Effects of boxing interventions on physical fitness and health-related quality of life in older people with Parkinson's disease: A systematic review with meta-analysis

Jordan Hernandez Martinez^1,2Izham Cid-Calfucura³Edgar Vázquez-Carrasco^4,5Nicole Fritz-Silva⁶Tomás Herrera-Valenzuela³Braulio Branco⁷José Zapata-Bastias⁸Pablo Valdés-Badilla^8,9*

• ¹Department of Physical Activity Sciences, University of Los Lagos, Osorno, Chile
• ²Programa de Investigación en Deporte, Sociedad y Buen Vivir, Universidad de los Lagos, Osorno, Chile
• ³Department of Physical Activity, Sports and Health Sciences. Faculty of Medical Sciences. Universidad de Santiago de Chile, USACH, Santiago, Chile., Santiago, Santiago Metropolitan Region (RM), Chile
• ⁴Occupational Therapy School, Faculty of Psychology, University de Talca, Talca, Chile
• ⁵Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile, Talca, Chile
• ⁶Department of Health, Universidad de Los Lagos, Puerto Montt, Chile
• ⁷Postgraduate Program in Health Promotion, Cesumar University, Maringá, Paraná, Brazil
• ⁸Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, V Valparaíso Region, Chile
• ⁹Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile

Objective: This systematic review with meta-analysis aimed to evaluate the available body of published peerreviewed studies on the effects of boxing (BOX) interventions on balance, cardiorespiratory fitness, motor function, and health-related quality of life (HRQoL) in older people with Parkinson's disease (PD). Methods: A comprehensive search of the literature, including peer-reviewed randomized and non-randomized controlled trials, was conducted to December 2024 in the databases of PubMed, Medline, Psychology and Behavioral Sciences Collection (EBSCO), CINAHL Complete, Scopus, and Web of Science (core collection). A randomeffects model was employed, and Hedge's g effect sizes (ES) were computed. The GRADE, ROB 2, ROBIN-1, TESTEX, and PRISMA tools evaluated the methodological quality and certainty of evidence. The protocol (code: CRD42024614097) was registered in PROSPERO. Results: Eight studies were included, with 100 older people with PD, of which only 3 could be meta-analyzed. No significant effects were evident (p = 0.05) which were small to moderate effects of BOX on ABC-Scale (ES = -0.56; p = 0.13), Timed up-and-go (TUG; ES = 0.24; p = 0.34), TUG dual task (ES = 0.20; p = 0.41), 6-minute walking test (ES = 2.16; p = 0.23) and PD Quality of Life Questionnaire (ES = -0.009; p = 0.98). Conclusions: BOX interventions do not significantly improve balance, cardiorespiratory fitness, and health-related quality of life in older people with PD.