Boxing in Parkinson’s disease

Exercise affords many health benefits for people with Parkinson’s disease (PD). Previous studies have shown effects on for example gait, balance and quality of life. In recent years, different community based sports, designed specifically for people with PD, have become increasingly popular. Examples include yoga, dancing and boxing.

This study was initiated bottom-up by Nathalie Timmermans, a physiotherapist specializing in PD and part of the national ParkinsonNet network in Delft, and Rinus Bosman, a specialized boxing instructor. Nathalie and Rinus had been giving boxing to people with PD for several years in their training facility in Pijnacker. Normally only punching techniques were given in this population because of the potential fall risk of adding kicking techniques. However, Nathalie and Rinus noticed that adding kicking techniques did not result in falls and they hypothesized that it may even improve balance because balance is challenged more during kicking than while punching. They reached out to researchers from the Center of Expertise for Parkinson and Movement disorders and the research group, led by Nienke de Vries, designed and executed a pilot randomized controlled trial on the subject.

In this study, people with PD who were willing to start weekly boxing classes, were randomized in either a group boxing class with both punching and kicking techniques or a group boxing class with only punching techniques. Classes were performed for 10 weeks and participants were assessed on balance, gait, fear of falling and quality of life before and after this 10 week period. The results showed no difference on any of the outcomes between groups. However, both groups did improve balance and importantly, no adverse events occurred. Participants also indicated the enjoyed the classes. These results indicate that adding kicking techniques seems to be safe and may enrich the repertoire of techniques used in boxing classes for people in PD, potentially making these classes more fun on the long term.

This study is part of a research line on non-pharmacological interventions in PD, which includes many other studies on for example increasing physical activity in PD (STEPWISE study), the cost-effectiveness of specialized nursing in PD (NICE-PD study) and the effectiveness of speech-language therapy (PERSPECTIVE study).

Publication in Journal of Parkinson's disease

Boxing with and without Kicking Techniques for People with Parkinson's Disease: An Explorative Pilot Randomized Controlled Trial

Josefa Domingos, Ana Ligia Silva de Lima, Tessa Steenbakkers-van der Pol, Catarina Godinho, Bastiaan R Bloem, Nienke M de Vries