By A.C. Woolnough
Many people think of Parkinson’s disease as afflicting only older people. They conjure up an image of someone with stooped posture, bent over a cane, slowly shuffling down the sidewalk accompanied by shaking or tremors. More enlightened folks (and readers of this column) know that stereotype is true for only a small percentage of PWPs (people with Parkinson’s). More common now is a picture of Michael J. Fox, Neil Diamond, Alan Alda, Jesse Jackson or Linda Ronstadt — all with PD and all in the news recently. Tremor, dyskinesia (uncontrolled and involuntary movement), impaired balance and bradykinesia (slowness of movement) are the more obvious motor symptoms of PD. (Don’t stop reading—the vocabulary lesson for this column is over.)
Non-motor symptoms are actually more prevalent — it’s just that they are not as visible — and include depression, constipation, loss of smell, apathy, facial masking, ED, soft voice and small handwriting. Side effects of the various Parkinson’s drugs can include compulsive behaviors (gambling, shopping and hypersexuality), brain fog (word finding difficulty) and other cognitive problems, low blood pressure, nausea, sleep issues, blurred vision and hallucinations.
These symptoms (both motor and non-motor) often lead to social withdrawal or isolation, and worsening ability to move and do physical tasks—like emptying the dishwasher. (Yes, that comes from experience.) Cognitive decline may be a frequent and unwelcome companion.
What is the solution? It seems obvious that exercise is one tool. Keep moving to keep moving! Doctors and therapists, however, rarely say exercise. Instead, they say, loudly and firmly: exercise, exercise, exercise. That was the genesis for a new program offered by Bonner General Health in partnership with our local PD support group — PowerPAC (Parky’s and Carepartners). Rock Steady Boxing is an international exercise program that uses the physical movements of boxing to combat both motor and non-motor symptoms of PD.
A typical bout (get it?) of RSB starts with stretches and yoga, moves on to making large and deliberate movements, then transitions into a variety of exercises for upper body, lower body and core. Some days we include weights. Every lesson (90 minutes two or three times a week) includes boxing moves. We do not hit each other, but we do beat up on speed bags, heavy bags and training bags. Each punch has a number associated. 1 is a left jab, 2-right cross, 3-left hook, 4-right hook, 5-left uppercut and 6-right uppercut. Odd numbered punches are left side; even punches are right side. We may do 30 seconds of half combinations followed by thirty seconds of three-quarters combinations. Sometimes people will call out numbers, and we then box with those punches mostly in sets of four — one slow, one loud, one fast and one hard. A 1-2-5 sequence calls for left jab, right cross and left uppercut. Remembering the sequence and following it can be very challenging. All of this happens while different mix tapes are played — helping amp up the effort on our part.
We may do 10 seconds of 10 different calisthenics before taking a 30 second break and then repeating the same movements or switching to different exercises that might include, jumping jacks, burpees, squats, lunges, kicks, pushups, medicine balls and arm circles. Many days, we end up doing three sets of 10 each of 10 different exercises — 300 in all. Always, however, we do boxing drills as part of our workout. My favorite thing to do is picture someone (usually a former boss) on the heavy bag and then really go after it. At times, we’ll do activities standing on one leg which, for some of us (me), is very difficult. We generally close with a cool down that includes stretches and a group cheer.
I can imagine someone saying, “So what? Sounds like something anyone can do any time anywhere.” This person needs to learn why this program is so effective for PWPs. Back in the beginning of this article, I touched on social isolation. With 10 or 12 people just like me in the gym, there is time to talk, laugh, socialize and not worry about being judged. Also, with our physical therapist (Tom) and our athletic trainer (Molly), we have skilled coaches who ensure safety and make modifications as appropriate. RSB works with PWPs in wheelchairs and using walkers. We have classes designed for each group. Indeed, we all exercise, exercise, exercise.
Just as important is the cognitive aspect of RSB. When numbers are called out and a sequence is to be followed, focus and executive function are required. RSB addresses movement (motor skills), socialization and cognitive skills. If it sounds like RSB is making a difference to the Parkinson’s community in the Sandpoint area, that’s because it is.
About that superpower: My balance has been compromised by PD, and for the past few years, I’ve had to lean on or grab something so as not to fall over while putting on my underwear after a shower. I could not stand on one foot without falling. Participating in RSB has improved my balance so I can now put on my underwear without tipping over — my new superpower. It may not sound like much but with a progressive condition (it’s going to get worse over time) like PD, any regression or improvement is a big deal. PWPs celebrate every victory —and that’s the subject of a future column.
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