Balance Matters: A neuro physical therapist’s journey to make “Sense” of Balance

Join us in this podcast episode where we explore the realms of balance and oncology rehab with specialist Derly Munoz. Get inspired by Derly’s unwavering commitment and discover valuable insights on initiating specialized oncology rehab programs. Gain empowerment through educational tips for both patients and clinicians seeking optimal care. Articles and Resources: Taking Charge of My Cancer on Apple Podcasts: Hosted by Derly Munoz and empathetic experts and individuals who have triumphed over cancer themselves, this show is a beacon of hope, inspiration, and tangible solutions for you while navigating the twists and turns after your cancer diagnosis. exercise-guidelines-cancer-infographic.pdf (acsm.org) Neurological Outcomes of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer: A Systematic Review and Meta-Analysis Outpatient Oncology Fall Risk: A Quality Improvement Project. Optimal outcome measures for assessing exercise and rehabilitation in chemotherapy-induced peripheral-neurotoxicity: Systematic review and consensus expert opinion - PMC (nih.gov) A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms - PubMed (nih.gov) Become a Board-Certified Oncology Specialist in Physical Therapy | APTA Specialist Certification - Governed by ABPTS About - PORi - Oncology Rehabilitation Courses Derly Munoz received her bachelor’s degree in physical therapy from the Rosario University in Bogota, Colombia in 1990. She moved to the United States in 1993 and completed a postgraduate Certification in Manual Therapy in 1995. In 2012, she became the team leader for the oncology rehab program at UF Health in Gainesville, Florida, and became a Certified Lymphedema Therapist. The Cancer Rehab program as more than doubled its size concerning clinic space, patients served, and therapists on the team since she has been the team leader. She also received her Certification in Cranio-Mandibular Disorders from Mariano Rocabado in 2016. Oncology being her main passion led to the opportunity to work with Dr. Singhal, with whom she developed a lymphedema surveillance program for the vascular lymph node transplant patients, as well as a lymphedema surveillance program beginning at pre-op for the breast cancer patients. Through this work, she has been a co-author of publications on the surveillance with the transplant patients and received The Breast Journal Award in 2015. Derly became APTA board certify oncologist specialist in 2020. She started her own podcast for cancer survivors and their families a few months ago call taking charge of my cancer and has been giving a lot of tools in education on her social media.

I am excited for this next interview with Susan Frikken to discuss her program Ballroom Basics for Balance, as it combines 2 of my favorite things balance and dancing. Susan Frikken, DPT, LMT Susan Frikken is physical therapist in private practice in Madison, Wisconsin, the co-founder and an instructor for Ballroom Basics for Balance and founding member of the Madison Area Wellness Collective [now Be Well Madison], making health and wellness choices easier through connecting practitioners and community. She is a graduate of the Doctor of Physical Therapy program at University of Wisconsin-Madison in 2013 and now serves as an adjunct faculty and guest lecturer at UW for the DPT program. She has been a massage therapist since 1993. Areas of special interest are restoring optimal posture and function, conservative scoliosis management, soft tissue work (massage), and – of course! – balance and falls prevention! She is certified leader of Stepping On, an evidence-based falls reduction program. Proudly, Most recenty I became a PK Silver Coaching Specialist and hold parkour classes with seniors. Originally from metro Detroit, Susan lives in Madison with her wife and animals. Quote from Susan: “My goal is to incorporate arts and nature into therapeutic practice, helping to change the way of health and wellness care in our country. I love to dance, bicycle, be outside, and play at just about anything, so I try to stay healthy and able in case I’m invited to join in! Resources: Highlights The Water Molecule DanceUpcoming curriculum trainingsPromo video about us (2019)Educational video about the keys to good balance and BB4BA core document summarizing the key elements of the curriculum. Home practice video. Flickr page from the years (photos and videos) A pilot study of their class.

I am very excited to share this next podcast episode, Ask the Parkinson Expert- Take 6 for PD. On this episode, I asked the same 2 questions to all the Parkinson experts I interviewed in April. When I meet with many of my clients with PD, they ask me what can I do to decrease the progression of the disease? I was curious how others would answer this question. So, I asked Dr. Melissa McConaghy, Josepha Domingos , John Dean, Dr. Eric Rhoden, Dr. Becky Farley, Betsy Vierck, and Catherine Ross the same question. It was fun to hear everyone’s perspectives and definitely made me think differently. I am also impressed with all the new emerging research on Pd, but it can be overwhelming. So, my 2nd question to everyone was what research are they following and what they would recommend others to follow that they feel can make a difference in people’s lives? Throughout the conversations we had some overlapping themes, as well as new and different perspectives. Question 1: 12 Tips to slow the progression of the disease from PD experts! Here is a great article and webinar discussing if there is a way to slow Parkinson’s progression: ‘Can We Put the Brakes on Parkinson’s Progression? | Parkinson's Foundation’. Question 2: What new research do PD experts recommend following? Various topics on research were discussed and we added some articles on each topic. (Please see all articles and resources here: Take6forPD to increase PD awareness – Step and Connect

