A Pilot Study of the Feasibility and Effects of Table Tennis Training in Parkinson Disease

Abstract

Objective: To investigate feasibility and effects of table tennis training on balance control and physical function in individuals with Parkinson disease.

Design: Single group, observational, before-after trial.

Setting: Table tennis training in a gymnasium.

Participants: Community-dwelling individuals with Parkinson disease (N=9; 5 men, 4 women) with an average age of 66.9 years, average time since diagnosis of 8.6 years, and a modified Hoehn and Yahr score between 2 and 2.5 participated in this study. Participants were recruited via newspaper advertisement, at the patient organization, and at the university hospital outpatient clinic. Eight participants completed the study. One participant withdrew for logistical reasons.

Interventions: Group training program consisting of 2 table tennis training sessions per week (120min each) for 10 weeks.

Main outcome measures: The primary outcome was feasibility, including attendance rate, drop-out rate, a final questionnaire assessing the participants' experience during the intervention, and any adverse events. The primary effect outcome was the Mini Balance Evaluation Systems Test (Mini-BESTest). Secondary effect outcomes were Parkinson's disease questionnaire-8, European quality of life questionnaire, Montgomery Åsberg Depression Rating Scale (MADRS), Unified Parkinson's Disease Rating Scale, 10-meter walk test, generic walking scale, activities-specific balance confidence scale, and physical activity measured with an accelerometer and the Frändin-Grimby scale.

Results: The average attendance rate was 84%. There were no adverse events reported. The participants reported that the training improved well-being. The mean total score on the Mini-BESTest before and after intervention was 21.2 versus 23.3 (P=.093). Statistically significant positive effects without adjustment for multiple comparisons were found for MADRS and the Frändin-Grimby scale.

Conclusions: This study demonstrates that table tennis training is safe and feasible, and may have the potential to improve balance control, mental well-being, and self-reported physical activity level. Further studies are required before table tennis can be considered an evidence-based recommendation for individuals with Parkinson disease.

Keywords: EQ-5D-3L, European quality of life questionnaire; Exercise; MADRS, Montgomery Åsberg Depression Rating Scale; MiniBESTest, Mini Balance Evaluation Systems Test; PD, Parkinson disease; PDQ-8, Parkinson's disease questionnaire-8; Parkinson disease; Postural balance; Rehabilitation.

Fig 1

Individual results and mean pre- and postintervention for (A) Mini-BESTest, (B) gait velocity, (C) MADRS, and (D) PDQ-8.