Pingpong helps people manage their MS symptoms
A look at the NeuroPong program
by Susana Cummings
Minutes after Michele Campana slowly crosses a church gym using two canes, she’s stepping from side to side in front of a pingpong table as she hits the ball over the net. Her canes lean against someone else’s walker. The sound of pingpong balls whacking back and forth mingle with laughter as 17 people — players with multiple sclerosis and other conditions, coaches and volunteers — gather for a NeuroPong table tennis session in Fort Collins, Colorado.
“I’ll do anything,” says Campana, who also lifts weights and practices yoga. “I just want to get better.”
Campana, 57, was diagnosed with MS 17 years ago, after her feet started tingling. At first, no one could tell there was anything wrong with her, she says. But soon, she was dragging her left foot. With limited opportunities to work out during the pandemic, her health went downhill. So, when she heard about a new table tennis group for people with neurological issues led by Antonio Barbera, MD, she joined.
Constructive corrections, balls delivered at just the right spot and the friendly banter keep her coming. Once leery of walking around her neighborhood because of her limp, Campana now realizes how helpful people are when she tells them about her MS, enjoys the camaraderie around the pingpong tables and appreciates an environment where she doesn’t feel judged. “You can miss the ball 40 times and nobody cares.”
After just a few months, Campana and others are singing the praises of the program Barbera started when he discovered that pingpong did wonders for his MS. He welcomes them twice a week to bat the ball, forget about their symptoms and feel comfortable regardless of the effects of their disease.
Campana says she walks away from the two-hour sessions happy and energized. As she goes about her daily life, she is more conscious about her gait. And she’s now strong enough to pick up her 2-year-old grandson. “That’s huge,” she says.
A joyful vocation
Barbera, 60, a native of Cosenza, Italy, decided to become a doctor at 16 after asking himself, “What can I do for other people?” He became a physician at 23 and came to the U.S. six years later for a fellowship. Once settled in Colorado, he became the kind of obstetrician-gynecologist who did not mind middle-of-the-night calls. “I’ve never seen my job as a job,” he says. “It was my life. For me, it was just a joy.”
But MS changed his professional path.
His first attack, an intense pain in his right hip, came in 2016. When a neurologist confirmed his MS diagnosis the following week, Barbera made the doctor repeat himself. Despite earlier unexplained symptoms and his experience with the disease as a physician, MS hadn’t crossed his mind.
As a gynecologist, Barbera had referred several women for an MRI and six had come back with the diagnosis. As a young doctor, he had volunteered at an event in Denver featuring former Olympic alpine ski racer Jimmy Heuga and many others with MS who tackled the slopes with instructors.
“I thought, ‘Oh my gosh, this condition doesn’t stop them. They keep moving, they keep thriving,’ ” Barbera recalls.
After his diagnosis, Barbera tried to embrace his condition. He read all the medical literature he could find, took steroids and reached out to friends with MS.
His second attack came one afternoon in 2017 while he was still exhilarated after an “amazing delivery” of twins hours earlier. Barbera was playing pingpong — a sport that kept him busy on Saturday afternoons as a teenager — when he realized his left hand couldn’t pick up the ball. Within six hours, he had lost all feeling in that arm.
Dealing with the diagnosis
With visualization, Barbera set out to make his paralyzed arm and leg imitate the opposite ones, just as he had taught himself to use both hands in surgery years earlier.
He soon realized he could no longer offer his patients the quality of care he wanted. As someone who thrived on busy days, he felt lost. After practicing medicine for 31 years, he had to give it up.
“I was very sad, you could say depressed,” he says. He also felt guilty about no longer being able to help others.
Months later, sensation returned to his arm. After a Thanksgiving weekend when he spent time playing table tennis in the basement with his son, he noticed that the pressure he usually felt on his chest, what he calls his elephant, was gone. His research turned to the benefits of the sport.
“Can pingpong be useful for other people like me?” he recalls asking himself. “This is when I started thinking, ‘OK, I’m going to do something again for others.’ ”
Neural and human connections
Fascinated by the idea that the brain is able to create new cells, Barbera started learning more about neurology and wondered: “Maybe cells that produce myelin are still good at doing that, but we need to challenge them.”
Barbera had a new calling. He founded a nonprofit, Table Tennis Connection, in 2021 and started connecting with experts and coming up with a protocol for its NeuroPong program. He asked anyone who would listen for a space, tables, donations, volunteer work and access to potential participants.
He met Francesca Vargas, 27, a pingpong champion with MS from Lima, Peru, while she was visiting the area. She eventually became head coach.
NeuroPong launched in 2022, with participants Barbera recruited from a Parkinson’s disease support group and an assortment of tables.
“I told them the first day, ‘I will challenge your brain,’ ” he says. “If we don’t, the hippocampus falls asleep and nothing happens. If you have only one way to go from point A to point B, and there’s an accident on the street, you’re not going anywhere.”
