Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Johnson, Andrew M.

Abstract

We conducted a scoping review to identify articles examining non-contact boxing programs for persons with Parkinson’s disease (PwP). Results suggested that gait, mobility, balance, and quality-of-life were the most-studied outcomes. Many qualitative articles explored the experience within in-person boxing programs, but no articles explored experiences within virtual boxing programs. We followed this review with an interpretative phenomenological analysis aimed at addressing this research gap and interviewed six PwP who had engaged with both virtual and in-person Rock Steady Boxing programming. Results suggested that although the virtual setting improved elements of the individual experience, the physical and social aspects were better experienced in person. Results also suggest that in-person programming better supported autonomy, competence, and relatedness, which predicts better intrinsic motivation according to the Self-Determination theory. Virtual programming may have potential for individuals requiring remote exercise but would benefit from better access to home boxing equipment, and improved socialization during workouts.

Summary for Lay Audience

Parkinson's disease (PD) is a progressive neurological disease largely impacting motor function by inducing slow movements, rigidity in muscles, resting tremors, and balance. Non-motor related issues also surface impacting mental health, cognition, and sleep. This is a result of dopamine-producing brain cells depleting in the midbrain. Despite pharmaceutical and surgical advancements, treatment can only manage symptoms. However, physical activity is a widely recognized adjunctive therapy, playing a role in slowing progression and symptom manifestation. Non-contact boxing programs, like Rock Steady Boxing (RSB), are an increasingly popular exercise for person's with Parkinson's disease (PwP) to increase their physical activity with.

We conducted a scoping review to understand the extent to which the impact of non-contact boxing interventions on PD symptoms have been explored in research. Our search results included a total of 51 published journal articles, conference proceedings and graduate student projects. Many studies investigated the impact on mobility, gait, balance, and quality of life. Mental health, cognition, and sleep were less commonly studied. Our review also showed that current qualitative literature has examined the experience of in-person boxing settings, describing aspects which promote autonomous motivation to engage in physical activity. A behaviour that is autonomously motivated is described by the Self-Determination theory as being longer lasting and can promote wellness. An environment that fosters the psychological needs of autonomy, competence and relatedness supports autonomous motivation. The qualitative literature thus far has described in-person boxing programs for PwP to be need-supportive environments.

The experience of virtual boxing programs in comparison to in-person settings and how this environmental change impacts motivation is yet to be explored. Therefore, we conducted an interpretive phenomenological analysis to address these gaps. Through interviews with six PwP, we examined three aspects of their experience: the individual, the physical and the social experience. The virtual setting impacts the individual experience by improving accessibility and convenience, however physical intensity and socialization lacked. Additionally, autonomy, competence and relatedness were better supported in the in-person setting. Future programs should consider ways to improve accessibility to boxing equipment at home and social connection in the virtual setting.

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