If you’re looking to develop a strength circuit class for people with neurologic diagnosis this episode is for you! Running a circuit class for people with physical and/or cognitive deficits can have challenges. You need to be mindful in order to ensure safety while also challenging your clients enough to promote change. This episode Erin Gallardo and Claire McLean will break down the method and approach that Claire uses at Rogue PT and Wellness running her 40 weekly exercise classes for people with PD.

In the show we’ll break down the types of exercises to include in your circuit, short cuts to reduce confusion, the flow and structure of a comprehensive class, how to approach the conversation about which class is right for your client, and when to split into different levels of classes.

Check out a related past episode: 

Episode 219: Hi-Fi exercise class episode

Curious about how using Virtual reality (VR) could help you with prevention, assessment and treatment of your neuro patients? VR and AR (augmented reality) is emerging as a powerful tool in the world of neurorehabilitation, and Ramiro Maldonado, PT, DPT, a physical therapist with UprightVR, shares the research on the transformative capabilities of this technology.

Ramiro highlights how the true power of a good VR system lies in its ability to drive neuroplasticity by creating immersive environments that challenge and retrain sensory systems. By manipulating visual inputs and leveraging principles of motor learning, VR tools can tap into the key principles of neuroplasticity, such as repetition, context specificity, and multimodal sensory integration. One particularly intriguing aspect is the concept of "avatar representation," where VR creates a digital clone of the patient, allowing them to witness and experience their own healthy movement patterns. This innovative approach can significantly enhance motor learning and functional recovery. Ramiro also discusses the potential of VR in balance assessment and training. By expanding on traditional sensory organization testing, VR-based assessments can provide highly accurate and standardized data, enabling clinicians to identify deficits earlier and tailor interventions accordingly. As the field of neurorehabilitation continues to evolve, the integration of virtual reality holds immense promise. By harnessing the power of this technology, clinicians can unlock new avenues for neuroplasticity-driven recovery, ultimately improving outcomes and quality of life for their patients.

UprightVR

UprightVR LinkedIn

Are you used to working with adults with neurologic conditions and get intimidated by young adults or those with “pediatric” diagnoses? Many neuro therapists feel like they’re not the best person to help an adult with cerebral palsy, autism, spina bifida or other typical diagnoses made in childhood… but they’re wrong!  In this episode hosts Erin Gallardo and Claire McLean talk to Cameron Brown, PT, DPT, PCS about care across the lifespan and give you the confidence you need to help these clients.

In the show we discuss why neuro therapists are well-equipped to work with younger populations and how to adapt what you do for this population. Working with autistic adults is something many neuro therapists may not be accustomed to. Learn which strategies will work best to help these clients succeed. If you’ve ever felt like you weren’t “cool” enough to get along with younger adult patients we’ve also got tips for that! Regardless of how you’ve felt in the past, this episode will allow you to have the confidence you need to help the clients who really need you!

Resources shared:

https://www.autisticphysicaltherapist.com/about

Follow Cameron Brown on IG @dr_mama_brown

National Association of Black Physical Therapists

Follow NABPT @nabpt_

Working with clients with Functional neurologic disorders (FND) can be confusing and challenging. If you’re stuck and aren’t sure how to help your clients you’ve gotta check out this episode! Occupational therapists and industry leaders in the treatment of FND Julie MacLean and Jessica Ranford discuss their expertise in using a sensory-based approach to treatment. In their work they noticed certain patterns emerging for people experiencing FND.

By conducting detailed sensory profiles and histories, the OTs were able to identify patterns in how these patients processed sensory information. Many exhibited heightened sensory sensitivity, sensory avoidance, and low sensory registration - leading to cognitive, emotional, and motor control issues.

The OTs developed a multi-step treatment approach focused on: 1) Increasing patient self-awareness of their sensory processing and arousal levels 2) Exploring individualized sensory strategies to self-regulate 3) Creating personalized "sensory diets" of activities to maintain balance

This sensory-based framework, combined with motor retraining when needed, has been effective in helping FND patients improve their symptoms and expand their participation in daily life.

Overall, this discussion highlighted the valuable role occupational therapy can play in assessing and treating the complex sensory processing difficulties experienced by many individuals with functional neurological disorders.

