Benefits of Therapeutic Boxing for Parkinson’s Disease
Parkinson’s disease is a multifaceted neurodegenerative disease that impairs movement, coordination, and cognitive function over time. Physical therapy-led exercise is a critical component of managing Parkinson’s disease, helping to manage symptoms, and even slowing progression of the disease. Therapeutic boxing is a unique targeted exercise therapy, requiring full-body movement, combining upper-body punching sequences with lower-body footwork to build strength, counter rigidity, and improve hand-eye coordination, balance, posture, and agility. Mangiarelli Rehabilitation physical therapist Bobby demonstrates therapeutic boxing with a Parkinson’s patient in the video below!
Understanding Parkinson’s Disease
Parkinson’s disease is a neurodegenerative disease that impairs movement, coordination, and cognitive function over time. Parkinson’s disease predominantly affects the dopamine-producing neurons in a specific part of the brain; dopamine is a chemical that coordinates movement in the body. The lack of dopamine in those with Parkinson’s contributes to unintended or uncontrollable movements, like shaking or tremors, stiffness, and balance and coordination issues.
Parkinson’s disease affects nearly 1 million Americans. Parkinson’s is the second most common neurodegenerative disease behind Alzheimer’s disease, often developing after age 60, though 5-10% of patients are diagnosed before age 50.
Common symptoms of Parkinson’s disease can include:
Motor symptoms:
Tremors in the hands, arms, legs, jaw, or head
Muscle stiffness and rigidity
Bradykinesia (slowed movement)
Postural instability
Balance and coordination difficulties
Challenges with motor planning and dual-task performance (walking while swinging arms)
Difficulty chewing or swallowing
Altered walking pattern, such as the Parkinsonian gait, which involves a forward leading posture with reduced arm swing and small quick steps or shuffling
Decreased facial expressions and softer, lower voice
Sleep disruptions and restless legs
Urinary or digestive issues
Non-motor symptoms:
Fatigue
Depression
Anxiety
Therapeutic Boxing for Parkinson’s Disease
Physical therapy-led exercise is a critical component of managing Parkinson’s disease, helping to manage symptoms and even slowing progression of the disease. Therapeutic boxing is a unique targeted exercise therapy to help Parkinson’s patients improve hand-eye coordination, balance, and agility through a combination of cardiovascular and strength training.
At Mangiarelli Rehabilitation, the physical therapist first works with the patient to master a set stable position and boxing stance to establish basic balance and practice a specific posture. Once that is mastered, the patient can move on to incorporating boxing footwork involving forward, side, and backward steps that are made with increased speed based on the set position.
The physical therapist then teaches the patient a series of punches against focus mitts (worn by the therapist). The punches are timed to maximize force based on balance, posture, and footwork. The therapist calls out various instructions to hit the focus mitts in a certain sequence using a number system (right cross, left hook). The patient is forced to translate the numbers called out to punches, which stimulates cognitive processing while also demanding balance, strength, coordination, and agility, and challenges patients to box using their strong and weak sides.
Mangiarelli Rehabilitation physical therapist Bobby demonstrates therapeutic boxing for Parkinson’s with one of our patients in the video below:
Therapeutic boxing for Parkinson’s disease was pioneered in 2006 by Rock Steady Boxing. Boxing provides multi-modal, higher intensity exercise that addresses fine and large motor impairments of Parkinson’s, stressing aerobic and strength training, core stability, balance, and flexibility. As a higher intensity exercise, boxing also helps increase dopamine-producing neurons which improves mood and relieves stress.
Benefits of therapeutic boxing include:
Improving balance, flexibility, and stride length
Addressing symptoms of tremors and postural rigidity by improving muscle control
Increasing patient’s postural stability which enhances independence with more functional tasks
Enhancing gait mobility and walking pattern
Increasing mobility and reducing fall risk
Providing cognitive stimulation
Improving hand-eye coordination and agility
Boosting mood and reducing anxiety
Enhancing quality of life
Research studies investigating the impact of therapeutic boxing in Parkinson’s patients have shown that it can improve symptoms of the disease and improve gait, strength, balance, and endurance. A study of Rock Steady boxers showed improvements in balance, gait, disability, and quality of life in the majority of patients at 12 weeks and all patients made improvements by the 24-and 26-week marks. A 2021 study noted that therapeutic boxing can improve gait stability and reduce the risk of falls significantly in patients with Parkinson’s disease.
A recent 2023 study assessed 10 individuals with early-stage Parkinson’s as they engaged in three one-hour boxing sessions per week over a 15-week study period. Each session involved a warmup and then rounds of non-contact boxing using a training device. The warmup involved 10 minutes of a sequence of rotational movements of major muscle groups and joints. This was followed by 10 minutes of boxing-specific movements and aerobics, such as differing boxing stances and movements to promote balance or boxing drills to enhance cardiovascular load. The last 25 minutes involved boxing sequences, consisting of unidirectional and bidirectional punches such as jabs, hooks, and uppercuts directed at numbered pads.
Therapeutic boxing under the supervision of a physical therapist can be an effective way to address symptoms of Parkinson’s disease and improve the mobility, coordination, and independence of Parkinson’s patients. Managing Parkinson’s disease is a marathon, and our physical therapists are here to accompany you as you navigate the condition to maximize your quality of life. Give us a call to start punching out Parkinson’s at Mangiarelli Rehabilitation!
