At Spartans Boxing Club, we have long championed the benefits of boxing for mental health. In previous blogs, we discussed the benefits of boxing for trauma, depression, and mental resilience. We have also reviewed studies examining the impact of exercise on general well-being, noting that boxing is one of the few modalities shown to benefit those recovering from mental health issues.
Just out is a recent study (Bozdarov, Jones, Daskalakis, and Husain, 2022) covering a review of research on boxing as an intervention for mental health. The author identified sixteen studies suitable for review, and in the following article, we will review the paper noting key findings.
The paper starts with a commentary on the benefits of exercise as an alternate treatment, especially for those who did not respond well to either therapy or pharmaceuticals. The paper notes that exercises involving breathing or High Intensity Interval Training (HIIT) are especially beneficial. The hypothesis is that boxing involves mindfulness and HIIT-based training, so it should be well suited to recovery from mental health issues. The author notes that the relationship between mental health and exercise is supported by a cross-sectional study of 1.2 million Americans conducted between 2011-2015, showing that those involved in physical exercise reduced the health burden by 20.1% (Chekroud, Gueorguieva, Zheutlin, et al., 2018).
The author decided on a scoping review as the most appropriate methodology for the study as there were too few papers to conduct a meta-analysis. The studies were strictly boxing, with other martial arts, such as Thai Boxing, excluded. Google Scholar, Medline and Psychinfo were used to source relevant studies. However, most sources identified for the review were rated as low-quality evidence.
The studies reviewed included qualitative, quasi-experimental, randomised control studies, case studies with pre-and-post measures, and mixed-method designs. Participants were from across the globe, New Zealand, Canada, China, the United States, Ireland and England. While the author identified 155 studies, 16 meet the stringent requirements for the review. 81% of the studies were journals, with the remainder reports and dissertations. 69% were with adults, 19% with youths and the remainder elderly with Parkinson’s 13%.
The boxing intervention was non-contact. A few studies included cognitive training. Typical routines included shadow work, pads and heavy bags and most interventions were in group settings (88%).
The positive impacts of boxing were apparent in all studies. A summary of findings is below:
“ As it relates to mental health, the majority of articles collectively included results that boxing reduced stress, and improved mood, self-esteem and quality of life (94%). Studies showed significant improvement in overall mood, reduced substance use, improvement in self-esteem and confidence, perceived physical ability, performance in school, and overall well-being and mental health. With the use of measurement-based care, a few articles reported a statistically significant reduction in specific symptoms burden post boxing intervention. These included symptoms of depression as per PHQ9, BDI-II and CES-D; symptoms of anxiety as per STAI; negative symptoms of schizophrenia as per PANSS; and symptoms of PTSD as per PCL-5. In addition, there was a statistically significant decrease in mental health distress and psychological symptoms as per BSi-18 and improvement in quality of life as per PDQ-39, WHOQOL and HRQoL.” (pg. 9). Other benefits noted in the study include an outlet for aggression, escape from rumination and negative emotions. Adverse effects were minimal and unrelated to mental health issues (e.g. muscle skeletal). Most importantly, there was no violence transfer from the training to the community.
While a critical review of studies indicates low quality, the general findings are difficult to dispute. Moreover, the causal mechanism for why boxing appears to be so effective for treating mental health appears tied to the unique focus on technique (mindfulness) and HIIT. At the same time, punching a bag has cathartic effects, and boxing reduces body fat and positively impacts cardiovascular health, two areas known to be impacted by depression. Boxing organically increases community involvement and social support. Music increases the enjoyment factor of members. The positive impacts do not appear to be affected by gender. The article also concludes that an optimal dosage may be as little as two 45-minute classes over a week.
Over the past three months, we have covered an extensive review of the benefits of boxing and mental health. Indeed, further evidence of the same findings would seemingly add little to the conversation. The jury is no longer out, and the judgement is in-boxing is a well-documented and well-supported intervention for mental health and recovery from mental health issues.
References
- Bozdarov J, Jones BDM, Daskalakis ZJ, Husain MI. Boxing as an Intervention in Mental Health: A Scoping Review. American Journal of Lifestyle Medicine. 2022;0(0). doi:10.1177/15598276221124095
- Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 12 million individuals in the USA between 2011 and 2015: A cross-sectional study. Lancet Psychiatr. 2018;5(9):739-746. doi:10.1016/S2215-0366(18)30227-X