April is Parkinson’s Disease Awareness Month

Healthy Aging Physical Therapy strives to give people living with Parkinson’s the support they need to better manage their symptoms - at all stages of the disease.

Chances are, if you’re reading this, you either have Parkinson’s Disease, know someone with Parkinson’s Disease or care for someone with Parkinson’s Disease. This is because Parkinson’s is the 2nd most common degenerative neurological disorder after Alzheimer’s disease, affecting nearly ten million people worldwide. Not only is it a very common disease, but the number of people diagnosed each year is RISING. Whether because we are living longer as a population, or because we are simply getting better at diagnosing this disease, it is estimated that from 1999 to 2015, the number of people living with PD actually DOUBLED.

Impacting the ability of the brain to create essential neurotransmitters like dopamine and serotonin, it also leads to an overabundance of neurotransmitters like acetylcholine. While these imbalances cause all sorts of symptoms in the body, Parkinson’s Disease is most commonly associated with the four cardinal signs: Rigidity, Bradykinesia, Postural Instability and Tremor. While less talked about, but often more disturbing, there are also non-motor symptoms commonly associated with Parkinson’s Disease, like low blood pressure and autonomic dysfunction, impairments in memory and cognition, anxiety and depression, trouble swallowing and frequent aspiration and bowel and bladder dysfunction, just to name a few. Fortunately, there are a number of medications that provide symptom management for people with Parkinson’s Disease by way of dopamine-replacement, or dopamine-support. Unfortunately, as the disease progresses, people often need higher and more frequent doses of these medications, which cause their own slew of side effects, including dyskinesias, the writhing, dance-like movements people often associated with this disease.

What you may not know, is that Exercise and Physical Activity has a HUGE role to play in the management of Parkinson’s Disease related symptoms. Not only can the right kinds of exercise slow disease progress, but it can be incredibly effective at managing both the motor and non-motor signs of Parkinson’s Disease. Beyond exercise, there are also many tips and tricks a Parkinson’s Disease Physical Therapist can teach you to ‘trick’ your body into doing what you want it to do, by taking the focus away from what isn’t working and redirecting it to strategies that will. Healthy Aging Physical Therapy was established to be a support to the Parkinson’s Disease community, by hiring Physical Therapists with advanced training in the care of people with Parkinson’s Disease. To live better with this disease, you need an expert by your side who knows how to guide you through all stages of the disease, as your needs will change as your disease progresses. We have providers who are certified in both BIG/LSVT and PWR! Moves Therapies, as well as providers with extensive experience working with the Americans with Parkinson’s Disease Association, who are here to help you every step of the way. Whether you choose 1:1 At-Home Therapy or join us for one of our Power over Parkinson’s Group Fitness Classes, we want to help you feel and function at your best.

To request an Free Phone Consultation to see How Healthy Aging PT can help you, click the button below:

To learn more about our Power over Parkinson’s Group Fitness Class, click the button below:

To learn more about BIG/LSVT & PWR! Moves Parkinson’s Therapy, click here the button below:

Healthy Aging Tip of the Week - FALL PREVENTION !

ALWAYS TELL YOUR DOCTOR IF YOU'VE HAD A FALL - ESPECIALLY IF YOU HIT YOUR HEAD !!!

Only about half of all falls are reported to the right people (doctors, therapist or the ER.) This means half of all people are putting themselves at risk of head injury or death.

Bob Saget was back in the news this week after autopsy reports showed his cause of death was likely a fall, that caused a brain bleed. Initially, it seemed like he may have fallen backwards, thought nothing of it, and went back to sleep. However, given the fact that he had fractures at the back and front of his skull, it looks more like he had a BIG fall (down a set of stairs, possibly?) and this likely caused what is called a coup contrecoup head injury. These types of injuries can cause major swelling that can put pressure on the respiration centers and other critical areas of the brain. At best, they may cause temporary brain damage that can be reversed with the proper care (draining, shunting, surgery etc), but at worst, they can cause permanent brain damage or death.

