When we think of boxing, it's understandable that we don't associate it with something "good" for the brain, quite the opposite. However, new research from Edith Cowan University (ECU) in Australia, carried out in collaboration with the Perron Institute and boxer Rai Fazio, has shown that this sport - without an opponent - could be a valuable way to improve one's quality of life of people with Parkinson's.
Also collaborating with Sir Charles Gairdner Hospital and the University of Western Australia, the ECU researchers had 10 people with early-stage Parkinson's do three one-hour boxing sessions a week for 15 weeks.
Instead of an opponent, the group fought against a 'Fightmaster' boxing unit, a commercially available device that features 11 padded hitting targets mounted on a stand.
The program consisted of three distinct segments: an introduction to boxing, a high-intensity component, and a cognitive challenge segment. Participants completed "rounds" of two to three minutes in which they had to hit the different pads in different sequences, followed by a maximum of two minutes of rest.
Dr Travis Cruickshank, of the ECU Center for Precision Health, has claimed that boxing has grown in popularity among those living with Parkinson's, despite little evidence supporting its use.
"So what we did was really robustly look at the feasibility of a boxing program for people with Parkinson's, something that hadn't been done in the past," he said.
To do this, they used heart rate monitors throughout the intervention to be able to see the cardiovascular load of the participants. They also used scales that measured their perceived levels of exertion from both a physical and cognitive standpoint. "We have many of the necessary parameters to say that it is safe, well tolerated and that people enjoyed it," says the researcher.
After the 15-week program, nine of the 10 participants improved their score on the Unified Parkinson's Disease Rating Scale, a tool used to measure disease progression and severity. The group also reported reduced fatigue and improvements in sleep.
Likewise, Cruickshank has ensured that group boxing has the benefit of combining many aspects of therapy, such as exercise, cognitive stimulation and socialization in a single exercise.
"In the past, I worked with people with Parkinson's and we did exercises in a gym, then a computerized cognitive training program and another event for the social aspect," he explained. "With boxing, we can combine all of that and do it very fast, which makes it more enjoyable and makes people follow it," he added.
For Dr. Cruickshank, a key aspect of the study has been establishing boxing as a feasible option to be prescribed to people living with early-stage Parkinson's.
Despite the high intensity of many of the workouts, the participants did not report any increase in muscle soreness from the program or significant injury, something that would be expected in people with the disease.
More importantly, everyone completed the 15-week program with almost 97 percent of the training sessions completed. "In fact, when we finished the study, they all decided to buy a Fightmaster and install it in their home," Dr. Cruickshank said.
In the future, programs like this could be delivered in homes or clinics, self-administered, supervised in a clinic, or delivered remotely via telemedicine, so that people from regional areas can still be included.
"We know that the camaraderie and positive relationships that were formed among the study members also served as motivation," said the researcher. "These social benefits cannot be underestimated, especially considering the link between socialization and emotional well-being," he adds.
For Dr. Cruickshank, the next step is to test the therapeutic efficacy of boxing in a broader group of people living with different stages of Parkinson's.
In his opinion, this therapy could be effective for other neurological conditions such as Huntington's disease, multiple sclerosis, stroke and traumatic brain injuries, among others.
"In addition to these neurological conditions, people with cancer can also obtain benefits, especially in bone mineral content and muscle mass, which are affected by treatments," he detailed, warning that "the ability to adapt the training to the individual state of each person is really important".
Thus, the researcher hopes that boxing programs can be applied "soon" to the treatment of Parkinson's disease "in the not too distant future." "Now we know that it is safe, that it is well tolerated and that people enjoy it," he reiterated. "Once we have established therapeutic efficacy with larger trials, then it will be ready to be deployed in the community," he concluded.
