THERAPEUTIC CLIMBING IN REHABILITATION: A NARRATIVE REVIEW
Abstract
Introduction and objective: Climbing has recently emerged as a promising form of movement therapy, combining physical and psychological benefits. This review aims to provide a comprehensive overview of current evidence regarding the therapeutic application of sport climbing—particularly bouldering and top-rope climbing—in rehabilitation settings. It focuses on its use in treating postural defects, neurological disorders, psychiatric conditions, and developmental disorders in children.
Review methods: The review is based on studies retrieved from PubMed, Google Scholar, ResearchGate, and other scientific databases. Included materials comprise clinical and preclinical studies, randomized trials, case reports, and reviews related to the use of sport climbing in rehabilitation.
State of knowledge: Therapeutic climbing has demonstrated benefits across diverse clinical populations, including individuals with chronic low back pain, scoliosis, multiple sclerosis, Parkinson’s disease, traumatic brain injury, cerebral palsy, ADHD, and autism spectrum disorders. Reported outcomes include improved balance, coordination, muscle strength, proprioception, mood regulation, and cognitive function. Climbing is also associated with enhanced motivation and social integration. However, limitations remain, such as the lack of standardised protocols, a scarcity of high-quality RCTs, and limited long-term data.
Conclusion: Climbing integrates physical exertion, neuromotor coordination, and emotional engagement, making it a multifaceted rehabilitation tool. Its ability to promote neuroplasticity and whole-body engagement suggests significant untapped potential. Nonetheless, to validate its clinical utility and ensure safety, there is a need for robust, standardised research and structured implementation protocols supervised by qualified professionals.
References
Exel J, Deimel D, Koller W, et al. Neuromechanics of finger hangs with arm lock-offs: analyzing joint moments and muscle activations to improve practice guidelines for climbing. Front Sports Act Living. 2023;5. doi:10.3389/fspor.2023.1251089
Fischer G, Schneeberger M, Petter SA, et al. Motion Analysis of the Wrist and Finger Joints in Sport Climbing. Bioengineering. 2024;11(4). doi:10.3390/bioengineering11040370
Schroeder C, Barnes RF, Volland L, Nguyen S, von Drygalski A. Effects of top rope climbing therapy on joint health in adult haemophilia patients with severe arthropathies. The Journal of Haemophilia Practice. 2018;5(1):93-102. doi:10.17225/jhp00115
Bobowik P, Świerczek J, Jaskulski K, Wiszomirska I, Gajewski J. EVALUATION OF BALANCE AND MUSCLE STRENGTH OF UPPER AND LOWER LIMBS IN ROCK CLIMBERS. Polish Journal of Sport and Tourism. 2023;30(4):19-25. doi:10.2478/pjst-2023-0021
Pasternak-Mnich K. WPŁYW WYBRANYCH RODZAJÓW AKTYWNOŚCI ZAWODOWEJ I POZAZAWODOWEJ NA JAKOŚĆ ŻYCIA ZWIĄZANĄ ZE ZDROWIEM CZĘŚĆ I INFLUENCE OF SELECTED TYPES OF PROFESSIONAL AND NON-PROFESSIONAL ACTIVITY ON THE HEALTH-RELATED QUALITY OF LIFE PART I Redakcja Naukowa.; 2021. http://wydawnictwo.umed.pl/
Kiełt M, Król A, Szczygieł A, Bilski J. THE CHARACTERISTIC BODY POSTURE OF PEOPLE PRACTICING ROCK CLIMBING. Medicina Sportiva. 2014;18(2):72-77. doi:10.5604/17342260.1110314
Grzegorz Z, Aleksandra B, Michał B, et al. The influence of sport climbing on depression and anxiety levels-literature review. Published online 2018. doi:10.5281/zenodo.1318229
Saul D, Steinmetz G, Lehmann W, Schilling AF. Determinants for success in climbing: A systematic review. J Exerc Sci Fit. 2019;17(3):91-100. doi:10.1016/j.jesf.2019.04.002
