Knock-Out Parkinsons with Aussie Mike

Early in my career I was very fortunate to meet a fellow by the name of Des Duguid, an ex amateur boxer who represented Australia in the 1960 Rome Olympics, (NB: for more on my first meeting with Des Duguid, click here) 

DES DUGUID REUNITING WITH A FRIEND AND FELLOW 1960 OLYMPIAN BY THE NAME OF MUHAMMAD ALI

As a lifelong boxing fan I knew something about Duguid’s boxing history, but still had to be convinced about his concept of selling boxing training to the general public.   But like so many people who came in contact with him he used his wit, guile and charm to make me agree to a 6 week trial period at the Coles Myer Fitness Centers I was managing at the time.

Following the success of this 6 week trial Des went on to popularize the boxacise concept in the land. Down Under bringing “boxing training without the lumps and bumps” to Fitness Centers throughout Australia. Follow link: https://downunder-fitness.squarespace.com/fitness-articles/2013/11/15/boxacise

After some intense training under Des and experiencing quite a few of the lumps and bumps associated with boxing  I became one of his team of instructors at the Australian Boxing Academy and helped him bring boxing skills to Fitness Clubs in Melbourne

From Coles Myer office workers, a Victorian Police cadet to Pentridge prisoners Des was a brilliant teacher of Boxing skills and movement.   Des also taught groups with profound learning disabilities and it was here that I saw his skills and human abilities shine. The look of joy on previous sullen faces when Des walked into the room to teach these folks how to skip or hit the speedball was a true testament to the strength of his humanity and friendly spirit.

Now 30 years later I have embarked on new adventure. After retiring from the World Bank in 2017 I began teaching boxing skills to folks with Parkinson’s disease at the Virginian Outpatient Therapy clinic in Fairfax Virginia. 

It is a great learning adventure. It gives me great pride to think that my old coach  Des Duguid who eventually would himself suffer from Parkinson's  and pass away from its complications in 2008 would be looking down with a smile ,knowing that his kind and irascible Aussie spirit lives on in his students, on the other side of the world 

My hope is that by sharing these articles and video  anyone with Parkinson’s disease or people  who may have  a friend or family member with Parkinson’s can be inspired to add a boxing component to their exercise program to assist with their balance and strength and overall fitness.

Click here if you would like to speak with Aussie Mike about starting a “Knock Out Parkinson’s Program “ for your group or organization.

Enjoy the articles and videos and keep Punching!!!

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Articles

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Boxing and improved Balance- a winning combination in the fight against Parkinson's

The American College of Sports Medicine (ACSM) defines Balance as “The ability to use the senses, such as sight and hearing, together with body parts in performing tasks smoothly and accurately.”

For people with Parkinson’s disease balance has a much more simple definition i.e.: the ability and confidence to carry out the daily tasks of living minus the fear of falling. My clients participating in the “Knocking out Parkinson’s’ Program “always point to improved Balance as being the major benefit they gain from regular participation in our boxing program.

Let’s hear from one of my regular clients Gail on the importance of balance and how boxing training helps improve this often neglected part of our Fitness program.

A new Perspective on Balance !!

 Even after 30 years of teaching boxing classes to people from all walks of life this has given me a new perspective on the benefits of boxing training.  I have taken balance for granted.   When typically asked about the physical benefits of boxing I would always site improved Aerobic Fitness, hand eye coordination and muscular endurance to be the major benefits.

 But when you look at the bio-mechanics of correct boxing technique it all starts with the correct balance. The ability to remain stable and punch effectively all relies on a good stable foundation. I was very fortunate to have been taught by a great teacher 1960 Australian Olympic Representative Des Duguid who always emphasized the need for correct balance and footwork

So how does boxing training actually help improve balance

 Footwork

To emphasize the importance of balance and correct footwork s we start with feet together.  I then ask the client to then do a Charlie Chaplin foot placement on their prominent side i.e. right foot for right handers, left for southpaws followed by a turn on the ball of that foot and a backward step.  While Charlie Chaplin may have less relevance for today’s millennials most people, and especially my Parkinson’s Pugilists can still relate to the famous slay-footed comedian of yesteryear.  Further cues can be given to encourage feet to remain in that position so that the back foot is behind and to the side of the front and there is a clear line in between the legs. (NB: This will require regular feedback as it is a unique foot placement not seen in most sports or activities)

Movement –

           Knees bent, upper body nice and relaxed and bobbing and swaying “like a cork in the ocean. “, are visual cues given to encourage balance and total body coordination throughout the movement

           All of these movement require balance and a strong foundation as demonstrated by the following video where I take Kelley Grant from the Virginian Outpatient therapy clinic through stance and the basic jab.