In this episode we have two special guests, Betsy Vierck and Catherine Ross and we discuss their new blog, Parkinson's from the Inside. They share through their writing to increase awareness of the lived experience of Parkinson's Disease. They dive deeper into what they want health care professionals to know, new standards of care, creativity in PD and besides a cure, their dreams for the future. Parkinson's From the Inside (parkinsonsfromtheinside.com) Elizabeth (Betsy) Vierck writes frequently on a wide range of topics including aging, health delivery, health education, health spending, demographics, inflammation, arthritis, and pain. She is the author of Chronic Pain for Dummies, The Idiot’s Guide to Inflammation, The Heart Disease Handbook, Growing Old in America, and Aging America (AARP). Betsy was a long-time staff member of the US Senate Special Committee on Aging in Washington DC. Betsy began having symptoms of Parkinson's disease in 2000 and she was diagnosed in 2008. Catherine L. Ross is a retired speech-language pathologist. Her career spanned educational, medical, clinical, and university settings. She divides her time between Wyoming and Florida and volunteers for Parkinson’s organizations. Cathy was diagnosed with Parkinson’s Disease in 2018. Resources/Articles: Evidence for Early and Regular Physical Therapy and Exercise in Parkinson’s Disease - PMC (nih.gov) (PDF) Why would Parkinson’s disease lead to sudden changes in creativity, motivation, or style with visual art?: A review of case evidence and new neurobiological, contextual, and genetic hypotheses (researchgate.net) More Than Movement: Exploring Motor Simulation, Creativity, and Function in Co-developed Dance for Parkinson’s - PMC (nih.gov) Time for a new image of Parkinson’s? | Special Reports | Parkinson’s Life (parkinsonslife.eu)

In this episode, Dr. Becky Farley discusses how she created a comprehensive PD-specific approach that begins with the building blocks of function called PWR!Moves®. Learn more about PWR moves and how you can incorporate motor learning principles into your sessions to optimize movement. Becky G. Farley, PhD, MSPT, PT, Chief Scientific Officer & Founder, Parkinson Wellness Recovery | PWR! Dr. Becky Farley received a PhD in Neuroscience from the University of Arizona, a Master of Science in Physical Therapy from the University of North Carolina, and a Bachelor of Science in Physical Therapy from the University of Oklahoma. During her postdoc, she co-created the LSVT® BIG therapy program and completed the initial NIH research on its’ short-term benefits. She has now created a more comprehensive PD-specific approach that begins with the building blocks of function called PWR!Moves®. The deterioration of these skills leads to functional decline and interferes with all physical activity. Dr. Farley has trained over 7000 physical and occupational therapists and exercise professionals to work together on shared PD-specific functional training goals to optimize functional mobility and fitness. In 2010, she launched the PWR!Gym in Tucson, AZ – a model community facility for implementing ongoing access to cutting-edge rehabilitation, group exercise and wellness programming. Resources: https://www.exerciseforbrainchange.org/category/research-update/ Parkinson Wellness Recovery | PWR! – Implementing research-based Parkinson specific exercise programs. PWR!Moves GET BETTER and STAY BETTER with Exercise. (pwr4life.org) A physical therapy decision-making tool for stratifying persons with Parkinson's disease into community exercise classes - PubMed (nih.gov) https://www.pwr4life.org/pwr-updates-and-news/ (Making function exercise, training PwP like an athlete, strength and agility research updates) Workshops overview page https://www.pwr4life.org/pwr-workshops/ Find a PWR! Professional Directory https://www.pwr4life.org/professional-directory/ Our Wellness Series on the third Wednesday of the month is open to anyone and we save the recordings for viewing later. https://www.exerciseforbrainchange.org/join-us-for-a-wellness-series/

