Who would have ever thought I would be writing about boxing? I'm that person who hides behind her coat in the movie theater during fight scenes! Luckily, boxing for Parkinson's disease (PD) is non-contact and a fight worth a good punch. In recent years, boxing programs for people with PD have been popping up all over the United States, many affiliated with Rock Steady Boxing in Indianapolis, IN. This onset of new exercise programs has brought with it many questions about the safety and effectiveness of boxing for PD.
I recently had the great pleasure of lecturing and teaching adapted tango workshops for people with PD, caregivers and physical therapists in Tel Aviv, Israel! Yulia Gamerman and Rita Elimelsh invited me to come work with their patients and colleagues and I got to see their thriving physical activity for people with PD — which happens to be ballroom dancing! Here I present a short interview with these two dynamos so you can learn a little more about what they are doing overseas.
This month, Dr. Hackney consulted Dr. Ramon Gil for his perspective on treating balance issues in PD. Dr. Gil is a Board Certified Neurologist specializing in Parkinson’s Disease and other Movement Disorders.
Dr. Madeleine Hackney: I'm interested in what you would consider "standard of care/current practices" for the treatment of balance issues in PD. What do you do when someone has balance problems?
When people think of physical therapy (PT), they often think of the cliché image of a person being stretched and massaged on a table. However, in the PD population, finding the right therapist is paramount in prolonging functional mobility, optimizing movement, and preventing falls/injury. But how do I choose the right therapist?
My formal background is primarily in engineering, and the majority of my work is focused on trying to “reverse-engineer” how Parkinson’s disease affects balance and walking, in order to identify new treatment targets.
That material is pretty technical (although it’s coming out now(1)), so I thought that I might use this forum to discuss a little bit about the question I receive most often when talking about PD with the people who are affected by it, which is: “are my kids going to get PD?”
What is the one exercise that is best? As an Exercise Scientist with a background in strength and conditioning I hear this A LOT. And what is typically meant by this question is, 'what is the ONE exercise I can do in the shortest amount of time that will fix all that ails me and will make me look good?' While we all want a magic exercise pill we know there is no such thing. And there is also no one exercise that will address the functional changes associated with having Parkinson's disease.
You may have heard that movement programs that include auditory cues, in the form of metronome or music (aka, Rhythmic Auditory Stimulation or RAS) might help movements for people with PD. In PD, RAS with metronome beats has been used to improve walking.
As many as 1 million individuals in the US are currently diagnosed with PD, while it is estimated that 10 million people worldwide are currently living with PD. Not only are the physical and psychological burdens amongst those with the disease significant, but the economic burden is daunting. It is estimated that the cost of PD to the US healthcare system is $25 billion annually! There has to be an effective way of combating this disease.
Yoga and PD? Are you crazy?!
We all are now well aware of the research that highlights the benefits of exercise for Parkinson’s disease (PD). Many neurologists now are saying that exercise could even be considered as a type of medication for PD, and it should be taken regularly.(1) Exercise has been shown to help slow the progression of Parkinson’s, prevent falls, improve balance and strength, result in better posture, and even assist your brain’s cognitive function.1 With all of these positive gains, who wouldn’t want to exercise?