Effect of a Boxing Program on People With Parkinson Disease
Effect of a Boxing Program on People With Parkinson Disease
This study is investigating the impact of a boxing training program on people with Parkinson
 Disease. The investigators were provided data for the intervention group retrospectively by
 the organizers of the boxing club to assess participants' benefit from participation. The
 outcome measures were selected to measure different aspects of functional mobility. Of
 particular interest is the impact of challenging whole-body activities designed for boxing
 and their impact on turning speed and gait. The second phase of the study will gather control
 group information from people with Parkinson Disease who have not participated in a boxing
 program to compare differences in pre-test and post-test data over a period of 12 weeks. The
 specific population and study design are currently pending global pandemic restrictions.
 Subject recruitment will involve people who have never had access to a program of this
 nature. An alternative population for recruitment may involve the same participants from the
 boxing club in a crossover study format since the boxing club has been suspended for over a
 year due to health and safety concerns during the pandemic. The control group of either
 situation would be instructed to carry on with their daily activities as usual without
 changing their physical activity. We hypothesize that the intervention group would show
 greater improvements in functional mobility compared to the control group.
The effects of Parkinson Disease are progressive and cause limitations in functional mobility
 and quality of life. This is a disease that greatly impairs the motor system with key
 presentation of resting tremors, rigidity and bradykinesia. These impairments cause further
 deficiencies in gait and postural stability. Most notable is festinating gait that is
 exacerbated by direction changes and becomes a fall risk for patients. These physical
 limitations can manifest fear and avoidance behaviors in people that ultimately decrease
 quality of life. Activities that can improve balance, strength and coordination allow people
 to gain confidence in their ability to participate in their daily activities. The purpose of
 this study is to investigate the impact of a boxing training program on lower extremity
 functional strength, fall risk, gait speed, and turning speed for people with Parkinson
 Disease compared to a control group.

 Data for the intervention group has been provided retrospectively by the organizers of the
 boxing club. This initial data was collected by volunteers of the club at the initial session
 and then at 12 weeks for purposes of progress reporting to the members. Data was
 de-identified prior to receipt by the investigators. The next phase of this study will
 involve recruitment of participants for a control group from areas that do not have
 established boxing programs. Pre- and post-tests will be conducted over a span of 12 weeks.
 Outcome measures for the future control group will be the same as the original tools provided
 by the boxing club. These measures will assess lower extremity functional strength, fall
 risk, gait speed and turning speed. Baseline data will be taken using 30-second sit to stand,
 Timed Up-and-Go, 180° turning speed, and gait speed. During the 12 week period, participants
 will be instructed to avoid changing their physical activity. At the end of 12 weeks the
 post-testing will be completed. Those participants in the control group will receive a gift
 card for participation in the study.

 If pandemic concerns prevent the recruitment of new participants for a control group, an
 alternative approach will involve a cross-over design in which the original participants from
 the intervention group will serve as the control group. The boxing club will be approached to
 contact the twelve participants who provided intervention data. The boxing club has not been
 held since March, 2020 due to the pandemic restrictions. A control period for this group will
 be established over a twelve week period where they do not participate in any new changes to
 their physical activity. The same outcome measures will be collected at pre-test and twelve
 weeks later for post-testing.

 Due to the nature of the in-person testing, extra precautions regarding Covid-19 have been
 implemented including a Covid-19 and Other Communicable Disease consent form outlining
 expectations of the participants as well as precautions by the investigators. These extra
 initiatives include appropriate facial masks and face shields by everyone involved at all
 times at the study site, physical distancing between investigators and participants with
 exceptions made for safety reasons, and any other procedures established by the study site.
Inclusion Criteria:

 -  Diagnosis of Parkinson Disease

 Exclusion Criteria:

 -  Inability to walk without physical assistance