Parkinson’s disease slows the mind and body down over time.
When Parkinson’s raised walls, they decided to climb
But this community is pushing back and looking up.
One move at a time, they’re finding their footing.
When Tony Rissi wakes up most mornings, Parkinson’s disease makes his body so stiff that he’s unable to get out of bed. But by 2 p.m. on Wednesdays, he’s 50 feet off the ground after scaling a rock-climbing wall.
It’s a feat that he’ll accomplish multiple times in an afternoon, alongside a couple dozen other people with Parkinson’s — all at varying stages of progression — who participate in an UpEnding Parkinson's Meetup at The Gravity Vault gym in Radnor, a suburb of Philadelphia.
The program offers Parkinson’s patients the opportunity for physical activity that has been shown to improve many symptoms and possibly slow progression of the disease. But it’s also become a sort of informal support group -- offering both a sense of empowerment and community for those who participate, and their caregivers.
For Tony, getting to the rock-climbing gym follows a carefully coordinated morning routine and a smorgasbord of medications, all with full support from his caretaker and wife of 55 years, Carol. His shuffling gait — a common symptom of Parkinson’s — is apparent as he heads toward his first climb, but the camaraderie and support in the room is palpable as he makes his way up the wall all on his own.
Tony Rissi was diagnosed with Parkinson’s disease five years ago.
Tony’s wife of 55 years, Carol, is his primary caretaker.
Rock climbing has helped restore some of Tony’s confidence that Parkinson’s had taken away, Carol says.
Tony works on word searches and other puzzles at home to help exercise his mind. Some days are better than others, Carol says.
"I think it’s built up his confidence more,” Carol says. Tony has always been someone who kept to himself, she says, but Parkinson’s-related changes have made him more of a “loner.” Regularly seeing the same group of people, who also understand what he’s going through, has helped.
"I think he’s afraid to approach people because he’ll lose his words,” she says. "It’s very difficult for him, and I don’t want him to feel like he’s less than because he forgets. Because he’s a very intelligent guy, it’s just something that happened, and it’s something we’re always working on.”
“Did that help you out?” Carol asks, turning to Tony. He also has Lewy body dementia, a form of dementia that was first discovered in patients with Parkinson’s disease. Carol listens patiently as Tony works to form his thoughts, and steps in only when he’s showing signs of frustration or defeat in the battle within his brain.
When he responds, his voice is low and slow, a symptom of the Parkinson’s — but his clever wit cuts through clearly.
"It helps me because, as you know, I’m just such a friendly guy,” Tony says, flashing Carol a sly grin. She laughs, and Tony seems to have achieved exactly what he meant to.
Parkinson’s disease is a progressive disorder of the nervous system that affects neurons in the brain that produce dopamine, the chemical the body uses to control movement. It can affect everyone differently, but hallmark symptoms include tremors, stiff muscles, slurred speech and slow movements that all get worse over time.
Treatment with medication can help patients’ brains make more dopamine to replenish the deficit caused by the affected neurons. But there is no cure for Parkinson's — which can leave many patients feeling hopeless.
When Bonnie Queen was first diagnosed with Parkinson’s 16 years ago, many of the doctors she saw early on made her feel like there was no point in trying to maintain her independence or quality of life.
“When I was first diagnosed, I thought I was going to walk out of the office and fall down. I was so devastated by the news, and the neurologist didn't help me,” she said. “I didn’t think there was anything I could do.”
She especially didn’t like that the doctors didn’t explain how important exercise could be and didn’t push her to do more.
“In fact, a friend of mine said that during her diagnosis, she said to the doctor, ‘So you're telling me that it's time to move it or lose it?’ But the neurologist said, ‘Move it and you're going to lose it anyway.’ How horrible is that?” Bonnie said. “I want to be as strong and independent as possible for as long as possible.”
She tried out more than a half-dozen doctors before finding one who better aligned with her philosophy and felt like he could be a true partner in the “lifelong connection” she knew she was looking for: Dr. Tsao-Wei Liang, division chief and medical director of movement disorders with Jefferson Health. Bonnie feels that he respects her as the expert of her own experience and values the emphasis he puts on physical exercise.
“The mindset that I can be a serious athlete and have Parkinson’s has been so good for me,” Bonnie said.
