Mike Quaglia was 42 when he was diagnosed with Parkinson's disease, which gradually robs its victims of their ability to move normally. For the next seven years, his condition deteriorated despite medication.
"I was at a point where I was either going to give up and let the Parkinson's take over, or I was going to decide to fight back," Quaglia says.
Fight back he did — literally. Last February he stumbled on a program called Rock Steady Boxing. That's right: It teaches Parkinson's patients how to box.
So now you can find Quaglia at Fight 2 Fitness, a gym in Pawtucket, R.I., several times a week, his hands encased in bright red boxing gloves.

Mike Quaglia says he needs less of his Parkinson's medication when he boxes.

Joel Hawksley for NPR

Alongside him are a dozen other Parkinson's patients. They range from a 46-year-old mother of teenagers — she sports pink boxing gloves — to an 84-year-old former phys ed teacher who uses a wheelchair.
They don't punch each other. They're hitting 100-pound punching bags when they're not stretching or doing calisthenics.

Article continues after sponsorship

Shots - Health News

Parkinson's Drugs Can Be A Gateway To Sin

On days Quaglia boxes, he doesn't need to take medication for six hours afterward — twice as long as usual. His depression has lifted, and he has more self-confidence. Boxing, he says, "doesn't cure, but it helps."
Parkinson's disease afflicts about a million Americans — more than multiple sclerosis, muscular dystrophy and ALS combined. Every year 50,000 more get the diagnosis, a number that's going up as the population ages. They face a gradual loss of control over their muscles, leading to tremors, loss of balance and difficulty walking or speaking.
And boxing, it turns out, is only one of an expanding array of movement therapies gaining in popularity as antidotes to Parkinson's. Other Parkinson's patients are drumming, dancing to a Latin beat, practicing the ancient Chinese art of tai chi or golfing.
Even patients with advanced disease can benefit. Jacobo Farina, 79, says he could barely move when he got up on the day of a recent drumming class for Boston-area Parkinson's patients. But when the drumming started, he was one of the most energetic participants.

Shots - Health News

Your Brain's Got Rhythm, And Syncs When You Think

"When you feel the music, your body — your spirit — it comes alive," Farina says.
Dr. Daniel Tarsy, director of the Parkinson's disease program at Beth Israel Deaconess Medical Center in Boston sees meaningful change in a lot of patients who go into these exercise programs.
"I'm a believer," Tarsy says. "Patients look a lot different walking out an hour later than they did walking in. They literally have a bounce to their step."
Tarsy says patients often report that their movements become more fluid. That's the opposite of the rigid, jerky movements typical of Parkinson's.

Quaglia unwraps his hands after a punching exercise.

Joel Hawksley for NPR

A 2012 study from the Oregon Research Institute and other institutions found Parkinson's patients who did six months of twice-weekly tai chi had better balance and control over their movements and were less likely to fall than others who did weight training or stretching. The weight trainers had improved balance and fewer falls than those who merely stretched.
Other recent studies show that Parkinson's symptoms improve with cycling and treadmill workouts.
"There is a growing consensus among researchers about the short- and long-term benefits of exercise for people with Parkinson's disease," the National Parkinson Foundation says on its website. "Research has shown that exercise can improve gait, balance tremor, flexibility, grip strength and motor coordination."
Tarsy says many patients feel that exercise liberates them from "this straitjacket that's called Parkson's disease. They say, 'I can do this!' And in many of those people it carries over into their everyday life."

Quaglia, center, joins a "Rock Steady" cheer at the end of a boxing class.

Joel Hawksley for NPR

Scientists are trying to figure out just how exercise can counter the effects of Parkinson's and possibly even prevent it. Among more than 43,000 Swedes followed for nearly 13 years, the risk of Parkinson's was almost cut in half for those who engaged in moderate levels of exercise.
One clue is that animals with a form of the disease have higher levels of dopamine — the brain chemical deficient in Parkinson's — if they're made to exercise.
Peter Wayne at Harvard Medical School and Brigham and Women's Hospital is looking at how the brains of humans with Parkinson's change in response to six months of exercise.

Shots - Health News

Tai Chi May Help Parkinson's Patients Regain Balance

His study uses tai chi, which has been shown to improve balance and strength in older adults.

Shots - Health News

Can Free Video Consults Make Parkinson's Care Better?

