Punching out Parkinson’s Disease with Therapeutic Boxing Physical Therapy
Parkinson’s disease is a multifaceted neurological disorder that impairs movement, coordination, and cognitive function over time. Physical therapy can help Parkinson’s patients increase their mobility, strengthen their muscles, improve coordination, balance, and posture, address altered walking patterns and gait issues, reduce freezing episodes, and decrease falls. Therapeutic boxing with a physical therapist offers an innovative and effective exercise intervention to enhance a Parkinson’s disease patient’s stride length, gait, strength, coordination, and balance. Therapeutic boxing requires full-body movement, combining upper-body punching sequences with lower-body footwork. Mangiarelli Rehabilitation physical therapist Bobby demonstrates therapeutic boxing with a Parkinson’s patient in the video below!
What is Parkinson’s Disease?
Parkinson’s disease is a multifaceted neurological disorder that affects over 1 million Americans; around 60,000 Americans receive a Parkinson’s diagnosis each year. Parkinson’s affects 50% more men than women and generally develops around age 60, although 5-10% can develop early onset Parkinson’s at age 50. Parkinson’s disease occurs when the nerve cells in the brain that control movements become impaired or die, causing a reduction in dopamine production and resulting in movement issues.
Common symptoms of Parkinson’s disease include:
Tremors in the hands, arms, legs, jaw, or head
Muscle stiffness and rigidity
Postural instability
Difficulties with balance and coordination
Challenges with motor planning and dual-task performance (walking while swinging arms)
Altered walking pattern, particularly freezing of gait or small, shuffling steps
Difficulties swallowing or speaking
Urinary issues and constipation
A softer, lower voice
Decreased facial expression
Sleep disruptions
Restless legs
How Physical Therapy Can Help Parkinson’s Patients
Physical therapy can help Parkinson’s patients increase their mobility, strengthen their muscles, improve coordination, balance, and posture, address altered walking patterns and gait issues, reduce freezing episodes, and decrease falls. One of the key ways that physical therapy combats Parkinson’s symptoms is through targeted exercise.
Exercise is a critical component of managing Parkinson’s, helping to manage symptoms and even slowing the progression of the disease. Exercise can induce neuroplasticity, the brain’s ability to change in response to behavioral changes. Through the aerobic, resistance, balance, and gait training involved in physical therapy, Parkinson’s patients learn new ways to move and think, helping to keep brain cells healthy.
Research on exercise for Parkinson’s disease reveals that higher-intensity forms of exercise, like therapeutic boxing, may promote the release of BDNF, brain-derived neurotrophic factor. BDNF supports the production and survival of dopamine in the area of the brain that Parkinson’s affects and may help improve motor skills.
There is significant high-quality evidence for the following exercise-related interventions for Parkinson’s patients during physical therapy: aerobic exercise, resistance training, balance and gait training, external cueing, and task-specific training. These interventions help improve aerobic capacity, reduce motor disease severity, improve functional outcomes, enhance mobility and balance confidence, improve stride length and gait speed, and improve quality of life and independence.
Physical therapists may also implement amplitude training and reciprocal movement patterns into the Parkinson’s program. Amplitude training involves having a patient practice exaggerated movements like taking high steps or swinging their arms to help retrain muscles and reduce slow, small movements. Reciprocal movements occur at the same time in opposite directions, such as swinging arms while walking. Physical therapy utilizes stationary bikes or elliptical machines that require reciprocal movement of the arms and legs to strengthen reciprocal movement patterns.
Punching Out Parkinson’s with Therapeutic Boxing
Therapeutic boxing with a physical therapist offers a unique, fun, and effective exercise intervention to enhance a Parkinson’s patient’s stride length, gait, strength, coordination, and balance.
Therapeutic boxing requires full-body movement, combining upper-body punching sequences with lower-body footwork to build strength, counter muscle rigidity, and improve hand-eye coordination, balance, posture, and agility. The varied high-intensity workout of therapeutic boxing provides a blend of both strength and cardiovascular conditioning that improves agility, coordination, and balance in Parkinson’s patients.
When engaging in therapeutic boxing during Parkinson’s physical therapy treatment, the physical therapist first works with the patient to master a set stable position and boxing stance to establish basic balance and practice a specific posture. Once that is mastered, the patient can move on to incorporating boxing footwork involving forward, side, and backward steps that are made with increased speed based on the set position.
Finally, the physical therapist teaches the patient a series of punches against focus mitts (worn by the therapist). The punches are timed to maximize force based on balance, posture, and footwork. The therapist calls out various instructions to hit the focus mitts in a certain sequence using a number system (right cross, left hook). The patient is forced to translate the numbers called out to punches, which stimulates cognitive processing while also demanding balance, strength, coordination, and agility, and challenges patients to box using their strong and weak sides.
Mangiarelli Rehabilitation physical therapist Bobby demonstrates therapeutic boxing in action with a Parkinson’s patient:
Therapeutic boxing for Parkinson’s disease was pioneered by Rock Steady Boxing in 2006 and has since spread throughout the United States to serve Parkinson’s patients.
Therapeutic boxing for Parkinson’s has numerous benefits:
Address symptoms of tremors and postural rigidity and instability
Improve balance, flexibility, and stride length
Enhance gait mobility
Provide cognitive stimulation
Improve coordination and agility
Research studies investigating the impact of therapeutic boxing in Parkinson’s patients have shown that it can improve symptoms of the disease and improve gait, strength, balance, and endurance. In one study of 31 individuals with Parkinson’s, participants were divided into a boxing intervention group vs. a conventional physical therapy control group. The study found that in the boxing intervention group, there were improvements in gait velocity. A study of Rock Steady boxers showed improvements in balance, gait, disability, and quality of life in the majority of patients at 12 weeks and all patients made improvements by the 24-and 26-week marks. A 2021 study noted that therapeutic boxing can improve gait stability and reduce the risk of falls significantly in patients with Parkinson’s disease.
Therapeutic boxing under the supervision of a physical therapist can be an effective way to address symptoms of Parkinson’s disease and improve the mobility, coordination, and independence of Parkinson’s patients. Managing Parkinson’s disease is a marathon, and our physical therapists are here to accompany you as you navigate the condition to maximize your quality of life. Give us a call to start punching out Parkinson’s at Mangiarelli Rehabilitation!
