NPF and APDA-Georgia Award Grants to Expand the PD

Gladiators Metro Atlanta Fitness Network

The National Parkinson Foundation announced in June that it had awarded community grants from its Moving Day® program to

PD Gladiators, Livramento Delgado Boxing Foundation and the YMCA of Metro Atlanta to expand the PD-specific group exercise classes they offer through the PD Gladiators Metro Atlanta Fitness Network. The Georgia Chapter of the American Parkinson Disease Association also awarded PD Gladiators a generous grant earlier this month to continue subsidizing existing programs. The Network offers 40 weekly classes for people with Parkinson’s disease and their care partners, including boxing training, tai chi, yoga, Zumba, Ageless Grace, Dance for Parkinson’s and general fitness classes. All Network instructors take a PD-specific training program, like the one offered by MDT Education Solutions, or must demonstrate other qualifications to lead a safe, high quality fitness class for people with PD.

PD Gladiators PD Gladiators organizes the independent members of the Network and maintains quality and safety standards to assure people with PD, their doctors and therapists that the group exercise classes offered by Network instructors are safe, effective and fun. With assistance from our sponsors and the generosity of the fitness instructors, programs will continue to be offered at low cost to the PD community. Please visit our website and click on the Metro Atlanta Fitness Network link for class descriptions, eligibility, times and pricing.

Livramento Delgado Boxing Foundation

LDBF operates the LDBF-PD Gladiators Boxing Training for PD program at Delgado Boxing, a gym in Sandy Springs run by retired champion Paul Delgado. The program is a typical non-contact boxing training workout that provides intense exercise along with the intentional mind-body, goal-oriented coordination that may help slow the progression of PD. In each class, participants stretch and warm up, perform calisthenics and receive instruction in boxing training techniques using focus mitts, heavy bags, speed bags, and double-ended bags. Thanks to an NPF grant, a separate

class is now offered for people with more advanced Parkinson’s symptoms who need longer rest breaks, more individual attention, and/or seated or supported exercise. Every participant is offered two free trial classes, and care partners are encouraged to participate, too. See our website at www.pdgladiators.org/atlanta-boxing-program.

YMCA of Metro Atlanta

Through their PD Gladiators at the Y program, the YMCA offers 19 Parkinson’s Movement Classes in 13 branches. The Y will use grants awarded by the NPF to expand their Parkinson’s program both by including more branches and adding classes to participating ones. By offering a variety of classes—including Adapted Tango classes based on the studies of local researcher Dr. Madeleine Hackney—coupled with their proprietary exercise adherence program “THE COACH APPROACH®,” the YMCA is laying the groundwork for people with Parkinson’s to create sustainable exercise routines. A wellness coach can even work with your physical therapist to customize a workout for your particular impairments. PD Gladiators members can join the YMCA at a reduced rate by signing up through the link on our website at www.pdgladiators.org/pd-gladiators-at-the-y.

Classes Instructor Location Facility

MONDAY11:00 am - 11:45 am  Total Body Fitness for PWPD Kimberly Rodriguez Marietta Robin's Nest Adult Day Care11:00 am - 12:00 pm  Parkinson's Movement Class YMCA Staff East Lake East Lake Family YMCA 11:30 am - 12:30 pm  Parkinson's Movement Class YMCA Staff Lawrenceville Tull-Gwinnett Family YMCA 11:30 pm - 12:30 pm  Ageless Grace Sandy Bramlett Druid Hills OLLI @ Emory, Executive Park12:00 pm - 1:15 pm  Boxing Training for PD (I/II) LDBF Sandy Springs Delgado Boxing2:30 pm - 3:30 pm  Tailor-Made Yoga for PD Cathy Hightower East Cobb Aloha to Aging

