Implementation of a Community-Based Exercise Program for Parkinson Patients: Using Boxing as an Example

Josefa Domingos, Danique Radder, Sara Riggare, Catarina Godinho, John Dean, Mariella Graziano, Nienke M de Vries, Joaquim Ferreira, Bastiaan R Bloem, Josefa Domingos, Danique Radder, Sara Riggare, Catarina Godinho, John Dean, Mariella Graziano, Nienke M de Vries, Joaquim Ferreira, Bastiaan R Bloem

Abstract

Background: Persons with Parkinson's disease (PD) benefit from continuous exercise through participation in community-based exercise programs. However, community programs often lack PD-specific knowledge needed to provide safe and adequately dosed exercise.

Objective: To evaluate the acceptability and safety of a PD-specific boxing program in the community.

Methods: We developed specific educational resources to facilitate the boxing instructors. We also organized an educational and practical workshop for patients (n = 26) and instructors (n = 10), and assessed: (a) participants' satisfaction; (b) instructors' appreciation of the educational resources; and (c) numbers of patients interested in participating in the boxing program. After 18 months, patients and instructors completed a questionnaire evaluating: (a) participants' satisfaction; (b) adverse events; (c) facilitators and barriers; and (d) proportion of participants at follow-up.

Results: Twenty-six persons with PD (62% men) and 10 boxing instructors participated in the workshop. 81% of patients and 80% of instructors were very satisfied. Instructors found the educational materials "very helpful" (60%) or "helpful" (40%). Patients expressed a clear interest (54%) or possible interest (46%) in the program. We initiated classes with 10 participants. At 18-months follow-up, the program consisted of four boxing sessions/week, led by three instructors, with 40 participants. Seventeen patients responded to the questionnaire at follow-up. Participants were "very satisfied" (53%), "satisfied" (35%) and neither satisfied nor unsatisfied (12%) with the program. Adverse effects were mild (e.g., muscle aches). Transportation and physical disability were the main barriers for participation.

Conclusions: The boxing program was well-received, with increasing numbers of participants at 18 months. The educational resources can support boxing instructors participating in current and future boxing classes being delivered in the community.

Keywords: Boxing training; Parkinson’s disease; community exercise; physiotherapy.

Conflict of interest statement

Bastiaan R. Bloem currently serves as Associate Editor for the Journal of Parkinson’s Disease, has received honoraria from serving on the scientific advisory board for Zambon and Kyowa Kirin, has received fees for speaking at conferences from AbbVie, Zambon and Bial, and has received research support from the Netherlands Organization for Scientific Research, the Michael J Fox Foundation, UCB, AbbVie, the Stichting Parkinson Fonds, the Hersenstichting Nederland, the Parkinson’s Foundation, Verily Life Sciences, the Topsector Life Sciences and Health, and the Parkinson Vereniging.

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