Some 70 people with neurological impairments now come together in Fort Collins and Boulder for training sessions. At the door, they drop a couple of dollars to help pay rent.
They show up alone, with their caregivers or their service dogs. Among them: a 93-year-old woman with macular degeneration in both eyes. A woman with MS who, after her first pingpong session, felt her hip for the first time in 28 years. A top neurologist who was injured in a car accident and had two strokes.
Barbera sees people of different capabilities instead of their limitations. “If you’re able to maneuver your wheelchair, you’re better than me. I’ve never done that.”
“The only limitation,” says participant Mark Lauterbach, 56, pointing at his forehead, “is right here between our eyes.”
After welcoming first-timers, Barbera asks about their condition, other issues, medications and physical activity. He assesses their movements, cognitive function and ability to walk on their own. He finds out if they’re down, tired or isolated.
After a 15-minute warmup when participants move their arms, walk backwards and do launches to loosen up, balls start bouncing.
With the complex and fast sport, Barbera says, players get a workout, improve their balance, become more flexible and strengthen their core. At the same time, their brains fire on all cylinders. Not only do their eyes, hands and feet need to be in sync, but they must process information in less than half a second for the paddle to react to the ball.
Coaches monitor players constantly. Whether it’s making observations about their posture, reminding them to drink water or taking the time to chat when they need it, a personal touch is key in coaching, Barbera says.
“One day, a gentleman told me, ‘Antonio, if I’m concentrating on that and you give me more words, I get overwhelmed.’ I say, ‘Oh, good to know. I’m going to be silent,’ ” Barbera says. “Other people tell me, ‘No, Antonio, stay on top of me. Tell me more.’ So, I try to adjust movements on the fly.”
Participants have come a long way since the first session, he says, when “you could hear the ball falling on the ground right and left then. Now, you don’t hear the ball hitting the ground as often because they are controlled.”
A thoughtful approach
“It’s impressive when you watch folks walk in and then see them play,” says Boulder physical therapist Karen Zacharewicz, who raised about $2,000 for NeuroPong through GoFundMe. “It’s really darned good.”
In addition to pushing players to work at the top of their ability, the sessions give them an opportunity to interact with others. The “silly ball,” Barbera says, creates bonds and sparks joy in players.
“They come and smile and laugh, and we’re creating a community,” he says.
Robyn Moore, president of the Colorado-Wyoming chapter of the National Multiple Sclerosis Society, was among those who opened the door when Barbera came calling. Moore was impressed by Barbera’s infectious energy and his passion for helping people with chronic illnesses. Plus, she’s played pingpong since she could barely see over the table, she says.
At an event the two organized in December 2022, pingpong lit up the lives of the 10 people with MS who turned up, Moore says. Hesitant participants ended up feeling successful at the game thanks to coaches who have a special way of helping, such as serving the ball thoughtfully, she adds.
Among the participants was Alison Bacus, 65, of Loveland, Colorado, who was diagnosed with MS in 2010 and often uses a wheelchair. She has balance issues, she says, but that day, her brain was so engaged in hitting the ball that she got on her feet and, without holding on to the table, played for 20 minutes.
“It was an epiphany,” Bacus says. “The fear of falling goes away. The most fun was finding out that I could stand up and rally and do something new.”
Vargas eased her nerves and helped Bacus with her forward hand. More important, the pingpong champ with MS inspired Bacus with her accomplishments.
“For those of us with MS,” Bacus says, “it’s always really edifying to see someone who has overcome challenges and is still having a good, fun, exciting life. It’s a revelation.”
Vargas, who struggles with fatigue, says she hears often from students that table tennis eases their symptoms, helps their bodies relax and improves their mobility.
“Being part of something that is helping them in their daily life truly fills my heart,” she says.
Participants’ games get better after a few sessions, Barbera says, but NeuroPong’s goal isn’t winning tournaments. Its true purpose, beyond making players move and offering fun, is improving their functions elsewhere. His hope is to be able to tell participants that pingpong helps the brain produce new cells and improve their quality of life. He plans to conduct studies.
“I am not Antonio Barbera who woke up yesterday and just out of the blue, decided, ‘OK, I am the best pingpong guru,’ ” he says. “I need people who have experience in the care of this population and they support it and they work with me in this project.”
Beyond that, he hopes NeuroPong will go way beyond Colorado, with trainees offering table tennis as a form of neurorehabilitation for people with different conditions.
Lauterbach, who was diagnosed with MS in 2014, says NeuroPong changed his life. In a few months of sessions, he went from hardly being able to walk to balancing on one foot and riding his bicycle again. The workouts make his neuropathy disappear during sessions.
“I was hopeless, and [Bandera] gave me hope, and here I am helping others,” says Lauterbach, who has recruited others for the program.