Parkinsonisms: What Parkinson’s Is… and What It Isn’t

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist, Owner of Healthy Aging PT

When most people hear “Parkinson’s disease,” they picture a very specific condition—and for many, that’s accurate. But in our work at Healthy Aging Physical Therapy, we often meet patients whose symptoms look like Parkinson’s… but don’t quite follow the same rules.

These are called Atypical Parkinsonism syndromes, or simply Parkinsonisms.

As a Parkinson’s specialty practice, we’ve had the unique opportunity to work closely with individuals living with conditions like Lewy Body Dementia (LBD), Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA) and Corticobasilar Degernation (CBD). These diagnoses are less common - but incredibly important to recognize, as while there is overlap with Parkinson’s disease, the rehabilitation approach must be thoughtfully adapted for each condition.

Let’s break it down.

What Are “Parkinsonisms”?

“Parkinsonism” is a term used to describe a group of neurological conditions that share key movement features seen in Parkinson’s disease, such as:

• Slowness of movement (bradykinesia)

• Stiffness (rigidity)

• Balance and gait difficulties

However, these conditions have different underlying causes, faster progression, and often respond differently (or poorly) to typical Parkinson’s medications like levodopa.

How Are Parkinsonisms Diagnosed?

Diagnosis can be challenging and often evolves over time. Often, someone is initially diagnosed with Parkinson’s Disease, but when symptom progression is different than expected, or the individual does not respond to medications as expected, an atypical form may be suspected. Other signs might include:

• Early balance impairment or falls

• Cognitive or autonomic changes early in the disease course

• Eye movement abnormalities (especially in PSP)

• Imaging and neurological exam findings

In many cases, diagnosis is clinical and may take time, as symptoms unfold and patterns become clearer. Fortunately, we now have more concrete ways to differentiate between the different syndromes including DAT Scans and Skin Biopsies:

• DAT Scans: A DaTscan is a specialized imaging test that looks at dopamine activity in the brain. By looking at the patterns, doctors can now better identify if symptoms are coming from a neurodegenerative cause, like Parkinson’s Disease or an Atypical Parkinson’s Syndrome, or from something else, like Essential Tremor or drug-induced symptoms. It is important to be aware a DAT Scan can NOT differentiate between idiopathic Parkinson’s and Atypical Parkinson’s Disease.

• Skin Biopsies: A skin biopsy can be taken and analyzed for abnormal alpha-synuculein deposits. When these are identified in the sample, it can help differentiate between the idiopathic form of Parkinson’s and some of the atypical forms of the disease. It is important to note that while it can differentiate the two from one another, it can NOT identify which Atypical Parkinson’s disease a person may have.

As you can see, while we have many more tools at our disposal for proper diagnosis of Parkinson’s Disease and Atypical Parkinsonisms, it still remains a largely clinical diagnosis based on symptoms, progression of disease and response to medication treatment.

What are the Different Atypical Parkinson’s Diseases?

1. Lewy body Dementia (LBD)

   Lewy Body Dementia is a neurodegenerative condition characterized by a combination of:

   • Cognitive impairment

   • Parkinsonian motor symptoms

   • Fluctuations in alertness

   • Visual hallucinations

   What Makes It Different Than Parkinson’s?

   • Cognition is affected early, often before or alongside movement symptoms

   • Fluctuating attention and alertness (good days and bad days are common - and presentation may even within throughout the day)

   • Visual hallucinations are common

   • Patients may be sensitive to certain medications

   How Is Rehab Different?

   Rehabilitation for LBD requires a flexible, patient-centered approach:

   • Session-to-session variability is expected. Therapists must be prepared to adjust treatments, as needed, in real time.

   • Patients do best when care is focused on routine, familiarity, and caregiver involvement.

   • Due to the cognitive challenges, communication should be clear, calm and simple.

   • Balance and mobility training are still essential, but, patients may may need shorter sessions or breaks and should focus should focus more on compensatory strategies as it will be harder for patients to carryover instructions from session to session.

