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

doi:10.3233/JPD-191616

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

J Parkinsons Dis. 2019;9(3):615-623. doi: 10.3233/JPD-191616.

Authors

Josefa Domingos^{1

2}, Danique Radder¹, Sara Riggare³, Catarina Godinho⁴, John Dean⁵, Mariella Graziano⁶, Nienke M de Vries¹, Joaquim Ferreira^{7

8}, Bastiaan R Bloem¹

Affiliations

¹ Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
² Department of Sport and Health, Laboratory of Motor Behavior, Faculty of Human Kinetics, University of Lisbon, Portugal.
³ Department for Learning, Health Informatics Centre, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden.
⁴ Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Monte de Caparica, Portugal.
⁵ Triad Health AI, Boulder, CO, USA.
⁶ Neuro-Physiotherapy Practice, Esch-sur-Alzette, Luxembourg.
⁷ Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal.
⁸ CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Boxing*
Exercise Therapy / methods*
Follow-Up Studies
Humans
Neurological Rehabilitation / methods*
Parkinson Disease / rehabilitation*
Patient Acceptance of Health Care*
Patient Education as Topic*
Patient Satisfaction*
Process Assessment, Health Care*
Qualitative Research