Waxing physically and philosically...

After literally years of deliberation, and as a result of some delicate and some less delicate prodding, this blog is my effort to organize - to bring together - my thoughts about my work as a conductor and as a personal trainer, to rant and rave as necessary, to celebrate the little things and the larger moments of brilliance, and to share some conductive magic and life lessons gained through 'waxing physically and philosophically'.

Saturday, July 23, 2016

With a song in my heart ...

Last Thursday I went to a Parkinson's singing and voice group that is hosted locally by the wonderful RZ, a professional singer accompanied on piano by her husband MG.  The group is attended by several people from my Conductive Education Parkinson's exercise group and from my Counterpunch Parkinson's classes.  

On the day I attended there were 17 or 18 people sitting in RZ's living room -- and I am told that several were missing -- I'd like to think that it wasn't the thought of listening to me sing that kept them away... This photo doesn't do justice to the wonderful site of two rows of people - two rows of people with Parkinson's and some of their husbands or wives smiling, laughing, chatting, sitting up straight (and sometimes standing), and of course, singing. 

I enjoyed taking part in the singing and I enjoyed being in a room full of people singing -- and for the rest of the day I had songs in my head, a smile on my face, and a song in my heart.  Actually I still feel that song singing in my heart every time I think about the experience.

There certainly are physiological benefits of singing and voice work for people with Parkinson's -- improvements in speech and voice control, articulation, volume, facial expressions, breathing, and posture -- but these almost seem like a side effect to the psychosocial benefits of making of music and merriment,  to the act of defiantly raising voices in song instead of being hushed by Parkinson's, to the positive mantras the singers were being encouraged to shout or sing when energy or volume started to lag offering messages that echoed and resonated well into the next song, to the way that singing together reaches in and touches people's souls and connects these souls to each other.

"I sing sometimes like my life is at stake, 'cause you're only as loud as the noises you make.  And I'm learning to laugh as loud as I listen, 'cause silence is violence ... And we can make music like we can make do..." -- Ani DiFranco, My I.Q.

My heart from the experience of singing, not just with any people, but with this group of people. My heart sang from the experience of watching RZ passionately lead the group through song and voice work -- for the opportunity to sit at the feet of a master of her craft and to listen to her sing and to be a part of a group that she was running, and the sense of gratitude for the opportunity.

And, my heart sang with pride - for RZ is not just a wonderful singer and teacher, RZ is one of my Conductive Education students, a woman battling her own Parkinson's.  My conductor's heart sang watching my participant in her orthofunctional glory standing in front of all of these other people teaching, giving, leading, conducting, encouraging, motivating, and singing.  Thank you RZ, from the bottom of my heart for what you are doing for your singers, and for showing us all what it means to rise above, and to raise our voices in song.

Here are two of my favourite songs that make my heart sing, and here is to you and your singers RZ!

Sing, sing, sing                        Singin' in the Rain

Tuesday, July 19, 2016

Exercise and the brain...

 Exercise recommendations for people with neurological conditions like MS and Parkinson's have changed drastically in recent years.  We know a lot more about neurological conditions, we know a lot more about exercise, and we know a lot more about neurology - and we know that we are only at the tip of the iceberg about what there is to know about all of these things and their interactions.  It is actually really important to understand that exercise recommendations have changed for everybody - the general population, athletes, people wanting to lose weight, older adults, people managing injuries, people with illnesses - so it really should be no surprise that the recommendations have changed for people with neurological conditions.  

When it comes to exercise as a tool for promoting brain health, it actually doesn't matter if you do or do not have a neurological condition -- the exercise recommendations are the same.  Though we talk about the benefits of exercise for people with neurological conditions, it needs to be made clear that these guidelines are for everybody who might be looking at exercise as something that might discourage disease progression, that might protect our brain cells from ageing, that might encourage our brains to continue to adapt throughout our lives, or that might promote healing of damage or injured brain tissue, the exercise.    The right exercise may in fact help us stave off or delay onset of neurological conditions by making our brains healthier and more able to fight disease, and exercise habits learned and enjoyed before the onset of a neurological condition  are easier to sustain and adapt than to introduce after a diagnosis.  

When we are talking about exercise and brain health, we are talking about more than efficiency of oxygen supply or muscle strength or mental health or cardiovascular endurance.  We are asking if exercise might promote neuroprotection, promote neuroplasticity, or even encourage neuroregeneration.  And more and more, based on the little bits and pieces that we do know, we think that the answer to that question is yes.  However, just as we know that certain exercise is better for promoting muscle growth or weight loss, we also know that exercise for brain health needs to meet certain criteria.  Let's explore this further.

One of the new guidelines for people with neurological conditions is that at least for short intervals, exercise should be at a high intensity - high enough to get their heart pumping and for them to feel puffed.  This is because when exercising at this intensity our muscles produce a nifty little protein called cathepsin B.  Cathepsin B travels to the brain, and in the presence of cathepsin B, our brain cells start to produce neurotrophins which kick start new cell growth - also known as neurogenesis.  The research also indicates that long term consistency of exercise involving periods of high intensity, over weeks, months, and years, is more important than the duration of individual training sessions when it comes to this effect.  