In this episode we will dive deeper into deep brain stimulation for Parkinson's, the role of the health team, patient self-advocacy and the importance of effective communication. Dr. Eric Rhoden's unique experience and expertise brings us new perspectives and ideas. Dr Eric. Rhoden was born and raised in San Diego, California, making Austin, Texas his home in 2016. Dr. Rhoden has always thrived on competition and learning new skills. After dabbling in many sports over the years, soccer became his primary focus. Just before playing soccer at the collegiate level, he sustained a knee injury, removing him from the sport and solidifying his desire to pursue a career in physical therapy. He graduated Magna Cum Laude with his bachelor’s in Kinesiology from California State University, San Marcos and received his Doctorate of Physical Therapy from Loma Linda University. Following his academic accomplishments, Dr. Rhoden has served in various institutions and corporations as an advisor for health-related products, policies, and research projects. He has over 10 years experience in wellness coaching, nutrition, and personal training. During the past 6 years, Dr. Rhoden has been a movement disorder specialist with a local neurology practice. During the height of the pandemic, he co-founded a remote COVID-19 testing company to support the community. In addition, Dr. Rhoden has also spent time providing continuing education courses throughout the US on comprehensive Parkinson’s care and enjoys presenting to local groups throughout the Austin area. References: Comparison of Globus Pallidus Interna and Subthalamic Nucleus in Deep Brain Stimulation for Parkinson Disease: An Institutional Experience and Review Update on Current Technologies for Deep Brain Stimulation in Parkinson’s Disease - PMC (nih.gov) (PDF) Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson's disease? (researchgate.net) Physical therapy and deep brain stimulation in Parkinson's Disease: protocol for a pilot randomized controlled trial - PubMed (nih.gov) Effects of deep brain stimulation on balance and gait in patients with Parkinson's disease: A systematic neurophysiological review - PubMed (nih.gov)

In this episode, physiotherapist Josefa Domingos MSc and PhD Candidate and speech language pathologist John Dean MA CCC-SLP discuss dual task training for Parkinsons and how you can implement dual task training to address cognitive domains: attention, executive function, working memory and visual spatial. They discuss the programs they developed both in person and online, including the Lisbon Falls Trampoline Training program. Physiotherapist Josefa Domingos MSc and PhD Candidate and speech language pathologist John Dean MA CCC-SLP are clinicians specializing in Parkinson’s and related disorders. Since 2011, the duo has been collaborating on their approach to Dual Task Exercise for Parkinson’s, combining movement, voice, and cognition, with multiple publications on their approach, training programs for clinicians in the EU and the US, and countless hours of classes and clinical work, both online and in-person. Currently, they can be found online with the Inova Parkinson and Movement Disorders Center, The Parkinson’s Foundation of Western Pennsylvania and the Parkinson Association of the Rockies, among others. They also volunteer with a number of US and international organizations, including the International Parkinson’s and Movement Disorder Society, the World Parkinson’s Coalition, The Davis Phinney Foundation, and Parkinson’s Europe. Resources: Dual Task for Parkinsons Parkinson's Europe ExerciseCast Virtual Classes: Dual Task for Parkinson’s: Exercise to improve movement, voice & cognition: Every Monday and Wednesday from 3:00 pm – 4:00 pm Zumba Gold for PD: Every Tuesday and Thursday at 1:00 pm (EST). RECENTLY DIAGNOSED BOOT CAMP: 3RD TUESDAY OF EACH MONTH FROM 2:3O – 4:00 PM (EST) 8-part “Exercise Pizza” Series: Week 8 – Thursday, April 27: “Speech Recognition Challenge” (12:30-1:30 MST) Articles: Community Exercise: A New Tool for Personalized Parkinson’s Care or Just an Addition to Formal Care? - PMC (nih.gov) A Novel Boot Camp Program to Help Guide Personalized Exercise in People with Parkinson Disease - PMC (nih.gov) An Online Dual-Task Cognitive and Motor Exercise Program for Individuals With Parkinson Disease (PD3 Move Program): Acceptability Study - PMC (nih.gov) Lisbon Intensive Falls Trampoline Training (LIFTT) Program for people with Parkinson’s for balance, gait, and falls: study protocol for a randomized controlled trial - PMC (nih.gov) Is Being Physically Active Enough or Do People with Parkinson’s Disease Need Structured Supervised Exercise? Lessons Learned from COVID-19 - PMC (nih.gov)

In this episode we discuss specialized Parkinson's programs and the journey to get them started to help thousands of people. Melissa McConaghy, the founder and a visionary leader, shares with us what is PD Warrior and the Insight into PD conference. Resources: Exercise Based Parkinson’s Treatment – Live Brave - PD Warrior Research articles - PD Warrior Online Global Conference – INSIGHT 2023 - PD Warrior Dr. Melissa McConaghy is a Fellow of the Australian College of Physiotherapists, Specialist Neurological Physiotherapist and holds a Master of Health Science (Neurological Physiotherapy). She has been working with Parkinson’s patients for 19 years and was recently awarded Australian Physiotherapist of the Year. As an educator, clinician and author, Melissa is a strong believer in exercise and its importance in the Spemanagement of progressive conditions. In addition to founding and curating the largest ONLINE global Parkinson’s Conference, INSIGHT into PD in 2018, she has authored the Amazon best seller The New Parkinson’s Treatment: Exercise is Medicine and founded PD Warrior, an early intervention approach for treating Parkinson’s disease. PD Warrior has now been taught to thousands of health professionals world-wide and is currently under license in nine countries. She currently sits on the NSW Branch Council of the Australian Physiotherapy Association (APA), is recipient of the ‘Contribution to the Profession Award’ as awarded by the NSW Branch Council and is the past Chair and National Representative of the NSW Neurology Group for the APA.

