A Neuro Physio Podcast

Haseel Bhatt is a neurological physiotherapist, researcher and adjunct lecturer at the University of Toronto. He holds a Bachelor of Science in Kinesiology and completed graduate studies at the Movement Disorders Research and Rehabilitation centre in Waterloo, Ontario, Canada before studying physiotherapy. His primary research focus has been in Functional Movement Disorders and freezing of gait in Parkinson’s disease and he now runs his own practice Neurology Rehab in the Durham Region, Ontario.

Haseel regularly posts evidence-based educational content on his Instagram page @parkinsonsphysiotherapy

We cover his unique career pathway, why he developed his social media page, the latest in evidence-based Parkinson’s management including how to assess for targeted intervention. We also discuss the right time and care for FND, anxiety as a cause of freezing of gait, visuo-motor issues in PD and burnout in neuro physio.  

Let us know what you think!

1.45 Career pathway 

7.10 Transitioning from research to clinical 

13.05 Social media as an allied health professional  

18.40 FND - Evidence-based physio on social media, rehab readiness

26.00 Haseel’s approach to explaining FND  

29.05 What are we missing in physio for Parkinson’s? 

36.05 eye movements in Parkinson’s 

44.55 Body systems assessment in Parkinson’s 

52.51 Burnout in neuro physio 

Resources/links: 

Haseel’s physiotherapy practice website  https://neurologyrehab.com/ 

Instagram: @parkinsonsphysiotherapy

Haseel's Courses 

• FND PT/OT 2-Day Course Waitlist (clinician-focused): https://neurologyrehab.kit.com/2bb52170b8
• Self-Paced FOG Course (for caregivers and patients with PD-FOG): https://courses.neurologyrehab.com/courses/freezing-course

Articles Haseel discussed in the episode:

Exercise & physiotherapy efficacy for Parkinson's Nature Reviews Neurology updated review

Anxiety & Neuropsychiatric Symptoms (Non-Pharmacological Approaches) 

Anxiety is associated with freezing of gait and attentional set-shifting in Parkinson's disease 

Does anxiety cause freezing of gait in Parkinson's disease?  

Factors Influencing Triage to Rehabilitation in Functional Movement Disorder 

Integrated model of care for functional movement disorder: targeting brain, mind and body  

Eye Training & Gait Stability 

Functional Dystonia Rehabilitation 

Doorway Sampling & Freezing
Tracy Tan's work on PD gaze in cluttered environments (graduate thesis)

Eghotez Martens on illuminated doorways and freezing - second most freezing when only seeing the doorframe illuminated

Lab findings on doorway sampling during dual-task (when FOG is most vulnerable)

Mini BESTest 

International Consortium for Freezing of Gait – Updated definition of FOG   

Ky Wynne Journal of Physiotherapy - Burnout in physiotherapy article  

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A Neuro Physio | Facebook

A Neuro Physio Podcast (@aneurophysio) / X

LinkedIn

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Professor Janice Eng, OC, is a University Killam Professor and Canada Research Chair, University of British Colombia Department of Physical Therapy. Janice is currently the co-director of the Centre for Aging SMART at Vancouver Coastal Health. Her work includes the GRASP upper limb program, the FAME fitness and mobility program, robotic exoskeleton research and her most recent Walk n’ Watch multi-site trial. Having published over 300 peer-reviewed journal articles, we discuss how her work is focussed on how to effectively and safely deliver high doses of therapy in complex healthcare environments, and make sure it is implemented widely in clinical practice.

20 sec Career Pathway 

2min 45 sec Filling the evidence gap in neuro  

5min 33sec Managing control groups in clinical trials 

8min 54sec Capturing meaningful improvements with outcome measures 

13min 28sec Importance of sufficiently funded trials 

15min 40sec Success of Janice’s trials changing practice across the world 

20min 29sec Resistance from clinicians about repetitive, task-specific & independent practice  

24min 28 sec GRASP program 

26 55sec FAME program 

29.17 sec Walk n’Watch 

32.52 Who benefits from feedback on performance, clinicians or patients? 

36.00 Avoiding boredom doing reps 

39.14 Gender issues in rehab trials 

Links & Resources

REACH scale for Everyday Arm-use in the Community and Home extremity 

REACH | Neurorehabilitation Research Program 

Rating of Everyday Arm-Use in the Community and Home (REACH) Scale for Capturing Affected Arm-Use after Stroke: Development, Reliability, and Validity - PMC 

Full article: A biomechanical analysis of the effectiveness of the Graded Repetitive Arm Supplementary Program (GRASP) for chronic stroke rehabilitation - Movement quality (speed, smoothness) improved in GRASP 

GRASP – GRASP | Neurorehabilitation Research Program 

FAME - FAME – Fitness and Mobility Exercise Program – A Group Exercise Program for People after Stroke 

Walk ‘n Watch Walk ‘n Watch | Neurorehabilitation Research Program 

Safety and effectiveness of the Walk ‘n Watch structured, progressive exercise protocol delivered by physical therapists for inpatient stroke rehabilitation in Canada: a phase 3, multisite, pragmatic, stepped-wedge, cluster-randomised controlled trial - ScienceDirect

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Dr Vivienne Travlos is a Respiratory Physiotherapist at the MND Association of Western Australia and Principal Physio at Breathe Physio. She has a PhD, MSc of (Management of hildhood Disability) a GradCert in university teaching. This episode is all you want to know about neuro respiratory. We chat neuromuscular disorders, respiratory pathophysiology and disease, night respiration, airway clearance, assessment and measurement, intervention according to severity. Also heard answers to listeners questions - evidence base, physio role across the complex disability continuum of care.

2.03 Welcome & Career Pathway

8.59 PhD – Adolescents with NMD physical health & mental wellbeing

12.59 What are neuromuscular disorders? What resp issues occur?

18.25 Night respiration issues

21.49 NIV

26.15 Lung volume recruitment

31.00 Airway clearance

39.46 EBP in neuro respiratory

43.19 Key outcome measures

49.22 Lung tissue integrity

52.49 Future proofing

1.00.44 Reflection

Links & Resources

Email: [email protected]

Physiotherapists: A vital part of MND multi-disciplinary care

Viviennes' LinkedIn

Vivienne's phd papers/ research gate

Neuro Respiratory Physiotherapy Academy (Jac Agostinello)

MND Western Australia

MND Victoria

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

A/Prof Simone Dorsch is a lecturer in neurological physiotherapy at Australian Catholic University in Sydney and a Director at the StrokEd collaboration. Simone holds a Masters of Health Science (Neurological Physiotherapy) and a PhD in increasing strength after stroke from University of Sydney. We spend time talking about strength training after stroke, dose and intensity of practice, courses offered by Stroke Ed including the Upper Limb Stroke Rehab Massive Online Open Course (MOOC) that ran for the first time in June 2024.

There’s chats about empowerment in rehab, the family role, personalising practise and what interventions we should and shouldn’t be using.

0 Intro
23.00 Current roles & career
45.00 MOOC UL stroke rehab
14.45 Stroke Ed courses
17.50 Coaching
21.10 How much to ‘talk’ as a physio
24.20 Empowerment & engagement
29.05 Strength training
32.45 Clinical reasoning framework of TST
35.10 What interventions we should be doing
38.30 Teaching how to practice - how not to scare people off
41.30 Hands-on approaches
44.30 Personalising practise
53.20 Family empowerment
57.10 Definition of Bobath in studies

Links

Simone’s ACU profile 

Simone’s X 

Simone’s phd papers/ research gate

LinkedIn 

Stroke Ed website

Caitlin reed episode link 

Other StrokeEd presenters episodes:

Dr Annie McCluskey 

Dr Kate Scrivener

Resources

Articles discussed in episode:

Xu Wen Eng 2014 Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

Bobath Systematic reviews: 

https://www.sciencedirect.com/science/article/pii/S183695532030103X'

https://www.sciencedirect.com/science/article/pii/S1836955322001151

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

We are chatting with James McQuillan one of the Australian Steelers – the Aussie wheelchair rugby team. Not just that but an Australian Steeler who has had an incredible journey from recreational sportsman to national representative in just over 11 months. In this episode James shares his story, the injury that led him to having a SCI, how he came to be part of the Steelers, and all about Wheelchair Rugby as a sport. He also tells us about being an elite sportsman, his SCI rehab journey, nerve & tendon transfer surgeries to get more function in his upper limbs and some tips for working with people with SCI. Enjoy!

2.00 Intro

2.34 sec Bio

6.44 Wheelchair Rugby

11.48 Classification

13.05 Getting into para sport

17.53 Equipment required

17.54 Fitness for elite wheelchair rugby & SCI

21.46 Role in Aussie Steelers 

25.55 Nerve transfer & Tendon transfer surgeries

30.31 Rehab – knowledge, motivation, prioritising

36.12 What rehab clinicians did well 

45.12 Reflection

Resources

Forged In Steel - Australian Steelers documentary

Paralympics media release 

SCI PT guidelines sciptguide.com

Paralympics websites
https://www.9now.com.au/paralympic-games-paris-2024
https://www.paralympic.org.au/
https://olympics.com/en/paris-2024/paralympic-games

Austin Health Nerve  & tendon transfer team

Links

Instagram @jamesmcquillan5

James' LinkedIn

ANZ Smashing through barriers

Paris 2024 Profile

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Dr Jess Nolan recently completed her PhD on Lateropulsion. Jess is a physio from Perth, Australia. Her credentials include BSc (Physio) - Curtin Uni, Grad Dip (Neuro Rehab) – UWA, member of ANZSO Emerging Stroke Clinician Scientist Committee, and Physio Working Party for the Stroke Foundation Living Guidelines. Jess worked as a senior physio, a physio coordinator of stroke services and is now at Curtin University in a teaching & research role.  This episode is all about Jess’ PhD journey and results. Lots of lateropulsion clinical application in this one. 

2.00 sec Intro

2.28 Career pathway/Interest in Lateropulsion

8.45 What is lateropulsion? Can it be mild?

13.20 Prevalence

14.05 Outcome Measures

18.29 Verticality

22.38 Assessing SVV – bucket method

23.00 PhD results - LOS needs, ANSNAP LOS predication accuracy, 1 year outcomes

37.10 Unknown pathophysiology of lateropulsion

40.20 Other components of lateropulsion – SPV – graviception, vestib impairment

43.35 Treatment

49.22 Fear of falling

50.45 Education

53.01 Treatment 2.0

56.28 What’s next for this work

1.04.17 Erin & Matt's reflection

Articles discussed in episode:

Lateropulsion prevalence: Dai 2022 systematic review 

Assessment of verticality: Piscicelli  & Pérennou 2017 

Lesion location: Van Der Waal 2023 systematic review

Thalamic involvement: Rosenzopf 2023   

Treatment approaches: Paci 2023 scoping review 

Lateropulsion outcome measures: Koter 2017

4 Point Pusher Score validation: Chow 2019   

Lateropulsion & falls (inpatient): Lewis, Heinemann...Nolan 2024

Links

Jessica's Linkedin

Twitter @jessnolan__

Check out the episode webpage for Jess' PhD papers

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

This episode is all about codesign. Dr Emily Ramage is a neuro physio & expert in an approach to codesign called Integrated Knowledge Translation. She’s used the methodology through her PhD (codesign of a PA intervention aimed at reducing secondary stroke risk) & in other projects which she speaks about in the episode. Emily's PhD work was piloted as part of the ENAbLE pilot trial involving physical activity AND diet intervention, we heard about it in our episode with Coralie English (season 1 Website    Apple podcasts)

Emily’s recently been an Allied Health Research Translation lead in Victoria & an Implementation Research Associate for the international AVERT program at the Florey in Melbourne. She’s affiliated with the University of Newcastle, the University of Melbourne & is a member of the Emerging Leader’s Group for the International Stroke Recovery and Rehabilitation Alliance.

1.47 Introduction

2.05 Career pathway

6.55 Doing a PhD as a mum

11.45 When a PhD is advertised by a researcher team

19.10 End-user collaboration in research

20.20 Emily’s PhD – codesign of PA for secondary stroke risk

25.32 What does codesign mean?

36.00 Power differentials in codesign

39.51 Running IKT workshops – communication; knowledge & language diversity

45.02 Will codesign become a check box?

48.00 World Stroke Organisation Future Leader Program

Articles/Resources discussed in episode:

Fit for purpose. Co-production of complex behavioural interventions. A practical guide and exemplar of co-producing a telehealth-delivered exercise intervention for people with stroke

Secondary prevention of stroke. A telehealth-delivered physical activity and diet pilot randomized trial (ENAbLE-pilot)

iREBOUND 

ISRRR – International Stroke Recovery and Rehabilitation Alliance

Stroke Foundation module – Working effectively with people with lived experience to design, conduct and promote stroke research

Links

Link in Marlena Klaic’s ep Victorian AH Research Translation Lead:  Website    Apple podcasts

Link to Prof Coralie English’s ep: Website    Apple podcasts

Emily’s LinkedIn 

World Stroke Bio 

Twitter @emilyrramage

Email – [email protected]

Episode webpage: http://aneurophysio.com/emily-ramage

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Dr Julie Vaughan-Graham is an IBITA Basic and Advanced Tutor, holds a Masters degree in neuro rehabilitation and a PhD investigating the clinical reasoning process of expert Bobath physiotherapists. She owns her own clinical practice in Toronto, and developed the online iNeuroRehab training courses. Julie also holds a post-doctoral fellowship and adjunct lecturer position with the Department of Physical Therapy, University of Toronto. 

This episode focuses on The Bobath Concept, clinical reasoning and the Model of Bobath Clinical practice which Julie co-developed. It picks up from our previous Bobath episodes with Janet Stevens (season 1) and Dr Kim Jennings (season 2), going deeper, and addressing some of the criticisms of the Bobath concept.

2.00     Introduction

2.41 Career pathway 

16.20 PhD findings – 

How Bobath instructors problem solve & clinically reason

22.00 Model of Bobath Clinical Practice 

26.48 Bobath and the RCT 

28.45 Applying the Bobath concept – Hemiplegic UL example

36.47 Using sensory cues in Bobath

43.38 Using the Bobath Concept is a skill to develop 

47.25 Neuroscience & Bobath

53.50 Movement diagnosis & hypotheses

57.53 Discrete interventions vs Bobath Concept (a framework of intervention)

Papers and References

IBITA Model of Bobath Clinical Practice

Julie's ResearchGate

Professional & Scholarly activities

Links

Julie’s private practice in Toronto, Canada

iNeuroRehab

Julie's LinkedIn

Candanian Bobath Instructors Association profile

Janet Steven’s episode Webpage    Apple podcasts

Dr Kim Jennings episode Webpage     Apple podcasts

Episode webpage: https://aneurophysio.com/julie-vaughan-graham/

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

This month we are chatting with Dr. Sarah Milne from Murdoch Children’s Research Institute who is also the Coordinator of the Friedreich's Ataxia Clinic at Monash Health in Melbourne, Australia. Sarah is an expert in hereditary cerebellar ataxias and after completing her PhD in 2018 she is trying to bolster the evidence base about the right rehab for people with Friedreich’s Ataxia. 

This episode will appeal to people treating Friedreich’s Ataxia or any of the inherited cerebellar ataxias, and to anyone who sees people with cerebellar pathology. Also of interest are the chats about challenges of rehabilitation research. The audio quality in this episode isn’t up to our usual standard with a lot of static happening – sorry!

2.01 Intro & career pathway

4.38 Friedreich’s ataxia

7.00 How is Friedreich’s ataxia different to the hereditary cerebellar ataxias?

8.36 Phenotypes in neurological conditions and the RCT paradigm

11.20 PhD results   

15.02 State of the Friedreich’s ataxia evidence

16.49 Ataxia outcome measures 

20.03 Ataxia assessment

24.25 Compensation vs optimal cerebellar functioning

27.00 What can imaging tell us about cerebellar conditions?

29.55 Treatment 

36.16 Efficacy vs Effectiveness, challenges of rehab trials 

39.23 Aquatic physio for this population

41.43 Episode reflection

Links
Research Gate
PhD - 4 studies – Pilot rehabilitation trial for people with Friedreich’s Ataxia. Clinical audit of LL spasticity relationship with ataxia severity & function. Sensitivity of balance, gait measures and instrumented measures of gait & balance change over time.

LinkedIn

University of Melbourne profile

Articles discussed:
Brain Changes Associated with Postural Training in Patients with Cerebellar Degeneration

Home aerobic training for cerebellar degenerative diseases: a randomized controlled trial

Cycling regimen induces spinal circuitry plasticity and improves leg muscle coordination in individuals with spinocerebellar ataxia

Predictors of loss of ambulation in Friedreich's ataxia

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Dr. Kate Scrivener is a Senior Lecturer of Physiotherapy at Macquarie University, Sydney, Australia where she’s an educator and researcher. She’s also an educator with the Stroke Ed collaboration and that energy for education & innovation has seen her develop the REPS app and website - a set of exercise programs designed to help stroke survivors exercise at home, and the TRAIN program - a clinician’s guide to effective task specific training. Until recently she also worked clinically at Concentric Rehab in Sydney. She’s the lead investigator on the HiWalk trial and is involved in a number of other projects we didn’t get to talk about in the episode.

Kate’s episode zeros in on a number of her passion areas:
-  Education - making neuro easier to understand for students and implementing evidence into practice for practicing physios. 
-  Improving mobility, especially in the chronic phase in the community
-  Increasing dose of therapy

All this culminates in her HiWalk trial which has just finished recruitment.

There’s plenty to take away from this episode.

2.02 Intro – Work roles & life balance, neuro career

7.17 Teaching Neuro

10.21 TRAIN modules

11.42 Career pathway

15.19 Stroke Ed courses – practical ways to apply stroke guidelines

19.44 Australian NSF guidelines – to what setting do they apply? 

20.44 Interest in rehab in community sector 

23.48 HiWalk project

28.19  Intervention research pipeline - basing research trials on intervention feasibility 

31.47 Interest in walking after stroke, PhD

35.48 We need clinical researchers

36.34 Do you need a PhD to be a clinician researcher? 

41.22 HiWalk intervention package

43.10 Are reps the best way to quantify dose?

52.10 Kate’s favourite ways to increase dose of therapy

55.36 Post episode reflection

Links

Macquarie Uni profile 

Linked In profile

ResearchGate 

REPS app – download on Android or link TASK program website 

TRAIN program – A clinician’s guide to effective task specific training 

Articles discussed in the episode

Stroke survivors have fallen into a ‘black hole’ editorial

Schneider 2016 systematic review – amount of additional usual therapy  to improve activity after stroke 

Kate’s PhD articles – Exercise dose and mobility outcomes post stroke see Kate's ResearchGate

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.