Louisville NE 68037 & Plattsmouth NE 68048

Physical Therapy for Dementia

September 26, 2023

Dementia is a group of conditions that affect the brain, causing problems with memory, thinking, communication, and behavior. Dementia has many forms, including Alzheimer’s disease, vascular dementia, Lewy body dementia, and more. It’s a big deal. According to the WHO, it’s the seventh leading cause of death worldwide and one of the major causes of disability among older people. While there is no cure for dementia, there are ways to manage the symptoms and improve the quality of life for people living with this condition.

Physical activity is one common recommendation. While exercise is certainly beneficial to everyone, the evidence for exercise’s effect on dementia symptoms is mixed. Most studies do show that exercise can help delay or reduce symptoms like depression, or apathy. Some studies also show a benefit in delaying or reducing cognitive declines. If you’re familiar with the benefits of exercise, this all makes sense. We know exercise has a positive effect on mood and depression. When your heart pumps harder during exercise, it increases blood flow throughout your body, including to your brain. 

Does Any Type of Exercise Work?

For people with dementia, it doesn’t appear as simple as “exercise and symptoms improve.” Studies have shown that the type of exercise, duration, and frequency all make a difference. For example, one study showed that people with dementia who engaged in dance movement therapy had less depression and better physical function. A second group who performed other types of exercise at the same intensity did not see those benefits. This is where a physical therapist can be incredibly beneficial. 

Physical therapy for dementia is tailored to each individual’s needs, goals, abilities, and preferences. The physical therapist will conduct a thorough evaluation of the person’s medical history, physical condition, cognitive status, functional level, and personal interests. Based on this information, the physical therapist will design a personalized treatment plan that includes specific exercises and activities that target the areas that need improvement.

The treatment plan may include:

  • Aerobic exercises to improve cardiovascular health, oxygen delivery to the brain, mood, energy levels, and cognitive function.
  • Strength exercises to build muscle strength and power.
  • Balance exercises to challenge the person’s ability to maintain equilibrium and prevent falls.
  • Functional exercises that mimic or practice daily activities that are important or meaningful to the person, such as climbing stairs, getting in and out of bed or a car, or using utensils.
  • Coordination exercises or more complex movements like dance or tai chi. Evidence shows more complex movements like these have larger effects on more dementia symptoms than a simpler exercise like riding a stationary bike. 
  • Dual – task or cognitive exercises like combining walking with doing math out loud, or solving puzzles while on a stationary bike or treadmill. Again, research shows that combining physical and cognitive challenges can have an effect on dementia symptoms. 

The physical therapist will monitor the person’s progress and adjust the treatment plan as needed. They’ll also provide feedback and encouragement. The physical therapist will also educate and advise the person and their family or caregivers on how to continue or incorporate physical activity into their daily routine and lifestyle.

Physical therapy is a safe and effective way to help people with dementia improve their physical and mental health, as well as their quality of life. Physical therapy can also provide support and guidance to people with dementia and their caregivers, helping them cope and adapt to the changes and challenges that come with this condition.



Lumbar Strains and Physical Therapy

September 19, 2023

It happened to me! I was cleaning up the garage and moving some tables after a gathering. When bending down to lift the 5th table to be moved I was worried more about what I needed to get done that day versus what I was supposed to be focusing on. As I lifted and turned I lost my lifting mechanics and tweaked my back. I had immediate spasms of my lower back and could not stand up with resting me hands and arms onto something to help hold me up. For the rest of the day I laid in bed and tried not to move too fast or in the wrong direction. I tried taking some meds to decrease pain and spasm, I used heat packs and warm water baths to try to relax the muscles. Both of these took the edge off but did not improve my symptoms overall.

The next day I started doing some basic therapy mobility exercises to get my back moving without increasing my spasms. I used a TENS unit to decrease the pain so that I could get up and move more effectively. I went to therapy and got some work done to decrease my spasm and tone and to improve the mobility of my back. By the next day I was back on my feet all day long and work and moving more normally, but not yet 100%. I continued to do these exercises and keep moving and by the third day I was back without any restrictions.