As we age, blood vessels become more friable, and taking aspirin or other blood thinners make it more likely to have bleeding in the brain if you hit your head. This is why it is CRITICALLY important that you report any fall in which you hit your head to your doctor right away. I can’t say this LOUD ENOUGH. If you fall, and hit your head, PLEASE TELL YOUR DOCTOR OR VISIT AN ER! There are plenty of good reason to report falls, but this is arguably the most important. Even if you fall, and feel fine, and don’t hit your head, it is still a good idea to let your doctor know. Why? So they can call helpful people like ME to come check your balance, assess your fall risk and help you make a game plan that will help you stay on your feet (and be ready to land safely if you do head for the floor!).

Healthy Aging Physical Therapy takes pride in not only teaching our patients how to prevent falls, but how to be PREPARED for them. Chances are, if you’ve fallen once, you’ll fall again (#facts), so you are better of being ready for it, than going through life scared or trying to avoid any and all potentially fall-causing scenarios (when a new patient tells me proudly ‘oh I haven’t fallen, but I’m REALLY careful’ I know we have problem…). There are ways we can teach you to fall SAFELY with reduced risk of head injuries and fractures, and ways we can teach you to GET BACK UP so you can get on with your day.

There are three questions you can ask yourself to help determine if you are at risk for falls - and whether you may benefit from seeing a physical therapist for fall risk assessment and a course of therapy:

1. Have you had a fall in the last year?

   (If you’ve had a fall, you are 3x more likely to have another).

2. Do you feel unsteady while standing or walking?

   (This speaks to your balance perception - lack of balance confidence, leads to increased risk of falls)

3. Do you worry about falling?

   (Fear of falling = fear avoidance behaviors = reduced activity = increased risk of falls)

If you answered YES to any of these, we would LOVE to help you. And I’m not just saying this to drum up business (we are full and waitlisted!) but seeing stories in the news like Bob Saget’s untimely death just reminds me how important it is to spread the message that FALLS ARE AVOIDABLE and everyone deserves the chance to live life without fear of falling.

Actual Healthy Aging patient REDUCING her risk for falls!

If you are reading this and we don’t see patients in your area, reach out anyways - I’d be happy to try to help you find a good physical therapist near you. There are also GREAT resources out there for education on Fall Prevention and Fall Preparedness, including the CDC STEADI programs which we use to drive our fall assessment and intervention and the Stay on Your Feet AU program, that has some great printable resources.

If you live in and around Wakefield, Massachusetts, consider joining me at the new FUNctional Fitness class starting up at the Wakefield Council on Aging. We’ll meet every Tuesdays from 9-10AM staring March 1st to work on increasing our strength and balance exercises so we can stay ACTIVE and RESILIENT and FALL-FREE. This class is FREE for the month of March, and registration is required ahead of time by calling (781) 245-3312.

If you live further out, or prefer to take classes virtually, I also offer Strong Bones, Strong Life classes through the Steinberg Center for Mind and Body. These classes run in 8-week sessions and are offered Mondays from 1:15-2:15PM and Thursdays from 9-10AM. Focused on Osteoporosis Prevention and Management, we work on strength, postural control and balance designed to improve bone health and prevent falls and fall-related injuries. Next session starts up in March, and we kick off with a FREE Strong Bones, Strong Life workshop on March 3rd, from 7-8PM.

So, remember, if you’ve had a fall, don’t let pride or embarrassment get in your way of saving your life! Let your doctor know ASAP so they can make sure you’re okay and help you get on the path to Fall Preparedness!

See, therapy isn’t that bad…we actually have FUN!

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📆Upcoming Events:

🌟POWER over Parkinson's Class - Wednesdays 10:30-11:30 @ the Americal Civic Center in Wakefield, MA

🌟Strong Bones, Strong Life - Mondays 1:15-2:15PM and Thursdays 9-10AM Online through Steinberg Wellness

🌟Staying STEADI - Starting April 2022!

🌟FUNctional Fitness - Tuesdays 9-10AM @ the Wakefield Council on Aging staring March 1st, 2022

🔗Learn more @ www.healthyagingpt.com/classes

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⭐️Ready to schedule an Evaluation with a Healthy Aging Physical Therapist? ⭐

📞Call or Text: (617) 851 5315

📧Email: Katie@HealthyAgingPT.com

📝or Click the Button below request a Consultation Phone call:

How Can Physical Therapy and Regular Exercise Help Older Adults?