In this episode, get ready to spark your creativity as Jacob Weiss shares fun ways to engage individuals with coordination exercises. He discusses how he developed HandEyeBody Method from over two decades of work researching the design of online tools for health and wellness, energizing audiences around the world as a professional juggler and keynote speaker, and teaching thousands of people and teams how to connect to their full potential through fun and accessible exercises. Jacob Weiss, PhD, is the founder of HandEyeBody Academy, a social enterprise with a mission to help people learn how to move better, focus better, and function better, by teaching hand-eye coordination exercises that are creative, fun, and accessible for all abilities. Since graduating from Princeton University and completing his PhD in Biomedical Informatics at Vanderbilt University, Dr. Weiss has developed and shared his interactive training programs with teachers, trainers, coaches, therapists, movement educators and organizations around the world. Watch the interview in a video format here to see exercise examples. To learn more about the coordination charts and exercises, go to HandEyeBody Academy - Hand-Eye Coordination Training & Professional Development

In this episode, we discuss some key elements when designing successful wellness programs. Learn how Brett started and grew 110 Fitness and tips to help you incorporate new wellness programs into your practice. Key elements: Brett Miller, PT, Founder and Owner of 110 Fitness Home | 110 Fitness | Rockland MA Brett is the founder and owner of 110 Fitness in Rockland, Massachusetts, an all-inclusive wellness center as well as the largest wellness center in the world for individuals with Parkinson’s Disease. The mission of his wellness design is to set a new standard for the world in the “fight back” against Parkinson’s Disease through holistic and fitness-based approaches as well as breaking down all barriers for adults and children limited by disease or disability by sharing his exceptional mental and physical training and conditioning experience. Brett is a licensed physical therapist with 27 years of experience in all settings including sports therapy, acute and intensive care, long-term care, and wound care. He has worked in the fitness industry for 29 years with extensive experience in kickboxing, boxing, spinning, rowing, and strength and conditioning. He has worked as the strength and conditioning coach for world-class boxers and Olympic athletes focusing on injury prevention and rehabilitation. Additionally, he is the co-owner of Boston Orthotics, Inc. for the past 20 years. Brett also volunteered as an adaptive sports coach at New England Disabled Sports at Loon Mountain in Lincoln, New Hampshire for 18 years. Brett is a U.S. Army veteran and is proud to have served as a combat medic trainer for special operations. He recently published, It’s A Beautiful Day To Save Lives: A Medic’s Journey to His Destiny. Brett serves as the co-chair for the Massachusetts Parkinson’s Registry as well as a Commissioner on the Massachusetts State Athletic Commission. He also serves as an ambassador for the Michael J. Fox Foundation for Parkinson’s Research and the Davis Phinney Foundation. He is a research consultant for the Cleveland Clinic and for innovative United States research companies as well as prominent Boston hospitals. Brett is proud to serve as a Legacy Guardian for the Til Valhalla Project and is an ambassador mentor for Hives for Heroes Articles to support designing wellness programs for individuals with PD

Great discussion on neurorehabilitation perspectives. We discussed are we addressing the client’s perspective? What does the client want and what is their needs vs. what we think may be important. In neurorehabilitation, the therapist is interested in how the person completes the activity, not just the task completion. We talked the importance of observation skills and dived deeper into the Bobath model and current research, as well as compensatory movements, movement synergies and sensory integration. Bio: Julie Vaughan-Graham PT, PhD Advanced IBITA Instructor (Honorary Life Member 2020) Founder, Physio-Logic and iNeuroRehab Assistant Clinical Professor (Adjunct), School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada Adjunct Lecturer, Department of Physical Therapy, University of Toronto, Canada Julie graduated from St. Thomas’ Hospital, London, England in 1986 and has worked in the area of neurorehabilitation since 1988. Julie emigrated to Toronto in 1991, initially taking a position at Lyndhurst, Spinal Cord Injury Centre, and then later opening her own private community neurorehabilitation practice, Physio-Logic, in Toronto in 1993. Julie completed her MSc in Neurological Rehabilitation at Leeds Metropolitan University, UK in 2010, and her PhD at the Rehabilitation Sciences Institute, University of Toronto in 2016. Julie has had a number of post-doctoral positions and she holds an Assistant Clinical Professor (Adjunct) position in the School of Rehabilitation Science at McMaster University and, an Adjunct Lecturer appointment in the Department of Physical Therapy at the University of Toronto. Julie recently founded iNeuroRehab, an e-learning platform for clinicians. She is an Advanced IBITA instructor, and instructs post-graduate clinical neurorehabilitation courses across Canada and internationally. Articles we discussed and published by Dr. Vaughan-Graham After 55 Years of Neurorehabilitation, What Is the Plan? - PubMed (nih.gov) Motor Control: A Conceptual Framework for Rehabilitation in: Motor Control Volume 26 Issue 4 (2022) (humankinetics.com) Vaughan-Graham, J., Patterson, K., Brooks, D., Zabjek, K., & Cott, C. (2019). Transitions sit to stand and stand to sit in persons post-stroke: Path of centre of mass, pelvic and limb loading – A pilot study. Clinical Biomechanics, 61, 22-30. doi:https://doi.org/10.1016/j.clinbiomech.2018.11.004 http://www.sciencedirect.com/science/article/pii/S026800331830620X Michielsen, M., Vaughan-Graham, J., Holland, A., Magri, A., & Suzuki, M. (2017). The Bobath concept – a model to illustrate clinical practice. Disability and Rehabilitation, 1-13. doi:10.1080/09638288.2017.1417496 https://doi.org/10.1080/09638288.2017.1417496 https://www.tandfonline.com/doi/full/10.1080/09638288.2017.1417496 Vaughan-Graham, J., Patterson, K., Zabjek, K., & Cott, C. (2017). Conceptualizing movement by expert Bobath instructors in neurological rehabilitation. Journal of Evaluation in Clinical Practice, 23(6), 1153-1163. doi:10.1111/jep.12742 https://doi-org.myaccess.library.utoronto.ca/10.1111/jep.12742