Often when we have acute back pain we take some meds and stay in bed. That is what I did the first day. However, that is not what experience and the research say is best for the immediate resolution of our symptoms and the long term benefit of our backs. Most of the time the faster you can access care for your low back the quicker it gets better. The research shows that starting physical therapy within a day or two of the back pain starting gives you a better chance of relieving the backpain without needing stronger prescription strength drugs, injections, or possibly surgery. This recent example of my issue and treatment helps to prove that theory. I was able to access therapy 24 hours after the initial injury and I was able to continue to do these activities for the next few days to get back on my feet at 48 hours after the injury and be back to 100% 72 hours after the initial injury.

I have the benefit of having physical therapy at my fingertips, but so do you. If you have an injury you can call Witte Physical Therapy and we can start to get you help right away. You have direct access to come directly to the clinic for care, meaning that you do not have to see the physician first. Sometimes it may be appropriate for you to see your physician prior to starting therapy and we can help you through the steps to make that process as efficient as possible. If you have any aches or pains, don’t hesitate to give us a call and we can help get you moving and back on the road to being 100% you faster!

Physical Therapy and the 9/11 Attacks

September 12, 2023

Never Forget | New York Giants remember 9/11

Yesterday we experienced the 22nd anniversary of the 9/11 attacks on our country. On this anniversary we remember those lost and look at the changes made to the former site of the World Trade Center. These changes include a museum, a memorial, and now a state of the art performance space. All of these physical buildings were built for different reasons and to remember different aspects of that day and the people who were affected. 

The people who were there that day and survived or worked to find the survivors and victims of the attack are still dealing with several different health issues from being at ground zero that day. These ailments could include upper respiratory conditions, GERD, cancer, PTSD, depression, anxiety and substance abuse. This is just a sampling of the problems they are dealing with and does not include the secondary conditions and issues that arise from this list. Chronic pain, inflammation, and heart issues can all be items that physical therapy could help with. 

Physical therapy can help with the deconditioning that comes from dealing with upper respiratory issues and cancer side effects. Physical therapy can help to decrease inflammation and improve pain free mobility. Physical therapy can help with chronic pain to retrain our bodies how to perceive pain and can help us tolerate more activities and become more functional with less pain. Not all of these issues are solely related to the 9/11 attacks, but they can been seen with a variety of patients with cardiovascular, respiratory, and cancer related issues. 

If you are not feeling 100% don’t take that feeling as being your new normal. Visit with a physical therapist about your next steps and how physical therapy may be able to help get you back on your feet and enjoying your entire life! 





Happy Labor Day!!!

September 4, 2023


We have just completed Labor Day weekend. This is a weekend of celebration of the annual accomplishments of the workforce and is noted as a federal holiday and a day off for many people. In many larger cities it often includes a parade to acknowledge the larger workforces of the area. Examples include many labor unions and city workers.

As we look at Labor Day and its history of celebration, I believe we can tie it in to physical therapy. Labor Day is a celebration of the work done by so many of the year. For our patients’ physical therapy is work. (Luckily for our therapists, physical therapy is fun!) We try to make physical therapy as fun as possible, but it takes the work and dedication of our patients to come to each appointment and to make the most of it. Our patients work extremely hard in the clinic and with their programs at home to get better as fast as they can. Our therapists work hard to provide a fun atmosphere for our patients to improve and be cared for.

I hope everyone used this past weekend as an opportunity to celebrate the work they have put in this year and to renew their dedication to continue to put in 100% effort moving forward. Our therapists will continue to work hard, train and educate themselves to give our patients 100% of their effort in developing plans of care that are specialized to each individual patient. I know our patients will do the same to follow that plan of care and complete their home exercise plan to maximize their results and efficiency.

We look forward to a great last few month of 2023 and for the opportunity to plan for an even better 2024!

Physical Therapy and Ankle Fracture

August 29, 2023


A freak accident or weird fall can result in a myriad of injuries. One of these injuries can be an ankle fracture. Your ankle is composed of three bones, the tibia, the fibula, and the talus. These three bones can result in a variety of fractures and injuries from a fall. Most of these fractures do require surgery and/or physical therapy.

