{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T22:27:28Z","timestamp":1788647248993,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study investigated the effects of a non-contact boxing exercise program on maximum expiratory pressure and aerodynamic voice measurements. Methods: Eight adult males diagnosed with Parkinson\u2019s disease participated in the study. Individuals participated in twice-weekly exercise classes lasting one hour across 12-months. Dependent variables were measured on three baseline days and then at six additional time points. A pressure meter acquired maximum expiratory pressure, and a pneumotachograph system acquired transglottal airflow and subglottal air pressure. Results: Measures of average maximum expiratory pressure significantly increased after 9- and 12- months of exercise when compared to baseline. There was an increasing trend for these measures in all participants, with a corresponding large effect size. Measures of transglottal airflow and subglottal pressure did not change over the course of 9- or 12-months, although their stability may indicate that the exercise program influenced maintenance of respiratory-phonatory coordination during voicing. Conclusions: A non-contact boxing exercise program had a significant effect on maximum expiratory pressure in people with Parkinson\u2019s disease. The aerobic nature of the program and challenges to the respiratory muscles potentially explain the \u201cingredient\u201d causing this effect. The small sample size of this pilot study necessitates future research incorporating larger and more diverse participants.<\/jats:p>","DOI":"10.3390\/jcm12144806","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T01:58:38Z","timestamp":1689904718000},"page":"4806","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Pilot Study of the Effect of a Non-Contact Boxing Exercise Intervention on Respiratory Pressure and Phonation Aerodynamics in People with Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5355-5961","authenticated-orcid":false,"given":"Christopher R.","family":"Watts","sequence":"first","affiliation":[{"name":"Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth, TX 76109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3421-1207","authenticated-orcid":false,"given":"Zo\u00eb","family":"Thijs","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences & Disorders, Molloy University, Rockville Centre, New York, NY 11570, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9527-5167","authenticated-orcid":false,"given":"Adam","family":"King","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Texas Christian University, Fort Worth, TX 76109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0874-0110","authenticated-orcid":false,"given":"Joshua C.","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Texas Christian University, Fort Worth, TX 76109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6873-9210","authenticated-orcid":false,"given":"Ryan","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Texas Christian University, Fort Worth, TX 76109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"ref_1","first-page":"993","article-title":"Respiratory Disorders in Parkinson\u2019s Disease","volume":"11","author":"Guilherme","year":"2021","journal-title":"J. Park. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.parkreldis.2015.06.020","article-title":"Incidence and mortality trends of aspiration pneumonia in Parkinson\u2019s disease in the United States, 1979\u20132010","volume":"21","author":"Akbar","year":"2015","journal-title":"Park. Relat. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"724","DOI":"10.3389\/fneur.2019.00724","article-title":"Dysregulation of Respiratory Center Drive (P0.1) and Muscle Strength in Patients with Early Stage Idiopathic Parkinson\u2019s Disease","volume":"10","author":"Zhang","year":"2019","journal-title":"Front. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Baille, G., Perez, T., Devos, D., Deken, V., Defebvre, L., and Moreau, C. (2018). Early occurrence of inspiratory muscle weakness in Parkinson\u2019s disease. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0190400"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Watts, C.R., and Awan, S.N. (2019). Laryngeal Function and Voice Disorders: Basic Science to Clinical Practice, Thieme Medical Publishers.","DOI":"10.1055\/b-006-161128"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1044\/2016_JSLHR-S-14-0314","article-title":"Laryngeal Aerodynamics in Healthy Older Adults and Adults with Parkinson\u2019s Disease","volume":"60","author":"Matheron","year":"2017","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"580.e11","DOI":"10.1016\/j.jvoice.2018.01.016","article-title":"The Effect of Parkinson Disease Tremor Phenotype on Cepstral Peak Prominence and Transglottal Airflow in Vowels and Speech","volume":"33","author":"Burk","year":"2018","journal-title":"J. Voice"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1044\/2021_JSLHR-21-00216","article-title":"Progression of Self-Perceived Speech and Swallowing Impairment in Early Stage Parkinson\u2019s Disease: Longitudinal Analysis of the Unified Parkinson\u2019s Disease Rating Scale","volume":"65","author":"Watts","year":"2022","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000266286","article-title":"Speech and swallowing symptoms associated with Parkinson\u2019s disease and multiple sclerosis: A survey","volume":"46","author":"Hartelius","year":"1994","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1002\/mds.27460","article-title":"Speech treatment in Parkinson\u2019s disease: Randomized controlled trial (RCT)","volume":"33","author":"Ramig","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1044\/2020_AJSLP-19-00024","article-title":"The Effect of SPEAK OUT! and The LOUD Crowd on Dysarthria Due to Parkinson\u2019s Disease","volume":"29","author":"Behrman","year":"2020","journal-title":"Am. J. Speech-Lang. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Watts, C.R. (2016). A Retrospective Study of Long-Term Treatment Outcomes for Reduced Vocal Intensity in Hypokinetic Dysarthria. BMC Ear Nose Throat Disord., 16.","DOI":"10.1186\/s12901-016-0022-8"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3730","DOI":"10.1044\/2022_JSLHR-22-00262","article-title":"Respiratory Responses to Two Voice Interventions for Parkinson\u2019s Disease","volume":"65","author":"Richardson","year":"2022","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcomdis.2013.12.001","article-title":"Increased vocal intensity due to the Lombard effect in speakers with Parkinson\u2019s disease: Simultaneous laryngeal and respiratory strategies","volume":"48","author":"Stathopoulos","year":"2013","journal-title":"J. Commun. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1044\/jshr.3904.798","article-title":"Aerodynamic mechanisms underlying treatment-related changes in vocal intensity in patients with Parkinson disease","volume":"39","author":"Ramig","year":"1996","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8961493","DOI":"10.1155\/2020\/8961493","article-title":"Exercise-Induced Neuroplasticity in Parkinson\u2019s Disease: A Metasynthesis of the Literature","volume":"2020","author":"Johansson","year":"2020","journal-title":"Neural Plast."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"160","DOI":"10.2165\/00007256-199520030-00004","article-title":"Exercise and brain neurotransmission","volume":"20","author":"Meeusen","year":"1995","journal-title":"Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1038\/nrneurol.2017.128","article-title":"Long-term effects of exercise and physical therapy in people with Parkinson disease","volume":"13","author":"Mak","year":"2017","journal-title":"Nat. Rev. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/S0306-4522(03)00096-4","article-title":"Exercise induces behavioral recovery and attenuates neurochemical deficits in rodent models of Parkinson\u2019s disease","volume":"119","author":"Tillerson","year":"2003","journal-title":"Neuroscience"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/mds.21346","article-title":"Exercise improves efficacy of levodopa in patients with Parkinson\u2019s disease","volume":"22","author":"Muhlack","year":"2007","journal-title":"Mov. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1152\/japplphysiol.00208.2020","article-title":"Maximal strength training in patients with Parkinson\u2019s disease: Impact on efferent neural drive, force generating capacity, and functional performance","volume":"129","author":"Helgerud","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"ref_22","first-page":"1217","article-title":"ParkinSong: Outcomes of a 12-Month Controlled Trial of Therapeutic Singing Groups in Parkinson\u2019s Disease","volume":"10","author":"Tamplin","year":"2020","journal-title":"J. Park. Dis."},{"key":"ref_23","first-page":"594","article-title":"Effects of singing on voice, respiratory control and quality of life in persons with Parkinson\u2019s disease","volume":"39","author":"Radig","year":"2016","journal-title":"Disabil. Rehabil."},{"key":"ref_24","first-page":"615","article-title":"Implementation of a Community-Based Exercise Program for Parkinson Patients: Using Boxing as an Example","volume":"9","author":"Domingos","year":"2019","journal-title":"J. Park. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3233\/NRE-130828","article-title":"Community-based group exercise for persons with Parkinson disease: A randomized controlled trial","volume":"32","author":"Combs","year":"2013","journal-title":"Neurorehabilitation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"132","DOI":"10.2522\/ptj.20100142","article-title":"Boxing training for patients with Parkinson disease: A Case Series","volume":"91","author":"Combs","year":"2011","journal-title":"Phys. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jns.2017.11.015","article-title":"Effect of Lee Silverman Voice Treatment (LSVT LOUD\u00ae) on swallowing and cough in Parkinson\u2019s disease: A pilot study","volume":"383","author":"Miles","year":"2017","journal-title":"J. Neurol. Sci."},{"key":"ref_28","first-page":"1897","article-title":"Establishing Equivalent Aerobic Exercise Parameters Between Early-Stage Parkinson\u2019s Disease and Pink1 Knockout Rats","volume":"12","author":"Salvatore","year":"2022","journal-title":"J. Park. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s00702-019-02055-3","article-title":"Motor and non-motor function predictors of mortality in Parkinson\u2019s disease","volume":"126","author":"Bugalho","year":"2019","journal-title":"J. Neural Transm."},{"key":"ref_30","first-page":"CR241","article-title":"Predictors of mortality among nursing home residents with a diagnosis of Parkinson\u2019s disease","volume":"8","author":"Fernandez","year":"2002","journal-title":"Med. Sci. Monit."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1111\/ene.15743","article-title":"A systematic review and meta-analysis of respiratory dysfunction in Parkinson\u2019s disease","volume":"30","author":"McMahon","year":"2023","journal-title":"Eur. J. Neurol."},{"key":"ref_32","first-page":"696","article-title":"Maximal respiratory pressures: Normal values and relationship to age and sex","volume":"99","author":"Black","year":"1969","journal-title":"Am. Rev. Respir. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4806\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:16:09Z","timestamp":1760127369000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,21]]},"references-count":32,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jcm12144806"],"URL":"https:\/\/doi.org\/10.3390\/jcm12144806","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,21]]}}}