This visual images and cues encourages free flowing movement rather than stiff robotic punches. 

 And as Gail said this in our previous video this combination of correct footwork and concentration makes boxing a very effective way to improve balance.

By emphasizing balance throughout the class you become more aware of the benefits of boxing training and the benefits it can give your clients. This is particularly important for our Parkinson’s clients whose quality of life is greatly enhanced by improved balance.

The 2019 Parkinson's Foundation of the North Capital Area (PFNCA) Symposium" Aussie Mike's thoughts and observations

Over the course of a 32 year career Management career in the Fitness Industry and a secondary career as a freelance writer, I have attended many conferences, seminars, symposiums, retreats or whatever term is used to describe a meeting of the minds for people with similar professional interests.

Last Saturday March 23, 2019 I attended a vastly different gathering: “The 2019 Parkinson’s Foundation of the Northern Capital Area (PFNCA) Symposium,” an event designed for those facing Parkinson’s disease and their care partners.

Over the course of a day lectures, panel discussions and question and answer sessions were presented by movement disorder specialists, neurologists, neurosurgeons and health educators.

Why a conference on Parkinson’s disease (PD)?

My previous Blogs have provided details on a part time role I have pursued in post-retirement teaching boxing classes to Parkinson’s patients (http://www.aussiemikejames.com/new-blog-1-1/2018/5/21/) the Virginian Outpatient Therapy clinic in Fairfax Virginia. Boxing is one of the major exercise regimes that have shown to be beneficial in delaying the progress of the symptoms of PD.  

While I have many years’ experience teaching Boxing and an educational background in exercise science I am not a Doctor or physical therapist. Aside from basic first Aid and some long past certifications in Massage therapy and exercise for rehabilitation I have no real medical training.

 By attending this symposium I hoped to increase my knowledge on the origins of PD, its causes, treatments and hopefully potential future cures.  Most importantly I wanted to get to know my clients better and have a greater understanding of the challenges they face on a daily basis.  Hopefully all of this can only help me provide a better product for them.

As a keen boxing enthusiast and all aspects of exercise I have always been fascinated by the clinical manifestations of PD.  I was always puzzled how prominent sufferers of PD in the boxing fraternity like Muhammad Ali, until his final years, and today trainer Freddie Roach could still perform coordinated boxing movements like hitting the punching bag in Ali’s case and in Roaches’ case taking world champions like Manny Pacquiao through his paces on the focus pads, and yet still face significant   common PD symptoms like muscle stiffness and rigidity and bodily tremors in the arms and legs.

 Another powerful impetus for me to understand more about PD was the passing of my boxing coach, mate, and mentor 1960 Aussie Olympic representative Des Duguid in 2008n from PD.

http://www.aussiemikejames.com/new-blog-1-1/2017/10/31/cddl0da2s8mfs0ln8bi9rihtgqgy57

First impressions

I knew from the outset that initially the biggest difference from my previous professional conferences would be visual.  Unlike Fitness Industry conferences, there was nary a bulging bicep, lululemon leotard water bottle and omnipresent protein bar in sight. And unlike writing conferences there were no hard bitten journalists with weary visages from overindulging  in coffee, tobacco, and other  stimulants to fulfill an impending deadline or starry eyed novelists intent on  learning how to write the next great American novel.

There was at least (by my count) 300 attendees and true to the demographics of the disease, the age range skewed to the over 60 years bracket and predominately male with varying degrees of movement restrictions. Some attendees ‘movement patterns were noticeably affected, some barely at all.

As one of my clients told me “for us PD sufferers everything is done slower and more methodically and that truly means everything.”  With this in mind I was also careful to refrain from the usual robust, take no prisoners straight ahead, chest out, stomach in, lats spread, walking style you see from Fitness Industry folks.  At Fitness industry conferences, particularly the trade shows, you almost spend more time apologizing for bumping fellow attendee’s shoulders than looking at equipment.”  Not a good idea at a PD symposium. (NB: Ok for me the stomach in part might be a stretch, but be nice dear reader, you get my general idea!!)

Naturally after a 32 year career in Management that involved a great deal of planning and event management my thoughts turned to logistics. How for instance would the event coordinators cater the meals without encountering long queues and myriad other issues especially if it was hot food? Fortunately the organizers were well ahead of my concerns and actually provided mobile catering direct to participants as they sat listening to lectures. All done very quickly and efficiently including delivery and clean up.

Ok now that my visual and Managerial curiosity was satisfied, what did I actually learn about PD?

8 Key learning takeaways

1.  Exercise the best medicine

   Nearly all lecturers mentioned that regular intense exercise was the best therapy for delaying the progress of common PD symptoms, like muscle rigidity, loss of strength, balance and motor coordination.