TUESDAY10:30 am - 11:15 am  Zumba Gold for PD Kimberly Rodriguez Dunwoody Adult Day of Dunwoody10:30 am - 11:30 am Ageless Grace Lori Trachtenberg Vinings Kaiser Permanente (members only)11:00 am - 12:00 pm Yoga for PD Dawn Benson Suwanee Yoga Dawning Studio11:00 am - 12:00 pm Parkinson's Movement Class YMCA Staff Decatur South Dekalb Family YMCA 12:00 pm - 1:00 pm Dance for Parkinson's Eleanor/Rob Rogers Cumming Still Pointe Dance Studios12:30 pm - 1:30 pm Parkinson's Movement Class YMCA Staff East Cobb McCleskey-East Cobb Family YMCA 1:00 pm - 1:45 pm  Parkinson's Movement Class YMCA Staff Decatur Decatur Family YMCA 1:00 pm - 1:45 pm Parkinson's Movement Class YMCA Staff Alpharetta Isakson-Alpharetta Family YMCA 1:15 pm - 1:45 pm Parkinson's Movement Class YMCA Staff Buckhead Sanders Family YMCA at Buckhead 2:00 pm - 3:00 pm  Tai Chi for PD (Standing) Aloha to Aging East Cobb Aloha to Aging2:15 pm - 3:15 pm  Tai Chi for PD (Standing) Yellow River Center Morningside Morningside Presbyterian Church 

WEDNESDAY10:30am - 11:30am Ageless Grace Lori Trachtenberg Brookhaven Briarwood Park Community Center11:00 am - 12:00 pm  Parkinson's Movement Class YMCA Staff Cumming Forsyth County Family YMCA11:00 am - 12:00 pm  Parkinson's Movement Class YMCA Staff East Lake East Lake Family YMCA 11:30 am - 12:15 pm Stand Up! to Parkinson's Kirsten Magee Decatur United Methodist Church12:00 pm - 1:15 pm  Boxing Training for PD (I/II) LDBF Sandy Springs Delgado Boxing12:00 pm - 1:00 pm Ageless Grace Sandy Bramlett Decatur Decatur Senior Center1:00 pm - 2:00 pm  Parkinson's Movement Class YMCA Staff Newnan Summit Family YMCA2:00 pm - 3:00 pm  General Fitness for PD Maureen McCord Tucker Northlake Church of Christ 

THURSDAY10:00 am - 10:45 am  Zumba Gold for PD Kimberly Rodriguez Dunwoody Adult Day of Dunwoody11:00 am - 12:00 pm  Ageless Grace (2nd & 4th Th) Maureen McCord Johns Creek The Cohen Home 11:15 am - 12:10 pm Parkinson's Movement Class YMCA Staff Chamblee Cowart Family/Ashford Dunwoody YMCA12:15 pm - 1:15 pm  Parkinson's Movement Class YMCA Staff Newnan Summit Family YMCA12:30 pm - 1:30 pm  Parkinson's Movement Class YMCA Staff East Cobb McCleskey-East Cobb Family YMCA 1:00 pm - 1:45 pm  Parkinson's Movement Class YMCA Staff Alpharetta Isakson-Alpharetta Family YMCA 1:15 pm - 2:00 pm  Parkinson's Movement Class YMCA Staff Norcross Fowler Family YMCA 2:00 pm - 3:00 pm  Tai Chi for PD (Seated) Aloha to Aging East Cobb Aloha to Aging

FRIDAY10:15 am - 11:15 am  Parkinson's Movement Class YMCA Staff SE Atlanta Villages at Carver Family YMCA 11:00 am - 12:00 pm  Parkinson's Movement Class YMCA Staff Cumming Forsyth County Family YMCA11:15 am - 12:15 pm  Tai Chi for PD (Seated) Yellow River Center Decatur The Regency House11:30 am - 12:30 pm  Parkinson's Movement Class YMCA Staff Lawrenceville Tull-Gwinnett Family YMCA 11:30 am - 12:30 pm  Parkinson's Movement Class YMCA Staff SW Atlanta Andrew & Walter Young Family YMCA 1:30 pm - 2:30 pm  Tai Chi for PD Yellow River Center Snellville Centerville Community Center

SATURDAY12:00 pm - 1:15 pm  Boxing Training for PD (I/II) LDBF Sandy Springs Delgado Boxing1:15 pm - 2:45pm Boxing Training for PD (III/IV) LDBF Sandy Springs Delgado Boxing

PD GLADIATORS METRO ATLANTA FITNESS SAMPLE NETWORK SCHEDULE

To view an up-to-date schedule or learn more details about any of these classes, including how to sign up,please visit our website at www.pdgladiators.org and select "Metro Atlanta Fitness Network" from the navigation bar

Data released in June from the National Parkinson Foundation’s Parkinson’s Outcomes Project shows that people with Parkinson’s disease who start exercising earlier experience a significant slower decline in quality of life than those who start later.