After the injury you will be placed in a CAM boot. This boot has its pros and cons. It allows for earlier motion and mobility which can decrease your recovery time. However, it is hot, heavy, and can cause issues with being able to drive or be independent. Physical therapy can help to address all these issues. During your initial appointment we will work on evaluating how the boot and the restrictions of your injury are currently affecting your life and what needs addressed to get you back to 100%.

Initially physical therapy will focus on your mobility, flexibility, and non-weight bearing muscle strength. We will design a plan of care that works within your MD restrictions. These restrictions could include weight bearing status, a CAM boot wear schedule, etc. The more mobility and flexibility you can attain before the boot comes off the easier it will be to start walking as soon as you lose the boot.

Once you’re able to bear weight outside the boot we will start to work on weight bearing muscle strength. We often call this functional strength, and it leads right into your balance and proprioception. At this point you are often starting to feel better and working back to normal. However, it is important to address the balance and proprioception of your ankle to improve your overall stability. This step is often missed but can have lasting effects on the future of your ankle when on unstable surfaces or faced with another fall situation.

After you have completed all these steps you can get back to your normal life with renewed confidence and strength in your ankle and its ability to handle what you put it through!

How Physical Therapists Help Children with Cerebral Palsy

August 22, 2023

Cerebral palsy (CP) is a group of neurological disorders. It is caused by damage to the immature, developing brain, usually before birth. CP can have a broad range of effects. People with CP may have trouble seeing, hearing, feeling, thinking, or communicating. Difficulties can range from mild to severe. CP also typically affects movement, muscle coordination, and balance. This can result in problems moving and walking, abnormal muscle tone, exaggerated reflexes, and involuntary movements. There is no cure for CP, but early treatment can help.

Physical therapy is one of the most important forms of treatment for children with CP. PT can help children improve their movement skills, stay active, and perform daily tasks. PT can also help prevent movement problems from getting worse over time and reduce physical discomfort. Let’s look at a few of the ways PT can be helpful:

Take Advantage of Neuroplasticity

Neuroplasticity is the ability of the neurons and neural networks in the brain to form new connections and change their behavior. This can help the brain to adapt or “train” other areas to take over the function that the damaged part was intended to do. Neuroplasticity is highest during the first few years of life, when the brain is still developing and forming new connections. This means that early intervention PT can have a greater impact on the brain’s ability to reorganize and learn new skills.

Early PT can help children with CP enhance neuroplasticity by providing exercises and activities that stimulate and challenge their brain and nervous system. This could involve playing with children in different positions that challenge their balance and stability, encouraging the use of affected limbs, or using different forms of sensory stimulation. 

Improve Motor Skills and Function

Children with CP often have difficulty with motor skills and function due to muscle spasticity, weakness, or stiffness.

PT helps children with CP improve their motor skills and function by providing exercises and activities that target the large muscles in the arms, legs, and abdomen. For example, a physical therapist may use strength training, stretching, or balance training to improve the child’s muscle tone, range of motion, and stability. For young children, a PT might also use functional training techniques like crawling, climbing, walking, or propelling a wheelchair to improve the child’s mobility and independence.

Prevent or Delay Secondary Complications

Secondary complications are problems caused or are worsened by the primary diagnosis of CP. These can include muscle atrophy, loss of range of motion, muscle spasticity, pain,  joint inflammation, and contractures. Secondary complications affect the child’s daily function, health status, and quality of life.

PT can help children with CP prevent or delay secondary complications by providing exercises and activities that maintain or improve their physical health and functioning. Examples include massage or stretching to relax and lengthen the muscles, positioning devices to improve posture, or braces, splints, or orthotics to support and align the affected joints.

Increase Quality of Life and Well-being

Movement limitations and environmental barriers can affect the self-esteem, confidence, and social relationships of children who have CP.

PT can improve the quality of life and well-being of children with CP by providing exercises and activities that are tailored to their individual needs and goals. Adaptive equipment such as wheelchairs, crutches, or bicycles can help the child access their community and enjoy recreational activities. A physical therapist will also work with the child’s family and other professionals to provide education and support for the child’s overall health and development.


Early physical therapy is a vital form of treatment for children with cerebral palsy. It can help them take advantage of neuroplasticity, improve motor skills and function, prevent or delay secondary complications, and increase their quality of life and well-being. PT can help kids with CP be as independent, comfortable, and healthy as possible. 

