Boxing Exercise: A Therapy for Parkinson's Disease
Authors: Somil Bhushan, Simon Jiang
Edited by: Fahad Hasan Shah
Parkinson’s disease is a neurodegenerative disease and movement disorder that predominantly affects the dopamine-producing-neurons in a specific area of the brain called the substantia nigra⁶. Dopamine is a chemical that coordinates movement in the body and in Parkinson’s disease there is a lack of this neurotransmitter. This leads to unintended or uncontrollable movements, such as shaking or tremors, stiffness, and difficulty with balance and coordination⁸. In addition to movement-related health issues, there are non-motor impairments associated with Parkinson’s such as depression, anxiety, apathy, hallucinations, constipation, orthostatic hypotension, sleep disorders, loss of sense of smell, among a variety of cognitive impairments⁶. Parkinson’s disease is the second most common neurodegenerative disease behind Alzheimer’s disease. Most people with Parkinson’s first develop the disease after age 60, but about 5% to 10% experience onset before the age of 50⁸. The Michael J Fox Foundation, a non-profit organization dedicated to Parkinson’s disease research, estimates that Parkinson’s affects nearly 1 million people in the United States and more than 6 million people worldwide⁴. In addition, an incidence study from the Parkinson’s Foundation discovered that a new person receives a Parkinson’s diagnosis every six minutes leading to 90,000 people diagnosed with the disease every year in the U.S⁵. Parkinson’s disease affects each diagnosed individual differently and there is no standardized version of care for the disease. With the prevalence and incidence of the disease and there being no cure, current efforts to address the health issue involve research towards finding a potential cure and clinical treatment with physical and psychological therapies to help individuals yield the best quality of life.
Various forms of exercise have long been promoted as methods to reduce the symptoms of Parkinson’s. While we still don’t fully understand the disease and can’t cure it entirely with our current methods, physical activities have been observed to decrease the risk of an individual falling down and deter the degradation of motor function that are associated with advancing cases of Parkinson’s. Johns Hopkins Medicine advises balance exercises, stretching and flexibility, and mild strength training during less advanced stages of Parkinson’s to be effective at fighting the disease’s symptoms³. Among other activities, boxing has been studied as a potential therapy for Parkinson’s. It is especially valuable for elderly patients, who often lack the joint mobility or muscular coordination needed for traditional resistance training; boxing is generally easier on weak joints than heavy lifting. Additionally, Parkinson’s disease does not limit itself to wealthy victims - many of those diagnosed with Parkinson’s do not have access to or cannot afford a physical therapist. For many, basic boxing equipment is more readily available than prescribed physical therapies, making it necessary to further examine boxing as a potential therapy for Parkinson’s. Although not every paper on the subject has yielded results favorable to boxing’s therapeutic use, the literature as a whole supports that boxing is an effective way to stymie the progression of Parkinson’s for those with minimal personal and financial investment.
Boxing as a therapy exercise for Parkinson’s disease was pioneered by non-profit organization Rock Steady Boxing. As an exercise, boxing is known for helping to improve hand-eye coordination, balance, and agility through a combination of both cardio and strength training (RSB). As exercise can slow down the progression of Parkinson’s symptoms, a high-intensity physical therapy like boxing can be especially helpful to increase dopamine-producing neurons which improves mood and relieves stress². Rock Steady Boxing created a non-contact program for individuals with Parkinson’s disease that helps to improve symptoms related to the disease through better posture, stronger core, improved balance, more fluent rhythm, improved gait, wider range of motion, improved motor skills, and better hand-eye coordination². A research study looked at participants of Rock Steady Boxing and non-participants to examine satisfaction and improved quality of life. Adults with Parkinson’s who had heard of Rock Steady Boxing completed a 20 min, 61-question electronic survey including the Parkinson's Disease Questionnaire-39 (PDQ-39) and the Self-Efficacy for Exercise (SEE) scale¹. Results indicated that the majority of current participants reported that Rock Steady Boxing improved their social life (70%), fatigue (63%), fear of falling (62%), depression (60%), and anxiety (59%). It was concluded that Rock Steady Boxing is a specific non-contact boxing program that is growing and increasing in popularity but has limited data on its effect on PD symptoms and quality of life¹. Another community-based boxing program conducted by researchers at Rush University displayed how boxing eased both motor and non-motor symptoms in adults with early Parkinson’s disease⁷. The researchers evaluated patients’ Parkinson’s symptoms both before and after the program and analyzed patients’ motor symptoms and non-motor symptoms such as depression, anxiety, sleep problems, pain, apathy, and memory problems⁷. Results pointed towards significant decreases in the total score for motor symptoms, as well as several non-motor symptoms, including depression, anxiety, sleep, and pain⁷. Boxing exercise remains to be an exercise therapy geared towardParkinson’s disease that needs more research and time to truly understand how it affects the progression of the disease over time. Current knowledge of the exercise demonstrates that it is not a cure or solution but rather serves as a viable physical therapy modality for individuals to utilize to increase their quality of life and fight against the disease.
