Birmingham City University, Birmingham, United Kingdom
| | - Hai-Ning Liang
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Nilufar Baghaei
- School of Natural and Computational Sciences, Massey University, Auckland, New Zealand.,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Xiaoyue Ma
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Kangyou Yu
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Xuanru Meng
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Shaoyue Wen
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
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Emmanouilidis S, Hackney ME, Slade SC, Heng H, Jazayeri D, Morris ME. Dance Is an Accessible Physical Activity for People with Parkinson's Disease. PARKINSON'S DISEASE 2021; 2021:7516504. [PMID: 34721836 PMCID: PMC8556098 DOI: 10.1155/2021/7516504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/16/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the outcomes of face-to-face, digital, and virtual modes of dancing for people living with Parkinson's disease (PD). DESIGN Systematic review informed by Cochrane and PRIMSA guidelines. Data Sources. Seven electronic databases were searched: AMED, Cochrane, PEDro, CINHAL, PsycINFO, EMBASE, and MEDLINE. METHODS Eligible studies were randomised controlled trials (RCT) and other trials with quantitative data. The PEDro scale evaluated risk of bias for RCTs. Joanna Briggs Institute instruments were used to critically appraise non-RCTs. The primary outcome was the feasibility of dance interventions, and the secondary outcomes included gait, balance, quality of life, and disability. RESULTS The search yielded 8,327 articles after duplicates were removed and 38 met the inclusion criteria. Seven were at high risk of bias, 20 had moderate risk of bias, and 11 had low risk of bias. There was moderately strong evidence that dance therapy was beneficial for balance, gait, quality of life, and disability. There was good adherence to digital delivery of dance interventions and, for people with PD, online dance was easy to access. CONCLUSION Dancing is an accessible form of exercise that can benefit mobility and quality of life in people with PD. The COVID-19 pandemic and this review have drawn attention to the benefits of access to digital modes of physical activity for people living with chronic neurological conditions.
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Affiliation(s)
- Sara Emmanouilidis
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Madeleine E. Hackney
- Emory University School of Medicine, Department of Medicine, Division of Geriatrics and Gerontology, Atlanta, USA
- Atlanta Veterans Affairs Centre for Visual & Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Susan C Slade
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Hazel Heng
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Dana Jazayeri
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Meg E. Morris
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
- Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia
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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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Larson D, Yeh C, Rafferty M, Bega D. High satisfaction and improved quality of life with Rock Steady Boxing in Parkinson's disease: results of a large-scale survey. Disabil Rehabil 2021; 44:6034-6041. [PMID: 34498995 DOI: 10.1080/09638288.2021.1963854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare demographics, self-reported symptom burden, Health-Related Quality of Life (HRQL), and Self-Efficacy for Exercise (SEE) between participants and non-participants of Rock Steady Boxing (RSB), a non-contact boxing program for individuals with Parkinson's disease (PD) that focuses on agility, balance, and speed training. MATERIALS AND METHODS Adults with PD who had heard of RSB completed a 20 min, 61-question electronic survey including the Parkinson's Disease Questionnaire-39 (PDQ-39) and the Self-Efficacy for Exercise (SEE) scale. Differences between participants and never-participants were analyzed using chi-squared test, fisher's exact test and Wilcoxon test. RESULTS Of 2054 individuals enrolled in the survey, 1709 were eligible for analysis. 1333 were current participants, 166 previous-participants, and 210 never-participants. RSB participants were median age 69, 59% male, and 97% Caucasian. The majority of current participants reported that RSB improved their social life (70%), fatigue (63%), fear of falling (62%), depression (60%), and anxiety (59%). Compared to previous and never-participants, current participants had better median PDQ-39 scores (36 and 32 vs 25, p < 0.01) and SEE scores (43 and 48 vs 54, p < 0.01). CONCLUSIONS This is the largest survey of RSB use in PD. RSB participants report improvement in non-motor impairments and have significantly better HRQL and ESE compared to never-participants.IMPLICATIONS FOR REHABILITATIONParkinson's disease (PD) is a slowly progressive neurodegenerative condition that affects motor function and subsequently, quality of life.Exercise is increasingly recognized as an important treatment for motor and non-motor symptoms of PD.Rock Steady Boxing (RSB) is a specific non-contact boxing program for PD that is growing and increasing in popularity, though there is limited data on its effect on PD symptoms and quality of life.
