Making strides in physical therapy research

During UIndy Night at the Pacers on April 14, Health Sciences Dean Stephanie Kelly (left) and President Robert Manuel took the floor to recognize the groundbreaking research of associate professor Stephanie Combs-Miller (center).

During UIndy Night at the Pacers on April 14, Health Sciences Dean Stephanie Kelly (left) and President Robert Manuel took the floor to recognize the groundbreaking research of associate professor Stephanie Combs-Miller (center).

The evidence is in: boxing training helps Parkinson’s patients Participants have reported anecdotal success for years, but new research by the University of Indianapolis now provides evidence that people with Parkinson’s disease who participate in boxing training maintain greater physical ability and quality of life than those who participate in other modes of exercise. “We found that people who exercise in a boxing program demonstrate a higher level of function,” said Stephanie Combs-Miller, associate professor and director of research for the Krannert School of Physical Therapy.

The longitudinal study by Combs-Miller and her students involved 88 central Indiana volunteers with Parkinson’s disease, half of whom participated in Rock Steady Boxing, a regimen that includes lateral foot work, bag punching, stretching, resistance exercises, and aerobic training. Founded locally in 2006 by Parkinson’s patient and former Marion County Prosecutor Scott Newman, Rock Steady Boxing has spread to locations around the globe. Every six months for two years, UIndy students conducted standard physical therapy assessments of the study subjects and surveyed them on quality-of-life issues. They found that boxers demonstrated significantly better balance and walking function over time, as well as greater distance on a functional reach test, compared to people who chose other forms of exercise. The survey responses also indicated a higher perceived quality of life among the Rock Steady participants.

The findings reinforce the notion that boxing training is a safe and feasible nontraditional mode of exercise for people with Parkinson’s and that boxing-related concepts can be effective in community-based settings and incorporated into the clinical practices of physical therapists. The key may not be boxing per se, but instead the unique combination of activities that are common to boxing training, said Combs-Miller. The Rock Steady Boxing program enhances strength, agility, endurance, flexibility, and other positive traits.

Grant to support stroke research

Combs-Miller also was awarded a $144,000 state grant to study how a patient’s motor control and potential for rehabilitation can evolve in the initial months after a stroke. Serving as co-principal investigators are statistics expert Elizabeth Moore, assistant professor in UIndy’s College of Health Sciences and School of Nursing; and biomechanics expert Eric Dugan, associate professor and director of the Center for the Study of Sport and Exercise at Seattle University. The first-of-its-kind effort will use wireless sensors to track the physiological complexity of the subjects’ movements while walking, with readings taken at one, three, and six months after stroke. The goal is to understand trends so treatments can be tailored to the needs and abilities of individual patients. “What we know is that people with stroke, their movements are much less complex,” says Combs-Miller, principal investigator for the two-year study that begins in July. “What we want to know is, does that change over time? What is their potential, and how do we need to change our interventions as their abilities change?”

The study is titled “Physiological Complexity of Gait Over the First Six Months Post Stroke.” The financial support comes from the Indiana Spinal Cord and Brain Injury Research Fund, which was established by the state and partners with the Indiana State Department of Health.To identify and recruit participants for the project, Combs-Miller worked with therapy teams at Franciscan St. Francis Health-Indianapolis on the city’s southeast side and Community Rehabilitation Hospital on the northeast side. Many patients are still hospitalized during the first month after acute stroke, so Combs-Miller and a research assistant will visit them on site to gather initial data on their walking ability, balance, and other basic functions, using small portable sensors that attach to various parts of the body and transmit readings wirelessly. Subsequent measures at three and six months after stroke will take place at the Movement Science Laboratory in the UIndy Health Pavilion. One unique characteristic of the study is that it will follow the same group of participants and track their ability to adapt their movement patterns throughout a certain timespan, unlike previous research efforts that have assessed different groups of patients at various points after stroke.