Objective:

To test the efficacy and sustainability of twice-weekly karate classes designed for individuals with mild to moderate Parkinson’s Disease (PD) on quality of life and individual goal attainment over six months and maintenance of karate practice at 12 months compared to individuals randomized to a waitlist.

Background:

Karate is a group-based martial art incorporating aerobic, strength, resistance, and mindfulness training, each of which individually confer benefits for individuals with PD. In our pilot of twice weekly, PD-specific karate classes (KICK OUT PD), we demonstrated high retention (79%), adherence (87%), and 18% improvement in quality of life over ten weeks, p = 0.01). To rigorously test these findings, we designed a six-month, randomized, waitlist-controlled trial.

Design/Methods:

We recruited and 1:1 randomized individuals with Hoehn & Yahr (HY) stages 1-3 PD to six months of twice weekly, 60-minute, no-cost, PD-specific karate classes or a waitlist control. We gathered baseline demographics, quality of life, and individual participation goals. We assessed adherence (% class attendance), quality of life, and goal attainment at six months. Finally, we assessed continued karate practice in the active group at 12 months.

Results:

We randomized 52 individuals (mean age: 65.7 years, 61.5% male, mean PD duration: 7.8 years, 88.5% HY 2). Mean attendance was 92.5% and active participants experienced a clinically significant improvement in quality of life (PDQ-8 within-group change: 24.2 vs. 15.0, p = 0.002) while the waitlist control group did not change (p = 0.12). Among active participants, 84% achieved their Individual goal and 63% continued karate classes of their own accord at 12 months. 

Conclusions:

In this randomized, controlled trial, six months of karate for PD improved quality of life and was met with remarkable adherence and sustained 12-month participation. Future investigations into this promising exercise modality are indicated.