Jaimy Wahab PT, DPT, NCS is a neurologic and vestibular physical therapist. She is the founder/owner of the Balance and Neurologic Center of the Rockies and an affiliate instructor for the Doctor of Physical therapy program at Regis University. She is an Affiliate Educator at Re+Active Education, an online, international continuing education platform, teaching advanced vestibular rehabilitation content. She became board certified as a Neurologic Clinical Specialist in 2007 and recertified in 2017. Current clinical interests include evaluation and treatment of patients with complex vestibular disorders, movement disorders, and functional neurologic disorders. She has a special interest in treating visual motion hypersensitivity and functional dry needling in the person with spasticity and dystonia to optimize outcomes and quality of life. She has been an invited panel member for the Brain Injury Hope Foundation. She has been involved in research regarding peripheral neuropathy and Parkinson’s Disease as well as Dual task with Parkinson’s Disease at Regis University. Katherine Deines, PT, DPT, NCS is a neurologic and vestibular physical therapist and owner/founder of STEP UP Physical Therapy in Colorado. She achieved her competency in vestibular rehabilitation through Emory University in 2002. She became a board certified neurologic clinical specialist in 2007 with recertification in 2017. Teaching experience includes assisting in the neurologic and vestibular coursework for the University of Colorado Doctor of Physical Therapy program. She is an affiliate educator with Re+Active Education, an online continuing education platform, teaching advanced vestibular rehabilitation content. The popular course, A Positive Spin on Dizziness, reached an international audience. Her clinical research with Regis University investigated peripheral neuropathy in Parkinson’s Disease. Current clinical interests include the evaluation and treatment of those with complex vestibular disorders with a special interest in visual motion hypersensitivity and those with movement disorders including Parkinson’s Disease, dystonia, and functional neurologic disorders. She is passionate about improving the function and quality of life of her patients. References: Optic flow, Visual dependence, visual vertigo (dizziness-and-balance.com) Hum Mov Sci

