Defying Gravity: A Pilot Study of the Effects of Rock-climbing on Physical and Psychosocial Function of Individuals with Parkinson's Disease

Research

Objectives: To investigate the effects of a structured rock-climbing program on individuals with Parkinson’s Disease (PD) on physical and psychosocial function hypothesizing improvements in two primary outcomes (mobility/balance, agility) and seven secondary outcomes (dexterity, upper extremity reaction time, grip strength, resilience, apathy, social adaptation, quality of life).

Design: Quasi-experimental observational pilot study used pre-to-post-test. Setting: Community rock-climbing gym. Participants: Convenience sample of 28 individuals with PD (Hoehn & Yahr 1-3) who walked independently. Interventions: Twelve-weeks of twice weekly top-rope climbing sessions. Each 60–90-minute session included at least three climbs using harness and rope under one-on-one supervision and tailored to skill level. Wall angles, hand/foot holds, and routes were varied from climb to climb and progressively more difficult as skills increased. Main Outcome Measures: Measures of physical function were: Community Balance & Mobility Scale (CBMS); Agility-T Test (ATT); 9-Hole Peg Test (9HPT); upper extremity reaction time using BlazePod® flash devices (UE-React); and grip strength with hand-held dynamometer (GS). Measures of psychosocial function were: Connor-Davidson Resilience Scale (CDR-25), Starkstein Apathy Scale (Starkstein), Social Adaptation Scale (SAS), and Parkinson’s Disease Quality of Life-39 (PDQ-39).

Results: Participants were: 8 women and 20 men; mean age=66.1 years; average disease duration=4.0 years. Paired t-test comparisons were made on all outcome measures and effect sizes (ES) with 95% confidence intervals (CI) were calculated for all statistically significant results using Hedge’s g for conservative estimate. Comparisons of change between pre- and post-tests of physical function were: CBMS (p <.001; ES=.573, 95%CI=.178-.960); ATT (p <.001; ES=.462, 95%CI=.078-.838); 9HPT (p <.001; ES=.480, 95%CI=.094-.858); and UE-React (p <.001; ES=.329, 95%CI=-.045-.696). GS changes were non-significant. Comparisons of change between pre- and post-tests of psychosocial function were statistically significant: CDR-25 (p=.022); Starkstein (p=.023); SAS (p=.005); and PDQ39 (p=.010), but all ES were small and had CIs crossing 0.

Conclusions: Rock-climbing demonstrated medium-size effects on mobility/balance and small-size effects on agility and dexterity. Changes in psychosocial outcomes were negligible. These findings suggest rock-climbing could impact functioning in everyday activities. Clinical guidelines for exercise in PD strongly support incorporating aerobic challenge, resistance training, balance demands, and external cueing. Rock-climbing encompasses these characteristics as well as unique somatosensory and visuospatial experiences. Participants demonstrated motor learning and enhanced movement capabilities beyond task-specific gains. Rock-climbing should be considered in rehabilitation and wellness of individuals with PD. Author Disclosures: Molly Cupka is Founder/President of UpENDing Parkinson's, the climbing protocol studied. No other authors have any conflicts to disclose.