2. Progressive Supranuclear Palsy (PSP)

   PSP is a neurodegenerative condition that affects:

   • Balance and walking

   • Eye movements (especially looking down)

   • Postural control (and most notably, results in retropulsion, or the sensation of falling backwards)

   • Spinal mobility (rigidity is a marked feature in people with PSP)

   What Makes It Different Than Parkinson’s?

   • Early and frequent falls, often backward

   • Difficulty with vertical eye movements, especially downward gaze

   • Speech and swallowing issues tend to appear earlier

   • Minimal response to Parkinson’s medications

   • Axial rigidity (stiffness in the trunk more than limbs)

   How Is Rehab Different?

   Rehabilitation for PSP is very focused on safety and proactive management of symptoms:

   • Fall prevention is a #1 priority. This often involves prescribing an appropriate assistive device (we love the USTEP for our patients with PSP!), making changes to the home to make it safer and making recommendations for adequate supervision and teaching caregivers the skills they need to help their loved one move safely.

   • Therapists should assess and treat ocular coordination impairments. When patients can’t look down well, this impacts depth perception and fields of vision, making things like using stairs, curbs and navigating uneven terrain more difficult. People with PSP benefit from working on compensatory skills like visual scanning, and also on using visual exercises to maintain the ocular control they have.

   • Because of the areas impacted by PSP, people with PSP will have a more difficult time improving balance reactions and walking. They frequently do better with use of external cuing, like using targets on the floor or a laser, or by putting signs up throughout the home to remind them to use safe strategies like pushing off the chair to stand up, or holding on to a surface for support before reaching for something.

   • It is critical for someone with PSP to get therapy early! Progression of PSP is faster than in typical Parkinson’s Disease and the earlier we can address emerging changes and new symptoms, the more impact we can have on safety and quality of life.

3. Multiple Systems Atrophy (MSA)

   MSA is a progressive neurological condition that affects:

   • Movement (Parkinsonian features)

   • Posture (more rounded, head-down positions)

   • Autonomic Nervous System (causing changes in blood pressure, bladder control and breathing)

   What Makes It Different Than Parkinson’s?

   • Significant autonomic dysfunction causing frequent low blood pressure and syncope (passing out)

   • Bowel and bladder dysfunction is more common

   • Progression is faster than in typical Parkinson’s Disease

   • Minimal response to Parkinson’s medications

   • May also include cerebellar features like coordination issues

   How Is Rehab Different?

   Rehabilitation for MSA is requires careful monitoring and management of blood pressure in particular:

   • Vital sign monitoring should be completed before and during sessions and sessions may need to be modified to keep blood pressure in safe ranges.

   • Education should focus on strategies to maintain blood pressure in safe ranges throughout the day. This often requires a combination of medication management and coordination with doctors, and education for the patient and caregivers for using things like compression stockings or abdominal binders to help keep blood pressure high enough when they stand up.

   • Because orthostatic hypotension is common in MSA (drops in blood pressure with standing), it is important to include a seated warm up and slow progression to standing and walking activities during sessions.

   • Hydration is critical for patients with MSA. Being dehydrated will make the autonomic dysregulation worse and is a frequent cause of falls and hospitalizations for these patients.

4. Corticobasilar Degeneration (CBD)

   CBD Corticobasal Degeneration (CBD) is a rare neurodegenerative condition that affects both the cortex (brain) and the basal ganglia, leading to a combination of movement and higher-level motor planning difficulties. It often presents asymmetrically, meaning one side of the body is significantly more affected than the other.

   What Makes It Different Than Parkinson’s?

