“It’s time to hit something,” said one of the men, Tony Foster.

“Let’s work on our punches a little bit,” Smeltzer said as she and the five boxers put on their gloves and formed a circle in the middle of the exercise studio at the Advocate BroMenn Health & Fitness Center in the Center for Integrated Wellness, Bloomington.

For the next several minutes, the five boxers and Smeltzer jabbed at the air with their right hand, then their left hand, while turning on their feet.

But some of the men couldn’t bounce on their feet; they turned slowly, made an effort to look up and struggled to get their arms up high enough.

“Let’s be on our toes,” a smiling Smeltzer called out encouragingly. “Eyes up. Keep your hands up.”

After the jabbing drills, the men worked on their hooks and upper cuts, with Smeltzer and volunteer assistant Guadalupe Garcia providing support and motivation.

Then the men formed a line and quickly took turns punching boxing mitts held up by Smeltzer, practicing their jabs, hooks and upper cuts.

“One, two, one, two,” Smeltzer called out as Tom Rousey punched Smeltzer’s boxing mitts. “Rockin’ Rousey — I like it!”

Some of the men punched hard. Others barely made contact. But all five were perspiring and working hard in their battle against a common opponent:

Parkinson’s disease.

All five men have the progressive disorder of the nervous system that results in imbalance, stiffness, slowing of movement and tremors. While they experience the disorder at varied levels of severity, all are trying to combat it using the last exercise that someone may associate with a person with Parkinson’s — boxing.

“It’s an interesting phenomenon,” said Jane DesCarpentrie of Eureka, who has Parkinson’s disease. “You would think people with Parkinson’s would stay away, but they keep coming back because they see the results.”

The results are improved mood because of the camaraderie with others battling the same disorder, increased energy and relief from symptoms, even if the relief is only temporary.

Rock Steady Boxing is an exercise class that includes non-contact boxing drills for people with Parkinson’s disease.

“People aren’t getting hit in the head,” Smeltzer emphasized.

Rock Steady Boxing began a month ago at the Advocate BroMenn fitness center in the Center for Integrated Wellness and already averages seven participants each class, said Smeltzer, a veteran Bloomington-Normal exercise physiologist who is fitness center manager and a certified Rock Steady Boxing instructor.

Rock Steady Boxing began a year ago at the Eureka Bible Church in Eureka and averages 12 to 15 boxers per class, said DesCarpentrie, a certified instructor along with her husband, Stan.

What’s happening in Central Illinois is part of a health and fitness phenomenon that began with a program in Indiana with six participants in 2006 and now includes 280 Rock Steady affiliates led by certified instructors in 44 states and several countries and thousands of participants.

With more than one million people in the United States alone with Parkinson’s disease, the potential application of Rock Steady Boxing is huge, supporters said.

“I’m definitely in favor of it,” said Dr. Herman Dick of Advocate Medical Group-Neurology in Bloomington. “It helps Parkinson’s patients in many ways — including improving strength, flexibility and coordination — and it’s done in a supervised setting with an instructor who can make adjustments based on who’s attending the class. That’s important because there are degrees of disability with Parkinson’s.”

Parkinson’s disease causes deterioration of balance, agility, speed, muscular endurance and hand-eye coordination but these all are skills that boxers work on, Dick explained.

Boxing maneuvers force a person to react quickly and use areas of the brain that are weakening in a person with Parkinson’s disease, Dick explained. So boxing drills can protect those areas of the brain by working them, he said.

“Rock Steady Boxing encourages the brain to use many different systems of neurons in the brain at once,” Dick said.

A person riding an exercise bike is using a single motion, he explained. But, in boxing, a person is moving their arms across their body, aiming for a target, while staying light on their feet, Dick and Smeltzer explained. They are moving in multiple planes while working hand-eye coordination.

“Rock Steady Boxing uses different areas of the brain and they all are areas weakened by Parkinson’s Disease,” Dick said. “This activates those areas and make them more fit.”

“Research shows that neuro-plasticity in the brain is restored,” Smeltzer said.

“We’re not sure it slows the overall progression of disease,” Dick said. “But when a person is able to ambulate more quickly and steadily, when they are more physically fit and when they have more endurance and energy to get through the day, that gives them more confidence and their quality of life improves.”

Dick has gotten good feedback from several patients who have gone to the Eureka class.

“You are doing something to combat your symptoms,” DesCarpentrie said. “It is not a support group but it’s a supportive atmosphere. You no longer feel isolated.”

Smeltzer said one participant leaves her class and doesn’t need to take her Parkinson’s medicine in the afternoon but is able to return to work, writing and typing, because her tremor has temporarily dissipated. Another participant who can’t raise his knees or hold a ball at the beginning of class is able to do both by the end of class, she said.

“Some patients have reported that they don’t need as many medicines,” Dick said. “For Parkinson’s disease, the amount and dosages of medicine can be adjusted at certain times of the day based on how the patient is feeling.”

Exercise — such as Rock Steady Boxing — should be considered along with medication to help patients with Parkinson’s to maintain quality of life, Dick said.

“They (people with Parkinson’s) are facing a lifelong condition that worsens over time,” Dick said. “Anything that can be done to improve things, even a little, is beneficial.”

Participants make adaptations based on their abilities, Smeltzer said. For example, during the warm-up, Garcia assisted Rousey and participant Warren Ullrich in getting up out of their chairs. Smeltzer helped both men — whose symptoms were more severe than that of the other boxers — during their agility work.

“Every boxer goes through an assessment with me (before they begin the class) and they go through a reassessment every six months,” Smeltzer said. “But anybody at any level of Parkinson’s can participate.

“I have noticed an amazing camaraderie,” she said. “They push and cheer and support each other. Their mood improves.”