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Affiliation(s)
- Danielle Larson
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Chen Yeh
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Miriam Rafferty
- Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation and Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Danny Bega
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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21
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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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22
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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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23
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Abstract
Parkinson's disease (PD) is a progressive, neurodegenerative disorder of the central nervous system. While it primarily affects motor function, patients eventually develop non-motor symptoms including depression, anxiety, and eventually dementia. Although there is currently no cure, treatment is aimed largely at improving quality of life though medication or surgical techniques to reduce motor symptoms. However, there is vast evidence of the benefits of physical activity as adjunct therapy for Parkinson's disease. In this review, we analyze 31 studies or reviews and highlight the role of exercise and rehabilitation in PD treatment. This study serves to provide clinicians with a comprehensive resource of the wide variety of exercises with proven benefit for patients affected by Parkinson's disease. Specifically, patients report significant improvements in motor function, cognition, mood and sleep habits.
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Affiliation(s)
- Mallory Emig
- Department of Neurology, 7547Saint Louis University, Saint Louis, MO, USA
| | - Tikku George
- Department of Neurology, 7547Saint Louis University, Saint Louis, MO, USA
| | - Justin K Zhang
- Department of Neurology, 7547Saint Louis University, Saint Louis, MO, USA
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24
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Burtscher J, Millet GP, Place N, Kayser B, Zanou N. The Muscle-Brain Axis and Neurodegenerative Diseases: The Key Role of Mitochondria in Exercise-Induced Neuroprotection. Int J Mol Sci 2021; 22:6479. [PMID: 34204228 PMCID: PMC8235687 DOI: 10.3390/ijms22126479] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Regular exercise is associated with pronounced health benefits. The molecular processes involved in physiological adaptations to exercise are best understood in skeletal muscle. Enhanced mitochondrial functions in muscle are central to exercise-induced adaptations. However, regular exercise also benefits the brain and is a major protective factor against neurodegenerative diseases, such as the most common age-related form of dementia, Alzheimer's disease, or the most common neurodegenerative motor disorder, Parkinson's disease. While there is evidence that exercise induces signalling from skeletal muscle to the brain, the mechanistic understanding of the crosstalk along the muscle-brain axis is incompletely understood. Mitochondria in both organs, however, seem to be central players. Here, we provide an overview on the central role of mitochondria in exercise-induced communication routes from muscle to the brain. These routes include circulating factors, such as myokines, the release of which often depends on mitochondria, and possibly direct mitochondrial transfer. On this basis, we examine the reported effects of different modes of exercise on mitochondrial features and highlight their expected benefits with regard to neurodegeneration prevention or mitigation. In addition, knowledge gaps in our current understanding related to the muscle-brain axis in neurodegenerative diseases are outlined.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland; (G.P.M.); (N.P.); (B.K.); (N.Z.)
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Grégoire P. Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland; (G.P.M.); (N.P.); (B.K.); (N.Z.)
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Nicolas Place
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland; (G.P.M.); (N.P.); (B.K.); (N.Z.)
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland; (G.P.M.); (N.P.); (B.K.); (N.Z.)
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Nadège Zanou
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland; (G.P.M.); (N.P.); (B.K.); (N.Z.)