While scientists may still be a long way from permanently liberating patients of Parkinson’s disease, boxing provides an affordable and effective method for slowing the progression of Parkinson’s. Though boxing has existed for millennia, its effectiveness as a therapy for Parkinson’s has only fairly recently been the subject of study. Most of the limited scientific literature supports consistent boxing sessions’ ability to decrease a patient's risk of falling, ease motor symptoms, and improve the overall quality of life by reducing fatigue and depressive symptoms. Additionally, boxing comes with less side effects than many pharmaceutical treatments, being far less likely to adversely impact the health of the patient than some popular medications. The fight against Parkinson’s won’t be easy; the brain is often considered the organ in our bodies we understand the least about, so it may be a while before we finally defeat Parkinson’s disease. Until that day comes, we have to do all we can to clot the flow of the disease in those who have it. Though we don’t fully understand exactly how boxing reduces the progression of Parkinson’s, further research into it will be invaluable for helping those diagnosed with the disease reduce its impacts on their lives. Boxing may not cure Parkinson’s, but its ability to slow it down is one of the most valuable tools we have for fighting it right now.
Parkinson’s disease is a complex, neurodegenerative disease that currently has no identified cure. Through physical therapy and consistent exercise, individuals living with Parkinson’s are able to better manage motor symptoms of the disease. Boxing exercise was garnered as a high intensity physical therapy method that has shown to serve the Parkinson’s community in a positive manner. As every individual with Parkinson’s has their own specific needs, boxing exercise may serve as a new exercise method that can help manage their motor-related health issues and help promote a better quality of life.
References
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. 2022;44(20):6034-6041. doi:10.1080/09638288.2021.1963854
Meter, V. (2023, January 9). Looking for parkinson's disease treatment? try boxing. Rock Steady. Retrieved March 7, 2023, from https://rocksteadyboxing.org/looking-for-parkinsons-disease-treatment-try-boxing/
Physical therapy for parkinson's disease. Physical Therapy for Parkinson's Disease | Johns Hopkins Medicine. (2021, August 8). Retrieved March 7, 2023, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/physical-therapy-for-parkinsons-disease
Parkinson's 101. The Michael J. Fox Foundation for Parkinson's Research | Parkinson's Disease. (n.d.). Retrieved March 7, 2023, from https://www.michaeljfox.org/parkinsons-101
Parkinson's Foundation. (2023, January). Parkinson's Awareness Month. Parkinson's Foundation. Retrieved March 7, 2023, from https://www.parkinson.org/parkinsons-awareness-month#:~:text=Our%20incidence%20study%20found%20that,a%20cure%20for%20Parkinson's%20disease.
Parkinson's Foundation. (n.d.). What is parkinson's? Parkinson's Foundation. Retrieved March 7, 2023, from https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons
Rush University. (2022, June 20). Study: Boxing may ease parkinson's symptoms. News | RUSH University. Retrieved March 7, 2023, from https://www.rushu.rush.edu/news/study-boxing-may-ease-parkinsons-symptoms
U.S. Department of Health and Human Services. (2022, April 14). Parkinson's disease: Causes, symptoms, and treatments. National Institute on Aging. Retrieved March 7, 2023, from https://www.nia.nih.gov/health/parkinsons-disease#:~:text=Parkinson's%20disease%20is%20a%20brain,have%20difficulty%20walking%20and%20talking.