- Associated Press - Friday, March 25, 2016

COLUMBIA, Mo. (AP) - Fist after fist, Terry Skinner punched the heavy black bag with all his might. He had 30 seconds left before he got a break, and he looked winded.

He began to hit the bag slower and slower as he started to struggle. Skinner had already worked through several exercises that day, and they were catching up to him, the Columbia Missourian (http://bit.ly/1UpuYjr) reported.

“Keep going, you’re almost there,” said his trainer, Courtney Meyers. “Don’t give up on me.”

Skinner, 68, a retired director of advising and planning at the Missouri Lottery, isn’t the type to give up. He didn’t give up during the recent Wednesday boxing session, and he didn’t give up after being diagnosed with Parkinson’s disease 10 years ago.

Skinner participates in the Rock Steady Boxing program at the MU Human Performance Institute, an improvised gym in a strip center off Nifong Boulevard. Rock Steady is an exercise program for Parkinson’s patients. It’s a multimodal regimen that targets common effects and problems that people with Parkinson’s experience daily.

The boxing sessions are the culmination of a series of stretching, agility exercises and boxing workouts tailored to the struggles each person is having with the disease.

“It’s the hardest workout I’ve ever had,” Skinner said. “It forces you to push yourself, and when you have Parkinson’s, you need to push yourself.”

Recent research suggests that the boxing workouts promote better overall physical functioning. People like Skinner say it’s rigorous, yet fun, and it builds a support system for those with Parkinson’s.

Rock Steady Boxing is a national program that arrived in Columbia in mid-February. It was the first Parkinson’s boxing program in Missouri, and it has sparked a lot of local interest, said Patsy Dalton, leader of the Columbia Parkinson’s support group. When Rock Steady trainers came to a Parkinson’s support group meeting to talk about the program, Dalton said the response was immediate.

“From what I could tell, quite a few people were actively planning to sign up for the program after they talked to their doctor,” she said.

The program is designed for anyone with Parkinson’s, said Becky Edwards, physical therapist and supervisor of Rock Steady Boxing. “We can really tailor the program to anyone just by modifying the activities done during a session,” she said.

The disease has a number of symptoms, and they can be different for each person. The four main motor symptoms are tremors, stiffness, instability and slowness in movement, according to the National Parkinson’s Foundation.

Meyers, a trainer, said the most common symptom is stiffness. It can cause extreme discomfort and affect almost everything a person does. That’s why stretching at the beginning and end of a session is so important.

It’s not all about boxing. Sessions incorporate actions like sitting down, getting out of a chair or getting up off the floor to help balance and flexibility in problematic situations.

“Anything we do in Rock Steady Boxing is supposed to help people in their daily life and routine,” Meyers said. “It’s the little things that people like you and I don’t have problems with, but they struggle tremendously with, that we target during the boxing.”

A session starts with several stretches and agility exercises, but after about 30 minutes, it’s time to really fight back.

The boxers put on big red boxing gloves for various exercises like hitting the heavy bag and punching the trainer’s gloves in a simulated boxing match.

The boxing technique targets all of the symptoms and has proved effective in reducing tremors, Edwards said. Thinking about punching with a certain hand, then coordinating that thought with motion, are the keys.

“What we’re experiencing is that while they are boxing, a lot of them don’t have tremors,” Edwards said. “And when they do this boxing, it carries over into other activities in life and can reduce the amount of tremors.”

Watching a session, you can see people fall into a rhythm and release much of the stiffness that is obvious at the beginning of a session. Even without seeing them, you could hear them. The voice sometimes weakens with Parkinson’s, so auditory exercises are designed to target that problem.

“We want them to say what they are doing - yell it, or even scream it,” Meyers said.

The boxers will say “jab,” ”hook” or “uppercut” as loudly as they can as they execute the motions.

“The overall goal of cheering and shouting is not just to get pumped up but to strengthen their voice,” Edwards said. “They feel like they’re being loud because it takes a lot of effort to talk, but, in all actuality, they’re not being loud at all.”

Overall, the goal is to reduce the pain and help each person feel better inside and out.

“Right now it’s hard for us to see where our boxers are at because the program is new,” Meyers said. “But we hear people say they feel a lot better, more flexible and better with themselves in general.”

Research shows that Parkinson’s progresses more slowly in those who work out. Recent research has found that those engaged in boxing programs, as opposed to traditional workouts, showed even better results.

Stephanie Combs-Miller, a researcher at the University of Indianapolis, followed patients with Parkinson’s over two years and looked at the effects of boxing versus traditional exercise. Her team of student researchers measured the functioning of the participants, and those who boxed were ranked higher in several categories.

“Boxing certainly showed more positive results,” Combs-Miller said. “The people that boxed tended to maintain a higher level of functioning than the other folks, and that’s a big deal with Parkinson’s disease.”

Combs-Miller said this does not mean the boxers got better, though.

“We didn’t see an improvement over the two-year span of time, but they maintained their functioning and weren’t getting worse,” she said. She attributed that to the program’s high-intensity and multimodal exercises.

“If you go out walking, you’re only getting one mode of exercise - you’re not varying it very much,” she said. “Boxing is addressing multiple different modes of exercise, so you’re addressing all of the things that people with Parkinson’s are having trouble with.”

Support systems

Dalton’s husband has Parkinson’s disease. So she knows what she’s talking about when she says having a good support system is crucial.

“So many of us are given the diagnosis, but we’re not given very much information on how to handle it,” Dalton said. “It’s a complex disease, and not a lot of people understand it.”

While boxing is about fitness, the routine also gives people a place to meet others who know what they’re experiencing.

“They understand each other and know what each other are going through,” she said. “In other places, people might not understand them.”

Combs-Miller agreed with this notion, saying that the camaraderie between the boxers is also helpful in fighting the disease.

“It’s comprised of people with Parkinson’s, and I think that alone can have a huge impact on their quality of life,” she said. “It establishes a cohesive group, and that keeps them motivated to continue boxing.”

Jay Brunk, 62, a boxer who drives to Columbia from St. Genevieve to put on the gloves, was diagnosed about five years ago and said he is pretty functional right now. He’s optimistic that the boxing will hinder the progression of the disease.

The other benefit is that he really likes to hit the bag.

“I get a sense of satisfaction,” he said. “I feel like I’m doing something, and I’m doing it well.”

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Information from: Columbia Missourian, http://www.columbiamissourian.com

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