Table tennis could improve balance in Parkinson’s patients – study

A 12-week table tennis programme may improve movement, balance and walking endurance in people with Parkinson’s, a small pilot study suggests.

Participants were able to walk further after completing the NeuroPong programme and reported fewer symptoms of depression than at the start.

The programme combines table tennis instruction with exercises tailored to people with Parkinson’s.

Most participants completed the programme and no adverse events were reported. Researchers said the findings support further testing in larger, controlled clinical trials.

The researchers wrote: “The multidimensional motor and cognitive demands of table tennis may contribute to these observed benefits.”

“These findings contribute to a growing body of evidence suggesting that task-specific, cognitively engaging, and socially interactive physical activities may be effective in treating Parkinson’s.”

Parkinson’s is caused by the gradual loss of nerve cells that produce dopamine, a chemical messenger that helps nerve cells communicate and plays a role in controlling movement.

Symptoms can include tremor, slow movement and balance problems. People may also experience depression, anxiety, sleep problems and changes in thinking.

Although treatments can ease symptoms, exercise is considered an intervention that may influence the course of the condition.

However, there is no universal agreement on the type, frequency or duration of exercise that provides the greatest benefit.

Table tennis has attracted interest because it combines physical activity with quick decision-making, hand-eye coordination, balance and motor planning. These skills are often affected by Parkinson’s.

Its effects in people with the condition have so far been tested only in small studies using different training methods, making firm conclusions difficult.

The researchers wrote: “Unlike traditional exercise modalities that often target isolated domains (e.g., strength or endurance), [table tennis] simultaneously engages motor, cognitive, and adaptive processes in a dynamic and unpredictable environment.”

“These characteristics make [table tennis] particularly well-suited to address the complex, multidimensional impairments observed in [Parkinson’s].”

A team led by researchers at the University of Colorado School of Medicine evaluated NeuroPong, a standardised table tennis rehabilitation programme designed for people with neurological conditions and adapted for Parkinson’s.

The pilot study enrolled 30 people with Parkinson’s, three-quarters of whom were men. Their average age was 70 and 26 completed the programme.

Participants attended supervised two-hour sessions twice a week for 12 weeks.

The sessions included warm-up exercises, instruction in table tennis strokes and guided play adapted to each person’s movement abilities, balance and fatigue levels.

Attendance averaged about 90 per cent and no adverse events were reported.

Researchers assessed participants’ Parkinson’s symptoms, mobility, cognition, mood and quality of life before and after the programme using several standardised tests.

Movement symptoms, measured using Part III of the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale, fell by an average of 5.73 points.

The assessment is widely used to measure Parkinson’s movement symptoms, with lower scores indicating less severe difficulties.

The researchers wrote: “Reductions in MDS-UPDRS Part III of 3-5 points may reflect perceptible improvements in motor symptoms in individuals with PD [Parkinson’s disease].”

Participants also improved across several measures of physical function.

Scores on the Berg Balance Scale, which assesses balance and the risk of falling, increased by an average of 3.08 points.

In the Timed Up and Go test, participants were an average of 1.04 seconds faster. The assessment measures how quickly someone can stand, walk a short distance, turn and sit down.

Walking endurance, measured using the Six-Minute Walk Test, increased by 66.8 metres, described in the original study report as about 20.4 feet.

Researchers said the faster standing and walking times and the increase in walking endurance represented clinically relevant improvements.

The team wrote: “These findings parallel reports in Tai Chi and dance interventions, which similarly incorporate multidirectional movement and coordinated weight transfer.”

Participants also reported a modest reduction in depressive symptoms.

However, cognition, anxiety, daytime sleepiness and overall quality of life did not change significantly during the 12-week programme.

The researchers wrote: “A structured [table tennis]-based intervention is feasible and associated with improvements in motor function, balance, and walking endurance in individuals with [Parkinson’s].”

The study was limited by its small size, single-centre design, lack of a comparison group and short intervention period.

However, researchers said the high attendance rate and lack of adverse events suggest the programme is practical and well tolerated.

They called for larger, longer and blinded trials to determine whether the improvements last and whether further effects emerge with continued participation.