We also know that strenuous exercise might influence how certain genes function in the brain.  For example, strenuous exercise encourages our brains to make a substance called "brain derived neurotrophic factor" or "BDNF".  When BDNF levels are low, we are more likely to see cognitive decline but when BDNF levels are sufficient or high we see brain cells grow and remain healthy and vigorous and we see more efficient connections between brain cells allowing the brain to function better.  But that isn't all - if someone is sedentary the genes responsible for BDNF production may be muted or get gunked up by other molecules.  However, during higher intensity exercise ketones are produced.  Ketones -- byproducts of our bodies using fat as an energy source -- protect the BDNF gene by stopping other molecules from being able to gunk that gene up - an example of how exercise can be neuroprotective.

The idea of neuroplasticity is even more exciting - especially because the guidelines and reasonings are 'more tangible' and less 'neurochemical'.  Neuroplasticity refers to notion that our brains are capable of change over our lifetimes, that our brains reorganise themselves physically and functionally in response to learning, our environment, our behaviour, our thinking, our circumstances including injury or trauma, our motivation, and our needs.  Neuroplasticity is also, paradoxically, a scary idea - because in the same way that we can do positive things things to encourage our brains to be more adaptive and to grow and change, we can do negative things or do nothing which actually will reinforce negative changes and patterns.  By this token, "use it or lose it" really applies to brain health; if we use certain connections they will get stronger and more plentiful and the connections we do not use will weaken and wither. 

In order for exercise to promote neuroplasticity it needs to be challenging, frequent, mentally and emotionally engaging, reinforced by positive feedback and positive results, fun, specific, worthwhile, and relevant or goal specific.  This type of exercise includes trying new things, leaning new skills, having fun, and being fully present and engaged while we are doing so.  Regardless of whether we do or do not have a neurological condition, this type of exercise is really important to brain health.   We are never too old for it, and from a human and psychological point of view it is exciting to think that by challenging ourselves and being engaged and having fun we are also promoting brain health.  

These are just some of the emerging ideas about exercise and brain health, and why the exercise guidelines for people with neurological conditions as well as those for the general population are changing.  It will be really exciting to follow the research in these areas over the next few years and to see how the health, fitness, and education practice shifts as a result.

Some light reference reading can be found here:

How Exercise May Help the Brain Grow Stronger

The 10 Fundamentals of Rewiring your Brain

Does this exercise protein boost your brain power?

Exercise triggers brain cell growth and improves memory, scientists prove

Thursday, June 23, 2016

Digging into Neuroplasticity

Last year I attended a conference about muscular dystrophy.  Despite what may sound like gloomy subject matter, it was incredibly exciting with researchers talking about what they were working on and what they have achieved with such positivity and hope.  In and amongst this positivity and hope and details about amazing new findings were honest discussions about what we don't know.  One researcher, talking about genetics of muscular dystrophy, said that genetic research was like digging a hole - as you dig deeper, you unearth more information but you don't necessarily get to the bottom of the hole, you just get a bigger hole with more possible information to unearth, and that at present the hole still seemed bottomless.  

The concept of neuroplasticity has made its way into pop culture, seemingly without the same honest discourse about the bottomless hole of what we still don't actually know, what has yet to be unearthed.  One minute the earth is flat, the next minute it is round end of story...  I feel like everybody has jumped on the neuroplasticity wagon - and the promise of neuroplasticity is being used to sell everything from exercise to rehabilitation to learning an instrument to counselling to crystal healing to healthy food without anyone knowing or understanding the concept as anything more than 'something that's good for your brain'.  

Certainly my professions, Conductive Education and exercise, have both been linked to neuroplasticity - so I suppose I should be excited that what I do is so avant guard and cutting edge that it makes your brain grow.  It isn't that I don't think these things, my things might actually promote neuroplasticity.  It's more that I cringe when something so interesting and important as a concept as neuroplasticity is being bandied around without real meaning; I almost expect to see things like 'neuroplasticity guaranteed' or 'book now so you don't miss out on your chance for this neuroplasticity opportunity'.   I also cringe at the reductionist idea that something as all encompassing as education or exercise or well-being can be reduced to neurobiology as if neurobiology trumps every other psychosocial or human experience.  What if, when we are actually able to assess whether a practice or intervention promotes neuroplasticity, we find that dancing the tango is just dancing? Does the music stop?

Don't get me wrong - neuroplasticity is exciting business, especially for people with neurological conditions or brain injuries, the people who love them, and the people who work to support and rehabilitate them.  That our brains are capable of protecting, rewiring or repairing themselves and that there are things we can do to promote, nurture, enable, and even enhance these processes are amazing and fascinating and exciting.  And yes, we understand a little bit about some of these processes, and yes we are digging deeper and unearthing more, but we have only just started digging and the hole is only getting bigger - the bottom is nowhere to be seen.  I actually hope that we never find the bottom of this hole - that we never understand everything about our amazing brains, that neurobiology doesn't explain everything... that we continue to unearth mysteries about our minds, our souls, and ourselves as humans.

