Sports climbing linked to improved posture in Parkinson’s disease

Sports climbing can help improve posture in patients Parkinson’s disease (PD), including in older patients, new research suggests.

In a randomized controlled study, those who participated in wall climbing using ropes and fixed anchors had less slope during 12 weeks than a control group that participated in some form of unsupervised physical activity.

Dr. Heidemarie Zack

The findings confirm that it’s never too late to learn a new sport or type of movement — and that this type of intervention may have significant health gains, said study researcher Heidemarie Zach, MD, associate professor of neurology, Medical University of Vienna, Austria. , Tell Medscape Medical News.

“There is no great obstacle you cannot overcome, or a burden you cannot overcome,” Zack said. “As long as you can walk independently and go up the stairs, you can go up.”

The Results are displayed At the International Conference on Parkinson’s Disease and Movement Disorders (MDS) 2022, held in Madrid, Spain, approx.

Common feature of PD

The analysis is part of a larger project that includes a The study was published Last year showed a decline in the Unified Parkinson’s Disease Rating Scale, Part III (UPDRS-III), which scored nearly 13 points in patients who participated in the sport of climbing. Activity was also significantly associated with improved slowness, rigidity, and tremors.

The current analysis focused on stooped posture, which is a common feature of Parkinson’s disease in addition to motor symptoms. This postural distortion can lead to severe discomfort, pain, and a reduced quality of life.

Researchers note that drug treatments are often ineffective for postural abnormalities. Physical therapy may help improve symptoms, but only a few randomized studies have examined improvement in Parkinson’s with physical therapy in general and alternative sports in particular.

Zack, who has yet to explore further research on this intervention, said athletic climbing is “really unique” in PD. As a climber herself, she was recommended by one of her patients: a 79-year-old man with Parkinson’s disease who was a walker and hiker, and ended up loving the sport. She described him as a “pilot patient”.

“No obstacle is too big to climb or weigh you down
“It can’t be beat,” said study researcher Dr. Heidemarie Zach.

The single center study included 48 adult participants up to age 78 (mean age, approximately 65) with mild to moderate GPD. Most of them were in Hoehn & Yahr Stage 2, others in Stage 3. They have no previous climbing experience. Exclusion criteria included the presence of a condition other than PD.

The researchers randomly assigned the participants to a climbing sport course or a control group.

The sports climbing group did a 90-minute climbing session every week for 12 weeks in an indoor gym. Under the supervision of an instructor, they were harnessed and tied with ropes with mats laid on the ground for safety.

The climbing wall was about 15 meters (50 feet) high. Zak noted that participants usually started at 2 or 3 meters (6.5 to 9.5 feet) and worked their way up.

Those in the control group were asked to participate for 12 weeks in unsupervised physical activity, as recommended by the World Health Organization and European Physical Therapy Guidelines for Parkinson’s Disease. This included at least two and a half minutes of moderate-intensity activity or 75 minutes of vigorous activity each week.

full body workout

The primary outcome, Zack said, was an improvement in posture, measured using a “simple” but highly reliable tool. While patients were standing with their back straight against a wall, the researchers measured the distance in centimeters between the C7 sagittal vertical axis (C7SVA) and the wall.

The mean C7SVA at baseline did not differ significantly between the two groups, at 8.2 cm for the climbing group versus 7.7 cm for the control group.

However, the results showed that only athletic climbing was associated with lower anterior flexion of the cervical spine

The climbing group showed a C7SVA decrease of 1.7 cm (95% CI, 0.8–2.6 cm). “So climbers had more erections and less descent after 12 weeks,” Zak said.

She noted that the mean difference in the control group was 0.5 cm (95% CI, -0.2 to 1.3 cm), which is “almost nothing”.

Zak noted that there does not appear to be any predictor, such as age, gender or body mass index, for what patient subgroups would benefit most from the intervention.

In explaining why climbing helps with standing, she said it’s like a “full-body workout.”

Zak noted that this activity increases upper body strength by using the shoulder and back girdle muscles, as well as joint flexibility. The movements involved in climbing, such as repetitive access to a far fist, work the muscles of the hip and hip flexors.

Since these movements reduce rigidity, the climbing movement may also promote upright posture. She said that wall climbing involves planning and executing movements, it trains spatial body awareness, an important component in maintaining and correcting posture.

Zack noted that motivational group dynamics also likely contributed to the success of the intervention. “They were cheering for each other at the bottom” of the climbing wall, she said.

The results showed that posture could add to the already documented improvements in Parkinson’s from climbing, including improved motor symptoms, rigidity, and tremors, she said. Zack added that the next step on the research agenda is to show whether the intervention has a positive effect on walking.

“Very adventurous”

Comment on searching for Medscape Medical NewsRebecca Gilbert, Ph.D., chief scientific officer of the American Parkinson’s Disease Society, said she would welcome “any new idea” to help Parkinson’s patients — and that climbing sounds “very adventurous.”

“The general concept that you’re asking the body to move in a new way is good for everyone and especially for people with Parkinson’s,” said Gilbert, who was not involved in the research.

She noted that in PD, the ideal exercise intervention involves a combination of four modalities: stretching, balance, aerobic exercise, and strengthening. Gilbert said rope climbing includes many of those, as well as a cognitive component. She added that it’s also important for people with Parkinson’s disease to participate in an activity they enjoy.

However, she stressed, safety should be “weighed”, especially for patients with stage 3 Parkinson’s disease, who often have problems with balance.

“It can be difficult to climb the rope if you have balance problems,” Gilbert said. “The intervention needs to be tailored to the existing disability, and perhaps this activity makes more sense for patients in milder stages.”

Zack and Gilbert reported no related financial relationships.

International Conference on Parkinson’s Disease and Movement Disorders (MDS) 2022. Abstract 739. It was introduced on September 16, 2022.

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