Age-old lessons from the stage bring new hope for Parkinson's patient
'Parkinson's has become interestingly and unexpectedly, my passion'
Candace Cox and Phil Roberge stand facing each other, their hands held up and pressed together, like dancers poised for a routine.
"Let's see what you've got!" says Cox, her tone bright and encouraging.
She tenses her arms and tells Roberge, 75, to push against her stiff posture. They walk in unison, Cox stepping back while Roberge moves forward, intentionally propelling himself off the ground with each step.
Like dance partners, Cox and Roberge move together and respond to the tension in each other's muscles, trying to create something beautiful: movement.
Roberge has Parkinson's disease, a condition that three years ago left him unable to stand up from a chair or get out of bed.
Cox is an actor whose work in perfecting body movements on the stage has led to an unlikely career change. She is now a therapist who helps patients like Roberge regain agility.
As an actor, Cox trained in the Alexander Technique (AT), which is based on the idea that people can re-think habitual body movements and re-train their motions in order to diminish unnecessary tension in their muscles.
A lack of balance in one's body affects mental health, Cox says, and AT practitioners talk about the importance of working on both.
In Parkinson's circles, the Alexander Technique is treated as part of a suite of body-based therapies, such as yoga and tai chi. But Cox thinks more research needs to be done on exactly how this treatment has helped people like Roberge.
The two appear to share a special relationship, one driven by Roberge's success and Cox's joy in seeing him.
That kind of relationship is key to working with Parkinson's patients, Cox says.
"I put my hands right onto their symptoms and help wrestle them. So, in some way, I'm in the ring with them, even just to give them a little break before they're on their own again."
A body that feels 'confused'
Roberge is a truck driver who spent 40 years hauling gravel, fuel and engine oil. He was diagnosed with Parkinson's disease in 2007.
People with the disease don't produce enough dopamine, a chemical that allows muscles to move. That affects everything from your ability to walk or even to smile. It's a progressive disease and there is no cure.
By 2016, Roberge felt his body was "confused."
"You try to move a foot and it didn't want to move. Or, if you're leaning up against something and you know if you stop leaning on it, you're likely to drop and hit the floor," he said.
While doctors had prescribed him drugs to control his symptoms, Roberge and his wife, Blanche, were hungry for other options.
At that point, Roberge's six-foot frame had crunched down to five-six. He couldn't sit in a chair or get dressed by himself.
Then he attended a session on the Alexander Technique hosted by Cox at the Buchanan Centre in Edmonton.
Cox worked on his muscles to "lengthen" them and ease the tension that had developed through years of Parkinson's symptoms. They repeated exercises and talked about how to think about balance and posture in every movement: how you lift your arm, how you turn your head, how you lift your foot to take a step.
"All of us at the Parkinson's centre were cheering and clapping, because he made such strides in five days," remembers Cox.
The Alexander Technique was developed more than a hundred years ago and is commonly used by actors and musicians to improve stage presence and performance.
Cox learned the technique as an actor in Saskatchewan almost 30 years ago. She was intrigued and eventually headed to London for three years of training to become an instructor.
In 2016, the Parkinson Association of Alberta invited Cox, who is based in Ontario, to host sessions in Edmonton. Now, she travels here regularly.
"It's an aspect of what we would call body-based complementary therapy, things like massage and Alexander Technique and yoga ... all these kinds of things that are fairly mainstream, though there's not a ton of research behind a lot of them," said Brandi La Bonte, a spokesperson for the association.
Parkinson's has become interestingly and unexpectedly, my passion.- Candace Cox
It's hard to pin down the exact number of Parkinson's patients in Alberta, since not everyone is diagnosed, nor are those affected compelled to report their diagnosis to a provincial body. The association estimates about 10,000 people in the province have the disease.
The average age of onset is 56, and the disease is progressive. The likelihood of having Parkinson's rises exponentially with age.
La Bonte says exercise is one of the best things patients can do. Alexander Therapy falls into that category, even if there is limited direct research on the approach.
"We don't choose one (therapy) over the other. I've had clients who love and rave about it, and others who say it really wasn't their cup of tea.
"The good news about Alexander Technique is it provides another outlet and option. Because what may not be appealing to you when you're first diagnosed may become appealing five or 10 years down the road when the disease itself changes."
More research needed
Cox is desperate to see more research into the Alexander Technique. She has presented her own small-scale studies twice at the World Parkinson Congress, and is currently working on a book about using the Alexander Technique to mitigate Parkinson's symptoms.
"It consumes my life," she says.
She knows the technique is not a cure for Parkinson disease, nor will it help everyone as dramatically as it has helped Roberge.
But Cox still thinks every patient should get a shot at the therapy, and believes there should be proper protocols on how to use the technique with patients.
"Parkinson's has become interestingly and unexpectedly, my passion. I've been shocked in how much we're able to help people who have lost hope. And that's a good thing to do."
For Roberge, his low point came when his driver's licence was revoked, a depressing setback for the veteran trucker who had spent years on the road.
But he worked with Cox on movements that would allow him to move his foot quickly from gas to brake.
They practised for hours and, eventually, he regained his licence. Now, with the help of his wife, he exercises and stretches for several hours each day.
"From being stuck in a bed to being able to drive in three years time; it's a godsend."