KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson’s Disease

Abstract

Background Multiple exercise modalities and mindfulness activities are beneficial in Parkinson's Disease (PD). Karate is a martial art that combines aerobic and large-amplitude movements, balance and core training, and mindfulness, suggesting a potential benefit for individuals with PD from multiple perspectives. Objective To evaluate the feasibility of community-based Shotokan karate classes involving physical activity and mindfulness among individuals with mild-to moderate-stage PD, and to explore the effects of karate on objective and patient-reported outcomes. Methods We conducted a 10-week, unblinded trial of twice weekly, PD-specific karate classes. Feasibility was assessed by: dropout rates, adherence via attendance records, adverse effects and falls, and continued participation six months post-intervention. Participants completed pre-and post-intervention assessments of disease-related quality of life (Parkinson's Disease Questionnaire-8, PDQ-8), falls, and post-intervention assessment of change in overall wellbeing (Patient Global Impression of Change, PGIC), with exploratory measures of mobility using the Timed Up and Go (TUG), mood using the Hospital Anxiety and Depression Scale (HADS), and cognition using digit span forward and backward and the Symbol Digit Modalities Test (SDMT).

Five Weeks of Yuishinkai Karate Training Improves Balance and Neuromuscular Function in Older Adults

“…Following the training intervention, all participants showed improved performance in postural control through a decrease in time taken for dynamic postural reaction during the balance test. This enhanced dynamic balance performance leads to better postural control in older adults with or without chronic conditions, which is congruent with similar studies that observed the stabilizing effects of 'hard' martial arts [3,13,16,17,40]. Balance requires complex neuromechanical integration of muscular, somatosensory, visual, and vestibular coordination [2,17,[41][42][43].…”

“…Effect size (Cohen's d) was calculated to provide a standardized magnitude of changes [39]. Small (0.2-0.5), medium (> 0.5-0.8), and large (> 0.8) effect sizes descriptors were used as in a similar study [13]. The level of signi cance was set at p < 0.05, with group data reported to 3 decimal places and p < 0.05 for the single subject and the group 95% CI analyses.…”

“…The karate sessions were delivered by black-belt instructors experienced in teaching martial arts in community-based settings. This "dosing" schedule was used to replicate both the approach taken in previous strength and locomotor interventions conducted in our laboratory [25][26][27][28][29][30] as well as to mimic the timing and delivery taken in other community-based martial arts programs [5,13,22,24]. Since rehabilitative applications often necessitate time e ciency, preference for a short duration for compliance and demonstration of e cacy was chosen.…”

“…Other martial arts interventions mention the style of exercises used, such as Shotokan karate with a mixture of kihon, kumite, and kata [5,6]. A recent publication included a detailed overview of planned movements for a 10-week training intervention, with a weekly syllabus showing the intended progression of the techniques [13] but there was no quanti cation of the movements done during the session or how many were done by each participant. Here we add to the literature and assist future investigations by documenting speci c movement volume throughout the training period.…”

“…Investigation of effective therapeutic dose of martial arts is needed with documentation of movement tracking to advance the knowledge for future applications and real-world implementation. Additionally, the duration of training interventions has varied considerably from 5 weeks to 3 years [4][5][6][7][12][13][14][15][16][17][18][19][20][21][22][23][24]. For clinical application, better documentation of activities undertaken, assessment of minimum timing for e cacious outcome, and extension to more commonly found community martial arts (eg.…”