Parkinson’s disease

Disease

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substancia nigra and the striatum of the basal ganglia in the midbrain. It is the substancia nigra pars compacta which is more marked by the death of dopaminergic neurons. This lack of dopamine affects the entire internal circuit of the basal ganglia, resulting in excessive inhibition of motor neurons in the cortex. Indeed, as it is dopamine which modulates the system of the basal ganglia, the movements are diminished, which is why PD is said to be a hypokinetic motor disorder.

Symptoms

PD is characterized by four predominant motor symptoms: tremor, bradykinesia (slowness of movements), muscular rigidity and postural instability. It is the presence of at least two of these symptoms that usually helps to diagnose the disease. By this time, more than half of the dopaminergic neurons would already be destroyed.

In addition to motor symptoms, there are a variety of other so-called non-motor symptoms that may occur during the course of the disease: dysregulation of saliva, change in taste and other senses, difficulty swallowing, constipation, incontinence, pain, dementia and cognitive problems, hallucinations, depression and anxiety, sexual disorder, orthostatic hypotension, diurnal hypersomnolence, insomnia, etc. That being said, there are important variants in the course of the disease and the symptoms can be quite different from one person to another.

Exercise and Illness

Physical activity can be a wise treatment that helps people with PD to preserve their functional abilities as long as possible. Indeed, exercise acts as an adjuvant to traditional treatments (pharmacological and surgical). Physical activity has been shown to have positive effects on mobility, walking, balance and muscle strength in people with PD [1,2]. Exercise would also improve the quality of life and symptoms of depression [3], and would help to maintain autonomy by enhancing the ability to perform activities of daily living [4, 5].

Discover the benefits of boxing

Physical activity is linked to a multitude of benefits in people with neurological disorders. Beyond the traditional aerobic and resistance exercises, non-traditional exercises such as tai chi, qigong and dance seem to be beneficial in order to improve several aspects of mobility and balance in people with PD. Another of these non-traditional exercises that is increasingly being researched in people with PD is boxing. The lure of boxing is that it focuses on endurance, explosive strength, as well as coordination between the upper limbs and lower limbs. Endurance training would be beneficial to counter deconditioning associated with physical inactivity and could also reduce fatigue. Training of the explosive force, especially of the legs during movements, could facilitate changes in direction and overlap during destabilization, which would improve the balance and could reduce the risk of falls. Finally, coordination training between the upper and lower body could also improve the balance and reduce the number of falls.

Scientific studies on the benefits of boxing have shown that this type of exercise is appropriate and safe for people with PD, even those who are at moderate or advanced stages [6]. Benefits of balance [6,7], walking [6,7], activities of daily living [6] and quality of life [6,7] were observed. These data suggest that the implementation of a boxing program would be beneficial for people with PD.

 

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Sources

  1. Goodwin VA, Richards SH, Taylor RS, Taylor AH, Campbell JL. The effectiveness of exercise interventions for people with Parkinson’s disease: a systematic review and meta-analysis. Movement disorders : official journal of the Movement Disorder Society. 2008;23(5):631-40.
  2. Tomlinson CL, Patel S, Meek C, Clarke CE, Stowe R, Shah L, et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease. The Cochrane database of systematic reviews. 2012;8.
  3. Dereli EE, Yaliman A. Comparison of the effects of a physiotherapist-supervised exercise programme and a self-supervised exercise programme on quality of life in patients with Parkinson’s disease. Clinical rehabilitation. 2010;24(4):352-62.
  4. Cedarbaum JM, Toy L, Silvestri M, Green-Parsons A, Harts A, McDowell FH. Review Article: Rehabilitation Programs in the Management of Patients with Parkinson’s Disease. Neurorehabilitation and neural repair. 1992;6(1):7-19.
  5. Patti F, Reggio A, Nicoletti F, Sellaroli T, Deinite G, Nicoletti F. Effects of Rehabilitation Therapy on Parkinsonians’ Disability and Functional Independence. Neurorehabilitation and neural repair. 1996;10(4):223-31.
  6. Combs SA et al (2011) Boxing training for patients with Parkinson disease: a case series. Phys Ther. 2011;91:132–142.
  7. Combs SA et al (2011) Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. NeuroRehab. 2013;32(1):117-124.
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