   CBD has several unique features that sets it apart:

   • Marked asymmetry with one side affected more than the other

   • Apraxia is a key feature, which is difficulty performing purposeful or functional movements with a limb despite having the strength and motor control to do so

   • ‘Alien Limb’ phenomenon is common - an arm or leg may seem to move involuntarily or feel disconnected from the body

   • Cortical sensory deficits make it difficult to interpret sensory information

   • Myoclonus is often present which looks like jerky or uncontrolled movements

   • Minimal to no response to Parkinson’s medications

Unlike Parkinson’s disease, where movement is primarily limited by slowness and rigidity, CBD involves a breakdown in motor planning and control at a higher neurological level.

How Is Rehab Different?

Rehabilitation for CBD Rehabilitation for CBD requires a shift in approach from “strength and movement” to motor planning, task breakdown, and functional adaptation:

• Therapy should focus on task-specific training, and patients do best when breaking down movements into smaller, step-by-step components

• Cuing should incorporate external cues, hand-over-hand support and modeling or demonstration as interpretation of body-based or sensory-cues will be very hard to understand

• Compensation with the less affected side is critical to maintaining independence as long as possible

• Consider use of adaptive strategies and equipment early on so training can be incorporated while motor control and cognition is at it’s best.

The Big Picture: Similar…But Not the Same

While all Parkinsonisms share common movement challenges, the differences between them matter—a lot. In Parkinson’s disease, we typically see a slower progression, a good response to medication (especially early on), and a rehabilitation approach that emphasizes amplitude, intensity, and long-term maintenance. In contrast, atypical Parkinsonisms often present with a faster or more complex progression and a more limited response to medication. Because of this, rehabilitation must shift—becoming more adaptive, more preventative, more caregiver-inclusive, and more medically integrated to address the broader range of symptoms these conditions can bring.

Hopefully this information has helped you better understand some of the key differences between typical, or idiopathic, Parkinson’s disease and the atypical forms of Parkinsonism. Whether you are a patient, caregiver, or therapist reading this, it is critical to recognize these differences—not only to advocate for an accurate diagnosis if things “just don’t feel right,” but also to find providers who understand these conditions and can truly individualize care.

OneStep Closer: Making Sense of your OneStep Data

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist and owner of Healthy Aging Physical Therapy

Last month, we introduced OneStep, the walking and movement app we now use at Healthy Aging Physical Therapy to better understand how our patients move in the real world - at home, in the community and both with and without their therapists.

While we’ve been loving the experience of using OneStep so far — and many of you have enjoyed seeing your progress in real time — we’ve also received some great feedback: “What do all these numbers actually mean?”

So this month, we’re diving deeper. This blog — along with our social media posts throughout March — will focus on breaking down exactly what we’re measuring, what the data tells us, and why it matters for your safety, strength, and independence.

Let’s break down what we’re measuring—and why it’s so powerful.

Walking Is More Than Just Speed

Most people assume walking is simply about how fast you move from point A to point B. In reality, walking is a complex, whole-body activity that reflects strength, balance, coordination, confidence, and even cognitive load.

Using OneStep, we’re able to measure multiple aspects of your walking pattern over time, giving us a clearer picture of both current safety and future risk.

The Big Picture: Your Walk Score

One of the first things you may notice in OneStep is your Walk Score.

This is a single number (out of 100) that summarizes how:

• Steady your steps are

• Consistent your rhythm is

• Smoothly you move from step to step

A higher Walk Score reflects a safer, more efficient walking pattern. While we never rely on one number alone, this score helps us track meaningful changes over time and identify when something may need attention.

Understanding other Key Walking Parameters

Walking Speed (Velocity)

Walking speed is measured in meters per second and is one of the strongest indicators of functional mobility.

• Slower speeds may reflect weakness, balance challenges, or reduced endurance

• Inconsistent speed may signal fatigue, distraction, or instability

While 1.0–1.2 m/sec is typical for healthy adults, many of our patients do very well with a goal closer to 0.8 m/sec, which is strongly correlated with safe household mobility and independence.

Cadence (Steps per Minute)

Cadence is how many steps you take per minute while walking.

