It's not about feeling the burn. In Beth Mirman's exercise class, it's about regaining control--and having fun.
Experts have long touted the benefits of exercise for Parkinson's disease patients, citing studies suggesting that stretching limbs and strengthening muscles may slow the neuromuscular disorder's degenerative process.
But it is doubtful that researchers have charted the effects of show tunes on patients. And few studies have likely delved into the healing powers of Bette Midler.
A dynamo in black leggings, Mirman, 63, has proven that fun music and a good sense of humor can, along with physical therapy, boost the quality of life of a Parkinson's patient.
She delivers her "one-and-two-and-up-and-down" with the same gusto one would use to shout over a disco track to a group of leotard-clad twentysomethings.
Instead, her 50- to 80-year-old students at the Santa Anita Family YMCA in Monrovia spend most of the hourlong class sitting on folding chairs, lifting their arms as best they can to George Gershwin's "How Long Has This Been Going On?" and Midler's version of "I Believe In You."
"Aren't you my dancing darlings?" Mirman said without irony to a recent class of 30, including caregivers. "You're doing great."
And, according to the patients and their caregivers, they are.
"Without the exercise, I'd be a lot worse," said Heather Hewitt, who was diagnosed as having Parkinson's disease 11 years ago and started coming to Mirman's class in 1995. "If you're not active, you just get more and more locked up."
There are other therapy programs for Parkinson's patients throughout Los Angeles: County-USC Medical Center sponsors one, as does Huntington Memorial Hospital in Pasadena. But patients who have shopped around for classes said few are as fun as Mirman's.
"She just plays around all the time," Hewitt said. "She acts silly, but she's so cute doing it, she can carry it off."
A retired schoolteacher, Mirman was heading an aerobics class for housewives at St. John Vianney Church in Hacienda Heights four years ago when she met Mary Willis, the City of Hope's Parkinson's program coordinator.
Marveling at Mirman's enthusiasm, Willis invited her to meet Parkinson's patients and asked her if she would hold an exercise program for some of the City of Hope's support groups.
At the time, Parkinson's was not a part of Mirman's life. She knew of no friends or relatives who had the disease.
But she fit in just fine.
"When you work with Parkinson's patients, you have to offer hope. Which she does. You have to be enthusiastic, which she is," Willis said.
In partnership with the YMCA, the exercise sessions developed into a three-days-per-week class that "the patients just love," Willis said. "It gives them a purpose. Some of them hadn't been out of their pajamas in years."
Researchers at USC who study the disease said apathy is as common a symptom of Parkinson's as trembling and stooping. Therefore, simply stating that exercise can help is not enough; patients need to be led to the workout mat.
"They do better exercising in a group than individually," said Mickie Welsh, director of movement disorder research at USC. "It's the whole philosophy behind joining a gym. If you join the gym and pay the money, you have to go because you made the investment."
In Mirman's $15-per-month class, the investment is more emotional than financial.
Most of Mirman's students are elderly married people whose spouses bear much of the burden of taking care of them. And while it motivates the patients to work, the class also gives caregivers a chance to stretch, relax and socialize.
"By the end of the day, the caregiver is exhausted," Mirman said. "They need this just as much. They're burned out."
With her cheery, upbeat encouragement, the instructor draws spouses, caregivers and even toddler grandchildren into the workout.
"Sometimes we bring our sandwiches in here and have a little gab session after the class," said Norma Walker, an Alhambra resident who attends the classes with her husband, George, who is a Parkinson's patient. "Caregivers get a real plus out of it, not only with the exercising but with the visiting."
The class has evolved into a kind of family--celebrating personal triumphs, noting changes in each other's conditions and mourning the loss of its own. Four patients from the class have died during the three years the group has been working out, and some caregivers of the deceased patients continue to show up at class.
"They need this," Mirman said, "for the support."
Today's centerpiece focuses on Beth Mirman, an exercise instructor at the Santa Anita Family YMCA, who teaches a class for Parkinson's disease patients. The class is offered through a joint venture between the YMCA and the City of Hope. For more information call (818) 359-9244 or (818) 301-8985.