Blog

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.

Conclusion

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.

References

(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!

Witte Physical Therapy Areas of Concentration: Vestibular and Balance Therapy

July 11, 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 vestibular and balance therapies.

Vestibular therapy aims at improving balance and vertigo related symptoms associated with an inner ear dysfunction. It is important to note that not all balance issues are vestibular because our vestibular system is just one part of our overall balance. Three “systems” that make up our balance system are our eyes, our ears, and our musculoskeletal system. Vestibular deals with the ear and the mechanism that helps us feel where we are at in space. This system needs more specialized work than traditional physical therapy normally provides. We have a duct system in our inner ear that has a X, Y, and Z axis. This system houses tiny crystals that move in these canals as our bodies move in order to keep us upright and centered. Special evaluation techniques, interventions, and exercises are used to correct these crystals if they get stuck or travel down the wrong duct system. We have therapists who has taken extra training in working with and correcting these issues. 

Balance therapy can include vestibular components, but sometimes balance issues are related only to musculoskeletal deficits. When we start to use our balance we use three strategies to try to prevent a fall. Our ankle strategy focuses on quick and reflexive foot movements to correct a loss of balance episode. Our hip strategy takes over if we need more help to stop a fall. It involves try to shift our center of gravity over our current base of support. Finally our stepping strategy is engaged if we are unable to stop a fall without widening our base of support. Physical therapy can help make sure these strategies are all operating optimally and in the correct sequence. 

If you are having any balance 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!

Sleeping Strategies with Shoulder Pain

June 27, 2023

If you are experiencing shoulder pain often it affects many aspects of your life. It can make reaching for objects, getting dressed, or trying to lift anything a pain. Many people do not realize that their shoulder pain can also cause great issues with sleeping. Laying on your back or on your side can be very uncomfortable. If you are a stomach sleeper often you put your arms above your head, this position can also cause a lot of discomfort. So how can you find a way to get some sleep?

One option that many try is to sleep in a recliner. Sleeping in a recliner allows you to adjust your head height. This adjustment can take pressure off of your shoulder and help to keep the joint better aligned which will decrease your pain and stress. 

Another option is to try to sleep on your back with pillows under your shoulder blade to help support your shoulder complex. This is often another technique that can help decrease your shoulder pain with sleep.

The position of your shoulder that often offers the most space and thus the least pain is the 30 30 position. This position puts your shoulder into 30 degrees of flexion and 30 degrees of abduction and provides a way to avoid any excessive compression. Positioning your shoulder with pillow propping into this position while laying on your back or side can often provide some shoulder relief.

Overall there is no one right answer to decrease your shoulder pain to help you sleep, but helping your body to get rest is pivotal in working on improving your recovery and decreasing your pain.

Dehydration

June 20, 2023

As we are in our hottest run of hot weather yet this summer the topic of dehydration has come up multiple times in the clinic. Keeping properly hydrated is important for our normal health, but becomes increasingly important as we are healing and as we are dealing with increased temperatures.

Dehydration is caused by losing more fluids than we take in. This can cause a host of issues in our bodies due to the imbalance of fluid and nutrients that it causes. Some early signs of dehydration are a dry mouth, feeling thirst, feeling tired, urinating less, or having urine that smells or looks differently. 

Dehydration can affect anyone, but being an athlete or active adult, having chronic medical conditions, or recovering from an illness or procedure can make you more susceptible to dehydration.

If you are experiencing any of these issues it is important to remember to try to drink more fluids. If doing this makes you feel sick, then you need to take more frequent smaller drinks. Try to avoid any flavored or carbonated beverages. Tea and coffee may also not be the best choice when trying to get rehydrated. 

Staying hydrated will keep your blood levels up and flowing through your body. This allows for the nutrients and oxygen that you need to feel you best and that your tissues need to heal. It is recommended adults should drink at least 64 ounces of fluid per day. If you are at risk for dehydration that amount should be increased. 

Perhaps a water bottle (Witte Physical Therapy has some!) should be just as important of an accessory to carry around with you as your phone is!

