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D. Miner1, S. Glass1, M. Vick1, R. Despain1, I. Melendez1, M.K. Sowers1, C. Byrum1, C. Gilmore1, C. Kolb1, P. Tarman1
1Radford University Carilion, Physical Therapy, Roanoke, United States
Background: The effect of levodopa on different domains of balance and gait in people with Parkinson’s Disease (PwPD) remains controversial. Evidence suggests that gait speed and turning velocity may improve with levodopa, but postural control in quiet standing may be worse. There is a growing body of evidence to suggest that “exercise is medicine” for PwPD. One increasingly popular but understudied mode of exercise for PwPD is Rock Steady Boxing (RSB).
Purpose: The purpose of this study was to examine the effects of a community boxing program on balance and postural control using clinical outcome measures and instrumented force plate assessment.
Methods: N=20 participants (8 F; Age 74.9±7.1; Years Since PD Diagnosis 7.18±3.5; Hoehn & Yahr 2.4±0.6; Unified Parkinson’s Disease Rating Scale-Motor Score (UPDRS-III) 40.35±15.8; Montreal Cognitive Assessment (MoCA) 25.4±3.4; “ON” medication (n=10, 1-hour post-dose), “OFF” medication (n=10, 30 min. pre-dose)).
Baseline testing: All participants were evaluated on the UPDRS-III, MOCA, Mini Balance Evaluation Systems Test (MBT),Functional Gait Assessment (FGA), and instrumented Modified Clinical Test of Sensory Interaction and Balance (mCTSIB) (Bertec, Columbus, OH). Center of pressure (CoP) data acquired during mCTSIB was used to compute virtual time-to-contact (VTC), from which the average of local minima (VTCM) was calculated as the primary balance outcome of interest.
Intervention: All participants completed 8 weeks of the RSB training program, two 60 min. sessions/week and maintained exercise logs.
Post-test: All outcome measures above were reassessed following 8 weeks of training.
Statistical Analysis: Dependent t-tests analyzed the differences in pre- vs post-test scores. A 2x2 repeated measures ANOVA was performed to examine differences in performance based on “ON” vs. “OFF” medication status.
Baseline testing: All participants were evaluated on the UPDRS-III, MOCA, Mini Balance Evaluation Systems Test (MBT),Functional Gait Assessment (FGA), and instrumented Modified Clinical Test of Sensory Interaction and Balance (mCTSIB) (Bertec, Columbus, OH). Center of pressure (CoP) data acquired during mCTSIB was used to compute virtual time-to-contact (VTC), from which the average of local minima (VTCM) was calculated as the primary balance outcome of interest.
Intervention: All participants completed 8 weeks of the RSB training program, two 60 min. sessions/week and maintained exercise logs.
Post-test: All outcome measures above were reassessed following 8 weeks of training.
Statistical Analysis: Dependent t-tests analyzed the differences in pre- vs post-test scores. A 2x2 repeated measures ANOVA was performed to examine differences in performance based on “ON” vs. “OFF” medication status.
Results: Significant improvements (p<0.05) were observed in the following outcomes: MBT-total (Pre=17.3±4.5, Post=20.3±5.5, p=0.001); MBT-reactive (p=0.003); MBT-anticipatory (p=0.005); FGA (Pre=18.25±5.8, Post=21.6±6.7, p<0.001); VTC_min_avg (mCTSIB- Eyes Open/Firm Surface) Pre=2.62±0.56, Post=2.90±0.65; t[13]=-1.78, (p < 0.05), and approached significance on VTC_min_avg (mCTSIB- Eyes Closed/Firm Surface) Pre=2.10±0.57, Post=2.36±0.77; t[13]=-1.49, (p < 0.08). No significant differences in performance we observed based on “ON” vs. “OFF” medication status (p= >0.05).
Conclusions: Improvements across multiple domains of balance, including anticipatory and reactive postural control, dynamic balance during gait, and greater average VTCM were observed in PwPD following an 8-week RSB training program. Though the change in mean outcome scores did not exceed minimum detectable change thresholds, these preliminary results may suggest that RSB may decrease fall risk in PwPD.
Implications: Community exercise programs such as RSB may improve balance for PwPD regardless of the impact of levodopa therapy on balance and gait.
Funding acknowledgements: No funding was received for this project
Keywords:
Parkinson's Disease
Balance
Exercise
Parkinson's Disease
Balance
Exercise
Topics:
Neurology: Parkinson's disease
Health promotion & wellbeing/healthy ageing/physical activity
Neurology: Parkinson's disease
Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: Radford University
Committee: Institutional Review Board
Ethics number: 2021-474-OCS
All authors, affiliations and abstracts have been published as submitted.