“This study makes it clear that everyone with Parkinson’s disease should be exercising. Patients suffer when they delay starting their exercise, and it doesn’t seem to matter what they do, they benefit from just getting up and moving,” said Michael S. Okun, MD, NPF’s National Medical Director.

Researchers looked at data on nearly 3,000 patients receiving care for three years at NPF Centers of Excellence participating in the Parkinson’s Outcomes Project—the largest clinical study of Parkinson’s ever conducted. Over 1,300 of the study participants reported little regular exercise at the beginning of the study. Five hundred of those individuals began exercising greater than 2.5 hours per week within the next two years. The researchers compared participants who exercised regularly for the entire two years, to people who didn’t exercise at the beginning of the study, but then started to exercise regularly.

In this study, they didn’t separate what types of exercise were done, just the total exercise reported. Quality of life scores were compared using the Parkinson’s Disease Questionnaire (PDQ-39). The PDQ-39 is a self-reported questionnaire that measures the impact of PD on daily life through multiple factors, including mood, movement and social interaction. Over the two-year study period, the PDQ-39 scores worsened 1.4 points in the early starters and 3.2 points in the late starters.

“This analysis is interesting because it is structured as a ‘delayed start’ trial, comparing people who start early versus those who start late. This design is the standard approach to show an intervention slows the disease: if it just improved symptoms, people who start late would get the same benefit as those who start early,” explained Peter Schmidt, PhD, NPF’s Senior Vice President and Chief Mission Officer and an author of the study. “We found that people who start exercise early get more benefit than those who start late.”

Lead study author Miriam Rafferty, PT, DPT, whose doctoral research at the University of Illinois at Chicago focuses on exercise and PD, noted that this difference of almost two points on the PDQ-39 could be enough to make everyday activities feel harder.

“This is great news that people can have a positive impact on the course of their own disease,” said Joyce Oberdorf, NPF’s former President and CEO. “It is tremendously empowering.”

The Evidence is Mounting: The Sooner People with PD

Start to Exercise, the Better Their Quality of Life Will Be

Emory’s Dr. Jorge Juncos Speaks at Georgia

Neurological Society Annual Meeting Dr. Jorge L. Juncos, Associate Professor of

Neurology at Emory University School of

Medicine and a Movement Disorder Specialist

at the Emory Clinic, has proposed a new

paradigm upon diagnosis of Parkinson’s

A CALL TO ACTION

For Doctors & Therapists: Please contact us to discuss

the importance of informing your PD patients about

establishing a safe, effective and sustainable exercise

routine. We can send information about the latest

research and Network classes, arrange a Lunch & Learn

or have Emory’s Dr. Jorge Juncos respond personally.

For Patients & Care Partners: If you have an upcoming

appointment with your neurologist or PT and would like

to encourage them to prescribe exercise, please contact

us and we’ll mail you a folder to present at your next

visit that highlights the latest scientific research on PD and

exercise and provides information about Network classes.

Contact Info: (770) 450-0792 or pdgladiators@gmail.com

disease, recommending engagement of a physical therapist

immediately and referral of PD patients to community-based

exercise programs. Dr. Juncos–a member of the PD Gladiators

Board–announced the proposal in a presentation to the

Georgia Neurological Society’s 2015 annual meeting in

February based on the latest clinical research supporting a

positive effect of vigorous exercise on PD, which has not yet

been fully disseminated to practicing neurologists, physicians

and physical therapists. Dr. Juncos also noted that the

American Academy of Neurology is currently reevaluating its

guidelines regarding the benefits of exercise in PD.

