Research Report
Population: Adult
Stephanie A Combs-Miller, PT, PhD, NCS, Associate Professor of Physical Therapy and Director of Research, University of Indianapolis, Krannert School of Physical Therapy scombs@uindy.edu
Elizabeth Moore, PhD, Assistant Professor, University of Indianapolis, College of Health Sciences moorees@uindy.edu
Keywords: Participation, Boxing, Parkinson’s Disease, Exercise
Introduction: The purpose of this longitudinal, outcomes-based study was to compare differences across domains of the ICF between people with Parkinson disease (PD) who participated in an intensive, community-based, group boxing program and those who participated in other modes of exercise, such as physical therapist lead group programs or individual programs.
Subjects: Eighty-eight participants with PD were enrolled in a two-year longitudinal outcomes study. Participants who completed at least two of five testing sessions were included in the current analysis [n=83; mean age 66.3(9.3) years; male 69%; months post diagnosis 67.4(53.7), Hoehn and Yahr range 1-3, mean 2(0.8)].
Methods: Participants were tested at baseline, 6, 12, 18 and 24 months. Participant demographics and PD characteristics were collected at baseline. Participants were categorized as “boxer” if they reported participating in boxing training at 2 or more of the testing sessions (n=45). The remaining participants were categorized as “non-boxers” (n=38). Exercise behavior and outcomes across ICF domains of impairment [Nine Hole Peg Test (NHPT), grip strength], activity [comfortable 10-meter walk test (10MWT), functional reach test (FRT)] and participation [Parkinson Disease Questionnaire -39 (PDQ-39)] were assessed at each testing session. All participants were tested during the ON cycle of their anti-Parkinson medications. Data were analyzed using generalized estimating equations to account for missing data. Baseline data were used as a covariate in the equations to account for group differences at baseline due to non-randomization into groups.
Results: Groups did not significantly differ in age, gender, months since diagnosis, Hoehn and Yahr, and history of falls (p>.05). Boxers exercised significantly more minutes per week than non-boxers (p<.01). Boxers demonstrated significantly faster speed on the NHPT in the dominant and non-dominant hands compared to non-boxers (p=.01; p=.04 respectively). Significant differences between groups were not found for grip strength (p>.05). Boxers’ activity was significantly better overtime compared to non-boxers with faster 10MWT speed (p=.01), and farther distance reached on the FRT (p=.03). Boxers perceived their overall health-related quality of life to be better than that of non-boxers on the PDQ-39, (p=.04).
Conclusions: Boxers with PD had significantly better maintenance of function across all domains of the ICF over a 2-year period compared to those who participated in other modes of exercise. Trends in all measures were positive in favor of boxing. Type, amount and/or group aspects of boxing may have contributed to the higher levels of participation perceived by boxers warranting further research.
Clinical Relevance: It is critical for physical therapists to encourage their patients with PD to find long-term solutions for exercise beyond traditional physical therapy services. Building partnerships with established community programs is essential to promote the ongoing health and fitness in persons with PD.
Citation:
Combs-Miller, Stephanie A, PT, PhD, NCS; Moore, Elizabeth , PhD. Comparison of longitudinal outcomes across the ICF between different modes of exercise for people with Parkinson disease.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/004_combs-miller-et-al/