“Parkinson’s makes you feel feeble and frail and fragile but climbing and boxing are the opposite. They make you feel strong and cool and tough.”
Liang has been practicing neurology for more than 20 years, and he says that Parkinson’s is never easy diagnosis to give.
“For some people, it can signal the end, rather than, say, a new beginning or a new chapter in life. So it can be very difficult to accept,” he said. “Once a patient loses hope, I think that's when the condition begins to show more accelerated slides. I try my best to bolster spirits and to be their advocate, be on their side, throughout the journey.”
He says that exercise in general can help support both the physical and psychological health of people with Parkinson's, but there’s something particularly intriguing about rock climbing and the benefits it can provide — and he has even come to visit The Gravity Vault to see Queen and a few of his other patients in action during the UpEnding Parkinson's meetups.
One of the earliest challenges for people with Parkinson’s is motor planning, or the disconnect between the subconscious movements that we make every day without thinking about them and those that are more deliberate, Liang said.
“In terms of the how we move and how we think, we often don't necessarily slow it down to the level that you do in rock climbing or wall climbing, because you have to basically make every movement deliberate. It's planned,” he said.
Patients will often send him videos of themselves at the rock-climbing gym, sometimes catching another patient scaling a different wall in the background of the video frame — and Liang says he watches them all with joy and excitement.
“It's exhilarating and terrifying at the same time, and what does that do to someone's dopamine delivery systems? It can sort of spice things up and rejuvenate them,” Liang said.
"It's just as important to allow someone to see that you can live with Parkinson's disease. And I think this is one of those types of interventions,” he said.
While medications can be a good front-line treatment for Parkinson’s, effectiveness can wane over time and they can cause difficult side effects including nausea and dizziness, along with involuntary movements, hallucinations and other changes in behavior.
This has led researchers to pursue new and better treatment options, said John Lehr, chief executive officer of the Parkinson’s Foundation.
“A couple of decades ago, clinicians would tell people with Parkinson's not to exercise because they were worried about them falling or injuring themselves,” Lehr said. “Today, we know that exercise is probably one of the best things you can do to maintain your health — and not just your physical health, but your overall emotional health.”
The idea for UpEnding Parkinson’s started more than a decade ago, when an individual with Parkinson’s reached out to founder and president Molly Donelan-Cupka, who was then the director of a climbing gym in Virginia. The client wanted private lessons earlier in the day when the gym wasn’t as crowded because he was concerned about falling.
But climbing ropes offer a built-in safety net that can help encourage people to try out different movements without all the risk of falling, Donelan-Cupka said. “People can really push their bodies. It’s really adaptable for different abilities,” she said.
In general, exercise programs may make modifications for people with Parkinson’s — doing more movements from a seated position or less intensely, for example — because they’re worried about liability from risk of falling.
“That's not very fun and engaging for people,” Donelan-Cupka said.
“Climbing is inherently a sport that makes you feel accomplished when you get to the top of a climb, or even when you get through a move you didn't think you can do,” she said. "For some [people with Parkinson’s], this feeling feels like it's almost going the opposite direction of other things in their life might be going."
An estimated 90,000 people in the US are diagnosed with Parkinson’s each year, and Rose King was one of them this year. She joins the 1 million or so nationwide who are living with Parkinson’s, which is now considered to be the fastest growing neurological disorder in the world.
A strong community has built around the growing need, and Rose considers the program at The Gravity Vault one of her “Parkinson’s perks.” The Radnor location is unique in providing the program to Parkinson’s patients and their caregivers for free.
It’s been less than a year since her formal diagnosis, but Rose was expecting the news when it came.
“My hand had been shaking for probably two years, and then my legs started shaking,” she said. The picture became pretty clear when she also realized that neurological disorders that had been affecting her sleep for years were also precursors to a Parkinson’s diagnosis.
The formal diagnosis came by way of ruling other things out, Rose said, which brought its own rollercoaster of emotions. She was grateful to hear that she didn’t have amyotrophic lateral sclerosis or multiple sclerosis because she had seen the “terrible, rapid decline” they had on friends. But she went through a barrage of tests to understand her condition, and they were sometimes painful.