References:

https://www.nhsinform.scot/illnesses-and-conditions/nutritional/dehydration#:~:text=Dehydration%20is%20caused%20by%20not,of%20physical%20activity%20and%20diet.

https://extension.usu.edu/news_sections/home_family_and_food/summer-hydration

How to Travel After Surgery

June 13, 2023

It is summer! It is a great time of year to get out and enjoy the outdoors, catch a ball game, and take that family vacation. Unfortunately some of us need to have surgery in the summer. This could be elective or not our choice, but regardless of the reason surgery does not need to put a damper on your summer travel plans. Here are some tips to think about when you are preparing to travel after a surgery.

Travel with someone: After a procedure it is important to have a buddy when you travel. Whether you are driving a car or flying, traveling alone can contain some risks. These include faster fatigue, balance or gait issues, or some other rare side effects that your physician went over with you prior to traveling. Having a buddy with you ensures that there is an extra set of eyes to keep you safe.

Keep moving: After any procedure it is important not to sit too long. We want to get up and move every hour or two to keep our blood flowing. This also helps with trying to minimize blood clots, can work to improve swelling, and can keep fluid out of our lungs. 

Stay hydrated: This is a tip we all could probably do a better job of. Keeping our fluid intake up after a procedure if key in recovery. It is also another requirement in trying to avoid a blood clot.

Dress appropriately: We want to avoid wearing any restrictive clothing. As we travel and become active we may not be able to control or predict our swelling patterns. Restrictive clothing can be very uncomfortable and hinder blood circulation after surgery. Wear something loose and comfortable. 

Avoid stress: Traveling can be stressful, especially if you are on a schedule that you have to keep. Giving yourself extra time to get where you need to go can take some of the stress of traveling.

It is always important to talk to your surgeon about your travel plans to make sure that you know the risks and are aware of any precautions that you need to take. Having these conversations and proper planning can keep you safe and allow you to “let loose” this summer!

References:

https://newsnetwork.mayoclinic.org/discussion/when-your-summer-travel-includes-surgery-mayo-clinic-expert-offers-tips-for-a-safe-trip-2/

Witte Physical Therapy Areas of Concentration: Pediatric Physical Therapy

June 6, 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 our pediatric population and what we can do to help.

We are not a clinic that says we can see everyone. In the pediatric population there is a group of patients who need to be seen in a more complex setting. However, we can help many of our pediatric patients with their concerns. We can work with the on different aspects of the injuries, musculoskeletal, neuromuscular, or other developmental disorders. We can provide a clinic that is close to home and often smaller and less hectic than the larger clinics or health centers. This often helps kids stay calm and focused during their treatment. We can provide education and guidance on the disorders that are plaguing them and work with their families on plans for home and their improvement. We can work with other providers for adaptive equipment and enhancements to make their lives easier. We can not only provide their therapy care but be an advocate for what they need and work to help them obtain those items.

If you have a child who could use some physical therapy or you could use a resource to talk to about their healthcare, give us a call!

Family Health and Fitness

May 30, 2023

As we continue to look at our overall wellness and the role that physical therapy (and our 24/7 Wellness Center) can play it is important to note an upcoming date. The second Saturday in June (June 10th) is Family Health and Fitness Day. It is a day designed to promote the parks and rec departments of our local communities, county, and state. It notes the importance using these local and state resources to get our with your family, enjoy the outdoors, and get active. 

For some people getting and being active can create two problems. The issues that come with starting to become more active and the issues that come with an increased or prolonged active lifestyle. Physical therapy can help with both of these issues. Sometimes before starting a new activity it is important to get checked out in the muscles and joints that will be challenged with that activity. Physical therapy can be used to check out for issues before you start something new. You can get specific stretches or exercises to make sure that you are prepared for the new activity. Once you have started the new activity sometimes the repetition of your new favorite activity can cause issues over time. Repeatedly doing the some routine or movement can wear out joints and muscles faster and thus physical therapy could be needed to help with these issues. Physical therapy can work to identify the movement pattern, ensure that it is being done correctly and without compensation, and work to adjust your activity to avoid these repetitive motions. 