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
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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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26
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Blacker DJ. Being a patient with early stage Parkinson disease: reaction to the diagnosis and management. Intern Med J 2021; 51:121-124. [PMID: 33572025 DOI: 10.1111/imj.15154] [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: 09/18/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022]
Abstract
This personal viewpoint, written by a neurologist with Parkinson disease (PD), is to provide a patient's perspective, to accompany the clinical perspective in this issue of the Intenal Medicine Journal entitled 'Approach to the patient with early stage Parkinson disease'. The aim is to provide a personal insight into the numerous issues surrounding early diagnosis and management of PD, from the position of being a physician patient.
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Affiliation(s)
- David J Blacker
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia.,Department of Neurology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Department of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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27
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Klima DW, Rabel M, Mandelblatt A, Miklosovich M, Putman T, Smith A. Community-Based Fall Prevention and Exercise Programs for Older Adults. CURRENT GERIATRICS REPORTS 2021. [DOI: 10.1007/s13670-021-00354-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Jazayeri D, Heng H, Slade SC, Seymour B, Lui R, Volpe D, Jones C, Morris ME. Benefits and risks of non-slip socks in hospitals: a rapid review. Int J Qual Health Care 2021; 33:6183310. [PMID: 33755121 DOI: 10.1093/intqhc/mzab057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/01/2021] [Accepted: 03/23/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Non-slip socks are sometimes used in an attempt to prevent falls in hospitals despite limited evidence of benefit. We critique the current literature on their risks, benefits and effects. METHODS A rapid review was conducted following the Cochrane Rapid Review Methods Group Guidelines. To be included, studies needed to have data on single or multifactorial interventions that used non-slip socks in hospitals or their safety, risks or effects in a laboratory setting. Six electronic databases were searched: Medline, Embase, Cinahl, Cochrane, Allied and Medical Health Database (AMED) and Proquest Central. RESULTS Fourteen articles met the inclusion criteria. Nine used non-slip socks as an intervention in hospitals. Three assessed their effects in laboratory settings. Two reported risks in relation to bacterial transfer. Most studies that used non-slip socks to prevent hospital falls had negative or equivocal results and were of comparatively low method quality, with a high risk of bias. Two of the laboratory tests reported traction socks to be no safer than walking barefoot and to have similar slip resistance. The laboratory studies had a low risk of bias and showed that bacteria can sometimes be acquired from socks. CONCLUSION Non-slip socks have the potential to carry an infection control risk that requires careful management. There was no strong or conclusive evidence that they prevent hospital falls.
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Affiliation(s)
- Dana Jazayeri
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport and ARCH, La Trobe University, Plenty Rd and Kingsbury Dr, Bundoora, VIC 3086, Australia
| | - Hazel Heng
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport and ARCH, La Trobe University, Plenty Rd and Kingsbury Dr, Bundoora, VIC 3086, Australia
| | - Susan C Slade
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport and ARCH, La Trobe University, Plenty Rd and Kingsbury Dr, Bundoora, VIC 3086, Australia
| | - Brent Seymour
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport and ARCH, La Trobe University, Plenty Rd and Kingsbury Dr, Bundoora, VIC 3086, Australia
| | - Rosalie Lui
- The Victorian Rehabilitation Centre, 499 Springvale Rd, Glen Waverley, VIC 3150, Australia , ARCH Healthscope 312 St Kilda Rd, Melbourne, VIC 3004, Australia, and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Plenty Rd and, Kingsbury Dr, Bundoora, VIC 3086, Australia
| | - Daniele Volpe
- Villa Margherita S. Stefano Rehabilitation, Fresco Parkinson Institute, Via Costacolonna 6, Arcugnano, VI 36057, Italy
| | - Cathy Jones
- Healthscope, 312 St Kilda Rd, Melbourne, VIC 3004, Australia
| | - Meg E Morris