The effects of intense exercise on stimulating endorphin release to improve mood and alleviate depression was also a constant. However as an Exercise professional I do have one concern.   In my opinion there is a dis-connect between the medical and Fitness communities.   There appears to be a commonly quoted statistic regarding exercise intensity that advises people to exercise to” 85% of their maximum heart rate.”

Even the fittest individuals find exercising regularly at 85% quite difficult and physically taxing.   Also determining true maximum Heart rate can vary from individual to individual depending on age and previous activity levels. I would suggest more education on perceived Exertion scales as opposed to being too focused on achieving an estimated beats per minute statistic. 

 2. Medication Management

It is here where I learned the most. A drug called Levodopa is considered the number 1 drug for controlling the effects of Parkinson’s. The effectiveness of Levodopa and its side effects needs careful management. This Management is often a work in progress where the patient and medical provider have to work closely to determine the effective dosages and most importantly timing of the medication for maximizing its effectiveness.

 3. On/off Times

    On time is when symptoms are less apparent and daily activities can be pursued more easily. The body appears to have greater flexibility and general mobility.

    Off time is when the medication isn’t working and the symptoms are much more apparent with stiffness, shaking and less mobility.

   Managing the medication and daily activities around these on/off times becomes a major part of a person with PD’s daily life.

 As a teacher I really knew nothing of on/off periods  save for a basic gut instinct that  when one of my clients tells me they aren’t  feeling well enough to box I know they are making the correct decision. This is something an instructor has to be aware of.  Our PD clients aren’t high level athletes that you can goad or admonish with “push through the pain, no pain no gain” Rockyesque motivational cliches.   These are people seeking to improve their fitness around daily challenges that we non PD people can’t possibly fully understand.

 4. Psychological implications often overlooked

The largest impact PD has is on Depression. One presenter stated that depression is 2 times more likely to adversely affect the quality of PD patient’s life than motor impairments.

Depression is usually episodic and often coupled with anxiety and leads to functioning at a lower physical level.

Medications work well with P.D medication and when combined with Cognitive Behavioral Therapy can be every effective in combating Depression

 5) Some key terms in understanding Parkinson’s disease

Dyskinesia, - a form of involuntary movement that can range from inconvenient i.e. mild tremors to uncontrollable movements that make daily activities very difficult.

IADLS - “Instrumental activities of daily living," are activities related to independent living and include preparing meals, managing money, shopping for groceries or personal items, performing light or heavy housework, doing laundry, and using a telephone.

 Facial Masking, -This term refers to the loss of facial expressions giving the affected person a fixed, mask-like expression. In Parkinson's disease, masking can develop as the progressive loss of motor control extends to the facial muscles as it does to other parts of the body. Masked, expressionless faces can complicate an already difficult situation alienating acquaintances who may be put off or disturbed by the apparent lack of emotional response.

 Again this was something I was totally unaware of. I now joke with my clients that I understand why they don’t react to my attempts at humor. It has nothing to do with my jokes being NOT FUNNY!!

 6)  Newspaper reports on wonder drugs

Many PD neurologist and educators mentioned that Newspaper reports on new wonder drugs are often hyperbole and can give rise to unrealistic expectations that need to be curbed by a more realistic sober analysis from medical research professionals

 7)  Marijuana,

     Similarly Marijuana while a viable treatment modality also has contraindications and deleterious side effects for some individuals. It is not a panacea for all PD patients as often seems to be claimed in over simplified newspaper and media reports

 8)  The Power of Positivity. You have PD now go live your life

 The most meaningful sentiment I heard was from a PD person I spoke to at the conference. Let’s call him Ned.  He told me that after months of uncertainty he finally found a Medical specialist who told him.  “Ned you have Parkinson’s disease, there will be some challenges but now go live your life!!”

The positive outlook my clients have is a true inspiration that makes teaching them a very worthwhile experience

While these observations are  by no means definitive  I hope they can be a good starting point for other fitness professionals and people from all walks of life who  come to work  with PD clients.

Hopefully a cure is imminent.  My dear friend and boxing coach Des Duguid 1960 Olympian, Des Duguid eventually suffered from Parkinson’s before passing away in 2008.  But I take solace from knowing that Des is posthumously sitting up there in that “big boxing ring in the sky “ smiling like the proverbial Cheshire cat. No doubt he is regaling folks at the pearly gates, in typical colorful Aussie Vernacular, about how very proud he is that the skills he taught are being put to such good use helping people deal with Parkinson’s disease and to “go live their life’ with greater balance, enjoyment and the ability to Keep Punching out Parkinson’s.

Haka Inspires Parkinson's Warriors at the Virginian !!