This Is How We Do It: New Dance for Parkinson’s Class is

a Model for Community/Healthcare Alliances

Eleanor and Rob Rogers have brought years of experience in professional dance

and dance instruction to launch an innovative Dance for Parkinson’s class in

Cumming. This class–based on the Dance for PD® program developed by the

Mark Morris Dance Group–is an aesthetic experience using elements of

narrative, imagery, music and community to develop artistry and grace while

addressing such PD-specific concerns as balance, flexibility, coordination,

isolation and depression. While the Rogers deliver the magic to The Still Pointe

Dance Studios (Tuesdays at noon), this class is a model for how community-

healthcare alliances can create sustainable fitness programs for people with PD.

In their 2011 study “Promoting exercise in Parkinson’s disease through

community –based participatory research,” Hirsch et al said, “Novel strategies for developing and implementing community-

based exercise programs are necessary if we are to expect individuals with PD to exercise for the long term starting at diagnosis,

and we must all work together in multidisciplinary rehabilitation teams with patients and patient advocates in order to achieve

this vision.” The PD Gladiators Metro Atlanta Fitness Network is an attempt to rally the PD, medical and fitness communities to

work together to create safe, fun and effective places for people with PD to exercise.

The fitness community has risen to the challenge, with independent instructors and the YMCA of Metro Atlanta offering 40

weekly classes adapted for PD. But only by creating an alliance with healthcare professionals who consistently refer patients to

classes will the Network thrive. Several doctors and PTs

are referring patients to PD Gladiators, but the Dance for

Parkinson’s class is a model for how one enthusiastic

healthcare professional can assure a class’s success.

Kitty Chin—a physical therapist in Cumming—had been

experimenting with music to help her patients move

better or more automatically. After attending a Dance for

PD® workshop last year she began looking for a

professional dancer who would teach the program. A year

later she found Eleanor Rogers.

“She has been so gracious and receptive to expand her

teaching to this population,” Kitty says. “I am very grateful

to her and will continue to send her patients to make this

program a success.”

For Kitty, this is no idle promise. She lit up the phone lines,

and the first Dance for Parkinson’s classes have boasted

an average of 15 participants! “Of course, I meet

resistance and lack of interest,” she says. “I think my

enthusiasm for these programs comes across and I’ll even

take them boxing or dancing with the hope they’ll get

interested and sign up for classes.”

This is how we do it.

Featured PD Gladiator

Roswell resident Dove Johnson stretches each morning and exercises daily. Her favorite PD Gladiators classes are Cathy Hightower’s Yoga class in East Cobb and Kimberly Rodriguez’s Zumba Gold class in Dunwoody. During the summer, she walks and does water exercise at the local pool for at least 30 minutes every day.

Dove was diagnosed with PD 8 years ago, at age 65, but believes exercise and a positive attitude are responsible for her slow progression. ”When I exercise on a regular basis I have more energy, my movements are more fluid and my tremor is more under control,” she says.

When Dove couldn’t exercise for two months recently due to an injury, her symptoms temporarily worsened. “On those mornings when I just don’t want to do anything I remember how bad I felt overall when I couldn’t do any real exercise. I tell myself that I don’t want to feel that way all day.“

Featured PD Gladiator

Roswell resident Dove Johnson stretches each morning and exercises daily. Her favorite PD Gladiators classes are Cathy Hightower’s Yoga class in East Cobb and Kimberly Rodriguez’s Zumba Gold class in Dunwoody. During the summer, she walks and does water exercise at the local pool for at least 30 minutes every day.

Dove was diagnosed with PD 8 years ago, at age 65, but believes exercise and a positive attitude are responsible for her slow progression. ”When I exercise on a regular basis I have more energy, my movements are more fluid and my tremor is more under control,” she says.

When Dove couldn’t exercise for two months recently due to an injury, her symptoms temporarily worsened. “On those mornings when I just don’t want to do anything I remember how bad I felt overall when I couldn’t do any real exercise. I tell myself that I don’t

Featured PD Gladiator

Roswell resident Dove Johnson stretches each morning and exercises daily. Her favorite PD Gladiators classes are Cathy Hightower’s Yoga class in East Cobb and Kimberly Rodriguez’s Zumba Gold class in Dunwoody. During the summer, she walks and does water exercise at the local pool for at least 30 minutes every day.