FND specific resources: 

www.neurosymptoms.org 

www.FNDhope.org

Overcoming Functional Neurological Disorders Workbook, Reset and Rewire: The FND Workbook 

OT and sensory processing specific resources: 

Living Sensationally: Understanding Your Senses by Winnie Dunn 

The Spiral Foundation

Sensory Modulation & Environment: Essential Elements of Occupation by Tina Champagne

The Sensory Connection Program and Workbooks by Karen Moore 

Recent OT publications: 

Sensory Processing Difficulties and Occupational Therapy Outcomes for Functional Neurological Disorder: A Retrospective Cohort Study.

McCombs KE, MacLean J, Finkelstein SA, Goedeken S, Perez DL, Ranford J.

Neurol Clin Pract. 2024 Jun;14(3):e200286.  

Outpatient Approach to Occupational Therapy for Paroxysmal Functional Neurologic Symptoms: Sensory Modulation Training as an Emerging Treatment.

Ranford J, MacLean J.  Neurol Clin. 2023 Nov;41(4):695-709. doi: 10.1016/j.ncl.2023.02.008. Epub 2023 Apr 20

Sensory Processing Difficulties in Functional Neurological Disorder: A Possible Predisposing Vulnerability? Ranford J, MacLean J, Alluri PR, Comeau O, Godena E, LaFrance WC Jr, Hunt A, Stephen CD, Perez DL.Psychosomatics. 2020 Jul-Aug;61(4):343-352.

Occupational therapy consensus recommendations for functional neurological disorder.

Nicholson C, Edwards MJ, Carson AJ, Gardiner P, Golder D, Hayward K, Humblestone S, Jinadu H, Lumsden C, MacLean J, Main L, Macgregor L, Nielsen G, Oakley L, Price J, Ranford J, Ranu J, Sum E, Stone J. J Neurol Neurosurg Psychiatry. 2020 Oct;91(10):1037-1045.

Do you work with any clients who have trouble clearing their foot in swing phase of gait? If you said yes, this episode is for you! Dr. Tyler Susko, the founder and CTO of Cadense, Inc. is here to share the fascinating origin story behind Cadense's flagship product - the world's first variable friction shoes.

The concept stemmed from Dr. Susko's PhD research at MIT, where he developed the "MIT Skywalker" - a robotic system that allowed patients to walk by dropping the floor during the swing phase. A comment from a research participant led Dr. Susko to create a passive, material-based shoe design that can dynamically adjust its coefficient of friction.

Through extensive prototyping and user testing, the Cadense shoes have shown promising results for patients with a variety of neurological conditions, including stroke, cerebral palsy, Parkinson’s and multiple sclerosis. The shoes help facilitate foot clearance and improve gait symmetry and rhythmicity.

If you want to see these for yourself and try them out Cadense offers a free pair to clinicians who sign up for the Cadense Coaches program. The program provides free shoes and support to clinicians interested in incorporating the technology into their practice. He also shares exciting plans for future research and development, including projects on AFO-compatible shoes and variable friction on different sides of the shoe.

Learn more about Cadense and the Cadense Coaching Program at https://cadense.com 

Follow them on IG @cadenseadaptive

Ever wonder what to do with a patient with facial palsy? Can they recover? What should you NOT do that can actually make it much worse? Tune in and find out! In this episode, Erin Gallardo, PT, DPT, NCS had the pleasure of speaking with Dr. Sheri Donaldson, PT, DPT, NCS. Dr. Donaldson shared her extensive expertise in the niche field of facial rehabilitation and the specialized techniques she employs to help patients with facial paralysis recover.

Sheri emphasized the importance of the face in human expression and communication. She discussed the challenges faced by patients with facial paralysis, including the emotional impact and the difficulties with everyday tasks like eating and drinking.

A key focus of the discussion was the delicate nature of facial retraining and the need for a customized, precision-based approach. Sheri shared her insights on the do's and don'ts of facial rehabilitation, cautioning against a couple of things that are controversial like electrical stimulation, mirrors, acupuncture, and botox.