Classic texts say that tai chi will help you become “Strong as an oak, flexible as a willow, and [mentally] clear as still water.” It’s often called meditation in motion. Scientific studies are showing more and more health benefits that you can get from this practice. Dianne Bailey, CSCS, FAS, CTCI As a fitness professional, martial artist, and owner of a successful personal training studio in Denver, Dianne is passionate about creating the best opportunities for the mature adult to enjoy health and fitness. This passion has led her to create a system for learning Tai Chi which will empower fitness professionals to be able to offer this amazing form of exercise to their clientele and help others learn this wonderful form of “movement meditation.” Dianne is the author of three books: Eating Simply Open the Door to Tai Chi . . . Tai Chi for the Everyday Person Healthy, Happy and Fit – Ageless Exercise to enjoy Your Best Years Yet Dianne is a CSCS, a Functional Aging Specialist and a Certified Tai Chi Instructor. She has presented the benefits of Tai Chi at the Functional Aging Summit, ICAA Conference and Fitness Fest. In her engaging, easy-going yet commanding style, she hopes to encourage people to include Tai Chi in their offerings. Here are some Tai Chi resources. New 30 Days of Tai Chi. Here is the link to Day 1. A link to Diane's presentation, 'Who can use Tai Chi' Tai Chi for Balance - VeDA (vestibular.org) Articles: (So many choices) Wang LC, Ye MZ, Xiong J, Wang XQ, Wu JW, Zheng GH. Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis. J Am Geriatr Soc. 2021 Jul;69(7):2000-2010. doi: 10.1111/jgs.17094. Epub 2021 Mar 26. PMID: 33769556. Hu C, Qin X, Jiang M, Tan M, Liu S, Lu Y, Lin C, Ye R. Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review. Neural Plast. 2022 Mar 9;2022:3895514. doi: 10.1155/2022/3895514. PMID: 35309256; PMCID: PMC8926482. Zhang T, Lv Z, Gao S. Tai Chi Training as a Primary Daily Care Plan for Better Balance Ability in People With Parkinson's Disease: An Opinion and Positioning Article. Front Neurol. 2021 Dec 24;12:812342. doi: 10.3389/fneur.2021.812342. PMID: 35002945; PMCID: PMC8739955. Li G, Huang P, Cui SS, et al. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson's disease patients. Transl Neurodegener. 2022;11(1):6. Published 2022 Feb 7. doi:10.1186/s40035-022-00280-7 Guo G, Wu B, Xie S, et al. Effectiveness and safety of Tai Chi for chronic pain of knee osteoarthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022;101(2):e28497. doi:10.1097/MD.0000000000028497 Winser SJ, Tsang WW, Krishnamurthy K, Kannan P. Does Tai Chi improve balance and reduce falls incidence in neurological disorders? a systematic review and meta-analysis. Clin Rehabil. (2018) 32:1157–68. 10.1177 Zou L, Han J, Li C, Yeung AS, Hui SS-C, Tsang WWN, et al. . Effects of tai chi on lower limb proprioception in adults aged over 55: a systematic review and meta-analysis. Arch Phys Med Rehabil. (2019) 100:1102–13. 10.1016/j.apmr.2018.07.425

Mandy Shintani Mandy Shintani is an occupational therapist, gerontologist and the founder of Urban Poling. Her mission is to inspire all towards active living and wellness through innovative pole designs and education. As an avid proponent of life long fitness, she has experienced herself how Urban Poling fuels a healthy and fun lifestyle that includes, using poles with other exhilarating activities such as snowshoeing, hiking and adventure travel, which she is passionate about. As a therapist, her design of the patented ACTIVATOR Poles was rooted in her desire to create a tool that would revolutionize mobility and rehabilitation programs. She is an international presenter and is considered to be one of the leading experts on this activity. She was a finalist at the YWCA Women of Distinction Awards in the category of Innovation and Entrepreneurship. Resources: https://urbanpoling.com/activator-and-urban-poling-research/

Learn about vestibular rehab technology, infrared video goggles from Helena Esmonde, the co-founder of Vestibular First. Dr. Helena Esmonde, PT, DPT, NCS, is co-founder of Vestibular First, a company that makes affordable, FDA-cleared Insight Infrared Video Goggles as well as vestibular education tools. Helena has been treating patients with dizziness, vertigo, and imbalance for 15 years and passed the Emory Vestibular Competency Exam in 2015. She became certified to treat Cervicogenic Dizziness in 2016 and achieved Board Certified Neurologic Clinical Specialist designation in 2018. Helena has taught continuing education courses on concussion, BPPV, balance assessment, and visual vertigo treatment, serves as a teaching assistant at the University of the Sciences in Philadelphia, and regularly presents at the Balance Center rounds at the Hospital of the University of Pennsylvania and the Penn Medicine Mind Your Brain Conference. Vestibular First provides Helena the best opportunity for number one goal of helping others, with already well over a quarter million patients served by vestibular care via their technologies. References: Education - Vestibular First: List of articles demonstrate how infrared video goggles and related technologies have been used in the diagnosis and treatment of vestibular disorders. · Huh YE, Kim JS. (2013). Bedside evaluation of dizzy patients. Journal of Clinical Neurology. 9 (4): 203-213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840130/ https://dizziness-and-balance.com/disorders/visual/visual_dependence.htm