In previous Blogs I have written about the innovative exercise programs being used to combat the effects of Parkinson’s disease (PD) for patients at the Virginian Outpatient Rehabilitation in Fairfax Virginia

Programs like “LSVT Move Big (http://www.aussiemikejames.com/new-blog-1-1/2018/3/23/when-thinking-fitness-think-big-.) And Aussie Mike’s Boxing (http://www.aussiemikejames.com/new-blog-1-1/2018/5/21/knocking-out-parkinsons-at-the-virginian.)   Aim to improve the quality of movement, strength and endurance for people diagnosed with Parkinson’s disease.

A new addition to the rehab program at the Virginian was a project utilizing the traditional Maori Haka.  The Haka is an ancient war dance used by the Maori’s the Native people of New Zealand.  The Haka is used on the battlefields and also when groups come together to show pride and respect.  The Haka is a fierce display of tribe’s pride, strength and unity.  The movements used include violent foot stamping, facial expressions, tongue protrusions and rhythmic body slapping accompanied by loud chanting. 

The driving force behind this project at the Virginian, Matt McKeon, speech Therapist and Parkinson care team lead for the rehabilitation department, says that “the Haka is being used to symbolize the patients and staff at the Virginian’s mutual respect for each other and unwavering commitment to combat the effects of Parkinson’s disease.”  

I sat down recently with Matt McKeon, to find out how this traditional New Zealand Maori ceremonial war dance is being used to fight Parkinson’s disease

Matt, first things first, why the Haka?

“When I saw the Native Maori Haka being performed I couldn’t help but be inspired by the spirit and energy shown as well as the respect for each other and their tribal elders.  The various large movements the foot stamping, facial expressions and loud, proud use of their voice is the epitome of what we want our Parkinson’s patients to do. More than just doing exercise though the Haka expresses emotions and I thought it would be really inspirational if these people with Parkinson’s could do this well to show the global community this is what Parkinson’s can be . That people with PD can move well, they can show expression and emotion and are more than the sometimes stereotypical image you see of people with PD.  This can only help others with PD to do more.”

Can you give us some more specifics about the Movements used in the Haka ?

“For this project we sought to learn the “Ka Mate Haka” by Te-Rauparaha, chief of the Ngati Tao Rangatira of New Zealand. This Haka in particular embodied a message that permeates the lives of many people, especially those living with progressive neurological diseases such as Parkinson’s disease. "Ka Mate" (Tis death or Will I die?) and "Ka Ora" ( Tis life or Will I live?) is recited in the first 2 lines. It allowed our clients with Parkinson's disease to embrace the battle that rages within and supported their desire to combat the disease with an intensity that many have never experienced all while supporting the function of muscle groups needed for movement, expression, and verbal communication.  

How did your patients with PD view the project and react to learning the Haka which is not easy ?

“They initially struggled to learn the movements but they come back every week with their sheets, ready to practice. But they persisted and knew that the underlying message was to show the mutual respect they have for their fellow patients and the therapists who have chosen to help them in their fight against PD. For those with Parkinson's, the expression to "live" was performed with such purpose that they described the experience as "transformative."

 Matt in the video you refer to Parkinson’s as a Bully.  Can you explain more about that please?

“Well when you see conditions like Parkinson’s it is like a bully.  It comes, doesn’t ask your permission, shoves you on the ground and takes your freedom to move and your voice away. And like a typical bully unless you stand up and fight back it’s not going away.  So by performing the Haka with respect to the Maori traditions in a loud voice, and aggressive stance we hopefully instill a quiet confidence into our patients that whatever life throws at them we can fight against it.”

Did you, the rehab staff and patients gain new insight into the Maori Culture and the Haka?

“Most definitely.  Our goal is to also to be respectful to the native Maori culture. We are putting ourselves out there not to be them or compare ourselves with them but with utmost respect and admiration for the ancient Maori chiefs in their spirit to fight against sometimes seemingly insurmountable odds.

So after weeks of practice under the expert guidance of a native Maori descendant of the Kawati tribe the rehab staff and Parkinson’s patients at the Virginian came together in true warrior spirit to produce the following video to symbolize their fight against Parkinson’s disease.

Kudos to Matt Mckeon and the staff and patients at the Virginian Outpatient Rehabilitation in Fairfax Virginia for their innovative approach in the battle to beat Parkinson’s disease !!

https://youtu.be/TbSA_kt-uqE

When thinking Fitness - Think Big !!!

     I believe it was noted Fitness Industry consultant Thomas Plummer who said words to the effect of “Fitness Professionals of the baby boom generation were great at training people to run faster, jump higher and lift heavier weights and maybe add a six pack waistline here and there. This type of training regime made you faster, slimmer, more athletic and stronger, all while not being able to scratch your back or tie yours shoe laces without calling for assistance. 