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport and ARCH, La Trobe University, Plenty Rd and Kingsbury Dr, Bundoora, VIC 3086, Australia.,The Victorian Rehabilitation Centre, 499 Springvale Rd, Glen Waverley, VIC 3150, Australia , ARCH Healthscope 312 St Kilda Rd, Melbourne, VIC 3004, Australia, and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Plenty Rd and, Kingsbury Dr, Bundoora, VIC 3086, Australia.,College of Healthcare Sciences, James Cook University, 1 James Cook Dr, Douglas, QLD 4811, Australia
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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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30
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Counterpunching to improve the health of people with Parkinson's disease. J Am Assoc Nurse Pract 2021; 33:1230-1239. [PMID: 33859075 DOI: 10.1097/jxx.0000000000000598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Boxing programs designed specifically for people with Parkinson's disease (PD) can be beneficial in improving the physical, mental, and functional health of persons with PD. PURPOSE This study examined the effect of a boxing program, Rock Steady Boxing (RSB), on the health of people with PD from both the boxers' and their caregivers' perspectives as well as evaluated balance, quality of life (QoL), and depressive symptoms after 12 weeks of RSB. METHODS A mixed methods, one-group experimental design with focus groups were embedded within an intervention study. Six boxers completed baseline and 12-week postassessments. RESULTS The majority of boxers maintained or improved scores for balance, QoL, and reduced depressive symptoms. Findings indicate physical and mental benefits of RSB among persons with PD and this was further validated by qualitative data from boxers and caregivers, along with quantitative data of boxers. Caregivers and boxers reported that boxers' ability to perform activities of daily living (ADLs) improved and is supported by quantitative improvements in the Parkinson's disease Questionnaire-39 ADL subscale. All boxers reported reduced stigma, and caregivers and boxers valued the opportunity to work out in an environment free of stigma, a finding not previously reported. CONCLUSIONS It is important for nurse practitioners to recognize exercise benefits for people with PD and recommend the program to patients and include caregivers in their overall assessment of health and wellness. IMPLICATIONS FOR PRACTICE Nurse practitioners and other health practitioners may consider recommending a boxing program, such as RSB, for their PD patients as a sole or supplemental exercise program.
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Morris ME, Slade SC, Bruce C, McGinley JL, Bloem BR. Enablers to Exercise Participation in Progressive Supranuclear Palsy: Health Professional Perspectives. Front Neurol 2021; 11:635341. [PMID: 33633662 PMCID: PMC7902068 DOI: 10.3389/fneur.2020.635341] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 11/20/2022] Open
Abstract
Background: People living with progressive supranuclear palsy (PSP) can experience considerable difficulties with movement, walking, balance, and oculomotor control. The role of exercises and physical activities in mitigating the motor and non-motor symptoms of PSP remains uncertain. Aims: The aim of this study was to identify the perspectives and beliefs of health professionals about the benefits, enablers, and barriers to participation in exercise and physical activity across the course of disease progression of PSP. Methods: Qualitative methods, within a phenomenological framework, were used to obtain nursing and allied health professional perspectives and recommendations. Focus group and in-depth interview questions were derived from a systematic review on exercise for PSP. Expert opinions also guided the interviews, which were audio-recorded, transcribed verbatim, and de-identified. Two researchers independently conducted a thematic analysis. Results: Nineteen health professionals participated from the disciplines of nursing, physiotherapy, occupational therapy, and speech pathology. Four main themes emerged: (i) exercise and physical activities are important for living well with PSP; (ii) provision of information about the benefits of exercise and physical activities facilitates uptake; (iii) interdisciplinary teams work together to improve outcomes; and (iv) care partners can assist with the implementation of exercise and physical activities. Conclusion: Health professionals advocated physical therapies for people living with PSP. The expectation is that structured exercises and physical activities can help to optimize health and well-being, enabling people to continue to participate in social roles. The actual merits of such interventions must now be tested in large-scale controlled clinical trials.