If you are looking for an early intervention physical therapist for your child with cerebral palsy, you can visit Choose PT to find one near you.




  1. Physical Therapy for Cerebral Palsy – Improving Mobility. (n.d.). Retrieved from https://www.cerebralpalsyguide.com/treatment/physical-therapy/
  2. Physical Therapy for Children with CP. (n.d.). Retrieved from https://www.cerebralpalsy.org/about-cerebral-palsy/treatment/therapy/physical-therapy
  3. Cerebral palsy – Diagnosis and treatment – Mayo Clinic. (n.d.). Retrieved from https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-treatment/drc-20354005
  4. Cerebral Palsy and Physical Therapy. (2022, April 28). Retrieved from https://www.cerebralpalsyguidance.com/cerebral-palsy/treatment/physical-therapy
  5. Therapy has long-lasting benefits for children with cerebral palsy. (2021, November 9). Retrieved from https://www.nih.gov/news-events/nih-research-matters/therapy-has-long-lasting-benefits-children-cerebral-palsy
  6. Early Intervention for Cerebral Palsy: Examples & What to Do. (n.d.). Retrieved from https://www.flintrehab.com/cerebral-palsy-early-intervention/
  7. Morgan, C., Fetters, L., Adde, L., Badawi, N., Bancale, A., Boyd, R. N., Chorna, O., Cioni, G., Damiano, D. L., Darrah, J., de Vries, L. S., Dusing, S., Einspieler, C., Eliasson, A.-C., Ferriero, D., Fehlings, D., Forssberg, H., Gordon, A. M., Greaves, S., Guzzetta, A., … Novak, I. (2021). Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy: International Clinical Practice Guideline Based on Systematic Reviews. JAMA Pediatrics, 175(8), 846–858. https://doi.org/10.1001/jamapediatrics.2021.0878
  8. Therapy for Cerebral Palsy | Early Intervention | CerebralPalsy.org. (n.d.). Retrieved from https://www.cerebralpalsy.org/about-cerebral-palsy/treatment/therapy
  9. Early Intervention and the Importance of Early Identification of Cerebral Palsy – Physiopedia. (n.d.). Retrieved from https://www.physio-pedia.com/Early_Intervention_and_the_Importance_of_Early_Identification_of_Cerebral_Palsy
  10. Cerebral Palsy Early Intervention. (n.d.). Retrieved from https://cprn.org/cerebral-palsy-early-intervention/


Let’s Get Back Into A Routine!

August 15, 2023

Lack of Strength

As school is beginning to get started again for another year many of us are getting reminded of what is feels like to get back on schedule or to start a new routine. Our children are getting used to going to bed at a specific time and will soon be learning about their new routine for their school and class schedules. Even as parents we are getting used to being home more at night, ensuring our children (and ourselves) are getting the proper amount of sleep, and a new morning routine to try to get out of the house on time for school and work. Routines provide structure and promote physical and mental health benefits. While the word routine may bring on feelings of boredom, stress, or anxiety, it can be a very valuable tool in living our lives to their fullest.

We use the word routine a lot in therapy. It is one of the tools that we use to help a patient reach their fullest potential as quickly as possible. We try to develop a new routine for the patient that includes their home exercise plan, which is an integral part of an effective and efficient physical therapy plan of care. It is important that the therapist and the patient work together to develop a home exercise plan that they can complete and commit to. Making a plan with small changes and adjustments that are built around our current life and habits may make the routine easier to establish and follow.

Take some time as we work to get back into the school and fall season to begin to make a routine for you and your family to follow. Use the next few months of 2023 to try out this routine, make adjustments, and reflect on how it is working. This can allow for clearer resolutions for 2024 and catapult you into next year!