Dove was diagnosed with PD 8 years ago, at age 65, but believes exercise and a positive attitude are responsible for her slow progression. ”When I exercise on a regular basis I have more energy, my movements are more fluid and my tremor is more under control,” she says.

When Dove couldn’t exercise for two months recently due to an injury, her symptoms temporarily worsened. “On those mornings when I just don’t want to do anything I remember how bad I felt overall when I couldn’t do any real exercise. I tell myself that I don’t

New Blog “The Exercise Files: A Researcher’s

Perspective” Features Dr. Madeleine E. Hackney

Dr. Madeleine E. Hackney, Ph.D, a Research Health Scientist at the Atlanta VA Center for Visual and Neurocognitive

Rehabilitation and an Assistant professor of Medicine in the division of General Medicine and Geriatrics at the Emory School of

Medicine, has recently begun a monthly blog on the PD Gladiators

website entitled, “The Exercise Files: A Researcher’s Perspective.” Dr.

Hackney and her colleagues

will write about evidence-

based topics relating to the

effect of exercise on Parkinson’s disease. Dr. Hackney holds a Ph.D. in Movement

Science from Washington University and a BFA in Dance from NYU, Tisch School of the

Arts and has also been an American Council on Exercise certified personal trainer since

2000. Her extensive research interests include inquiry into challenging exercise

programs–traditional exercise, Tai Chi and partnered tango classes–designed to

improve physical function and quality of life in people with PD, older adults and those

with serious mental illness. In 2014, she co-founded MDT Education Solutions, LLC,

which has trained over 60 fitness and allied health professionals how to develop and

lead safe, evidence-based exercise programs for people with PD at all stages of the

disease, including almost all instructors in the PD Gladiators Metro Atlanta Fitness

Network (including the YMCA of Metro Atlanta).

To view previous installments of “The Exercise Files,” please visit the PD Gladiators

website and click on “Blog” in the navigation bar. If you would like to be informed

when a new installment is published and receive other news from PD Gladiators,

please contact us at pdgladiators@gmail.com and ask to join our mailing list.

Volunteer PTs Join the Fight!

The PD Gladiators Boxing Training for PD program operated by Livramento Delgado

Boxing Foundation has had over 80 participants since it opened in January 2014, and

its success has begun to capture the attention of the medical community. Several local

physical therapists have volunteered to keep LDBF’s boxers fighting back against PD.

“I have been a physical therapist for nine years and this is the first time I have been

made speechless by observing an exercise class,” says Leanne Hymes. “The trainers

helped each individual with compassion and skill that blew me away. After seeing the

intensity of the exercise these boxers go through, I was sure they might have some

aches and pains, as most athletes do.”

Hymes volunteers at the gym once a month to screen boxers and provide

recommendations on when to rest or make modifications to an activity.

Led by Volunteer Coordinator Amy Morse, another corps of PTs has been giving their

time to assist LDBF offer a new boxing training class (Saturdays at 1:15PM) for people

with more advanced PD symptoms. The PTs supervise volunteer DPT students and

assist trainers working with fighters who have balance issues or require one-on-one

attention. Besides Morse, Edward Bolt, Kitty Chin, Dhana Harrelson, Lauren Palmer,

Hannah Redd and Lindsay Walston have been making sure the boxers stay safe.

Board of Directors

Tricia Creel, DPT, NCS Prasant Desai, MBA, MPH John Dixon Andrew Friede, MD, MPH Steven Haas Jorge L. Juncos, MD L.E. Kahn Larry Kahn, JD Gil Kim Kimberly Rodriguez

PD Gladiators, Inc. is a Georgia nonprofit corporation exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code devoted to combating PD with vigorous exercise. Our mission is to focus the attention of people with PD and the medical community on the role of exercise in slowing the progression of PD and to make community-based exercise programs available to people with PD and their care partners.

PD Gladiators, Inc. E-mail: pdgladiators@gmail.com Phone: (770) 450-0792 Website: www.pdgladiators.org

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