Staszkiewicz R, Rokowski R, Michailov ML, Regwelski T, Szyguła Z. Biomechanical profile of the muscles of the upper limbs in sport climbers. Polish Journal of Sport and Tourism. 2018;25(1):10-15. doi:10.2478/pjst-2018-0002
Lin CY, Kuo SH. The role of the cerebellum in rock climbing. J Neurol Sci. 2017;383:158-160. doi:10.1016/j.jns.2017.10.050
Asan AS, McIntosh JR, Carmel JB. Targeting Sensory and Motor Integration for Recovery of Movement After CNS Injury. Front Neurosci. 2022;15. doi:10.3389/fnins.2021.791824
Pühringer M, Strutzenberger G, Leitl D, Holzner K, Schwameder H. Possibilities of altering arm and shoulder muscle activation in a static therapeutic climbing exercise through arm position, hand support and wall inclination. Eur J Sport Sci. 2017;17(9):1212-1219. doi:10.1080/17461391.2017.1356379
Engbert K, Weber M. The effects of therapeutic climbing in patients with chronic low back pain: A randomized controlled study. Spine (Phila Pa 1976). 2011;36(11):842-849. doi:10.1097/BRS.0b013e3181e23cd1
Kim SH, Seo DY. Effects of a therapeutic climbing program on muscle activation and SF-36 scores of patients with lower back pain. J Phys Ther Sci. 2015;27(3):743-746. doi:10.1589/jpts.27.743
Yuan W, Wang H, Yu K, et al. Effects of physiotherapeutic scoliosis-specific exercise in patients with mild juvenile scoliosis. BMC Musculoskelet Disord. 2022;23(1). doi:10.1186/s12891-022-05857-x
Berdishevsky H, Lebel VA, Bettany-Saltikov J, et al. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools. Scoliosis Spinal Disord. 2016;11(1). doi:10.1186/s13013-016-0076-9
Bruder A, Taylor NF, Dodd KJ, Shields N. Exercise Reduces Impairment and Improves Activity in People after Some Upper Limb Fractures: A Systematic Review.; 2011.
Langer A, Hasenauer S, Flotz A, et al. A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson’s disease. NPJ Parkinsons Dis. 2021;7(1). doi:10.1038/s41531-021-00193-8
Langer A, Roth D, Santer A, et al. Climb up! Head up! Climbing improves posture in Parkinson’s disease. A secondary analysis from a randomized controlled trial. Clin Rehabil. 2023;37(11):1492-1500. doi:10.1177/02692155231174990
Gassner L, Dabnichki P, Pokan R, et al. Therapeutic climbing in Parkinson’s disease: Differences in self-reported health and well-being, feasibility and clinical changes. Physiother Theory Pract. 2023;39(6):1163-1177. doi:10.1080/09593985.2022.2036279
Velikonja O, Čurić K, Ožura A, Jazbec SŠ. Influence of sports climbing and yoga on spasticity, cognitive function, mood and fatigue in patients with multiple sclerosis. Clin Neurol Neurosurg. 2010;112(7):597-601. doi:10.1016/j.clineuro.2010.03.006
Liu S, Gong X, Li H, Li Y. The Origin, Application and Mechanism of Therapeutic Climbing: A Narrative Review. Int J Environ Res Public Health. 2022;19(15). doi:10.3390/ijerph19159696
Christensen MS, Jensen T, Voigt CB, Nielsen JB, Lorentzen J. To be active through indoor-climbing: An exploratory feasibility study in a group of children with cerebral palsy and typically developing children. BMC Neurol. 2017;17(1). doi:10.1186/s12883-017-0889-z
Weinstock-Zlotnick G, Janowski LC, Wolff A. The role of hand therapy in facilitating participation in rock wall climbing: A case report of a woman with cerebral palsy. Journal of Hand Therapy. 2022;35(1):142-147. doi:10.1016/j.jht.2020.10.013
Luttenberger K, Karg-Hefner N, Berking M, et al. Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial. British Journal of Clinical Psychology. 2022;61(2):465-493. doi:10.1111/bjc.12347
Karg N, Dorscht L, Kornhuber J, Luttenberger K. Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: Results of a multicentre randomised controlled intervention study. BMC Psychiatry. 2020;20(1). doi:10.1186/s12888-020-02518-y