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Affiliation(s)
- Meg E. Morris
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Healthscope Academic Research Collaborative in Health (ARCH), Victorian Rehabilitation Centre, Glen Waverley, VIC, Australia
| | - Susan C. Slade
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Healthscope Academic Research Collaborative in Health (ARCH), Victorian Rehabilitation Centre, Glen Waverley, VIC, Australia
| | - Christopher Bruce
- Discipline of Occupational Therapy, School of Allied Health, Human Services and Sport, Science, Health and Engineering College, La Trobe University, Bundoora, VIC, Australia
| | | | - Bastiaan R. Bloem
- Radboud University Medical Centre, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands
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32
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Fleisher JE, Sennott BJ, Myrick E, Niemet CJ, Lee M, Whitelock CM, Sanghvi M, Liu Y, Ouyang B, Hall DA, Comella CL, Chodosh J. KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson's Disease. PLoS One 2020; 15:e0237777. [PMID: 32903267 PMCID: PMC7480843 DOI: 10.1371/journal.pone.0237777] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 07/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Multiple exercise modalities and mindfulness activities are beneficial in Parkinson's Disease (PD). Karate is a martial art that combines aerobic and large-amplitude movements, balance and core training, and mindfulness, suggesting a potential benefit for individuals with PD from multiple perspectives. OBJECTIVE To evaluate the feasibility of community-based Shotokan karate classes involving physical activity and mindfulness among individuals with mild- to moderate-stage PD, and to explore the effects of karate on objective and patient-reported outcomes. METHODS We conducted a 10-week, unblinded trial of twice weekly, PD-specific karate classes. Feasibility was assessed by: dropout rates, adherence via attendance records, adverse effects and falls, and continued participation six months post-intervention. Participants completed pre- and post-intervention assessments of disease-related quality of life (Parkinson's Disease Questionnaire-8, PDQ-8), falls, and post-intervention assessment of change in overall wellbeing (Patient Global Impression of Change, PGIC), with exploratory measures of mobility using the Timed Up and Go (TUG), mood using the Hospital Anxiety and Depression Scale (HADS), and cognition using digit span forward and backward and the Symbol Digit Modalities Test (SDMT). RESULTS Of 19 enrolled participants, 15 completed the study (79%). Among completers, mean adherence was 87% during the ten weeks of intervention, and 53% maintained karate participation six months later and endorsed sustained improvement, respectively. No adverse effects or change in fall frequency were detected. Among completers, 53% were women, and mean PD duration was 6 years (range 2-20). Quality of life improved to a clinically significant degree (PDQ-8: mean 25.3 (standard deviation (SD) 20.8) versus 19.3 (SD 19.6), p = 0.01, effect size 0.83). On the PGIC, 87% endorsed feeling moderately or considerably better. Mobility did not change significantly (TUG: 9.6 seconds (SD 2.23) versus 9.0 seconds (SD 1.89), p = 0.12, effect size 0.43), nor were there changes in overall physical activity, mood, or cognition (p = 0.35-0.92). CONCLUSIONS In a small, 10-week, unblinded trial of community-based karate classes for individuals with mild and moderate PD, high adherence was noted. Quality of life and wellbeing improved significantly, without changes in exploratory outcomes of mobility or neuropsychological outcomes. The study was underpowered, particularly for the exploratory outcomes. Controlled and longitudinal investigation is warranted to confirm our pilot findings and explore the long-term effects and sustainability of karate in PD. TRIAL REGISTRATION Clinicaltrials.gov: NCT03555695.
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Affiliation(s)
- Jori E. Fleisher
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- * E-mail:
| | - Brianna J. Sennott
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Erica Myrick
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Claire J. Niemet
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Monica Lee
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Courtney M. Whitelock
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Maya Sanghvi
- Yale College, Yale University, New Haven, Connecticut, United States of America
| | - Yuanqing Liu
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Deborah A. Hall
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Cynthia L. Comella
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Joshua Chodosh
- Department of Medicine, New York University School of Medicine, New York, New York, United States of America
- Medicine Service, VA New York Harbor Healthcare System, New York, New York, United States of America
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