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Rock Steady Boxing- Level 1 Adults and Seniors Fieldwork
Rock Steady Boxing- Level 1 Adults and Seniors Fieldwork
At John Lavin's Martial Arts Gym in San Rafael, Ellie Brewer (pictured on the right) and I implemented a fine motor program for individuals with Parkinson's disease as a research study under Dr. Kitsum Li, OTD, OTR/L, CSRS. This Marin program was established three years ago with three coaches and three women boxers with Parkinson's with only a few classes a week whereas now classes are roughly 10-16 boxers with Parkinson's and four coaches teaching about five classes a week. These boxers vary in Parkinson’s stages (1-3) and in age (50's +).
Over 3 months I got to use my OAS, Fundamentals, Human Movement, Pediatric and Foundational OT coursework to guide my application to the Rock Steady Boxing Program. Ellie and I implemented a fine motor exercise program designed by students in our program development course. They designed a sequence of exercises for the four activities we focused on, buttoning, jar opening, handwriting, and typing or playing the piano. These were decided based on a needs assessment focus group they had with these clients. For the study, we got to practice assessing the client's fine motor dexterity through the Box and Block test and 9-hole peg. I completed two certifications about Parkinson's Exercise through the Brian Grant Foundation and FitFixNow. At Rock Steady, they implement a biomechanical approach to fighting back Parkinson's through non-contact boxing. The biomechanical frame of reference refers to the use of body mechanics to gain performance like working on endurance, range of motion, strength, joint mobility and functional mobility for an activity (O’Brien & Hussey, 2012). This was used as the classes focus on the movements needed to participate in boxing like stretching, seeing what available range of motion each boxer has and balance and positioning for coordinating the series of exercises. Some coaches assess this through exercise circuits and others through dynamic balancing movements.
Though that time, many of these boxers have brought meaning and belonging in boxing. They are engaged in learning more about the disease's symptoms and how to age well.
Epiphanies from this fieldwork
Epiphanies from this fieldwork
My first epiphany was when a boxer who began at the Marin Rock Steady boxing three years ago said, "We are all just doing our best". This resonated with me as we age, we try our best and we should not compare ourselves to others or to expectations other than your own. No matter the age, it's important to value life as it is not for granted. This phrase reminded me of when I thanked my grandmother for letting me stay at her house for a few weeks and she had responded with "Oh it's my pleasure to live to see you grow up, I'm so lucky!" and I immediately responded with "No grandma, I'm grateful I got to spend this much time with you and see you. I'm lucky too!" Though age is what we associate with deterioration, one's mentality and attitudes towards life can drastically change one's outcomes. In Occupations of Adults and Seniors two I learned how the fear of falling is a lead factor into higher risk of falling, regardless of balance or gait challenges. This psychosocial aspect of attitudes towards life is critical to productive aging. I thus made the Home Assessment for Fall Prevention handout to the left. This resource was given to the Rock Steady Program to distribute to boxers who have an interest in it by displaying them at each class time for them to take. They are also given to boxers and their caregiver when they sign up for the Rock Steady Program Classes.
A second epiphany was when a boxer talking to a grandson asking questions for a school report: "Let's not talk about Nixon's presidency, I'm more than a living book". Though seniors want to have insightful conversations, they have more than just history in their back pocket. Politics was not a meaningful occupation for this boxer and felt that her life's work was more than survive time to be a live storybook for her grandchildren's benefit. This reinforces the narrative reasoning to every client as everyone has a story but each person will share a different story.
Self-advocacy in interdisciplinary teams is key. Ellie and I were the only occupational therapy professionals, there were two professional boxers, one PT student and one personal trainer and yoga certified teacher. Many caregivers (spouses, friends, children) came to classes to support their loved ones in the class. With this dynamic perspectives, we had to communicate to be clear on the objectives of classes and modifications. For example, the personal trainer's classes were focused on circuits and getting stretching and exercise drills done. Whereas the boxers promoted boxing drills, language, music, and social interactions. Caregivers helped class participants’ positions. Ellie and I had to remind the team that if someone would not perform an activity as planned, that they could make the activity more functional to live rather than simple exercises. For example, a client was practice lunging and touching the floor on the anterior side and he said he visualizes bowling. Another example is reaching for a cup in their mind instead of half a noodle. Additionally, practicing getting up and down a sidewalk rather than on and off a mat. Though boxing is an occupation, some boxers consider it meaningful occupations and others don't but regardless, occupational performance and participation in the interdisciplinary team's focus. We as a cohort have discussed the implications of collaboration and how beneficial it is to communicate clearly and effectively to other disciplines. I have also attended the interdisciplinary workshop for health professionals at Dominican University of California to further my knowledge on other close fields of practice.
My main takeaway from this fieldwork experience is that seniors, though aging and most likely have some health challenges, still are motivated to participate in meaningful activities and to work for wellness. I saw various late middle adults and seniors embrace health concerns in a positive way of fighting back for their life. I am grateful for this experience as it has made me more confident in what I can offer my clients and made me understand further the importance of aging well. We all all so lucky to have gotten as far into life as we have, we should live it the best we can.
References
O’Brien & Hussey, (2012) Introduction to Occupational Therapy 4th Ed. Elsevier Mosby.
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