• Very slow cadence can be linked to balance concerns, reduced confidence, or cautious movement

• Very fast or uneven cadence can indicate rushing or difficulty controlling speed

For many adults, a steady cadence between 100–120 steps per minute is associated with comfortable, efficient walking. In Parkinson’s Disease, we often see cadence increase which is reflective of a ‘shuffled’ or ‘freezing’ gait - and something we are quickly finding can be significantly improved with this type of in-the-moment feedback.

Velocity Variability

This measures how consistent your walking speed is from step to step.

• Low variability = steady, predictable walking

• High variability = frequent changes in speed, often linked to balance challenges, fatigue, or environmental demands

Our general goal is less than 20% variability, reflecting controlled and confident movement.

Consistency

Consistency looks at how similar each step is to the next and is scored from 0–100.

• Scores between 80–100 suggest a stable, repeatable walking pattern

• Lower scores may reflect coordination changes, balance challenges, or neurologic conditions

This is an especially valuable number to monitor for patients with Parkinson’s disease, neurologic diagnoses, or anyone at risk for falls.

Looking Deeper: Step Symmetry, Timing, and Joint Motion

Beyond the general measures above, OneStep allows us to analyze more detailed gait data about spatial and temporal parameters, and joint range of motion, including:

• Average step length

• Step length asymmetry

• Single-leg and double-leg support time

• Stance symmetry

• Step width

• Hip and femoral range of motion during walking

These details help us identify why your walking may feel uneven, where balance is breaking down, and how strength, coordination, or joint immobility may be contributing - and this level of insight allows us to be more precise, and more effective, in your treatment.

Daily Step Count: Measuring Movement to Get You Moving More

Finally, OneStep also tracks your daily step count by connecting to your phone’s internal pedometer (and can sync with devices like Apple Watch or Fitbit).

Why this matters:

• More daily steps are associated with better balance, strength, endurance, and overall health

• Even small increases in daily walking can lead to meaningful improvements

For the most accurate data, we recommend carrying your phone in your pocket during as many walks as possible. Together, we’ll determine a personalized, safe daily step goal that you can work up to slowly, to promote optimal health and wellness as you age or live with chronic disease or disability.

Why This Matters at Healthy Aging Physical Therapy

At Healthy Aging Physical Therapy, our goal is not just to help you walk more, but to help you walk better, safer, and with more confidence.

By combining expert clinical care with real-world movement data, OneStep helps us:

• Detect subtle changes earlier

• Personalize care more precisely

• Track progress that truly matters

• Support long-term independence and fall prevention

We hope this blog post helps you better understand what you’re seeing in your OneStep data and feel more confident about how we’re using it to guide your care. This is what modern, whole-person physical therapy looks like - and we’re excited to take this journey with you.

Home for the Holidays: 10 Tips, Tricks, and Helpful Products to Improve Safety at Home - and When You’re Away from Home

By Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist
Owner: Healthy Aging Physical Therapy

The holiday season brings joy, family, and togetherness — but also new challenges for older adults. Between traveling, hosting, and adapting to new environments, it’s easy to underestimate just how much energy it all takes. Whether you’re hopping on a plane or staying home in your coziest slippers, a little planning and the right tools can go a long way toward keeping the season safe and comfortable.

Here are ten of my favorite practical, therapist-approved strategies and helpful products to make your holidays easier — without sacrificing the fun.

1. Manage Energy Like It’s Money

One of the biggest challenges of the holidays is fatigue — not just physical, but mental. The social effort of being “on,” chatting with relatives, and maybe even trying to mask any impairments can be draining.

💡 Tip: Think of each day as a dollar — you have $1 to spend. How much will church cost? Dinner with family? A trip to the store for pie ingredients? Spend wisely.
If dinner with your daughter is the highlight, maybe let go of the baking marathon and supervise while the grandkids take over the kitchen.

🎁 Helpful Product: Super Ear Personal Sound Amplifier. Hearing clearly during conversation saves tremendous mental energy.