People often think of physical therapists as the go-to people to treat musculoskeletal pain, but physical therapy has much to offer beyond pain management, especially when it comes to the older adult. Read on for 5 Ways Physical Therapy can help you live your best life as you age.

Why is exercise important for older adults?

Inactivity is associated with most of the diseases we commonly associated with getting older. Inactivity increases your risk of diseases like heart disease, stroke and dementia. It also increases your risk of fall and resulting hip fracture - a major concern for many older adults! However, only 20% of older adults participate in adequate amounts of regular exercise. A Physical Therapist who specializes in Geriatrics can help you learn how to exercise safely - and use exercise to stay healthy and active as you age. Regular, moderately-intense exercise can reduce your chance of a premature death by up to 30%! Exercise is safe and beneficial for adults of all ages and in all conditions.

How does exercise reduce the risk of falls in the elderly?

Regular exercise can reduce the risk of falls in older adults by up to 20%. Participation in Evidenced-based balance programs (like the Otago Program offered by Healthy Aging Physical Therapy) can bring that risk down even more to 30-40%.

Physical Therapy can help you improve your strength, your endurance, help you mange pain, and improve your balance. We can help you if you’re dizzy or experiencing vertigo (Vestibular Rehabilitation). We can help you make your house a safer place to live and teach you ways to modify your movement and mobility to make moving around your home and community safer and easier.

However, falls are an unfortunate reality for many older adults, so it’s also important to be PREPARED for falls. Around 36 Million adults fall in the US each year. Learning to fall safely, what to do after you fall and how to get back up is just as important as working to prevent them.

How can Physical Therapy help me stay Independent?

By helping you manage all areas of your health and wellness, we can help you stay strong and fit so you can stay living in your home and be as independent as possible. Physical Therapy and exercise improves your cardiovascular, pulmonary, neurological, metabolic, musculoskeletal and psychological health. The stronger and fitter you are, the better your resilience to disease, decline and disability. If you do need help, we can help you find it, or teach your loved ones how to care for you - while making sure they also take care of themselves. This balance of keeping you as independent as you can, with guiding you towards the support you need is how physical therapy can help you age in place and remain active as you can within your home and your community.

How can Physical Therapy and Exercise help me Walk and Move better?

Physical Therapists are Movement Experts and as you age, it can be harder to get up and down from chairs or the toilet, to walk around the house, access your community or use the stairs. Through movement and mobility assessment, we can identify limitations in your range of motion, strength or muscle balance that may be making these tasks more difficult for you. We help you develop the strength and skills you need to make tasks like walking, using the stairs and getting off low surfaces like the toilet easier - and safer.

Can Physical Therapy and Exercise improve my Quality of Life?

Getting older doesn’t have to be painful, exhausting or depressing. Learning to care for your body better as you age and use Movement as Medicine can help you feel your best, move your best and live your best life. Regular exercise improves your sleep, reduces depression and anxiety and can help you be strong enough to continue living a life full of family, fun and purpose. To quote George Burns, “you can’t help getting older, but you don’t have to be old.“

A Physical Therapist who specializes in working with older adults has the skills necessary to help you live your Best Life, no matter what diseases or disabilities you may be living with - and no matter how old you may be.

Click Here to Request a Physical Therapy Evaluation

About the Author:

Dr. Katie Wadland, PT, DPT is the Owner and Primary Physical Therapist at Healthy Aging Physical Therapy. Healthy Aging Physical Therapy offers in-home Physical Therapy for older adults living in Melrose, Medford, Arlington, Stoneham, Winchester, Reading, Woburn, Wakefield and Lynnfield, Massachusetts. She is licensed to practice Physical Therapy in the State of Massachusetts (License #18193). She has over fourteen years of experience working with older adults with musculoskeletal and neurological impairments and advanced training in the care of people with Parkinson’s Disease, Spinal Cord Injury and Stroke.

Click here to learn more about Dr. Katie Wadland, PT, DPT or here to request an evaluation.

Be like a kid.

Sometimes the best advice comes from the least expected places. This week, I bring you wise words from my seven year old, as she taught me how to ‘relax’ by dancing on our back deck:

 “Let me show you how to be a kid. You just do the things your body tells you to do - the fun things!”

