First, my thanks to everyone who read last week’s column and encouraged me to continue writing. As you might imagine, writing is frequently a lonely pursuit, with uncertainty about whether anyone reads beyond the headlines (which are written by someone else). For now, I plan to continue. So, here is the column.

Parkinson’s disease (PD) is characterized by a progression of motor and nonmotor symptoms that make life increasingly difficult.

Those symptoms can include tremor, decrease in coordination, decreased arm swing on the first-involved side, soft voice, decreased facial expression, sleep disturbances, decreased sense of smell, a general feeling of weakness or fatigue, depression and slowness in thinking.

The onset of movement (motor) signs is usually one-sided with the most common initial finding being a resting tremor in an arm/hand. But over time, there is progressive slowing of movement (bradykinesia), rigidity, and difficulty walking characterized by leaning forward and shuffling along.

Although there are treatments available, there is no known cure for the progressive deterioration of PD. So, any way to slow that progression is a step in the right direction.

A recent study over three years found that weekly participation in dance training classes “drastically” reduced the expected decline among PD individuals in motor function and significantly improved speech, tremors, balance and stiffness.

Dance training also appeared to have benefits regarding cognition (thinking ability), hallucinations, depression and anxiety.

Although the mechanism of benefit is unclear, dance training may help either strengthen neurologic networks damaged by PD or build bypasses around the damage.

Prior studies that assessed various styles of dance by patients with PD showed beneficial effects regarding gait speed, balance, locomotion and aspects of quality of life.

The newer study followed 16 patients with mild to moderate PD who participated in a weekly dance class called Dance for Parkinson’s Disease, which is an established dance curriculum, involves aerobic and anaerobic movements. The protocol begins with a seated warm-up, followed by barre work, and ends with moving across the floor. All participants learn choreography for an upcoming performance. (Sixteen patients with PD who did not participant in the dance classes served as control patients.)

Over three years, testing for the daily rate of motor decline among the dancers indicated no increase in motor impairment, whereas among the nondancers, the motor decline during follow-up was as expected.

PD symptoms can lead to psychological issues, depression, social isolation and eventually the symptoms do get worse over time. But training with dance and music might slow this down and improve daily living and daily function.

For people with PD who do not want a dance program, the question arises about what type of exercise might be best. After all, there is no one-size-fits-all approach to an exercise regimen. Many people with Parkinson’s have been turning to boxing exercise regimens, including at our local YMCA.

A Parkinson’s boxing class is a full-body workout exercise program where you perform non-combat boxing exercises.

A typical Parkinson’s boxing class will involve the following:

Anywhere from 30-60 minutes of exercises

Stretches and warm-up exercises to prepare the body for the workout and to avoid injury.

Punching speed bags to help improve coordination and posture or punching heavy bags to build strength and muscle.

Vocal exercises to help with any voice disorder symptoms.

Footwork and other agility exercises will be used to help improve balance.

Group exercises that focus on socialization and community in each class.

The potential benefits of a Parkinson’s boxing exercise regimen include increased strength, improved hand-eye coordination, improved posture, better cognitive processing (thinking), decreased symptoms for soft-voice disorders, stronger core which can lead to a better gait, improved balance and agility, and improved reaction time.

Since the classes are non-combat, nobody will be punching or be punched by another person.

The class intensity can vary depending upon the instructor, but the average intensity is more than most seated Parkinson’s exercise classes.

You should always consult your health care provider before starting up any new intense exercise plan to make sure that it will be beneficial to you.

Dr. Terry Gaff is a physician in northeast Indiana. Contact him at or on Facebook. To read past columns and to post comments go to

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