2. Prepare for Low Surfaces

That comfy couch at your daughter’s house? Not so comfy when you’re stuck in it. While you may confidently get on and off the chairs in your own home, visiting friends, family and restaurants may leave you feeling like Goldilocks trying out difference surfaces to find the ‘just right’ seat for you. Avoid getting stuck with the tips below:

💡 Tip: Start “training” now. Practice sit-to-stands from different surfaces, even try sitting on a pillow to simulate a lower seat.
🎁 Helpful Product: Carex Up Easy Seat Assist — portable, hydraulic seat lift that helps you rise with less strain.

3. Conquer Community Stairs

Even if your home has no stairs, public places or loved one’s homes might. Don’t let a ‘3 STE’ (three stair entry in PT short hand!) stop you from enjoying the festivities.
💡 Tip: Practice toe taps and step-ups at home to build balance and confidence.
🎁 Helpful Product: Try a Stair Cane, which is a lightweight and portable “travel railing” for those steps without rails anywhere or the Stair Assist which lets you create a '“half step” to bridge the gap between the floor and a high step up anywhere you need one.

4. Sleep Smart in New Spaces

Guest beds are often softer, lower, or lack support for getting up. Further, the trip to the bathroom is unfamiliar, and likely dark and dangerous. Solution? BYO-Nightlight and a couple of helpful hints for chair placement:
💡 Tip: Place a sturdy chair or walker next to the bed, and use portable nightlights to light your path to the bathroom.
🎁 Helpful Product: Battery-Powered Motion Nightlights — compact, battery-powered and great for travel.

5. Fly Easier

Air travel can be exhausting long before you board. Fortunately, TSA has excellent support services available not only to reduce strain, but to speed you through long lines and reduce energy cost of travel.
💡 Tip: Call ahead to schedule TSA Cares Assistance for any air travel you have coming up — they’ll escort you by wheelchair through security and to your gate, often bypassing long lines.
🎁 Helpful Product: Drive Medical Nitro Dual Function Rollator/Transport Chair — walk when you can, ride when you need to, this dual-function walker/transport chair is one of my favorites to recommend to my patients.

6. Drive Safely AND Comfortably

While driving cross country may have been doable in your youth, as we age, even short road trips can become more challenging and may require advanced planning.
💡 Tip: Plan for frequent stops, avoid driving tired or at night, and consider public transit or rideshares for longer trips.
🎁 Helpful Product: A portable Car Cane + Car Handle and a Lumbar Support pillow can make getting in and out a breeze, and long drives more comfortable.

7. Stay Connected from Home

If you’re celebrating quietly at home, you can still fill your space with connection and joy.
Smart speakers like the Echo Dot can:

• Play your favorite holiday music (“Alexa, play Christmas music!”)

• Set medication reminders

• Control lights or thermostats

• Call for help in an emergency

Get even fancier with an Alexa Show which has all the fun features of a Dot with the addition of a 15” screen so you can see your reminders, follow along with recipes, watch the local news and even see your calendar for the day.

8. Give the Gift of Comfort

Nothing says “I love you - and want you to be safe” like warm, slip-proof slippers and house shoes. Fan favorites in my house AND with my patients include the classic LL Bean Moccasin and the Hey Dude Shoes — both easy to slip on, stable, and cozy.

9. Give the Gift of Health

Aging well takes time, effort and often, support. The good news is that there are great devices and services available to help your loved one stay healthy and active at home. Consider purchasing a portable elliptical like the Cubii or setting them up with a ten pack of training sessions with us through our Wellness365 program. We can bring personal training right to your home, with specialists who understand the needs of older adults.

10. Give the Gift of Safety

Technology is amazing and wearable devices can bring convince, accessibility and peace of mind. Devices like the Apple Watch can now detect falls and call emergency services — a simple, life-saving feature for any older adult.

Final Thought

The holidays aren’t about doing everything — they’re about doing what matters most. Whether that means a little extra planning for your trip to the kids or asking for help at the airport, small choices can keep you safe, confident, and able to enjoy what really counts: time with the people you love.