Healthy kids don’t have to set aside time to exercise, because exercise is simply part of their everyday life. They move constantly. They fidget, they chase their friends, they play sports and take gymnastics classes and dance. 

As adults, sometimes, we too often stop doing all the ‘fun things’ our body tells us to do. We replace the fun things with work, and stress, and sitting and to-do lists. We have to schedule exercise in, just to get it done.

But what if we started looking at exercise like a kid again? 

Did you know that most of the things to do count as exercise - even some of the things you do for fun? Anytime you are up and out of your chair, you are burning energy. Self-care, household tasks and leisure activities and hobbies - they all require movement. The intensity of each activity varies, but the concept is very much the same - and becomes even more important, for older adults. Older adults spend as much as 7-10 waking hours a day sitting. Have you ever seen a kid sit for 7 hours straight without being duct taped to a chair? (I know I haven’t..)

 If we all choose to incorporate movement throughout our days, we wouldn’t have to stress so much about ‘exercising’ or getting your steps in or whatever else we’re doing to cross it off our to-do lists. It all counts and it all helps you be a healthier, more active person. Many of these activities even has an assigned ‘MET’ (metabolic equivalent) designed to help us understand how much energy it typically burns - and how much it ‘counts’ towards your daily exercise:

I’m not sharing these to give you something else to calculate each day, but to help you understand that any and all movement COUNTS and is GOOD FOR YOU. Want an even easier way to understand how much your activity counts towards exercise? Next time something you are doing that requires movement, try using this Rate of Perceived Exertion scale. The beauty of this scale is that it takes into account that what might be challenging to one person may be less challenging to the next. We all start from different places and our levels of reserves (physiological and functional) vary and using this scale helps to reflect this:

If you find yourself working between a 0-3, you are performing light exercise. If you are feeling a 4-6, you are performing moderate intensity exercise. If an activity has you pushing 7-9, you are working at a vigorous level. Long story short, if you garden for 30 minutes and FOR YOU, this feels like a 5/10 - you just completed 30 minutes of moderate intensity exercise. THIS is how we get healthy.

Move like a kid. Do things you enjoy. Listen to your body. Exercise is Medicine - and all Movement is Exercise. 

#haept #stronger #fitter #functional #fallprevention #balance #neuro #geriatrics #physicaltherapist #physicaltherapy #doctorsofphysicaltherapy #mobilePT #geros #olderadults #healthyaging #optimalaging #successfulaging #exerciseismedicine #movementisexercise

Should I use a Cane or a Walker?

The answer is...it depends! (Shocking, right?)

As a Geriatric Physical Therapist, I spend oodles of time talking about assistive devices. Whether it’s working to wean off of one, or trying to convince my patient to use one, my day-to-day includes much talk of canes, walkers, wheelchairs and the like. But like most things in PT-world, the who-gets-what assistive device conversation is never black and white. That said, here are a few things I think about when deciding which assistive device to recommend.

Should I walk with a Cane?

These are your run of the mill straight stick supports like the guy is using above. They can have flat tops or curved; sometimes people buy fancy tripods to help them stand up or ice picks to add to the bottom to use in the winter. They come in all shapes and sizes, but have one thing in common - they will not stop you from falling if your legs give out. So, my first factor in determining whether to recommend a cane is strength. Basically, if you’re going to use a cane, you need to have enough strength to walk at least the distance you’ll be using it to walk (household or community) a couple of times in a row securely. The second factor I consider is balance. While a cane is great for folks who have minor balance impairments, you really need to have adequate reactive responses (the ability to catch your balance if you do start to fall) to make walking with a cane safe. The last thing I generally think about is coordination. Some people, (no judgement here..) are just not ‘cane-people’. Instead of helping, it becomes a hindrance. If the idea of using a cane seems overwhelming, requires a lot of focus or becomes another item to trip over, it probably isn’t the device for you. In fact, these are the folks I actually tend to focus towards without a device.

Does using a cane help with pain?

I tend to use canes for my folks that have pain. A cane is a GREAT way to reduce load on a painful joint - whether temporarily or ongoing as part of a pain management plan. Another pro for canes - it helps people walk with a more natural gait pattern (good for brain = good for gait). But there’s a catch - if you use a cane on the wrong side (the side CLOSEST to the painful side), you actually increase the load and as a result, the pain. So, if you’ve got a painful right  knee, the cane needs to go on the left so when you step onto that side, the cane is there to support it. I won’t go into much detail about the other cane options (large-based or small-based quad canes), because quite frankly, I don’t like them. It is hard for people to remember which way to use them (flat side goes toward you FYI), they get under-foot quite easily, and generally slow people down. Yes, they have their purpose for a small group of folks (like people with hemiplegia after a stroke) but for our general purposes today, I’ll leave them in them out of the discussion.

Should I walk with a Walker?

Walkers, like people, come in all shapes and sizes, and vary in quality. The old silver one with the wheels in the front and legs in the back is called a Rolling Walker. Four legs without wheels is a Standard Walker. (To save some time and energy, the only time a standard walker is going to the the ‘right answer’ is if you aren’t allowed to put full weight on your leg, or if you are missing a leg. Case Closed.) Despite the fact that we’ve developed crazy things like the INTERNET in the last hundred years, the design of these two basics actually haven’t changed much, if at all. These are the kinds of walkers you’ll come home from the hospital with if you’ve had a joint replacement or experience a fall and fracture. While the rolling walker has it’s time and place, and is certainly the safest option *in-home* for many people, it is not my favorite device. Using a rolling walker a) limits your speed (bad for brain = bad for gait), b) limits your trunk rotation and arm swing (again bad for brain = bad for gait) and c) frequently leads, in my opinion, to increased isolation because people often either don’t want to be seen by their neighbors and friends with a walker, or just find the darn thing cumbersome. I put *asterisks* around *in-home,* because my biggest walker pet-peeve is they are HORRIBLE for walking on most suburban streets and sidewalks. While they may work well l if you live in a brand new town with perfectly manicured roadways, where I live, between tree-roots and frost heaves, most areas I gait-train with patients are basically a head-over-heels situation waiting to happen. Watching a patient try to navigate uneven terrain with a rolling walker is not my favorite experience. Walkers don’t work on grass, they don’t work on sand, and in reality, they don’t work too well on sidewalks.

What is the best Walker to buy?

Enter the Rollator. Rollators get a bad rap because they move fast and because the brakes get loose, but I actually prefer to wean a patient onto a rollator when I can. Rollators, with their four wheels + hand brakes and a built-in chair, give a person an option for life outside of their home (in my humble opinion). Using a rollator, for most people, is more intuitive than a walker; it actually turns in a circle and makes turning corners way easier, it is smoother over uneven sidewalks, can actually go over grass - and my favorite, allows you the freedom to walk further because you have an option to sit and take a break when you need to! Rollators make  great choice for someone who may be limited by balance, endurance, cardiopulmonary impairments or back pain, but who still would like to be able get out and about in their communities. Quick note about rollator quality: while the general ‘got it for free from a neighbor’ rollator may not be the best, when a patient can afford it, I usually recommend a sturdier model called the Nitro. It is heavier, but stronger, more secure and is like the SUV of rollators.  (Nitro Walker)

Still wondering if a Cane or a Walker or Nothing at All is the right thing for you? Ask a PT:)

We are movement experts; our job is to help you find the safest way to navigate your environment while at the same time, giving you the maximum independence. For some, this may mean weaning off an assistive device; for others, it may means encouraging you to use one. The Cane Vs. Walker Showdown is rarely black and white. What may work in your home may not be what is best for use in the community. You may be able to use a Cane or Nothing at All during the day, but a Walker may be best at night. See, like I said…It Depends:)

About the author:

Dr. Katie Wadland, PT, DPT is the Owner and Primary Physical Therapist at Healthy Aging Physical Therapy. Healthy Aging Physical Therapy offers in-home Physical Therapy for older adults living in Melrose, Medford, Arlington, Stoneham, Winchester, Reading, Woburn, Wakefield and Lynnfield, Massachusetts. She is licensed to practice Physical Therapy in the State of Massachusetts (License #18193). She has over fourteen years of experience working with older adults with musculoskeletal and neurological impairments and advanced training in the care of people with Parkinson’s Disease, Spinal Cord Injury and Stroke.