At Witte Physical Therapy we also have the benefit of  having a 24/7 Wellness facility attached to our clinic. This allows for our patients to go back and forth and utilize both facilities and see our therapists in both places. We can use traditional physical therapy methods in the clinic or more advanced work in the wellness facility. If you would like a chance to see our facilities, meet our therapists, or have a free consultation to discuss your options give us a call!

Movement is Medicine: Physical Therapy & Arthritis

May 23, 2023

May is national arthritis month. Arthritis may seem relatively benign – everyone knows someone who has arthritis. But here are some numbers that help put the problem of arthritis into perspective:

• Arthritis is the leading cause of disability.
• Arthritis affects 1 in 5 adults and 300,000 children
• 1/3 of working-age people with arthritis have some kind of limitation in their ability to work
• Arthritis costs $156 billion each year in medical expenses and lost wages
• Nearly 1 million hospitalizations happen each year due to arthritis

It’s a serious condition, and a serious problem. The good news is that physical therapy is one of the most effective treatments for arthritis.

The Benefits of Physical Therapy for Managing Arthritis Symptoms

Arthritis comes in 2 forms: osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs because of wear and tear on the joints over time. Rheumatoid arthritis is an inflammatory, autoimmune disease. It occurs because of the immune system attacking the joint lining. Physical therapy can reduce joint pain, improve mobility, and help to prevent further damage to the joints. Using individualized exercises, physical therapists help people manage their condition and reduce discomfort. Physical therapists often combine advice on lifestyle modifications with exercise to maximize improvement. Let’s look at the types of exercise that can help manage arthritis symptoms next.

Range of Motion Exercises

These gently move affected joints through their entire range of motion. This can help reduce stiffness and improve mobility. Examples would include things like gentle stretching, tai chi, or gentle yoga.

Aerobic Exercise

Aerobic exercise creates repeated motion, moving the synovial fluid in the joints. It also increases blood flow and releases endorphins which reduce pain. Aerobic exercise also helps to control weight. Weight loss is proven to reduce the stress on your joints, which can reduce pain. Aerobic exercise for people with arthritis should be low impact. This would include things like walking, cycling, or swimming.

Strength Training

Strength training is an important part of managing arthritis. It decreases pain, improves strength, and function. Stronger muscles around the affected joints provide better support and protection.

Aquatic Exercise

Exercising in a therapeutic pool can be a great way for people with arthritis to get started. The buoyancy of the water helps to relieve some of the body’s pressure on the joints. The water pressure also provides compression on the joints. This offers some stability and pain relief. The movement of your body through the water creates resistance for your muscles. This allows them to get stronger in a protective environment.

Education

Besides designing a custom exercise program, a physical therapist will educate people with arthritis on lifestyle modifications to help mange their symptoms. Some suggestions might include weight loss, getting enough sleep, eating a healthy diet, and managing stress. A PT can also modify daily activities to help protect joints affected by arthritis. This can slow down or prevent progression of symptoms.

Physical therapy is a safe and effective treatment for arthritis. Current clinical guidelines for treating arthritis include strong recommendations for exercise and other physical therapy treatments. If you’re one of the 53 million Americans with arthritis, give your PT a call. They’re a great provider to help you reduce pain, manage your symptoms, and move better.

References:

• Research (peer-reviewed)
  1. Knee osteoarthritis: key treatments and implications for physical therapy- https://www.sciencedirect.com/science/article/abs/pii/S1413355520302434
  2. Osteoarthritis Management: Updated Guidelines from the American College of Rheumatology and Arthritis Foundation – https://www.aafp.org/pubs/afp/issues/2021/0115/p120.html
  3. Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice – https://sport-physiotherapie-halle41.ch/wp-content/uploads/2021/03/9-Physical-therapy-for-patients-with-knee-and-hip-osteoarthritis-2019.pdf
• Articles and Content
  1. May Is National Arthritis Awareness Month – News

Benefits of Exercise for Osteoarthritis | Arthritis FoundationHow Can Physical Therapy Help to Avoid Surgery? – Tucson Orthopaedic Institute