From all of us at Healthy Aging Physical Therapy, we wish you a safe, warm, and joyful holiday season.

Cutting Through the Chaos: Creating Effective Frameworks for Complex Patients

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist Owner: Healthy Aging Physical Therapy

If you’ve ever worked with, or been, a patient who seems to have more going on that meets the eye, you know how challenging it can be. Fortunately, these are also often the most rewarding patients - and, most importantly, the ones who need us most.

At Healthy Aging Physical Therapy, our team specializes in exactly that: caring for complex patients—people with multiple diagnoses, long medical histories, and functional challenges who often feel like no one knows where to start. They’re the ones who have seen five other therapists, have a dozen specialists, and still feel stuck.

Why Our Patients Are So Complex

When you’re in physical or occupational therapy school, you learn about impairments in isolation.

• A hip fracture? You study how to rebuild strength and balance.

• A cardiac patient? You learn to monitor vitals and improve endurance.

• A neurological condition? You focus on motor control, coordination, and safety.

But real-world patients with geriatric, neurologic, and complex medical needs don’t fit in tidy boxes. The people we serve are living with multiple comorbidities, often taking many medications, and facing social and emotional challenges that go far beyond their diagnosis list.

For example, many of our patients with Parkinson’s disease also experience osteoarthritis, chronic pain, memory loss, anxiety, and depression - and often have a partner who is also aging and managing their own medical issues to boot. Similarly, a patient referred for “hip fracture” is rarely just an orthopedic case. The fracture may have resulted from a fall, which stemmed from a combination of weakness, balance impairments, cardiac symptoms, and home safety challenges. Many live alone, with limited support and a history of sedentary behavior.

It’s no wonder that walking into these homes for an evaluation can feel overwhelming, even for seasoned clinicians.

Many of these individuals have already been discharged from other settings because progress stalled, the situation was too complicated, or insurance coverage ran out. Over time, we’ve become the go-to practice for these patients—the ones other providers refer when they aren’t sure what else to do. In many cases, we become the last stop—the “hail Mary” for patients who are exhausted from circling through the healthcare system.

So, how do we help?

Our Framework for Treating Complex Patients

Through experience and teamwork, we’ve developed a simple, realistic framework that helps our clinicians navigate these challenging situations - one that keeps both patient and therapist grounded, hopeful, and effective.

Whether you’re a therapist reading this, a patient with a complex background, or a caregiver trying to support a loved one, I hope these strategies help you cut through the chaos and find a starting point that leads to progress.

1. Focus on What Matters Most and Not Everything at Once

When faced with a dozen problems, it’s natural to want to fix them all. But that’s a recipe for overwhelm, and, inevitably, an ineffective therapeutic approach.

Instead, we teach our therapists to start by asking:

“What are the top one or two things we can help with right now that will most improve this person’s quality of life, safety, and independence?”

Sometimes that means addressing strength, balance, or mobility. Other times, it’s about helping the patient move again after weeks (or months) of fear and inactivity. Sedentary behavior, whether from pain, fear, or fatigue, triggers a cascade of physical and emotional decline and often, interrupting this cycle can be an important first step. Even small steps toward safe, confident movement can change everything. Sometimes, a compensatory approach is the right starting point: helping a patient obtain the proper wheelchair, walker, or other durable medical equipment to restore access to their home and community.

Time after time, we’ve learned that small wins matter. They build trust, confidence, and momentum - all critical ingredients for rapport and long-term success.

2. Layer in Support

We remind our team (and ourselves) that we can’t fix everything - and that’s okay. Somethings aren’t ‘fixable’ and other things are outside of our scope and capabilities.