Witte Physical Therapy Areas of Concentration – Orthopedics

August 8, 2023


Many people think of outpatient physical therapy and orthopedics as being the same thing. They feel that the main reason to go to a physical therapy clinic is because of pain or issues they are experiencing from an orthopedic issue. Orthopedic structures tend to fall into 3 categories: bone, muscle, and ligament. These tend to be the causes of back pain, shoulder, knee, or other joint pain, pulled muscles, joint replacements, worker’s compensation accidents, motor vehicle accidents, rotator cuff and other types of shoulder repairs, and the list goes on and on. For these issues physical therapy is a very common non-invasive, conservative treatment option that could save you from unnecessary medications, injections, and procedures.

At Witte Physical Therapy we have an Orthopedic Certified Specialist who can assist in the formation of our patient’s individualized plan of care and who regularly trains our therapists on how to treat and progress these issues as effectively and efficiently as possible. A therapist who has obtained an Orthopedic Certified Specialist certification has received extra training and successfully passed an additional federal board examination to be recognized as a specialist in the management and treatment of orthopedics. Witte Physical Therapy is fortunate to have one of the 5% of physical therapists who have achieved a specialist certification.

Treatment of any orthopedic condition can include a wide range of interventions using many different “tools from our toolbox”. While every treatment for every patient needs to be properly evaluated and assessed by a physical therapist to provide the best care for each individual patient, the list of interventions we can use is endless. Manual therapy can be used to improve soft tissue abnormalities and extensibility to improve motion and flexibility. Exercise can be used to improve strength and mobility. Other interventions can improve balance, stability, coordination, and function. Aquatic therapy, functional dry needling, IASTM, and many other tools can be used to improve all these areas. Witte Physical Therapy can address all these areas and use all of these tools to maximize your results!

How Physical Therapy Helps People with Parkinson’s Disease

August 1, 2023

Parkinson’s disease (PD) is a progressive neurological disorder that affects movement, balance, posture, and coordination. It can also cause non-motor symptoms such as pain, fatigue, mood changes and cognitive impairment. While there is no cure for PD, there are treatments that can help manage the symptoms and improve the quality of life of people living with PD.

Physical therapy is one of these treatments. PT can help restore or maintain physical function, mobility, and independence. Physical therapists are trained professionals who can assess, diagnose, and treat movement problems related to PD. They can also provide education, advice, and support to people with PD and their caregivers.

Benefits of Physical Therapy for People with PD

Physical therapy can help people with PD in many ways, such as:


Improving muscle strength and endurance. Both age and PD can weaken and decondition muscles. A physical therapist will prescribe exercises using light weights or resistance bands to improve strength. More strength helps with balance and mobility.

Enhancing amplitude of movement PD can cause people to reduce the size and speed of movements. This can affect walking, speech, facial expressions, and gestures. Physical therapy can help increase the amplitude of movement by teaching overexaggerated physical movements, such as high steps and arm swings. This is a way to retrain the muscles and brain to compensate for the reduced movement that Parkinson’s can cause. The LSVT BIG program is a specific set of exercises and activities that has been shown to improve mobility and quality of life.

Reinforcing reciprocal patterns. Reciprocal movements are side-to-side and left-to-right patterns, such as swinging your arms while taking steps as you walk. PD can affect these patterns, which makes walking slow and unstable. Physical therapy can help to reinforce reciprocal patterns by using machines like a recumbent bicycle or elliptical machine. Practicing walking with arm swings is another activity that can help restore reciprocal movements. This can improve coordination, rhythm, and fluidity of movement for people with Parkinson’s. Dance and tai chi are other activities that involve reciprocal patterns.

Improving balance and posture. PD commonly impairs balance. Your brain uses a complex mix of what you see, your inner ear and sensations from your feet and joints to maintain balance. Physical therapy can help to improve balance using exercises that challenge stability, such as standing on one leg or walking on uneven surfaces. PT will also focus on specific components of the balance system by doing things like having a person close their eyes to focus on the sensations from the feet and joints. Physical therapy can also improve posture by correcting any muscle tightness or weakness that may cause stooping or learning sideways.

Increasing flexibility and range of motion. PD also often causes muscle stiffness and rigidity. Physical therapy can help increase flexibility and range of motion with stretching exercises that target specific muscles. Common areas of issue are the hip flexors, hamstrings, and calves. Stretching regularly can also help to reduce pain and spasm.