     Admittedly this is a very broad description that some of our regular Yoga enthusiasts would totally refute. Plummer’s main point was that today’s personal trainers are being taught to incorporate more functional movements in their training  that makes for a much more balanced approach to Physical Fitness.

    These thoughts ran through my mind as I recently observed my colleague Maria Malca take 20 members of the "LSVT Move Big" class at The Virginian residences in Fairfax, Virginia.  As described in my previous Blogs I have been working closely with Maria by providing Boxing based exercise classes to people with Parkinson’s disease (PD) many of whom have been Maria’s regular clients in her Move big Classes

    Based on the LSVT BIG therapy program, Move BIG is a Parkinson- Specific class to improve quality of movement, walking, strength and endurance. The format also includes postural and stretching exercises. It is based on the principle that the brain can learn and change (neuroplasticity). It has been formulated from an existing program to help with speech for people with PD called the Lee Silverman Voice Treatment (LSVT).

The Big Class

    Held in a large assembly room with nary a dumbbell, barbell, dynaband or fitness prop in sight Maria began the session by leading the group through some Basic walking that used different gait patterns, forward and backward steps, and figure 8 patterns between chairs. Vocal inhibition and memory can also be affected by PD, so Maria engaged the participant’s brain and voices by having them yell out the names of Airports in the United States while they walked in a circle. 

     Following this was a series of seated exercise working through different body planes. As Maria's clients moved, forward, upward, sideways from seated to standing etc. they were encouraged to follow her cues in a series vocal exercises with forced exhalation.  Maria encouraged each participant to speak loudly, and confidently.  Facial stretches were also included to help engage the facial muscles which can suffer from palsy with the onset of PD. Basic stretches and relaxation concluded the 50 minute session

Boxing for PD

     As I watched Marie and her clients, my thoughts turned to my boxing class and how I could incorporate the same principles in my teaching. Boxing training, minus the lumps and bumps of contact, is becoming a very popular activity for our PD population.  If taught properly the many punch combinations, Jab, cross, hook and uppercuts when combined with total body movement like ducking weaving and slipping punches can be used very effectively to seek the same type of total body movement. 

     In the following video one of boxing’s premier trainers Freddie Roach who himself has PD mentions that the hand eye coordination he developed through pad work has been instrumental in his delaying the progression of his PD symptoms.

     While currently my class is based primarily on pad work and all its many variations. I look forward to working on a newly installed speedbag with the folks in the coming weeks. It is definitely a skill that can be taught to beginners as the following video shows

Some Final Thoughts

After viewing the LSVT Big Session at the Virginian I came away with 3 main impressions.

1.    A skilled leader like Maria Malca is essential.  It should be noted that while Maria has been taught the LSVT Big format she also has over 30 years of experience as a Group exercise instructor at the World Bank Fitness Centers. So not only is Maria knowledgeable, she also knows how to engage and lead groups of people  with the right combination of assertiveness while still making it fun for her clients.

2.    The exercises are very effective in working all aspects of fitness like  strength, muscle endurance, aerobic and flexibility while also including specific drills that encourage use of the voice, balance, gait and memory to address specific concerns for this population

3.    Finally over the years I have seen Degrees in my chosen field of Physical education adopt all types of pseudo-scientific nomenclature.  

       Back in 1983 when I received my degree,it was given the grandiose title of Bachelor of Applied Science (Phys Ed) Since then I have seen other names given to basically the same degree ranging from  Bachelors of Kinesiology, Exercise Sciences, Health and Physical Education, Sports and Exercise Science, Biomechanics , Exercise Physiology etc. etc.  

      However, I also remember that the very first degree available in my hometown of Melbourne Australia was at the Melbourne University in 1937.  It was call a Diploma in “Human Movement Studies”

     Human Movement is the oldest and the definitely the best title.  At its essence exercise is not just about running faster, lifting more and showing off a 6 pack. Exercise is about Human Movement in all its variations, for all sectors of the population.

      Like Maria Malca and her wonderful clients at the Virginian, when we think about our Fitness regimes, we should think BIG and incorporate all types of Human Movement into our program!

Boxing Training for Parkinson's... my thoughts and impressions!

      Over my 40 year career in the Fitness industry I have seen boxing training evolve from the stereotypical bastions of hyper aggressive masculinity practiced in sweaty, acrid, back yard gyms full of blokes with black eyes, busted lips and bad intentions, to today where there is usually some form of boxing activity in most corporate and commercial fitness centers throughout the world.  In my native Australia I was fortunate to be involved at the very start of this evolution, with my coach and great friend, former Aussie Olympic boxing representative Des Duguid, who pioneered the concept in the late 1980’s.