"Because the movements of tai chi are geared to be upright and moving," Wayne says, "they translate a little better into going downstairs and walking the aisles in a supermarket and being able to lift and put things down carefully."
Tai chi engages both mind and body; you might call it "mindful movement." Wayne thinks it may help patients use undamaged parts of their brains to compensate for the areas that normally control automatic movements such as walking.
But it may be that any kind of purposeful exercise is a tonic for the brain. Back at the gym, that's how Mike Quaglia sees it.
"It's all about pushing yourself past your limits and reaching that point where you don't think you can reach," Quaglia says. "You get that runner's high. Your neurons start clicking. You get new cells working. Everything works more effectively."
And then there's the social aspect of it. Rich Gingras, owner of the Rhode Island gym where Quaglia boxes, says Parkinson's patients often sit at home and get depressed.
"They're not moving at all," Gingras says. "So ... coming in here and just moving around and being happy — everybody's smiling — it's great!"
And after all, there's nothing more therapeutic than a smile.
 Almost any exercise is good medicine for someone with Parkinson's disease, a new study confirms.

Although physical activity may seem impossible for some Parkinson's patients, the new research review reaffirms what many specialists already believe: that exercise can have a long-term impact, improving gait and reducing risk of falls, in particular.

"I pretty much never see a Parkinson's disease patient without recommending exercise," said Dr. Michael Okun, medical director of the Parkinson's Foundation. He is also chairman of neurology at the University of Florida.

Parkinson's disease causes the brain to produce less dopamine, which leads to a loss of movement control. Physical symptoms include shaking, slowness and stiffness, but vary widely between individuals.

The review measured the combined outcomes of more than 100 studies conducted over the past 30 years on the effect of exercise in Parkinson's patients. It showed that physical activity has clear benefits, specifically for strength, mobility, flexibility and balance.

"When I started my career, we always said exercise is like a drug for Parkinson's disease. Now we say it and kind of mean it," Okun said.

The Parkinson's Foundation states that medication and exercise combined should be considered part of treatment.

About 1 million Americans live with Parkinson's, which can develop over many years, according to the foundation. Between 50,000 and 60,000 cases are diagnosed annually in the United States.

Martine Lauze is first author of the new review, published recently in the Journal of Parkinson's Disease. She's a kinesiologist, or body movement expert, and researcher at the University of Quebec at Montreal.

"A lot of people are afraid to exercise -- they don't know exactly what to do," said Lauze, who works with Parkinson's patients privately.

Dr. Andrew Feigin, a neurologist at the Cushing Neuroscience Institute in Manhasset, N.Y., has some suggestions for people wondering where to start.

Feigin said water aerobics or swimming are good ways to exercise without the risk of falling. He also recommends treadmills if walking outdoors is too challenging.

The best thing caregivers can do is to help loved ones access exercise -- driving them to the pool or gym, for example, Feigin added.

Lauze said the key to working with Parkinson's patients is to take a progressive approach. This can be as simple as walking around the house until they're ready to walk outside. She added that it's important to find the right activity for the individual, though that activity may not be perfect forever.

For early stage patients, Okun said that "if you had to go to one-size-fits-all, overall the most useful, safest and most bang for your buck is a recumbent cycle." On a recumbent bicycle, you sit lower to the ground with your legs out in front of you. As little as 10 minutes at a time is beneficial, he said.

Okun also said working with a personal trainer is useful for people late in their diagnosis. This might involve using resistance bands and practicing stretching techniques.

"We never think it's too late," said Okun. "You can do all sorts of things even if you lose the ability to walk."

The specialists agreed that patients should strive for relatively vigorous activity. The idea is to break a sweat without overdoing it.

Lauze explained that "when we talk about moderate intensity, that's what we're talking about. It's good to be warm."

She added that different people are capable of different levels of intensity, but the important thing is to keep moving.

The new review also suggests where more research is needed -- such as how exercise might affect learning, mood and depression.

Though there's no evidence that exercise prevents disease progression, other benefits are clear.

"One of the theories is that exercise releases 'Miracle-Gro' for the brain, the same thing that gets released by caffeine," Okun said, likening the popular plant food to compounds that contribute to brain cell growth.

The study's bottom line? Regular physical activity at any stage can benefit Parkinson's patients.