Melanie Cole, MS (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole. And today, we're talking about Rock Steady Boxing program for Parkinson's disease with Nicole Morton. She's an exercise specialist and the Rock Steady Boxing Head Coach at the Bryan LifePointe Campus. Nicole, thank you so much for joining us today. As we get into this topic, which is pretty cool, give us a little overview of Parkinson's disease and the symptoms that generally go with it.

Nicole Morton: So, Parkinson's disease is a movement disorder. With that, it affects the nervous system. It is progressive, there's no cure, and the disease also has many forms and stages. Therefore, symptoms are all over the board. We have physical symptoms as well as non-motor symptoms. The more motor or physical symptoms are going to be tremors, stiffness, slowness of your movement, some impaired balance, maybe some impaired coordination, sometimes you have some speech issues as well. And then, the non-motor symptoms are going to be more cognitive-based, maybe depression and anxiety, difficulty swallowing or chewing, issues sleeping, issues going to the restroom, and constipation as well. And due to this, there's lots of different ways that we can combat that.

Melanie Cole, MS: Thank you for that. And as we think of this list of quality of life-affecting issues, if you were speaking to patients and their caregivers about improving symptoms at home, and before we get into the Rock Steady Boxing program, what do you tell patients and caregivers about things they can try at home?

Nicole Morton: Yeah, I say a good quality of life is following recommendations by your doctor. We say 30 minutes, five days a week at minimum for exercise. That could be walking, doing some strength training or resistance training with bands or hand weights; different balance activities like walking, walking a tightrope or pretending to stand on one leg or maybe some tandem standing and stretching. We really want to have a well-balanced exercise program, making sure that we're doing that 30 minutes a day.

Melanie Cole, MS: Now, tell us about Rock Steady Boxing. What is it and how does it help patients living with Parkinson's?

Nicole Morton: Rock Steady Boxing is a boxing program for those with Parkinson's disease. It is meant to train the brain. We work on cognitive exercise to help them memorize things more. We work on posture. We work on gait to make sure that they're walking with big steps and not shuffling their feet. We also have balance exercises with a whole bunch of different tools to use to work on balance. We strength train. And then, most importantly it's a community for not only the participants, but also their caretakers and spouses that get to come and we have a fun time and make sure that they are getting the best out of their exercise.

Melanie Cole, MS: Tell us a little bit about what they can expect at these sessions and when you say it's a community and they're working together with all of these different specialists, tell us what that looks like. How long is a session? What does it look like?

Nicole Morton: Sessions typically run an hour and 15 minutes. To start off the class, we like to play a game, whether that be a just a silly game of soccer or dodgeball, or we use something like scarves or tennis balls to practice hand-eye coordination. During those classes, we work on five main components. So, a game to have the fun factor, a warmup of some kind to get rid of that stiffness. We go into our boxing where they have to memorize combinations of numbers and different ways to stand and different ways to move their feet. Then, we work on their core because with Parkinson's disease, they start getting rounded shoulders or drooping of their bodies. Therefore, we want to make sure they have strong cores. And lastly, we work on stretches to make sure that they are not sore the next day or that they get nice and loose throughout the process.

Melanie Cole, MS: That's so cool. What kind of improvements do you generally see, Nicole?

Nicole Morton: So, I test my athletes every three months. We do what's called an InBody scan, so I'm able to see where their muscle mass is, where their body fat is. The biggest motor things that I see is gait starts improving, range of motion starts improving, overall attitude and their ability to talk is sometimes improving. You just see a whole different person after three months of coming to the program.

Melanie Cole, MS: What should they be doing at home to complement a program like this? And while you're telling us that, is this something they do once or is this weekly or biweekly? Tell us a little bit about how often they go and what you tell them you'd like them to be doing at home.

Nicole Morton: Absolutely. Rock Steady Boxing is three times a week. So with that, they're getting two days a week that they need to be doing exercises at home. I send off exercises and have them practice different speech exercises, big and loud exercises. We do big steps, side steps, back steps. I always warm up the same way. I have them practice high steps and butt kickers and side steps throughout the week as well. And I encourage them to do them with their partners or caretakers so that everybody can be involved in the process.

Melanie Cole, MS: Now, next steps, if someone's interested in the Rock Steady program, how do they get involved in something like this? Is it referral based? How do they get involved?

Nicole Morton: What I would need is a referral from your doctor and that can be your primary care physician or the neurologist. And then, you would give me a call and we would set up an assessment. In that assessment, I do your health history, I do a Berg Balance Scale, and I do a couple strength tests as well. And then, from there, we decide what level of class you go into. Rock Steady Boxing has four levels. And so, we want to make sure that they are in the appropriate class, so that we make sure that they have everybody the same in their level. You can join us by going to our website at bryanlifepointe.com or our Facebook group at Rock Steady Boxing at Bryan Health.  

Melanie Cole, MS: Thank you so much, Nicole. What a great program. So, comprehensive and so helpful for caregivers and people living with Parkinson's. Thank you so much. And for more information on the Rock Steady Boxing Program at the Bryan LifePointe Campus, please visit bryanlifepointe.com. That concludes this episode of Bryan Health Podcast. Please always remember to subscribe, rate, and review Bryan Health Podcast on Apple Podcasts, Spotify, iHeart, and Pandora. I'm Melanie Cole. Thanks so much for joining us today.