Alaina Newell, PT, DPT Board Certified Clinical Specialist in Oncological Physical Therapy Board Certified Clinical Specialist in Women's Health Physical Therapy Alaina received her Doctorate of Physical Therapy from the University of Pittsburgh in Pittsburgh, PA in 2012. She completed her Women’s Health residency at UPMC and joined the team in 2014. She is one of the few Board Certified Clinical Specialist in Oncology as well as Women’s Health Physical Therapy. She is also a Certified Lymphedema Therapist from the Lymphology Association of North America. She enjoys treated a wide variety of oncological diagnoses from melanoma, pancreatic, bladder, ovarian to breast cancer as well as Women’s Health needs secondary to oncological diagnosis including urinary urgency, gastrointestinal dysfunction, pelvic pain and postural dysfunction. Alaina is passionate about approaching each patient’s individual needs and desires to improve their daily function and quality of life. She integrates her understanding of the foundational understanding of the neuromuscular, integumentary, musculoskeletal, cardiovascular systems with her advanced training in gastrointestinal and urogynecological system to approach each patient. She has a strong emphasis in restoring the body to its natural alignment to allow it to optimally function. Alaina is the Pelvic, GI & Sarcoma Cancer Clinical Coordinator at Oncology Rehab as well as sitting on Oncology Rehab's Breast Cancer and Chemotoxicity & Cancer Exercise teams. Resources: Oncology Rehab - Home PORi - Oncology Rehabilitation Courses - Home - Aggithaya MG, Narahari SR, Ryan TJ. Yoga for correction of lymphedema's impairment of gait as an adjunct to lymphatic drainage: A pilot observational study. Int J Yoga. 2015 Jan;8(1):54-61. doi: 10.4103/0973-6131.146063. PMID: 25558134; PMCID: PMC4278136. - Doruk Analan P, Kaya E. Postural Stability in Patients with Lower Limb Lymphedema. Lymphat Res Biol. 2019 Dec;17(6):647-650. doi: 10.1089/lrb.2019.0004. Epub 2019 Jul 19. PMID: 31329503. - Forner-Cordero, Isabel & Furtado, Fabianne & Cervera-Deval, Juan & Forner-Cordero, Arturo. (2016). Ground reaction force patterns during gait in patients with lower limb lymphedema. Acta Fisiátrica. 23. 10.5935/0104-7795.20160038. - Forner-Cordero, Isabel & Forner-Cordero, Arturo & Maldonado-Garrido, D. & Cervera-Deval, J.. (2009). Biomechanical study of the gait in patients with lower limb lymphedema. European Journal of Lymphology and Related Problems. 20. 1-6. - Yoosefinejad AK, Hadadi M, Eslamloo P. Evaluating the responsiveness of the fullerton advanced balance scale in patients with lymphedema secondary to breast cancer surgery. Lymphology. 2019;52(2):61-70. PMID: 31525827

Music can lift moods, help with studying, and make workouts more productive and enjoyable. I know I enjoy working out to music, I run further and push myself more when I listen to music. While all of those ways of listening to music are important, there is a difference between recreational music, therapeutic music, and clinical music therapy. Today we are going to learn from Sarah, a board-certified music therapist about the benefits of music therapy. Sarah's 2 tips to non- music therapists 1. Create a rhythm using words and then get your metronome to match it and try to emphasize the most difficult part. 2. Consider double priming, especially if someone is moving below 60 beats per min. Listen to learn more... Sarah Thompson, MM, MT-BC, CBIS is a board-certified music therapist who has used music to influence movement for 17 years. She specializes in working with survivors of neurologic injuries and individuals living with neurologic diseases. She is the founder and CEO of Rehabilitative Rhythms and is currently a PhD student. She is a lifelong learner who is passionate about providing evidence-based practice in healthcare while keeping compassion and patient satisfaction a top priority. Resources : www.PossibleWithMusic.org http://www.jessicagrahn.com/ Grahn, J. A., & Brett, M. (2007). Rhythm and beat perception in motor areas of the brain. Journal of cognitive neuroscience, 19(5), 893-906. Leow, L. A., Parrott, T., & Grahn, J. A. (2014). Individual differences in beat perception affect gait responses to low-and high-groove music. Frontiers in human neuroscience, 8, 811. Thompson, S., Hays, K., Weintraub, A., Ketchum, J. M., & Kowalski, R. G. (2020). Rhythmic Auditory Stimulation and Gait Training in Traumatic Brain Injury: A Pilot Study. J Music Ther. doi:10.1093/jmt/thaa016

Heather discusses posture assessment purpose and priorities: In terms of ’tips’ or a focused approach to improvement where posture, balance, and reduced fall risk are involved, I have two pillars on which I build recommended programs: Heather Campbell, PT, DPT, OCS has 43 years of experience integrating musculoskeletal and neurologic recovery. She earned her physical therapy degree from University of North Carolina at Chapel Hill, a master’s degree in motor control and exercise physiology from University of Denver, and a doctorate from University of Montana. Early in her career she qualified for a manual therapy competence certificate, and Board Certification as an Orthopedic Physical Therapy Specialist. Dr. Campbell has served on faculties of first professional and post-professional academic programs in physical therapy, medicine, and dentistry, as well as giving local, national and international professional education seminars. She currently serves as affiliate faculty at Regis University. With a career emphasis in musculoskeletal spine care, she focuses on postural, visual and vestibular interdependence and how to influence central sensory processing for recovery after injury or neurologic disease. Her expertise in concussion management links cervicovestibular assessment to all other components in a multidisciplinary approach to care. She awarded Colorado’s Outstanding PT of the Year in 2019 for her tireless efforts in promoting the return to play legislation, and she consulted in creating the PT department and program for the Marcus Institute for Brain Health in 2017-2018

