Parkinson’s Disease:Boxing Exercise as a Physical Therapy Treatment
Mangiarelli Rehabilitation patient Larry engaged in boxing exercise with physical therapist, Bobby Mangiarelli and supported by physical therapist, Michael Mangiarelli
[All patient photos, video, and patient name used with explicit written permission by patient.]
What is Parkinson’s disease?
Parkinson’s disease is a neurodegenerative disorder that affects dopamine-producing neurons. Nerve cells in the area of the brain that control movement become impaired, which can lead to movement problems in patients who have Parkinson’s disease. Patients with the disease also can experience a loss of nerve endings that produce norepinephrine, a chemical that functions as a neurotransmitter of the sympathetic nervous system, which controls a number of automatic functions of the body.
Parkinson’s disease occurs in both men and women, although it affects 50% more men than women. Individuals first develop the disease around age 60; however, five to ten percent of people may develop “early-onset” of the disease at age 50.
Symptoms of Parkinson’s disease develop gradually and can worsen over time. Symptoms generally develop on one side of the body or even in one limb on one side of the body and then spread to the rest of the body. The progression of the disease differs from person to person.
Symptoms include:
Tremor (trembling) in the hands, arms, legs, jaw, or head
Stiffness of the limbs and trunk
Slowness of movement and difficulty initiating or continuing movement
Impaired balance and coordination, sometimes leading to falls
Loss of smell
Depression
Difficulty swallowing, chewing, and speaking
Urinary problems and constipation
Voice change: softer and lower voice
Decreased facial expression
Sleep disruptions
Difficulty walking: The gait of a Parkinson’s patient involves a tendency to lean forward, making small quick steps (shuffling), and reduced swinging of the arms.
Restless legs
An estimated one million people in the United States suffer from Parkinson’s disease. It is second only to Alzheimer’s disease as the most prevalent neurodegenerative disease.
What is Boxing Exercise Treatment?
Boxing exercise as a physical therapy treatment for Parkinson’s disease involves the use of modified, non-contact boxing techniques. Boxing treatment for Parkinson’s disease was first pioneered in 2006 at Rock Steady Boxing.
At Mangiarelli Rehabilitation, boxing exercise treatment involves our physical therapist, Bobby, holding “focus mitts” as targets and calling out instructions for punching patterns, such as “one, two-three-two, four!” In that way, the patient knows which boxing pattern to follow to hit the focus mitts, as demonstrated in the video below. Bobby has the patient alternate throwing punches with his left and right hands as well as alternating between low and high punches. Bobby and the patient also move around the clinic to improve gait, step width, and stride length. Physical therapist, Mike, supports the patient with a gait support belt and accompanies the patient as he moves around the clinic for safety of movement.
Studies have shown that exercise can contribute to increasing dopamine, a chemical Parkinson’s patients lose due to the disease’s destruction of dopamine-producing cells. Patients who exercise have been shown to perform better on functional tests that assess motor symptoms and non-motor symptoms (such as depression). One analysis showed that patients who completed multiple-week exercise programs increased their serum levels of BDNF; BDNF is brain-derived neurotrophic-factor which helps the neurons that make dopamine survive.
How does Boxing Exercise help Parkinson’s Symptoms?
Boxing exercise is a therapeutic technique to improve coordination and balance. The boxing techniques help to build strength, counter muscle rigidity, and improve agility, balance, posture, and hand-eye coordination in patients who have the disease. This treatment requires whole-body movement, from upper-body punching motions to lower-body footwork. Boxing treatment addresses the symptoms of tremors, balance issues, gait mobility, and postural rigidity and instability by encouraging agility of movement in multiple directions, flexibility of the spine, and coordination of movement at faster speeds.
A case study of Rock Steady boxers who have Parkinson’s disease revealed that after 24 to 35 classes over the course of 12 weeks, all six boxers improved in at least five out of twelve outcome measures, including the Functional Reach test, cadence, stride length, step width, gait speed, and Parkinson Disease Quality of Life Scale. Those in the earlier stages of the disease improved more quickly at 12 weeks than those at a more advanced stage of the disease, although those with a more severe case also benefited from classes that ran 24 to 36 weeks.
If you or a family member has been diagnosed with Parkinson’s disease and are looking for treatment options, don’t hesitate to call Mangiarelli Rehabilitation. Through innovative treatment and unique exercise programs, we can help you manage this disease and regain function you may have lost in a safe and supportive environment!
