Dianne Cherne, 69, was diagnosed with Parkinson's disease 10 years ago. She had mild physical symptoms, but her biggest challenges were depression and anxiety. When she first heard about a pilot study on whether karate could ease Parkinson's-related symptoms, she was intrigued. "It sounded exciting and different from anything I had done before," she says.
After participating in the test program, called Kick Out PD (Karate Intervention to Change Kinematic Outcomes in Parkinson's Disease), Cherne says she was more energetic and upbeat—and more motivated to do other things. She also didn't feel so stiff and could move her arms and legs better, and she felt more relaxed. "I was able to do all the movements, and it restored a lot of my coordination." A bonus was exercising with other people who had Parkinson's. "We'd check in before each class about how we were feeling," Cherne says. "We could talk about different things that Parkinson's brings into our lives. We all felt really close to each other."
The idea for the pilot project came from a patient of Jori Fleisher, MD, MSCE, assistant professor of movement disorders at Rush University Medical Center in Chicago. The patient's nephew is John Fonseca, a karate world champion who runs five karate schools in Chicago. Under the guidance of Dr. Fleisher, who designed and conducted the study, the uncle and nephew created a program specifically for people with Parkinson's disease.
Fifteen patients with early- to mid-stage Parkinson's disease attended biweekly karate classes for 10 weeks. After the 10 weeks, participants reported fewer falls and an improved quality of life. In fact, their scores on a self-reported Parkinson's disease quality-of-life questionnaire (PDQ-39) increased by six points, says Dr. Fleisher. "And participants who reported they were falling infrequently before the program transitioned to saying they were never falling. That was exciting to see," she says.
Like Cherne, all participants commented on the sense of camaraderie and how valuable it was to see others in the class improve even when they didn't themselves. Many participants continued karate after the pilot classes, and some even competed in citywide tournaments with able-bodied students.
The results from this small program, which was designed to investigate feasibility and early signs of efficacy, confirmed Dr. Fleisher's hypothesis that karate could be helpful. "Karate combines aspects of many disciplines already shown to help people with Parkinson's disease, including yoga, Pilates, and tai chi, which all demonstrated improvements in balance and core strength," she says.
Tai chi's ability to improve motor function, depression, and quality of life for people with Parkinson's disease was supported by a meta-analysis published in Parkinsonism and Related Disorders in 2017, although it said larger-scale trials are warranted. Several other studies have found that various forms of exercise offer a range of benefits for people with Parkinson's disease, from improving mobility to alleviating symptoms of depression.
"Shotokan, a traditional Japanese discipline and the most popular karate style, is especially helpful for people with Parkinson's because it involves very large movements," says Fonseca. The practice incorporates blocks, kicks, punches, weight shifting, and different types of strikes. Students perform these in the air or they strike mitts or various targets, which is good for relieving stress, says Fonseca, adding that the classes also teach students how to fall properly. These large movements are similar to those that form the core of proven physical therapy for people with Parkinson's, says Dr. Fleisher.
To accommodate the balance challenges often associated with Parkinson's disease, Fonseca does not have new students stand at first. "Students lie on their backs or sides and practice various kicks," he explains. "As they become more familiar with the mechanics, they stand up and practice these kicks while holding on to the wall. The last stage is to practice standing without holding on to anything."
Once they can stand, students are instructed to grip the ground with their toes, bend their legs, shift their body weight to the bent supporting leg, squeeze their abs, and raise the other leg to deliver a swift, snapping kick. They are also encouraged to practice kicking low so that they can recover faster and to focus their eyes on a specific target when they deliver the kick, Fonseca says.
Dr. Fleisher presented results of her preliminary study at the World Parkinson's Congress in Kyoto, Japan, in June 2019. A documentary film about the karate classes (made by Jeff Spitz, founder of Groundswell Educational Films and associate professor of Cinema and Television Arts at Columbia College in Chicago) received an honorable mention in the video competition at the conference.
Dr. Fleisher is now conducting a randomized trial of the karate program over a longer period to confirm the pilot study's results. After that, she plans another study to determine which patients can benefit from karate and whether it can be modified for people in moderate to advanced stages of the disease.
If the results are positive, she and Fonseca hope to take the curriculum—which includes information about Parkinson's disease and how to teach this population—to other karate instructors. "We would love to create modules for karate instructors around the country, and potentially around the world," Dr. Fleisher says.
Perhaps the biggest benefit of karate for people with neurologic disorders is the fighting spirit and strong positive attitude teachers promote. "Karate is really a form of moving meditation," says Fonseca. "It's not about defeating an opponent, it's about never letting anything defeat you."
https://www.brainandlife.org/articles/karate-may-kick-out-neurologic-symptoms/
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