CHESTERFIELD, Mo. — “Up, up, up! Down, down, down! Side, side, side!” the trainer commanded as Jay Brunk, diagnosed five years ago with Parkinson’s disease, tried to punch the mitts on the constantly moving hands. “Perfect, perfect, perfect!,” the trainer yelled with each thump of Brunk’s boxing gloves against the targets.

“You are as strong as an ox,” trainer Jerry Morrison told him.

“Aw, I used to be,” said Brunk, a broad-shouldered 62-year-old man who spent much of his life in construction.

“You still are. You still are,” Morrison said. “Trust me.”

Brunk is fighting the debilitating effects of Parkinson’s by participating in the St. Louis area’s first Rock Steady Boxing class that began a month ago. The class, held at the Chesterfield Athletic Club, uses boxing-like drills to strengthen abilities that Parkinson’s attacks: agility, speed, endurance, accuracy, hand-eye coordination, footwork and overall strength.

Parkinson’s is a progressive, degenerative neurological disease with no cure. The brain declines in producing the neurotransmitter dopamine, which helps regulate movement.

Patients can experience tremors, loss of balance and coordination, stooped posture, slow speech and cognitive impairment. The disease progresses differently in each person, but symptoms can become so severe that patients need a wheelchair and assistance with daily activities. More than 1 million people in the U.S. live with the disease.

Several medications can temporarily relieve the symptoms of Parkinson’s, but research has shown that exercise is important in slowing the progression and improving symptoms in Parkinson’s patients.

Carolyn McKee, 47, of Frontenac, Mo., brought the Rock Steady franchise to St. Louis after researching ways to ease symptoms for her father, who was diagnosed with Parkinson’s about 10 years ago. It seemed like the perfect thing for her dad, who has long been fit and active, for two big reasons.

“First, it’s cool. It’s got a cool factor,” McKee said. “Second, is the explosiveness.”

Whenever her dad played golf, his tremors would go away as he hit the ball, she said. “I just knew the explosiveness of throwing punches would feel good.”

THE NEED TO FIGHT

McKee sent two athletic trainers she knew at the Chesterfield Athletic Club to earn certification to teach the program and has also become certified herself. Since starting the first week of April, five to 10 people attend classes held every Monday and Wednesday.

Brunk and his wife drive an hour-and-a-half from Ste. Genevieve County to come to the class. They were driving two hours to the affiliate in Columbia, Mo., which opened in February. Like others in the class, they talked of the need to fight.

“It is about taking control of a diagnosis that has no hope and putting hope into it,” said Jan Brunk, 62. “It gives you a feeling that you are doing something, rather than sitting here waiting for it to progress.”

Rock Steady Boxing was founded in Indianapolis in 2006 by former Marion County Prosecutor Scott Newman, who was diagnosed with Parkinson’s at the early age of 39. A few years after his diagnosis, he discovered that training like a boxer lessened his symptoms and opened a gym.

As demand for classes increased and word spread about its success, Newman created an affiliate program to train teachers in the method and bring it to other cities. Today, there are more than 125 programs in 32 states as well as Canada, Italy and Australia.

Trainer Brent Meyer, 32, teaches the program in Chesterfield along with Morrison, 61. “When people get diagnosed with Parkinson’s. They get this feeling of, ‘Just give up,’ They fall into a cycle of anxiety about the future,” Meyer said. He’s found that after the boxing classes, their eyes brighten. “They start to realize, ‘I can do this.’ It gives them a whole new outlook on life,” Meyer said.

USE IT OR LOSE IT

During a recent class, participants started with a warmup that included twisting, squatting, balancing and passing drills with a soccer-sized ball. They moved on to skills that included walking through rings and ladders on the floor and walking a straight line on their toes. They gritted their teeth through a circuit of jabs and upper cuts to standing bags, speed bags and a dummy.“Who’s ready for round 2?” Meyer asked after completing the demanding circuit. The group strapped their gloves back on with determination.

Caregivers stood on the side, supporting not just their loved ones, but one another. All needed hope in their corner. Jeff Graves, 75, of Twin Oaks, Mo., crossed his fingers and said, “I’m encouraged. I’m hopeful to at least stabilize this thing.” His wife, Loretta, was the only woman in the group. Men are twice as likely to develop Parkinson’s as women.

Gammon Earhart, director of the physical therapy program at Washington University School of Medicine, has studied how different forms of exercise such as walking on a treadmill, ballroom dance and tai chi improve Parkinson’s symptoms. All forms of exercise have been found to be helpful, she said, and high-intensity activities may be particularly beneficial.

“It’s totally important for people to be active and move,” Earhart said. “The key is finding an activity that they enjoy and appreciate over a long time, because it is a ‘use it or lose it’ phenomenon.”

She said larger and long-term studies are needed to find what particular mix of strength, cardiovascular and agility exercises are optimal. But many are still not learning the basics about how helpful it is to be active.

“General neurologists and practitioners often may not be pushing people toward exercise,” Earhart said, “Medication tends to be the first approach people use, but I think medication and exercise are equally important.”

When diagnosed, Earhart would like to see patients referred to a physical therapist who can design an exercise program around their abilities and goals using resources like Rock Steady Boxing. Currently, patients are not referred to a therapist until they fall and hurt themselves.

“There can be a lot of benefit to evaluating people early on,” she said. “We can design an exercise program they can do on their own in the community, and we would have a lot more success than the current model.”

Before enrolling students in Rock Steady Boxing classes, trainers perform a lengthy assessment of the participants so they can tailor the drills based on abilities. Classes at Chesterfield are currently for higher-functioning patients, but classes will be added for all levels as needed, McKee said.

While McKee became interested in the program to help her father, who lives in Kentucky, it has become much more. “I just want to help this population,” she said. “I wanted to do something that mattered, and this mattered to me.”

Brunk said he hasn’t seen change yet in his symptoms, but he looks forward to the classes, which give him a sense of accomplishment.

He’s a fix-it kind of person, he said. “It’s a challenge, and I like a challenge. I get a sense of satisfaction when I feel like I’m doing it right.”