Providing education and self-management advice. Physical therapy can help people learn more about PD and how it affects their movement. A physical therapist can provide tips on how to maintain safety when exercising, how to cope with fatigue or pain, how to use assistive devices if needed, and how to prevent or manage complications such as falls or freezing.

Sounds Great. Is There Proof?

Yes. Research backs up all these claims. One meta-study (a study that combines the results of many other studies) that covered 1827 participants found that when compared to no intervention, PT significantly improved:

  • gait speed
  • two- and six-minute walk test scores
  • Freezing of Gait questionnaire
  • the Timed Up & Go test
  • Functional Reach Test
  • and the Berg Balance Scale

These results indicate improvements in mobility, endurance, strength, and balance. Gait speed is an especially important measurement. Physical therapists often consider gait speed a “vital sign.” This is because low gait speed has been linked to:

  • declines in functional mobility
  • higher rates of hospitalization
  • higher fall rates
  • cognitive decline
  • increased disability
  • and higher risk of death


A larger meta study that included 191 studies with 7998 participants found that PT significantly improved motor symptoms, gait, and quality of life. Specifically:

  • Resistance and treadmill training improved gait.
  • Strategy training improved balance and gait.
  • Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait.


Physical therapy is a valuable treatment option for people with PD, as it can help to improve or maintain their physical function, mobility, and independence. Physical therapy can also enhance their quality of life, confidence, and well-being. If you have PD or know someone who does, consult with a physical therapist who specializes in PD to see how they can help you.


(1) Physical Therapy for Parkinson’s Disease – Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/physical-therapy-for-parkinsons-disease.

(2) Physical Therapy and PD | Parkinson’s Foundation. https://www.parkinson.org/library/fact-sheets/physical-therapy.

(3) Physical and Occupational Therapy for Parkinson’s: What to Expect. https://bing.com/search?q=physical+therapy+for+parkinson%27s+disease.

(4) Parkinson’s Disease Treatment Physical Therapy. https://www.parkinsonsdaily.com/parkinsons-disease-treatment-physical-therapy/.

(5) Physical, Occupational & Speech Therapies | Parkinson’s Foundation. https://www.parkinson.org/living-with-parkinsons/treatment/physical-occupational-speech-therapies.

(6) Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities – https://pubmed.ncbi.nlm.nih.gov/32917125/

(7) Physiotherapy versus placebo or no intervention in Parkinson’s disease – https://pubmed.ncbi.nlm.nih.gov/24018704/

Witte Physical Therapy Areas of Concentration – Pelvic Health

July 18, 2023


As a small community physical therapy company, we try to be as many things to as many people as we can. We try to serve our community both inside our clinic and outside.

Outside of our clinic we work to support many different groups and organizations to ensure they have the resources they need to continue to thrive in and serve their communities. We provide community service and work to be an advocate for our communities by being involved with different groups and boards.

Inside of our clinics we have worked to assemble a staff that puts patients first. They work to build an individualized plan for each patient so that not all patients who have had a total knee replacement get the same plan. We have also worked to get our staff extra training and experience in many different aspects of physical therapy. We have an orthopedic certified specialist on board. We have a therapist who has taken a special interest and more advanced training in vestibular and balance therapies. We have a therapist who has seen and worked with a variety of women’s health issues. And finally, we have a therapist who has an extensive background in pediatric therapy. These are just a few of the areas that we have tried to work with as many patients as possible for our therapists. Today, let’s focus on those patients who could benefit from pelvic health therapy.

Most of the time when we think of pelvic health we think of woman’s health and pelvic pain. This pain can be from childbirth, aging issues, or other causes. However, men can have pelvic issues leading to pain or incontinence. Physical therapy aims to help correct and treat these issues for all types of patients.

A physical therapy evaluation will be performed by our pelvic health physical therapist to determine the cause of your issues and to develop a plan of care based on those findings. Treatment could consist of a variety of techniques aimed at improving flexibility, strength of intrinsic and extrinsic musculature, and core stability to name a few. Your treatment plan will be specific to you and developed based on your symptoms and goals. Most of the time these treatments are performed in a private room to give you the privacy you need to be comfortable with what we are working on.

If you are having any pelvic issues give us a call and set up a time to talk to a therapist to develop a plan that will work best for you!