Scaling new heights: a pilot study of the impact of climbing on balance, agility, and dexterity in individuals with Parkinson's disease.

Abstract

Introduction: Exercise is known to be beneficial for individuals with Parkinson's disease (PD). Rock climbing contains exercise characteristics highlighted in published clinical guidelines for PD (e.g., aerobic, resistance, balance training, cued-movements, community-based) and also has unique somatosensory and visuospatial experiences that may facilitate motor learning. The purpose of this study was to investigate the effects of a climbing program on the physical function of individuals with PD.

Methods: This quasi-experimental observational pilot study used pre-to-post-test comparisons to assess participants with mild to moderate PD (Hoehn and Yahr 1-3) who walked independently. The intervention was 12 weeks of community-based, twice weekly top-rope climbing sessions under one-on-one supervision and tailored to skill level. Wall angles, hand/foot holds, and routes varied from climb to climb and became progressively more difficult as skills increased. The primary outcome measure was the Community Balance & Mobility Scale (CBMS); secondary measures were the Agility T-Test (ATT), 9-Hole Peg Test (9HPT), upper extremity reaction time using BlazePods (UE-React), and grip strength (GS).

Results: 28 participants completed the study: 8 women/20 men; mean age = 66.1 (sd = 7.4) years; average disease duration = 4.0 (sd = 3.6) years. Paired t-tests comparing pre- and post-test scores and effect sizes (ES) with 95% confidence intervals (CI) were calculated for statistically significant results using Hedge's g. Findings were: CBMS (p < 0.001; ES = 0.573, 95% CI = 0.178-0.960), ATT (p < 0.001; ES = 0.462, 95% CI = 0.078-0.838), 9HPT (p < 0.001; ES = 0.480, 95% CI = 0.094-0.858), UE-React (p <0.001; ES = 0.329, 95% CI = -0.045-0.696); GS changes were non-significant.

Conclusions: Rock climbing demonstrated medium-size effects on mobility/balance and small-size effects on agility and dexterity that could impact functioning in everyday activities.