It was already warm and sweat-scented inside the East Village gym when the boxing students arrived one afternoon last week. In their 60s and 70s, they wore their game faces as they stepped onto a Hulk-green mat.
Before donning their gloves, they stretched as seriously as if the bell had already rung. Their instructor, Luke Barrett, led them through shoulder rolls, chin tucks and breathing exercises.
Barrett, more educator than drill sergeant, often uses warm-ups and cool-downs for the boxing sessions to slip in tricks for improving daily life. One tip shared: before bed, relax muscles one by one before slowing your breath to mimic the rhythm of sleep. Sleep disruption is often one of the first symptoms of Parkinson’s disease, a neurodegenerative condition that destroys the brain cells responsible for producing dopamine, a neurotransmitter.
Parkinson’s is most associated with the characteristic hand tremors it causes, but can also cause a wide range of difficulties, including stiffness, memory loss and dementia. It often contributes to early death.
In 2019, Barrett, a longtime boxing and Muay Thai coach, opened the first New York City chapter of Rock Steady Boxing, a noncontact fitness program available nationwide for people with Parkinson’s. The classes he runs mirror standard boxing routines but add functional exercises tied to daily life, such as turning, rising from chairs and navigating tight spaces.
‘Punch like Muhammad Ali’
Underlying it all is the idea couched in Rock Steady’s motto: “Fighting back against Parkinson’s disease.” Some researchers question that kind of battle language, saying it can leave people feeling at fault for any decline. But Barrett said his students consider it “empowering.”
Barrett will sometimes tell students to “punch like Muhammad Ali.” It’s a cue Sofia Bragat, a caregiver to one of Barrett’s students, says motivates many in the room. Ali, one of the greatest heavyweight boxers in history, lived for decades with Parkinson’s and died of complications related to the disease. Experts believe his repeated head injuries in the ring contributed to his early-onset Parkinson’s.
Because traumatic brain injury is linked to a higher risk of developing Parkinson’s and can worsen symptoms, Barrett makes a point of reassuring prospective participants — and, often, their spouses — that Rock Steady is strictly non-contact. No one will get hit.
Wearing gloves and interdependence
In a program built around reclaiming control of their bodies, choosing privacy is one more way participants assert control over their narrative. Some haven’t told their families they have Parkinson’s, one man said.
Bragat, who has been a caregiver for more than 40 years, can’t say for certain whether boxing is the reason her client has stayed independent since starting Rock Steady. But she’s seen others with Parkinson’s, including people cared for by colleagues and a woman she supported decades ago, decline more quickly when they didn’t follow a consistent exercise routine.
Meanwhile, Bragat’s client, diagnosed six years ago after fine-motor struggles, only has mild symptoms: some memory lapses, cramped handwriting and difficulty with buttons. She takes private boxing sessions at home with Barrett (and sometimes Bragat) in addition to the gym workouts. And at home, she manages on her own for 20 hours a week.
Another participant said he’s already noticed an improvement in his mobility since starting Rock Steady six months ago. He had just asked for help with his coat sleeves. Off the mat, lending a hand with clothing — putting on a jacket or peeling off shoes — is one way participants support each other.
Research backs the punch
While exercise can slow Parkinson’s progression, boxing has been shown to offer additional advantages. Studies point to benefits from both cardiovascular exercise and strength training; as Barrett noted, boxing offers plenty of both. On top of that, the quick direction changes, hand-eye coordination and fast-paced combinations in no-contact boxing boost balance and agility.
A study published in March in the journal Frontiers of Aging Neuroscience found that boxing, when done safely and consistently, can improve lower-body strength, balance, mobility, gait, depression and the severity of symptoms overall.
In terms of Rock Steady, researchers in Australia conducted a small feasibility study in 2023 looking at 10 participants with early-stage Parkinson’s. Most showed improved motor skills after 15 weeks. They also reported better sleep health and less fatigue. A larger study of 1,709 participants in Minneapolis in 2020 found that Rock Steady improved participants’ mood, social life, anxiety, fatigue and fear of falling.
Still, many insurers won’t cover the cost of Rock Steady, which in the Manhattan chapter costs $40 to $50 per class (depending on the class package) or $260 per month for unlimited classes. Zoom classes are $20 to $25, Barrett said, while online subscriptions to videos of workouts are $7 per month.
Advocates point to small wins, including two insurers in Buffalo that started covering boxing classes for people with Parkinson’s in 2022. The Michael J. Fox Foundation urges patients to push for broader coverage.
‘Staying the same is winning’
Not all participants see the same benefits with Rock Steady. Parkinson’s progression is highly individual, and some people — especially those with more advanced symptoms, chronic pain or other health challenges — might find the program harder to sustain. One client “did all the right stuff,” Barrett said, but his neck posture and pain continued to worsen. He ultimately dropped out.
Bragat said that from her vantage point on the sidelines for the past five years, she thinks some participants now chat more and show more expressive faces than they did months and years ago. Meanwhile, Barrett said clients often report their neurologist found them improved since their last checkup — or the same.
“They say staying the same is winning,” he said. “You’re fighting two degenerative diseases: one is aging, which we’re all fighting, and then one is Parkinson’s.”
Learn more about Rock Steady Boxing’s Manhattan chapter.
—
This article was written with the support of a journalism fellowship from the Gerontological Society of America, the Journalists Network on Generations and the Commonwealth Fund.
