For retired medical assistant Cheryl Karian, 72, boxing is medicine. Karian received a diagnosis of Parkinson’s in 2020. She does not compete or spar [pessoa que auxilia o boxeador, simulando o adversário]but every Tuesday and Thursday he spends an hour training at Main Street Boxing and Muay Thai in downtown Houston, USA.
Before her diagnosis, Karian ran, played tennis, and worked with patients at the MD Anderson Cancer Center. That all changed in the years leading up to her diagnosis, in 2020, when she began to experience cognitive difficulties and frequent falls. “I can’t do what I used to do anymore,” she explained the day after boxing training.
Alongside two other class participants, Karian was shadowboxing, throwing punches in the air, under the direction of professional boxer Austin Trout, known as No Doubt Trout. The training is part of a program called Rock Steady Boxing, which specializes in boxing training for people with Parkinson’s, without physical contact with an opponent.
As Trout issued instructions, Karian threw different punches, dodging and moving his head, while maintaining a boxer’s stance, with his legs wide apart.
Non-contact boxing training has been gaining popularity over the past ten years; 4,000 new gyms sprang up before the pandemic in the US, and more than 5 million Americans donned boxing gloves in 2020.
Boxing’s varied, high-intensity workouts offer a mix of cardiovascular and strength conditioning that improves agility, hand-eye coordination and balance and can be especially beneficial for people with neurological disorders such as Parkinson’s.
Parkinson’s disease is caused by a chronic dopamine deficiency, which triggers increasing muscle stiffness, tremors, speech difficulties, fatigue, dizziness, and loss of motor coordination and balance.
Patients’ movements become very slow and small. Falls are a serious problem, especially as symptoms progress. And while there is no cure, or even a way to stop the symptoms, non-contact boxing training appears to offer a way to slow the effects and boost patients’ self-confidence.
“If you train boxing, you’ll see your coordination improve, your agility as well, your balance, ditto,” said Trout, former lightweight world champion. He’s been teaching Rock Steady for four years. “This is a way to fight Parkinson’s disease physically.”
Rock Steady Boxing was founded in 2006 by Scott Newman, a promoter from Marion County, Indiana, who found that boxing helped him manage the symptoms of early Parkinson’s disease. At first, it was just him and five other patients training with a former professional boxer, Kristy Follmar.
The strangeness of using boxing as therapy did not go unnoticed by them — after all, the sport has one of the highest rates of concussion and brain injury. While it’s unclear whether a lifetime spent suffering from brain concussions can trigger Parkinson’s, it may increase the risk.
Muhammad Ali, one of boxing’s greatest icons, developed Parkinson’s disease after a professional career in which he was famous for pushing the best heavyweights of his day to exhaustion by receiving repeated punches.
In Rock Steady classes, participants don’t get punched – they just throw them. Ryan Cotton, chief scientific officer at Rock Steady Boxing, said that early on, Newman and Follman worked on his hunch.
At the time, Parkinson’s experts recommended focusing on mobility and balance, but avoiding overexertion. The boxers’ open-legged stance and the shifting of their center of gravity when throwing a punch seemed perfect for training balance and posture.
“There was theory that this should work, but there was no scientific evidence,” Cotton said. “Science has ended up confirming many of the things we intuited and now supports them.”
Since then, research has revealed that many forms of high-intensity exercise, and especially boxing, can slow the progression of Parkinson’s symptoms. Boxing also appears to help with other neurological disorders such as multiple sclerosis and stroke.
Rock Steady has grown and spawned more than 850 affiliate programs in 17 countries, with training and certification programs for coaches like Trout, who want to work specifically with people with Parkinson’s who have symptoms of varying degrees of severity.
When Cheryl Karian learned she had Parkinson’s, she understood what her future would be like if she wasn’t proactive. She had seen her mother, who also had Parkinson’s, suffering for years as her quality of life deteriorated. But she has found that boxing helps with her balance, hand-eye coordination and mental functioning. “I’ll do as much as I can, for as long as I can,” she said.
About half of all Parkinson’s patients experience falls in any given year, most of them more than once. Like many boxing instructors, Trout emphasizes with his students the importance of maintaining a stable posture while keeping your hands close to your face and arms bent to protect your body and face.
“This is an exceptional fall prevention workout,” commented San Diego physical therapist Ben Fung, who practices mixed martial arts and specializes in helping patients, including Parkinson’s disease patients, avoid falls.
Many falls occur when a person is reaching for an object or changing direction or speed. Learning to stay in the boxer’s stance can help with maintaining balance, and keeping your hands up can protect your body and face in the event of a fall.
As part of the Rock Steady curriculum, participants practice takedowns. “Ending on the floor is common for Parkinson’s patients,” said Cotton, whose father was diagnosed with Parkinson’s a few years after he started working with Rock Steady. “Our boxers still fall, but they’re not paralyzed by fear.”
Less fear can mean fewer falls. “One of the biggest risk factors for falls is whether a person is afraid of falling,” explained Rebecca Martin, a professor of physical therapy at Hanover College in Indiana.
Martin has no ties to Rock Steady Boxing, but he was able to observe its effectiveness. This has led her to incorporate boxing techniques into her work, which includes teaching weekly exercise classes to people with Parkinson’s disease.
A recent study of therapeutic boxing found that Parkinson’s patients who train twice a week report experiencing fewer falls. The number of falls increased during the Covid lockdowns and fell again once isolation was lifted and people were able to return to training. This is something Trout saw firsthand, when many of his students — or “fighters,” as he calls them — came back from lockdowns tighter and shakier than they were before.
OUT OF THE RING
Parkinson’s disease also has psychological effects. As patients lose motor coordination and balance, many begin to doubt their abilities and withdraw, distancing themselves from their friends and family and limiting their going out of the house, for fear of falling.
“Parkinson’s robs people of trust,” Karian said. “You have to work on it to keep your self-confidence.”
In a recent survey of more than 1,700 people with Parkinson’s disease, nearly three-quarters of Rock Steady Boxing participants said the program improved their social lives and more than half said it lessened their fatigue, fear of falling, depression and anxiety.
“Parkinson’s disease is not just a condition that affects motor symptoms, such as the way you move, walk and talk. It can also affect your mood state, causing a person to feel lonely or isolated,” explained the researcher. neurologist Danielle Larson of Northwestern University in Illinois. She is one of the researchers who conducted the survey. Larson also has ties to Rock Steady, but said he now frequently recommends boxing to his patients.
For some of Trout’s fighters, boxing class is the only time of the week when they leave the house. Retired teacher Kathy Smith said that in her gym classes, she was often embarrassed by her lack of skill. At Rock Steady Boxing, she commented, “the people understand and help us adapt to our different skill levels.”
Translation by Clara Allain