My original intention when I started writing today was to open the conversation about what we do actually know about the effects of exercise on the brain... Sorry, I have digressed.  I will revisit that topic in my next blog post.  But for now...

Sunday, June 19, 2016

When life gives you Parkinson's, COUNTERPUNCH

The last few months have been busy, and a bit all over the place for me, to say the least, and my blog has been sadly neglected.  Resuming private practice and building a business that is sustainable and reflective of the work I want to be doing in Conductive Education and personal training while trying to get a semblance of work life balance have been energy and time consuming processes.  My business is starting to take shape - some conductive groups, some private clients that I see in their homes, some personal training at a groovy gym with a great team of fitness professionals, some consulting, and lots of boxing groups for people with Parkinson's.   I'd like to tell you a bit about what I'm doing with boxing groups for people with Parkinson's, why this appealed to me in the first place, and about why I love and value this aspect of my work so much.

For the past several years I've been reading about the work of an organization called Rock Steady Boxing based in Indianapolis, USA - in recent months I'd say seldom a week passes when they do not come up in my RSS feed.  Starting serendipitously - one person with Parkinson's boxing intensively with a trainer and seeing dramatic improvements - Rock Steady literally have taken the idea that non-contact boxing might be a useful exercise modality for people with Parkinson's and put it on the map.  They have developed programs, they have upskilled fitness and allied health professionals, and now have over 150 affiliated organisations and gyms offering their program in North America.  

Part of what caught my attention about the Rock Steady program is that it seemed to bring together disconnected parts of my two professions.  I have been working with people with Parkinson's in Conductive Education classroom settings for nearly 20 years.   As a personal trainer with boxing qualifications, I have been using boxing based training with many of my clients and have enjoyed adapting boxing drills to make them wheelchair friendly - and love boxing as part of my own fitness work too.  So at this very base level the idea of boxing groups for people with Parkinson's was exciting, and the idea niggled at me, kept calling me, and I decided to try to get a program running here in Auckland based on my own knowledge and experience, so I could see for myself how it might work.  

In October of last year SM, a colleague in the fitness industry, and I trialled a Parkinson's boxing group at the local YMCA where she worked -with some of the wives of my boxers and my husband helping out as program assistants.  The program went from a handful of brave participants all known to me to a large group in a matter of months.  We quickly outgrew the space we were using at the YMCA and I approached Shane Cameron, the owner of a local boxing gym and a New Zealand boxing champion about bringing my program over to his facility. I showed Shane what Rock Steady were doing in America and he came to watch my boxers - and he saw the magic that I saw.  

One of my boxers taking on Shane

Shane and I are now working towards emulating the Rock Steady model here in New Zealand, customising a program we have called COUNTERPUNCH PD and developing a training module for fitness professionals, and working to make COUNTERPUNCH PD available to people with Parkinson's nationally in NZ - watch this space for more details.  I will travel to Indianapolis to do the Rock Steady training course in August and am so excited about that; I am equally excited about experimenting with and encorporating Conductive Education tasks and methodology in a boxing environment and about making this program my own.  

Research has qualitatively and quantitatively supported the Rock Steady program.  However, the anecdotal and human interest stories featuring people with Parkinson's talking about what they get out of boxing groups speaks far louder to me.  It has been exciting and affirming to see my boxers make improvements and speak of the same results.  

It should also be noted that they exercise guidelines for people with Parkinson's have changed a lot over recent years with higher intensity exercise such as boxing being recommended, and the idea that the right exercise can be neuro-protective and promote neuroplasticity has been thrown around - I will address those concepts in a blog post in the very near future.  

From a Conductive headspace, there is so much about boxing for people with Parkinson's that makes sense to me - the use of visual cuing and rhythm for movement, the use of voice with movement, having something tangible as a target for movement; directly addressing movement challenges of Parkinson's such as complex coordination, agility, balance, speed and size of movement and practicing them and working to make them better instead of accepting them as problems; working in a positive and social group of peers; having fun; being challenged and being expected to rise to the challenge; the idea that there is an active and empowering approach that enables people to feel like they can do something to take control of their Parkinson's; the allegory of literally fighting Parkinson's - of being able to COUNTERPUNCH - and the sense of hope that comes from fighting. 

I love all of those aspects - boxing for people with Parkinson's makes clinical sense and is effective. But what I love most is that every session people with Parkinson's walk into the gym and as they put on their wraps and gloves and head out to the heavy bag or speed bag to warm up they transform into boxers, or kids happily playing, or some amazing combination of both.  I almost forget that they have Parkinson's - but more importantly, at least for that hour they seem to forget that they have Parkinson's.  It is amazing, magical, and transformational - and so much fun to be a part of.