“I was happy to get a diagnosis and move on,” she said. “We're sitting in church, and my leg is just going crazy and we’re trying to hold it down, like, this is nuts, you know? The knowing was very helpful.”
Now, she’s doing everything she can to slow the disease's progression. She has cut red meat and sugar out of her diet – she only really misses ice cream, she says, but frozen red grapes are a good alternative. She has alarms set to keep her medication schedule tight, she plays word games with her husband and son nearly every night, and she exercises as much as she can.
Rose says she tries to push herself physically and mentally at the rock-climbing gym, and a couple weeks ago, she fell for the first time.
“It was very unsettling at first, but I didn’t take it as a defeat,” she said. “Every muscle in my body was hurting when I was done that one climb. But I see everybody else there trying to do them. No matter what level they're trying to do, it doesn't matter. People are just so excited to get to the top.”
And she’s encouraged by the strength and resiliency she sees in patients who have been living with the disease for much longer who are still able to rock climb without inhibition.
Rose starts to tear up as she thinks about a fellow climber whose Parkinson’s had progressed enough that he needed a walker to get into the gym. He immediately fell after losing his balance when he stepped up on the mat, she said, but he climbed straight up to the top of the wall.
“I think that’s just amazing,” she said. “I was so taken over. Like, this is so cool. This is so cool.”
At least 15 people attend the UpEnding Parkinson’s meeting up at The Gravity Vault in Radnor each week, and the group is consistently growing. The regular meetings give participants the chance to bond over their experience in a setting that’s much more relaxed than a formal support group or a doctor’s office.
Participants rest between climbs during UpEnding Parkinson’s.
Les Brodsky stretches at The Gravity Vault gym.
Cathie Brodsky kisses her husband, Les.
Andre Washington has been living with Parkinson’s for about eight years and is managing his condition independently without a caregiver. He says that, along with his church community, the rock-climbing group is an important part of the support network he’s built.
“You have the same basic things that you can talk about that are affecting you,” he said, like insomnia, constipation and tremors. “And you’re also able to talk about things that you share in common that are positive.”
Andre also makes a concerted effort to stay informed about the latest developments in Parkinson’s research, and The Gravity Vault community has helped with that, too. They recently coordinated a Zoom meeting with two doctors to share insights about preventing and treating the disease.
The strengths of the Parkinson’s community is something that Andre reflects on often, especially with a friend who is living with a different chronic condition who wishes she had more of that for herself.
"I'm not saying I'm fortunate to have this condition,” Andre said. “But the fact that I have this support network and there’s so much research that is going on is very valuable."
During a session last month, Andre completed three climbs but got stuck on the fourth trying to find a handhold that would allow him to support the next upward push. But as with his quest to continue learning about Parkinson’s and keep himself healthy and well, his steady outlook was focused forward.
“It was good. It was challenging. So I have something to go back to work on,” he said.
Caregivers have also found much-needed support in the weekly program. For many, it’s one of only a few places where they can relax the heightened vigilance they need while caring for a person with Parkinson’s. There’s a depth to the connections formed there that aren’t always possible through other support groups.
Earlier this year, Tony had a particularly difficult couple of weeks that involved sleepless nights, hallucinations, a fall at home and a particularly deep fissure in Carol’s resolve. The couple still made it to the rock-climbing class that week, but another wife and caretaker could see that Carol wasn’t holding up well.
“I was on the edge of tears for like three weeks," Carol said. “One of the things Tony used to always say to me was, ‘Don't worry about things you have no control over,’ so I really try to live by that, and just pick up the pieces and just keep going forward, but I was so rattled and I finally broke down.”
She rushed to the restroom at the rock-climbing gym as the tears came and tried to brush herself off. When she came out, the fellow caregiver – now her friend -- was there to hand her a paper with her name and phone number.
“I think that's all you need — to know that somebody is there to listen to you,” Carol said. “At the Gravity Vault, everybody's really in it."
Carol has even started her own lessons so that she can share the experience with Tony. Their connection looks different than it did in decades past, but she works hard to keep the bond just as close — and climbing gives them a special way to do that.
“We always picked each other up. It didn't matter if it was his job or my job,” she said.
“I like that he feels safe and secure with people here,” she said. “He can really open his heart, because that's how he is. He's just such a sweet man."