      Since 1990, I have taught the boxing skills I learned under Des Duguid, to people from all walks of life, from sedentary office workers, weekend warriors, and skilled sportsmen, to talented pugilists at the Australian Boxing Academy.  But it is only recently that I have become involved in teaching boxing to folks with Parkinson’s disease at the Virginian residences in Fairfax, Virginia

      So far I have taught one 4 week Pilot program and we are now at the halfway mark of our first 8 week Boxing program. 

      Here are my thought and impressions.

First Impressions

      It has definitely been a great learning experience. I continue to learn more about courage, perseverance and the power of a positive attitude in the face of adversity from these folks than any other group I have taught. Rather than sit back and feel sorry for themselves these people are taking positive steps to address the various physical issues they face.

Teaching the skills

           With limited space and equipment, much of the work involves using Focus mitts which enable participants to punch into pads worn on my hands. Depending on the progression of an individual’s symptoms some of the skills may take a little longer to teach and perhaps never be quite mastered.

            Fortunately Des Duguid’s was a great teacher of human movement.  He taught me patience and the ability to break down complex skills simply and effectively

           Like with most groups I teach it is important to keep in mind that we are not teaching prospective pro boxers or world champions here. While correct technique is always the goal, the movement and benefit of exercise should be our primary focus rather than 100% picture-perfect technique.

          Instruction has to be clear and concise, with skills progressing from basic to more complex as the participants become more adept and confident.  I generally try not to teach more than a 3 punch combination to beginners.  This is particularly important for folks with Parkinson’s, as many have issues with neuromuscular coordination and muscle rigidity.

        Many experience difficulties discerning between left and right hand. That is quite normal for all populations learning boxing skills, so positive reinforcement should be used to encourage and correct where necessary. The person shouldn’t be admonished and made to feel like a Klutz.

       We all have learning curves. I experience these same difficulties when I try to dance, so I certainly can relate!!! (NB: In my defense my wife says that I am a great dancer.. for a bloke with 2 left feet!!)

        Working within abilities and limits of an individual’s movement is essential. Actually physically moving the person’s arms through the movement pattern, whether it is a jab, cross, hook or uppercut, can help some who are having a difficult time mastering the movements.

Breathe in Breathe out

        Breath holding is another common issue you find in all populations. People tend to hold their breath and exhibit tension when they exert against a resistance or when punching. Breathing freely and indeed forcefully exhaling when punching, should be encouraged to avoid complications like the Valsalva maneuver. This is especially important for Parkinson where breathing and shortness of breath can be one of the side effects.

 Vast improvements in Hand eye coordination and Punch Power

            Hand eye skills come quickly for some and not so quickly for others. However it is the one area I have seen to be the most visible improvement for nearly all participants.  By incorporating challenging group activities like random reflex test with the pads and foam noodles, reaction time and hand eye coordination can be greatly enhanced.

              The strength and power of the punches also improves markedly. I always emphasize drawing the power of punches using the whole body chain,  from feet to hand not just flailing from the arms. The power individuals develop is enough to make me sure I am cautious when using the focus mitts. I don’t want to cop a punch and become like one of the black eyes and busted lips brigade!

Footwork, ducking and weaving

          Footwork takes a longer time to master as freezing of the gait is a common symptom of Parkinson.  I have found that given our space restrictions limited forward and backward movement is the best method right now. My general impression is that the gross motor movement patterns involved in punching, are easier to achieve than the fine movement patterns required in regular boxing footwork, which can be quite complex.

           However movement skills like ducking and weaving can easily be taught.  With all populations I encourage participants to keep their eyes up and feel the movement. Again this ability will vary between individuals but opening their minds into thinking about these movements leads to increases in the neuromuscular firing required.

             Even soft blocking and parrying of punches can be taught at low intensity to add some realism into the sessions.  With all groups I emphasize that while these classes doesn't necessarily teach you to be a boxer, we should also realize  that in real boxing people actually hit you back. So it doesn’t hurt to learn some defensive skills.

It’s got to be Fun

              I have been a longtime proponent of former International Health Racquetball and Squash Association (IHRSA) president John McCarthy’s view that the Fitness Business is primarily a Hospitality business. Providing a great service with a people focus by remembering names and building relationships is definitely the most important skill you can have for success in the Fitness profession, especially when teaching group exercise classes.

              Most importantly it has to be Fun!!  Injecting humor along the way goes a long way to build teamwork and esprit de corps.