Are you adding vestibular rehab to your telehealth sessions? We have the honor to learn from a pioneer in telehealth rehab, Sarah Gallagher, PT, DPT, NCS, the owner of South Valley Physical Therapy, the founder of the Dizzy Clinic and founder and chair of the Vestibular SIG Telehealth Task Force. This interview was recorded a year ago prior to the pandemic when telehealth was not widespread. COVID-19 has quickly changed the landscape of telehealth. This interview is still extremely relevant as more clinics are transitioning to hybrid models and telehealth. This interview we mainly discuss the clinical applications regarding assessment and treatment during telehealth sessions? Tips on verbal instructions, observation skills and screening tools are discussed. Before you begin providing services via telehealth or using telecommunications modalities, consider federal and state legislation and regulations that govern your practice, billing and coding issues. Please check the APTA’s website with up to date info on telehealth resources and tips. https://www.apta.org/your-practice/practice-models-and-settings/telehealth-practice Dr. Sarah Gallagher PT, DPT, NCS graduated with her doctorate from MGH Institute of Health Professions in Boston, MA and completed an internship at Massachusetts General Hospital in acute care. After working several years in hospital settings, focusing in trauma, she transitioned to an outpatient setting. South Valley Physical Therapy specializes in neurologic and vestibular rehabilitation and as an owner she collaborates with regional and national experts to ensure the evidence based and cutting-edge treatment. Dr. Gallagher identified that access to expert vestibular rehab is limited due to limited expertise in the state of Colorado, long travel distances, and dizziness impeding commuting to the clinic. This problem led her to found The Dizzy Clinic which provides vestibular rehab via videoconferencing in 2017 as well as implemented tele rehab at South Valley PT for insurance reimbursement. She lectures at the University of Colorado PT school on vestibular rehabilitation and telehealth. She has presented at national conferences including CSM and several state APTA conferences on implementing tele rehab. She also is the founder of the Colorado Vestibular Support Group, member of: APTA, Academy of Neurology and Vestibular SIG, Vestibular Disorders Association (VeDA). She participates in the APTA FiRST Council, Telehealth track, and is founder and chair of the Vestibular SIG Telehealth Task Force. She authored an article for VeDA on telerehab with vestibular patients, published in January 2018. In 2020, she was awarded Colorado’s Outstanding PT of the year for her advocacy and training of telehealth. References: Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer?. Phys Ther. 2020;100(8):1260-1264. doi:10.1093/ptj/pzaa093 van Vugt VA, van der Wouden JC, Essery R, et al. Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial. BMJ. 2019;367:l5922. Published 2019 Nov 5. doi:10.1136/bmj.l5922 Tenforde AS, Hefner JE, Kodish-Wachs JE, Iaccarino MA, Paganoni S. Telehealth in Physical Medicine and Rehabilitation: A Narrative Review. PM R. 2017 May;9(5S):S51-S58. doi: 10.1016/j.pmrj.2017.02.013. PMID: 28527504.

“I think of optokinetics like I would think of a hammer. A hammer can both drive a nail and pull it out. Optokinetics can push the vestibular system or it can make it challenging to use for your balance.” -Kenda Fuller Kenda Fuller Bio: Kenda Fuller, PT, was a pioneer in the practice of vestibular and balance rehabilitation in the 1980’s, certified by the American Board of Physical Therapy Specialists as a neurological specialist in 1990. She is responsible for the neurologic content in Pathology: Implications for Physical Therapists, Elsevier. She contributed to Umphred’s Neurological Rehabilitation by writing chapters on Balance and Vestibular Disorders. Education has been a strong focus of her career as affiliate faculty at both University of Colorado and Regis University. She has provided extensive continuing education on balance dysfunction throughout the US. Invitations to give international lectures were associated with NeuroCom International, Inc which gave her access to interact with medical practitioners throughout the world. She was instrumental in the development of testing and treatment software for the Proprio 5000, used to identify balance impairments and determine functional limitations. She created the Vestibular and Balance exercise program for Physiotools (https://www.physiotools.com), an electronic exercise product used worldwide. As co-owner of South Valley Physical Therapy from 2002 to 2020, her independent practice has been focused on the care of patients with complex neurologic and orthopedic conditions causing imbalance. She understands the need to identify the impairments that lead to imbalance and determine best interventions to enhance functional status. References: Use of optokinetics based OKCSIB protocol in restoring mobility in primary progressive MS. Use of optokinetic chart stimulation to restore mobility and reduce ataxia in a patient with pseudo-Cushing ataxia. Repetitive optokinetic stimulation induces lasting recovery from visual neglect Randomized controlled trial on hemifield eye patching and optokinetic stimulation in acute spatial neglect. Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case. Study of Optokinetic Stimuli as Treatment for Mal de Debarquement Syndrome. The effect of repeated exposure to visual motion stimuli on visual dependence in normal healthy subjects The Use of Optokinetic Stimulation in Vestibular Rehabilitation The Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients.