201: Opportunities and Challenges Are Really A Matter Of Perspective

In this week’s episode we address a listener’s question about retropulsion in people with Parkinson’s. In the show we define retropulsion then provide a plethora of ideas for you to try with your clients to help them restore their ability to move backwards without falling!

• Sit to Stand (STS) and Standing Postural Issues:
• Biggest issue: inadequate weight shift forward
• Factors contributing: “off” medications, low medication with increased bradykinesia, dyskinesia “on” medication
• Postural changes are a cornerstone of Parkinson’s Disease (PD)
• Perceptual and visual changes, smaller base of support can impact retropulsion
• Medication Discussion:
• Importance of discussing medications with neurologists
• Hard to out-exercise being undermedicated
• Treatment Ideas:
• Weighted Vest:
• Balance Based Torso Weighting
• Exaggerate feeling by adding more weight behind or in front
• Aerobic Exercise:
• Intense, engaged, elevated heart rate
• Preferable on treadmill, multi-directional movement
• STS Treatment:
• Provide a target in front
• Encourage body awareness
• Challenge on different surfaces to augment error
• Use Blazepod for external cues and motivation
• Resistance Band Exercises:
• At the hips, pulling backward
• Secure attachment, various directions
• Include targets and external cues
• Repetition, variety, dual tasks, eyes closed
• Reactive Balance Training:
• Backward steps in various positions
• Posterior activation in quadruped, walking, tall kneeling, prone
• Clock Yourself App:
• Use front or back half of the clock for different movements
• Compensatory Strategies:
• Staggered stance, wider stance
• Conclusion:
• Encourage problem-solving and empowerment
• Highlight the importance of repetition, variety, and external cues

Let us know if you have more questions by sending us a DM @neurocollaborative or posting inside the NeuroCollaborative Professionals Facebook group!