           Finally the irony isn’t lost on me that some of boxing greatest champions including Muhammad Ali suffered from Parkinson’s.  Today the skills that Ali perfected are now being used to combat the effects of Parkinson’s

           Did the effects of boxing cause Ali and other boxers Parkinson’s? While there is no definitive proof, there appears to be increasing agreement in the medical community  that repeated punches to the head is likely a big factor that can cause Parkinson’s. 

            Sadly my coach and Ali’s fellow 1960 Olympian, Des Duguid eventually suffered from Parkinson’s before passing away in 2008.  But I take solace from knowing that my mate, coach and mentor Des is posthumously sitting up there smiling like the proverbial Cheshire cat. No doubt he is regaling folks at the pearly gates, in typical colorful Aussie Vernacular, about how very proud he is that the skills he taught are being put to such good use helping people deal with Parkinson’s disease. 

          The mental image I have of Dessies beaming smile mirrored by my happy class members is the biggest reward I can possibly ask for.

Rock on Rock Steady ! boxing training for Parkinsons Patients !

Boxing training for all ages, shapes and sizes!

Indiana non-profit uses boxing training for Parkinson’s patients!

By Mike James

If someone mentions the word boxing, chances are your thoughts turn to the fistic deeds of world famous pugilists like Muhammad Ali, or the exploits of celluloid heroes like Sylvester Stallone's "Rocky Balboa."

You probably either love it or loathe it. Many people are thrilled at the prospect of two individuals of equal weight displaying skill, courage and strength, in this ultimate "one on one" contest. Others revile boxing for its primitive display of brute force and naked aggression and point to the dire consequences it can have for the health of its competitors.

Indeed there is no sadder sight in sport today than ex heavy weight champion, Muhammad Ali, who in his prime, was a truly beautiful and gifted athlete, who could "float like a butterfly and sting like a bee". Unfortunately today he has the shuffling gait and tremor in his limbs most commonly associated with Parkinson’s disease.

No matter how you view boxing it is unquestionably one of the most physically demanding contact sports. Boxers require superior levels of aerobic fitness, strength, muscular endurance and flexibility together with excellent hand-eye coordination, speed, reflexes and manual dexterity.

Most fitness centers now recognize the pure fitness benefits of boxing training and incorporate some form of boxing into their group exercise schedule. However recent research has highlighted the rapid fire reflexes and manual dexterity required as being amongs the key benefits of this type of training. Recent research indicates that boxing movements with their particular emphasis on reflexes and hand eye coordination may be described as "neuro protective”.

“Rock Steady” a nonprofit Fitness Center in Indiana now offers boxing based classes specifically for Parkinson's patients.

http://www.rocksteadyboxing.org/about-rock-steady/faq/

To quote from the Rock steady website :

 "More recent studies, most notably at Cleveland Clinic, focus on the concept of intense "forced" exercise, and suggest that certain types of exercise are neuro-protective, which means that it is a type of exercise that may actually slow disease progression.

 A boxing regime provides a framework which fits the mold for neuro-protection. Boxing requires a combination of endurance, strength, power, speed, agility, flexibility, durability, hand-eye coordination and the ability to react appropriately to strategic situations.  Boxing improves balance and stability by forcing movements in all planes of motion. The rapid movements involved in jumping and punching increases over-all muscle fire ability.  In addition, Rock Steady has learned methods to combat specific symptoms through other Parkinson's exercise organizations (like Delay the Disease) to mix into our core boxing curriculum."

      For a practical example of this you only have to look at Freddie Roach trainer of Manny Pacquioa.  Freddie has been treated for Parkinson’s since 1992 years but can still provide world class boxers with rigorous workouts using the punch pads.

      A recent HBO's boxing specials interviewed Freddie’s neurologist Dr. Joseph Chung.  Dr.Chung agreed, albeit cautiously choosing his words, that Freddie's boxing regime and particularly the pad work helped fire the deep neural pathways and has help slow the progression of his Parkinson’s symptoms.

The advantage this form of training has over others is that it is a total body workout which also helps improve the motor skills required for superior sports performance. The speedball and floor to ceiling balls are particularly good for developing reflexes, lateral body movement and hand-eye coordination.  The footwork required to skip continuously boxing style is also a skill found in few other activities,

   However as the folks at Rock steady are quick to point out, there is no sparring.  The goal is to avoid emerging from a session with black eyes, blood noses and bruised egos. Our aim is to be "pretenders, not contenders" in the boxing stakes.

Here is a suggested format for boxing training to best capitalize on the fitness and reflex training benefits with some tips and instructional videos you may find useful for learning the various skills.

The Circuit

Boxing training usually takes the form of a circuit involving the traditional boxing equipment including skipping ropes, speed balls, medicine balls, punching bags and floor to ceiling balls.