Our role is to make a meaningful difference where we can, while also building a web of support around the patient to provide support for ‘the other things’. That often means:

• Connecting patients with mental health providers when mood disorders or anxiety is a barrier

• Coordinating with care team physicians and pharmacists to address medication-related issues

• Referring our patients to trusted home health aides, elder services, or aging life-care specialists

• Providing resources for community programs, support groups, and case managers

It’s not about doing it all ourselves - it’s about building the right team around each patient, one layer at a time.

3. Collaboration Is Key

When you work with a Healthy Aging therapist, you may only see one person walk through your door—but behind that therapist is an entire network of expertise.

Our team includes specialists in neurology, orthopedics, geriatrics, vestibular therapy, and cardiopulmonary rehab. We collaborate behind the scenes through discussion boards, case consults, and joint visits - bringing fresh ideas, new eyes and diverse perspectives to every complex case. Sometimes that collaboration means I’ll step in for a Complex Case Visit, working alongside the treating therapist to strategize solutions. Other times, the team shares insights online, helping each other troubleshoot mobility challenges, medication effects, or behavioral barriers.

That culture of teamwork is one of our greatest strengths—and one of the biggest reasons I feel our patients make progress where others have stalled.

4. Think Long-Term

Complex patients rarely fit neatly into a six-week plan of care. Their needs evolve, new issues arise, and maintaining stability often becomes the goal as much as improvement.

That’s why we emphasize continuity - treating each patient as someone we’ll likely know for years. When a patient is ready to discharge, we make sure:

• A comprehensive post-discharge home program is in place

• The patient has been connected with the appropriate community and medical supports

• We have established a clear plan for future follow-up

For many, we transition them into a Maintenance Plan of Care under Medicare Part B, or into our Wellness program, Wellness365, where they continue to receive guided exercise and ongoing support to prevent decline.

Because our ultimate goal isn’t just short term rehab - it’s recovery and resilience.

What This Means for Patients and Families

If you’re a patient, caregiver, or family member feeling frustrated that “no one knows how to help,” please know: you’re not alone, and your situation isn’t hopeless.

Working with complex conditions takes time, teamwork, and the right perspective. The most important first step is finding professionals who know how to cut through the chaos - and, most importantly, who see you as a person first, not just a list of diagnoses, which is the heart of what we do at Healthy Aging Physical Therapy.

Don’t Fall this Fall! Your Guide to Preventing Falls and Staying Strong

As the leaves begin to fall, let’s talk about a more serious kind of fall - one that affects 1 in 4 older adults each year. Of those, 1 in 5 results in serious injury, including broken bones and head trauma. Even more concerning: once someone experiences a fall, their risk of falling again doubles.

But here’s the good news - falls are not an inevitable part of aging. There are proven, evidence-based strategies that can help reduce fall risk, improve confidence, and even teach people how to fall more safely when accidents happen. And Healthy Aging Physical Therapy is here to help you or your loved ones put those strategies into action.

CDC STEADI Initiative and Fall Prevention

According to the CDC’s STEADI Initiative (Stopping Elderly Accidents, Deaths and Injuries), the key pillars of fall prevention include:

• Screening for fall risk using tools like the Timed Up and Go (TUG) or 4-Stage Balance Test

• Strengthening and balance training that’s appropriate for age and ability

• Medication review and management

• Vision and vestibular assessment

• Home safety modifications

• Education on what to do in the event of a fall

[Source: CDC STEADI Program – https://www.cdc.gov/steadi/]

At Healthy Aging Physical Therapy, we’ve structured our programs around this proven framework to deliver the most effective strategies for fall prevention. Keep reading to learn how we put each pillar into practice.

Screening for Fall Risk

During our therapy evaluations, our licensed physical and occupational therapists conduct standardized, evidence-based fall risk screens, using tools like:

• Timed Up and Go (TUG)

• 4-Stage Balance Test

• 5 Times Sit to Stand

• Berg Balance Scale

• Backwards Walking Speed

• Gait speed analysis

These assessments help us identify your current fall risk level, evaluate your balance and mobility, and guide the creation of a personalized plan of care. At Healthy Aging, we believe knowledge is power—so we don’t just give you a score, we help you understand what it means. Using age- and gender-based normative values and clinically validated cut-off scores, we compare your results to your peers and determine what they indicate about your individual fall risk. From there, we build a care plan that addresses specific areas of deficit and set clear, measurable goals. These goals allow us to track progress, ensure what we're doing is effective, and pivot when needed to keep you moving forward safely.

Strengthening and Balance Programs

Strength and balance are woven into nearly everything we do here at Healthy Aging Physical Therapy, because we know just how critical they are to aging well. Every Physical Therapy and Occupational Therapy plan of care we create includes targeted interventions to build strength, improve balance, and reduce fall risk. But we also go above and beyond traditional therapy by offering extended support through our Wellness365 program, where specially trained personal trainers work with older adults to maintain and build strength long after therapy ends. For those who enjoy the energy of group fitness, we offer evidence-based classes like Strong and STEADI, which blends balance training, reactive strategies, and floor recovery skills, and Fit & Fearless, our adaptive martial arts program that teaches safe falling techniques and improves agility and body control. Whether you’re just getting started or continuing your wellness journey, our strength and balance programs provide the foundation for safer, more confident movement.

Medication Review and Management

While we don’t prescribe or manage medications directly, our therapists play an important role in identifying potential medication-related fall risks. During every evaluation, we review your current medication list and screen for drugs that may contribute to dizziness, fatigue, or low blood pressure—such as sedatives, antihypertensives, and certain pain medications. When we identify red flags, we collaborate with your physician, nurse practitioner, or pharmacist to recommend a formal medication review or suggest adjustments that may reduce your risk of falling.

Vision and Vestibular Assessment

Our Vestibular Therapy services are provided by clinicians specially trained to treat conditions such as BPPV, vestibular hypofunction, and motion sensitivity. Addressing these issues can significantly improve stability, reduce dizziness, and restore confidence in movement, particularly during sudden turns, head movements, or nighttime activities when balance is most challenged. In addition to vestibular care, we also consider vision as an important piece of the fall prevention puzzle. While we don’t provide eye exams, we screen for vision impairments during PT and OT sessions and refer to optometry or ophthalmology when needed. We also help patients address visual-vestibular integration challenges and provide guidance on modifying the home environment to better accommodate vision changes. Want to learn more? Check out our Vestibular and Dizziness page here.

Home Safety Assessment and Modification

At Healthy Aging Physical Therapy, home safety is an essential part of every plan of care. Our Physical and Occupational Therapists assess your living environment during therapy visits to identify potential fall hazards and barriers to independence. We evaluate factors such as flooring, lighting, stairways, bathroom access, and furniture layout, and we provide tailored recommendations to improve safety and function. When modifications are needed, we help coordinate referrals to trusted professionals who can install grab bars, ramps, railings, and other accessibility features. For those seeking a more in-depth evaluation, either in conjunction with therapy or on its own, we also offer our Home Assessment & Resource Program (HARP). This program provides a focused, expert evaluation of your home environment with personalized safety recommendations and resource navigation to support aging-in-place confidently and safely.

Fall Preparedness Education

At Healthy Aging Physical Therapy, we also believe fall preparedness is just as important as fall prevention—because even with the best strategies in place, accidents can still happen. That’s why our therapists receive advanced training in fall preparedness education, including safe falling techniques, floor recovery strategies, and how to respond if a fall occurs. We routinely make getting on and off the floor a core part of therapy, recognizing that this essential skill is often overlooked in traditional rehab settings. Whether someone is learning to recover independently after a fall or safely call for help when needed, our goal is to build both skill and confidence. For those who want to go even deeper, our Fit & Fearless program offers a supportive group environment where participants practice safe landing techniques, controlled descents, and reactive balance drills inspired by adaptive martial arts. It's an empowering, innovative approach to fall preparedness that helps older adults feel strong, capable, and ready for whatever life throws their way.