At PWF, we are so fortunate to have a network of healthcare and fitness professionals who support our mission to empower those affected by Parkinson’s disease (PD) to live their fullest lives. One such person is Dr. José C. Cabassa, a neurologist and Parkinson’s and Movement Disorders specialist who also serves on our Fitness Advisory Committee.
Long committed to improving the quality and access to PD care—a calling inspired by his late grandmother, whose PD diagnosis robbed her of her vitality, mobility, and independence, Dr. Cabassa has treated hundreds of patients from all walks of life in his Harlem-based Movement Disorders practice. In 2019, he founded the Moving Brains Foundation, an intensive fitness program for people with PD and other neurological disorders. Taught by professional athletes and monitored by doctors, these workouts align with Dr. Cabassa’s core belief that PD patients who engage in quality, regular exercise alongside their clinical and medical care will have the best outcomes. For our debut “Ask an Expert” feature, we call on Dr. Cabassa to weigh in on the wonders of exercise when it comes to fighting PD.
For several years, you have been part of “the ringside physician world.” Could you tell us more about how you got into boxing, and why you wanted to introduce boxing fitness to the PD community?
In 2018, I was recruited to become a USA Boxing ringside physician, as they needed a neurologist with some expertise in head injuries to supervise boxing and mixed martial arts fights in the New York metro area. I had opened a private practice in East Harlem the same year, but I picked up this side gig, mainly doing amateur kickboxing and mixed martial arts fights once every two months. As I continued building my practice as a Parkinson’s and Movement Disorders specialist, the realities of our current medical system continued to wear me down. It came to a point where to survive, I could do one of three options: give up my practice (and my vision for it) and return to a major medical institution; follow a dubious model where the quality of care would not be a goal—and my oath as a doctor would walk a fine line; or forge through an uncertain future (still is!) with my vision of “movement medicine.” The need was to find a place to exercise and study people exercising, and there was a small boxing gym around the corner from the office. Around the same time, I met this actor and former boxing champion, John Duddy, through a mutual friend at dinner and told him of some of my ideas and about the gym.
We started our weekly pilot class on December 4, 2019, and with the exception of an extended pause during COVID, we restarted in March 2022 and haven’t stopped since! I had read much research on the benefits of exercise on Parkinson’s, but now I was able to facilitate it and be involved with it. Boxing training ended up ticking all the boxes on what I understood was needed, especially if we were able to push people safely and avoid injuries. Our approach was experimental. Our coaches had no experience training older people and people with PD, so I was the only one serving as a guard rail. I preemptively started taking blood pressure measurements and providing extra doses of PD medications when needed.
Fast forward to today: our program is an efficient, safe, whole-body fitness program disguised as a boxing program. Our coaches are former world champions or current athletes, and they treat you like normal clients or “fighters,” all under physician supervision and collaboration.
Your workouts are described as “high intensity.” Why is this elevated level of exercise important for people fighting PD?
High-intensity means exerting yourself, causing your heart to beat faster and hopefully breaking a sweat. People with PD have a disadvantage. Not only do they potentially have difficulty maintaining a steady blood pressure, known as dysautonomia, but their hearts also have difficulty reaching expected fast heart rates, a “high-intensity”. This often leads people on a downward spiral of deconditioning, worsening cognition, falls, and ultimately immobility. High-intensity exercises involve conditioning exercises, and general boxing exercises that involve moderate-intensity movements, with periodic bursts of higher intensity (what I call “going all out”) drills to maintain fitness and attack the problem. Many biochemical processes occur during higher-intensity exercises that promote brain and neuronal health in PD, in addition to improving cardiorespiratory fitness.
How does consistent exercise benefit people with PD?
In exercise, consistency is almost all that matters, and it’s one of the hardest problems. Results occur and are maintained only with consistency. You need to take medication every day. While exercise requires more effort and is time-consuming, the reality is it gives better, more sustained results. For me, the challenge starts at the personal level, then it becomes a bigger challenge at the professional level. It’s easy to prescribe medication, but it’s much harder to change a person’s behavior to commit to fitness. What I’m finding, however, is that we’re more likely to be consistent if we do it together. It’s very human. Meaningful social engagement is a great driver of longevity, and also creates some accountability which can lead to more consistency. Setting up structures that support continued engagement are needed for people with PD to help them access regular exercise with the least amount of barriers. For example, we also offer dance fitness programs to expand participation and engagement, including a Zumba-based fitness class with Dance for PD, as well as a theater jazz and tap at Steps on Broadway dance school. We’re currently working on starting a martial arts program too.
For people with PD who aren’t able to attend a Moving Brains workout or event in person, what tips do you have for keeping fit at home?
An ideal Moving Brains workout taught by top athletes with physician oversight is something we’re always aiming for, but it’s always a learning process. If joining our program isn’t an option for someone, some tips for doing high-quality workouts at home or elsewhere include: high-intensity exercises; a skill-based exercise or activity where you are learning something new; and meaningful social engagement. If you can’t find an activity that satisfies all, you can break it up. Perhaps you set aside time in the gym with a trainer to meet the high-quality, high-intensity exercise part, while also taking up a musical instrument or a cooking class with friends to satisfy the skill-based learning and social engagement. These are some strategies for maintaining brain health overall. The most important part is that you make it fun!
What motivated you to get involved with the Parkinson’s Wellness Foundation?
Working with like-minded individuals and seeking opportunities to engage and learn from others in the PD community led me to PWF. Their commitment to create a space for people with PD that parallels Moving Brains’ beliefs and enthusiasm motivates us to collaborate—and share a vision where movement as medicine is refined and delivered on our journey to maintain brain health.
Thank you, Dr. Cabassa! To celebrate the sixth anniversary of the Moving Brains Foundation, Dr. Cabassa and his team are hosting a special training session at Trinity Boxing Club, 20 Vessey Street, New York on Thursday, December 4. Training will take place from 10 am – 12 pm, followed by a small celebration. All are welcome to attend; please RSVP!