Schwarz L, Dorscht L, Book S, Stelzer EM, Kornhuber J, Luttenberger K. Long-term effects of bouldering psychotherapy on depression: benefits can be maintained across a 12-month follow-up. Heliyon. 2019;5(12). doi:10.1016/j.heliyon.2019.e02929
Luttenberger K, Stelzer EM, Först S, Schopper M, Kornhuber J, Book S. Indoor rock climbing (bouldering) as a new treatment for depression: Study design of a waitlist-controlled randomized group pilot study and the first results. BMC Psychiatry. 2015;15(1). doi:10.1186/s12888-015-0585-8
Stelzer EM, Book S, Graessel E, Hofner B, Kornhuber J, Luttenberger K. Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial. Heliyon. Published online 2018:e00580. doi:10.1016/j.heliyon.2018
Kleinstäuber M, Reuter M, Doll N, Fallgatter AJ. Rock climbing and acute emotion regulation in patients with major depressive disorder in the context of a psychological inpatient treatment: A controlled pilot trial. Psychol Res Behav Manag. 2017;10:277-281. doi:10.2147/PRBM.S143830
Kratzer A, Luttenberger K, Karg-Hefner N, Weiss M, Dorscht L. Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: results from a multicenter randomized controlled trial. BMC Psychol. 2021;9(1). doi:10.1186/s40359-021-00627-1
Michelsen F, Jenuwein S, Luttenberger K, Calvano C. Therapeutic climbing in inpatient rehabilitation:A qualitative study of subjective experiences, perceived effects and importance in the rehabilitation process from the perspective of people with mental disorders. Sports Psychiatry. 2024;3(4):163-172. doi:10.1024/2674-0052/a000093
Medernach JP, Memmert D. Effects of decision-making on indoor bouldering performances: A multiexperimental study approach. PLoS One. 2021;16(5 May). doi:10.1371/journal.pone.0250701
Angelini E, N Oriel K, M Myers G, Cook KDA, Drawbaugh RM, Price J. The Impact of an Adapted Climbing Program on Children with Attention-Deficit/Hyperactivity Disorder. International Journal of Physical Education, Fitness and Sports. Published online December 12, 2020:60-69. doi:10.34256/ijpefs2047
Kadiyeva M, Blagii O. The effectiveness of health-recreating programme of rock-climbing activities for 9-year-old children with attention deficit hyperactivity disorders. Quality in Sport. 2021;7(2):64-72. doi:10.12775/qs.2021.013
Lee HS, Song CS. Effects of therapeutic climbing activities wearing a weighted vest on a child with attention deficit hyperactivity disorder: a case study. J Phys Ther Sci. 2015;27(10):3337-3339. doi:10.1589/jpts.27.3337
Kaplan-Reimer H, Sidener TM, Reeve KF, Sidener DW. Using stimulus control procedures to teach indoor rock climbing to children with autism. Behavioral Interventions. 2011;26(1):1-22. doi:10.1002/bin.315
Kantor J, Hlaváčková L, Du J, et al. The Effects of Ayres Sensory Integration and Related Sensory Based Interventions in Children with Cerebral Palsy: A Scoping Review. Children. 2022;9(4). doi:10.3390/children9040483
Frühauf A, Niedermeier M, Sevecke K, et al. Affective responses to climbing exercises in children and adolescents during in-patient treatment for mental health disorders a pilot study on acute effects of different exercise interventions. Psychiatry Res. 2020;291. doi:10.1016/j.psychres.2020.113245
Kovářová M, Pyszko P, Kikalová K. Analyzing Injury Patterns in Climbing: A Comprehensive Study of Risk Factors. Sports. 2024;12(2). doi:10.3390/sports12020061
Quarmby A, Zhang M, Geisler M, et al. Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review. Front Sports Act Living. 2023;5. doi:10.3389/fspor.2023.1269870
Views:
75
Downloads:
43
Copyright (c) 2025 Władysław Hryniuk, Julia Kwiecińska, Jacek Sitkiewicz, Alicja Toczyłowska, Mateusz Muras, Łukasz Bialic, Lidia Mądrzak, Marta Korchowiec, Wiktor Chrzanowski, Katarzyna Krzyżanowska
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
