While there are great anecdotal reports and TV stories about boxing programs for Parkinson’s Disease,particularly Rock Steady Boxing, I thought it would be interesting to learn whether or not these results have been quantitatively measured. Stephanie Combs-Miller, a professor at the University of Indianapolis Krannert School of Physical Therapy and director of research for the University’s College of Health Sciences, has been studying the effectiveness of boxing programs for Parkinson’s Disease for 9 years.
In 2011, her team published a study in the Journal of the American Physical Therapy Association titled “Boxing Training for Patients With Parkinson Disease: A Case Series” (available on-line at http://ptjournal.apta.org/content/91/1/132). It was a very limited study with six patients with idiopathic PD attending 24 to 36 boxing training sessions for 12 weeks, with the option of continuing the training for an additional 24 weeks. Very specific motor tests were assessed at regular intervals:
The outcome measures were the Functional Reach Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Timed “Up & Go” Test, Six-Minute Walk Test, gait speed, cadence, stride length, step width, activities of daily living and motor examination subscales of the Unified Parkinson Disease Rating Scale, and Parkinson Disease Quality of Life Scale.
I’d encourage reading the report for more details on these criteria. Key observations:
All 6 patients in this case series showed improvements on at least 5 of the 12 outcome measures over the baseline at the 12-week test. Except for patient 6, all patients showed improvements in every outcome category, including balance, gait, disability, and quality of life.
Neil Sligar’s story is worth checking out. Diagnosed with Parkinson’s in 1998, he began a vigorous exercise program in 2000. He wrote about his experience after 10+ years.
There are at least 3 articles and 2 interviews worth viewing.
A write-up after 8 years describes his approach:
Setting small targets has been critical to my improved performances. Focus on tiny gains in the near future rather than big goals in the long term. You can surprise yourself how far you reach.
To mark 10 years of intense exercise, he wrote a follow-up article at http://katekelsall.typepad.com/my_weblog/2010/01/parkinsons-disease-and-intense-exercise-neil-sligars-10-year-experience.html
Here are a few key quotes for his lessons learned:
What have I learned?
Firstly, don’t accept the limitations others may predict, assume, or recommend because of Parkinson’s disease. I don’t, and won’t, accept that my physical capacity is any less than that of anyone else. Parkinson’s disease has been an inconvenience, not an obstacle, for strenuous, physical activity…
I’ve been working hard to regain the strength in my right arm that Parkinson’s took away from me. I’m making progress. Weight training is a key ingredient in these efforts. It is important to stress that vigorous exercise is not all about cardio, in fact, weight training is a key component.
More specifically, I’m referring to weight training as a progressive resistance exercise. This is a strength training method in which the load is gradually increased to allow muscles to adapt. The body adapts to exercise and needs to be constantly challenged in order to continue to grow and change. Essentially, this is the same basic concept we talk about with vigorous exercise, always pushing your limits.
As time progresses, you’re increasing the weight, increasing the number of repetitions between rests, increasing the number of sets, and/or adding additional exercises to target complimentary muscles.
Without a doubt, PD (and aging in general) makes this harder to achieve. But every small increase confirms that you’re getting stronger. And over time, those small increases can add up to something significant.
A few years ago, Dr. Daniel Corcos, with the University of Illinois at Chicago, led a 2 year randomized controlled trial of Parkinson’s which compared the effects of weight training vs. more general flexibility, strength and balance exercises. The conclusions were clear:
I’ve started this topic to collect references to studies that explore the neuroprotective benefits of vigorous exercise to slow the progression of Parkinson’s Disease.
Let’s start with a few quotes from the National Parkinson Foundation …
Research has shown that exercise can improve gait, balance, tremor, flexibility, grip strength and motor coordination.
There is a strong consensus among physicians and physical therapists that improved mobility decreases the risk of falls and some other complications of Parkinson’s.
Beyond this, we know that people who exercise vigorously, for example by doing things like running or riding a bicycle, have fewer changes in their brains caused by aging.
However, when it comes to exercise and PD, greater intensity equals greater benefits. Experts recommend that people with Parkinson’s, particularly young onset or those in the early stages, exercise with intensity for as long as possible as often as possible. Your doctor might recommend an hour a day three or four times a week, but most researchers think that the more you do, the more you benefit.
There is an Italian doctor, Antonio Costanini, who treats Parkinson’s patients with high doses of Vitamin B1 (Thiamin). He first published a report about his results in 2013: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762356/
There are interesting Before/After Patient videos (in Italian, but some have subtitles)…a few are embedded below, more are available at: