Pascal M1, Langan MK1, Frasier K1, Keifer S1, Paisley K1, Wasiakowski A1, Snyder T1, Brown E1
1Misericordia University, Physical Therapy, Dallas, United States
Background: Parkinson's disease (PD) is a progressive disorder, but there is emerging evidence that exercise can help to slow the disease process and ameliorate symptoms. High intensity interval training (HIIT) has been shown to promote neuroplasticity and functional improvement in people with neurological disorders, including PD. Boxing has been recognized as a helpful exercise due to its intensity and emphasis on weight-shifting and rotational movements. Delaying the results of the disease can improve quality of life and decrease the disease burden.
Purpose: To look at the long-term effects of HIIT, incorporating boxing and other exercises, in maintaining or improving balance and gait function in people with PD.
Methods: Twenty-four people with PD (Modified Hoehn and Yahr stages 1- 4) participated in this study. Participants exercised at a boxing gym in Old Forge, Pennsylvania, USA. The group exercise program was 90 minutes long, consisting of a warm-up, non-contact boxing exercises, strengthening exercises, gait and balance activities, flexibility exercises, aerobic exercises, and a cool-down. Participants were assessed each month by walking on an electronic walkway to assess gait parameters, and using the Timed Up and Go test (TUG), and the Five Times Sit to Stand Test (FTSTS) to assess balance and fall risk. Participants were tested from July 2017 to July 2018.
Results: Nineteen people completed the study. Every participant demonstrated improvement in at least one outcome measure from the inception of the study to one-year later. Sixteen participants maintained a preferred gait speed at least 1 m/sec, which is considered safe for community mobility. Eight participants maintained or improved their fast gait speed. There was no significant difference in scores on TUG over the year. Three participants score greater than 12 seconds on the TUG, indicating a fall risk. This did not change over the course of the study. There was no significant difference in scores on the FTSTS over the course of the study. One subject scored greater than 16 seconds on the FTSTS, indicating a risk for falls. The score did not change over the year.
Conclusion(s): Despite the progressive nature of PD, and although there were variations in performance during monthly testing, gait speed and balance remained stable or even improved slightly for all participants over the course of the year. Even subjects who began the study with greater impairments, and a higher score on the modified Hoehn and Yahr scale were able to maintain or improve their functional status. Regular exercise using high-intensity interval training has the potential to limit the progression of PD. Subjectively, subjects reported the camaraderie of the group setting was important in motivating them to continue their participation in the exercise program, even on days when they were reported amplified symptoms of the disease.
Implications: Education about the importance of exercise, especially HIIT, is important for both people diagnosed with PD, and their health care providers. Physical therapists can play an important role in education about and provision of exercise programs. Opportunities for engagement in group exercise may help reduce the impact of Parkinson's disease for individuals and society.
Keywords: high-intensity interval training, Parkinson's disease, gait
Funding acknowledgements: Partial funding from the Misericordia University, Summer Undergraduate Research Fellowship program
Purpose: To look at the long-term effects of HIIT, incorporating boxing and other exercises, in maintaining or improving balance and gait function in people with PD.
Methods: Twenty-four people with PD (Modified Hoehn and Yahr stages 1- 4) participated in this study. Participants exercised at a boxing gym in Old Forge, Pennsylvania, USA. The group exercise program was 90 minutes long, consisting of a warm-up, non-contact boxing exercises, strengthening exercises, gait and balance activities, flexibility exercises, aerobic exercises, and a cool-down. Participants were assessed each month by walking on an electronic walkway to assess gait parameters, and using the Timed Up and Go test (TUG), and the Five Times Sit to Stand Test (FTSTS) to assess balance and fall risk. Participants were tested from July 2017 to July 2018.
Results: Nineteen people completed the study. Every participant demonstrated improvement in at least one outcome measure from the inception of the study to one-year later. Sixteen participants maintained a preferred gait speed at least 1 m/sec, which is considered safe for community mobility. Eight participants maintained or improved their fast gait speed. There was no significant difference in scores on TUG over the year. Three participants score greater than 12 seconds on the TUG, indicating a fall risk. This did not change over the course of the study. There was no significant difference in scores on the FTSTS over the course of the study. One subject scored greater than 16 seconds on the FTSTS, indicating a risk for falls. The score did not change over the year.
Conclusion(s): Despite the progressive nature of PD, and although there were variations in performance during monthly testing, gait speed and balance remained stable or even improved slightly for all participants over the course of the year. Even subjects who began the study with greater impairments, and a higher score on the modified Hoehn and Yahr scale were able to maintain or improve their functional status. Regular exercise using high-intensity interval training has the potential to limit the progression of PD. Subjectively, subjects reported the camaraderie of the group setting was important in motivating them to continue their participation in the exercise program, even on days when they were reported amplified symptoms of the disease.
Implications: Education about the importance of exercise, especially HIIT, is important for both people diagnosed with PD, and their health care providers. Physical therapists can play an important role in education about and provision of exercise programs. Opportunities for engagement in group exercise may help reduce the impact of Parkinson's disease for individuals and society.
Keywords: high-intensity interval training, Parkinson's disease, gait
Funding acknowledgements: Partial funding from the Misericordia University, Summer Undergraduate Research Fellowship program
Topic: Disability & rehabilitation; Neurology: Parkinson's disease
Ethics approval required: Yes
Institution: Misericordia University
Ethics committee: Institutional Review Boar
Ethics number: 24-17-T3
All authors, affiliations and abstracts have been published as submitted.