The work/rest ratio employed depends on the person's present level of fitness and proficiency with the equipment. The beginner may find it hard to maintain a rhythm with the speed and floor to ceiling balls.

For this reason it is worthwhile incorporating a few aerobic stations like cycling, rowing or rebounders to help elevate the heart rate and obtain a training effect. For beginners 2 minute work, 20 -30 second rest ratio can be employed.

For the more advanced who can work the various apparatus with a fair degree of skill, a slightly longer work and rest ratio can be employed, for example, a 3 minute work, 10 second rest ratio.

There can be as many as 25 stations. The order of exercise is not important but it may be advisable to alternate aerobic, upper and lower body exercise to avoid repetition strain of one particular muscle group -for example, bike, speedball, skipping, floor to ceiling, rebounder. Boxing gloves should also be worn to avoid hurting the hands and wrists.

The Speedball

This is an excellent way to improve hand-eye coordination and strength in the shoulders and arms. Boxers require shoulder strength to help hold their gloves up, throw punches and pull the hand back quickly for defense.

The speedball also has many other sporting applications and is used extensively in training by sprinters requiring faster arm action and by racquet sports players to improve reflexes, timing and hand-eye coordination. There are many different ways of using the speedball.

https://www.youtube.com/watch?v=DDIOZ-sBE6w

For beginners it is important not to be mesmerized by the ball's erratic movements. Keep your eyes focused on the ball, hands held at shoulder height and start slowly. Try and hit through the ball. You will eventually get a rhythm. As you become more proficient you will be able to increase speed.

https://www.youtube.com/watch?v=UwnozO5ScvY

https://www.youtube.com/watch?v=sJvlRfT6JM0

The Heavy Bag/Boxmaster

It is essential that boxing gloves be worn here to avoid jarring the hands. Commence with light, glancing blows employing the basic jab and straight arm punches. As you become more proficient, move on to other punches like the hook and uppercut. This is very taxing aerobic training if done continuously for the 2 -3 minute round. As you improve, experiment with various jab, hook, and uppercut combinations in a fast non-stop manner to help anaerobic conditioning.

https://www.youtube.com/watch?v=KCKgfNBFICk&list=TLSNETo-KrTWk

It is important to have the correct stance so as to not waste energy. Stand with feet shoulder width apart, left foot slightly forward. Keep on the ball of your back foot. Your back foot will act as a motor, keeping you balanced and generating power. Your front foot will be like a rudder allowing you to transfer weight and force from the back foot.

The Floor to Ceiling Ball

This is an extremely difficult apparatus to master but excellent for speed, reflexes and lateral body movement. Don't be surprised if the ball springs back and hits you in the face on your first try. Remember you are working the ball, it's not working you. Attack it with a left jab and a straight right. (Right jab then straight left for left handers.)

https://www.youtube.com/watch?v=R9Em1iDPmuA

Skipping

This is an excellent aerobic conditioner. Most of us have some idea how to skip from our childhood days. Use a similar shuffling motion of the feet and try to let your arms and wrists do most of the work. Beginners should start slowly here as the calves and ankles may suffer soreness from the jarring.

The most important thing to note about all this equipment is that it takes time to master. Don't worry if you can't seem to get the speedball, floor to ceiling and skipping going at a mile-a-minute. They all require a great deal of patience and persistence. You will feel awkward at first but remember -Stallone trained for years to reach his level of proficiency for the conditioning scenes in "Rocky".

The Pads

To get the most from a work out with the boxing it is most important that the person holding the pads is experienced and well versed in boxing as well as fitness combinations.   Boxing expertise while not essential is helpful, but the most important factor is the holder should have good coaching and communication techniques

https://www.youtube.com/watch?v=j6iX21J0vrg

https://www.youtube.com/watch?v=HcqAWEAdTso

Some Useful Tips

Do

Incorporate some abdominal exercises - for example, medicine ball sit-ups and some light weight training movements.

·         Include some rhomboid fly's to help stretch and strengthen the rear shoulder area which is often rounded by the typical boxing stance.

·         Wear boxing gloves or mitts for hand protection and have your own pair for hygiene. Strapping the hands may also be useful.

·         Warm up and cool down paying particular attention to stretching the shoulders, chest, leg adductors and lower back.

DON'T

·         Become frustrated and give up because you look clumsy on the speed bag or floor to ceiling ball.  Keep practicing, you will be surprised how proficient you can become over time.

·         Try and emulate Floyd Mayweather or Manny Pacquioa on your first try. Your hands will come off second best.

Finally a big thumbs up to the Folks at Rock Steady boxing in Indiana for showing how boxing training can benefit people from all stages of life and levels of Physical Fitness.

Rock on Rock Steady !!