After one of our periodic social lunches, we had a very worthwhile visit from physical therapist, Ellen Krasniak, Clinic Director of Physiotherapy Associates in Ashburn, Virginia. A member who had benefited from her services recommended the group invite her in. We’re so glad we did! Points she made:
Gait issues : A metronome (or metronome app) can help provide a steady beat to promote a better gait. Listening to music can help the same way. Tape on the floor to provide a “runway” effect can also provide a visual cue to help.
Freezing: Think of freezing as the lack of ability to initiate movement. Ellen suggests signing up and participating in the BIG program to learn how to build momentum to aid with freezing .
Balance and Falls: As we age, our balance gets worse due to compromised vision and the loss of force production in your hips. As your posture shifts, leaning forward makes balance harder and you’re more likely to fall.Ellen suggests doing the BIG exercises every day for the rest of your life. But even general exercises , particularly ones that work on your core and your strength. Tai Chi is a good activity to work on balance.
How much exercise do you need each day? The standard is 150 minutes/ week or about 30 minutes a day. Someone with Parkinson’s Disease and gait issues would benefit from this exercise pattern: 5-10 minutes of warm up, 25-30 minutes of focused walking (paying attention to step length and foot placement) and and then stretching (Hold each stretch for about 20 seconds). Strength training 2-3 times/week is very useful, too.
This is my favorite take away from Ellen: She was addressing a question of a member with bad feet and said that her clinic gets patients who have bad feet or fused feet. She called it a “salvage procedure”. Being someone with bad feet, I love the expression.
Some time was spent discussing the role of physical therapists in the long-term care of people with Parkinson’s Disease. She says its important to find a PT that you relate to and to keep them informed. That person should be considered a member of your care team. You should stay in touch with your PT and let them help you stay in the best physical shape possible.
At the mention of a care team, there were a lot of questions: Who should be on your care team, who should be your gateway doctor? Why have a gateway doctor? The long and short of it is that whichever doctor you have a good relationship with, who is willing to assume the role is a good candidate for being the gateway doctor. And why have one? It just helps to have one Doctor who is seeing the whole you and making sure the every day medical maintenance doesn’t get lost in the forest of chronic disease demands. Are you on a good Parkinson’s regimen? Is your thyroid medicine adjusted best for you , if that’s a problem? But when was your last pap smear, your bone density scan or your mammogram? Maybe a gateway doctor could help keep an eye on the everyday issues.
Ellen shared that her office is offering complimentary injury screenings and have a good number of neurological therapists. If you can’t go online and find her office, let me know and I’ll help.
See you all in April. Wonderful speakers, Karl and Angela Robb, will be our guests. There’s so much to learn from them.