title: Boxing training for patients with Parkinson disease: a case series.
abstract: OBJECTIVE
  A nontraditional form of exercise recently applied for patients with Parkinson disease (PD) is boxing training. The primary purpose of this case series is to describe the effects of disease severity and duration of boxing training (short term and long term) on changes in balance, mobility, and quality of life for patients with mild or moderate to severe PD. The feasibility and safety of the boxing training program also were assessed.
  
  
  METHODS
  Six patients with idiopathic PD attended 24 to 36 boxing training sessions for 12 weeks, with the option of continuing the training for an additional 24 weeks (a seventh patient attended sessions for only 4 weeks). The 90-minute sessions included boxing drills and traditional stretching, strengthening, and endurance exercises. Outcomes were tested at the baseline and after 12, 24, and 36 weeks of boxing sessions (12-, 24-, and 36-week tests). The outcome measures were the Functional Reach Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Timed "Up & Go" Test, Six-Minute Walk Test, gait speed, cadence, stride length, step width, activities of daily living and motor examination subscales of the Unified Parkinson Disease Rating Scale, and Parkinson Disease Quality of Life Scale.
  
  
  RESULTS
  Six patients completed all phases of the case series, showed improvements on at least 5 of the 12 outcome measures over the baseline at the 12-week test, and showed continued improvements at the 24- and 36-week tests. Patients with mild PD typically showed improvements earlier than those with moderate to severe PD.
  
  
  CONCLUSIONS
  Despite the progressive nature of PD, the patients in this case series showed short-term and long-term improvements in balance, gait, activities of daily living, and quality of life after the boxing training program. A longer duration of training was necessary for patients with moderate to severe PD to show maximal training outcomes. The boxing training program was feasible and safe for these patients with PD.
authors.affiliation: Krannert School of Physical Therapy, University of Indianapolis, 1400 E Hanna Ave, Indianapolis, IN 46227, USA. scombs@uindy.edu
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Combs
authors.forename: M Dyer
authors.initials: MD
authors.lastname: Diehl
authors.forename: William H
authors.initials: WH
authors.lastname: Staples
authors.forename: Lindsay
authors.initials: L
authors.lastname: Conn
authors.forename: Kendra
authors.initials: K
authors.lastname: Davis
authors.forename: Nicole
authors.initials: N
authors.lastname: Lewis
authors.forename: Katie
authors.initials: K
authors.lastname: Schaneman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001914:Boxing; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000534:rehabilitation*; D004856:Postural Balance; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome