Novel walking pole gait pattern improves activity in an older adult with chronic low back pain.

A 65-year-old woman with chronic low back pain participated in a 1-week community walking poles course. Although the participant received instruction in the standard Nordic walking method, she independently adopted a novel, modified, two-point gait pattern. Subsequently, her pain and activity tolerance using walking poles were monitored at 6 and 12 months. The participant ambulated two times the distance and reported lower ratings of perceived exertion and pain at 6-month and 12month follow-ups when walking with poles compared with walking without poles. This case highlights the potential effect of respecting patient preference within the clinical decision-making model. Doing so empowered a participant with chronic low back pain to adopt a novel, self-selected gait pattern and improve her short-term and long-term outcomes associated with chronic musculoskeletal disease.

A Community-based Boxing Program is Associated with Improved Balance in Individuals with Parkinson's Disease.

In alignment with efforts to mitigate the negative health consequences of Parkinson's Disease (PD), the purpose of this investigation was to examine if participation in a community-based boxing program (CBP) was associated with improvements in balance and fall risk reduction among individuals with PD. In this retrospective cross-sectional study, de-identified data from 12 individuals with PD participating in a CBP was examined. Participants included those with a Hoehn and Yahr stage between 1 and 3, averaging 2.8 ± 0.8 CBP sessions per week for 6.1 ± 0.8 months between testing. Baseline and re-evaluation testing included the Fullerton Advanced Balance (FAB) Scale and Timed Up and Go (TUG) to quantify balance and fall risk. Sessions were 90-minutes in length involving a warm-up, boxing drills, strength and endurance exercises, and cool down. Sessions included multiple bouts of 30-60 second high-intensity exercise intervals (RPE between 15/20 to 17/20). Paired t-tests were used to determine if differences existed between the FAB and TUG from baseline to re-evaluation, with statistical significance accepted at p < 0.05 and > 0.8 interpreted as a large effect using Cohen's d. Results indicated a statistically significant increase and large effect in FAB performance, with a mean increase in score above previously reported minimal detectable change (MDC). While participation in CBP was associated with a statistically significant improvement and medium effect in the TUG, this did not demonstrate a population specific MDC. This study found that participation in a CBP was associated with improved balance among clients with PD.