Sheri emphasized the importance of early intervention, the use of outcome measures like the Sunnybrook Facial Grading System, and the value of seeking mentorship and continuing education in this specialized field.

Email: [email protected] 

Website: https://facefirstphoenix.wixsite.com/face-first-physical

Sunnybrook Facial Grading System

Facial Palsy.UK

https://facialtherapyspecialists.com

Have you ever thought, “I’m really not good at managing people”? Or felt overwhelmed by the idea of being responsible for someone else? As business owners, the success of our ventures often hinges on the strength of our teams. In this episode of the I Love Neuro Podcast, Emily Duval Ledger, Erin Gallardo, and Claire McLean share their experiences and lessons learned about leading a team.

Emily reflects on her early struggles as a new business owner, admitting that she initially tried to overcompensate for her insecurities by being overly decisive and not listening to her team. Claire and Erin echo the challenges of transitioning from skilled practitioners to effective managers. The conversation delves into the nuances of hiring the right people, creating a positive team culture, and having difficult conversations when necessary. The panelists stress the importance of understanding your own leadership style, being transparent with potential hires, and evolving job roles to align with individual strengths.

This insightful discussion offers a roadmap for aspiring and seasoned entrepreneurs alike, highlighting the challenges and rewards of building a thriving team. As you navigate the journey of business ownership, remember to embrace the opportunity for continuous improvement and the joy of watching your team members flourish.

On today’s episode Claire McLean and Erin Gallardo offer an update to a previous episode on setting up overhead harness systems for your neuro rehab gym the way Claire has it set up at Rogue. Rogue has a DIY, relatively inexpensive setup using things like anchors, rope ratchets, and construction-style harnesses.

The big update to share was finding some new products that have really improved the comfort and usability of their system. The addition of "quick links,” which are essentially two carabiners connected by a nylon spacer helps keep the bulky pulleys and hardware away from people's heads.

They also talked about using a spreader bar, which helps position the support points even further away when doing single-point balance training. Claire was really excited about these little upgrades, saying they were "game changers" that made a big difference in how comfortable and safe the system is for their clients.

Additionally they also discussed other helpful aspects of the treadmill set up like Swiss balls and chalk lines on the treadmills, to help people with conditions like Parkinson's take bigger steps. Lots of little tricks to make the training environment as supportive as possible.

The updates in this episode will help you create an even better set up and system! Please reach out with any questions or shares at [email protected] 

Episode 139: How To Create Your Own Harness Set Up Like Rogue’s 

Claire’s equipment mentioned (not affiliate links)

Anchor

Rope Ratchet

QuickLinks

Harness

Mass Rehab Inc

In this episode, hosts Erin Gallardo and Claire McLean interviewed Dr. Amy Ashmore, an expert in resistance training programming. Dr. Ashmore shared her extensive experience and passion for resistance training. Some of the key points she shares are that timing is critical. Dr. Ashmore emphasized the importance of precisely controlling the timing of concentric and eccentric contractions to target specific training adaptations, such as muscle power, strength, or hypertrophy.

She also notes the importance of adjusting volume for aging muscle citing that recent research suggests older adults may require higher training volumes, up to 36 repetitions per set, to stimulate muscle growth and maintain lean mass as they age. There is also a need to prioritize motor skill development for older or neurologically impaired clients new to resistance training and what the focus should be. Learn these insights and more by listening to the episode so you can get stronger clients starting today!

Learn more about Dr. Ashmore’s courses here:

https://physicaltherapy.education 

https://amyashmore.com/

https://www.linkedin.com/in/amyashmorephd/

In this episode of the I Love Neuro podcast, hosts Erin Gallardo and Claire McLean discuss important updates and research related to Parkinson's disease. They used neurologist Dr. Michael Okun’s Instagram account as inspiration for the recent research to discuss. 

The first article discussed is titled End-of-life Health Care Service Use and Cost Among Medicare Decendents With Neurodegerative Diseases. The discussion highlights the high healthcare costs and lack of planning for end-of-life care in neurodegenerative diseases like Parkinson's. The article emphasizes the importance of involving neurologists and having a comprehensive care plan to improve outcomes, and we discuss what that might look like.

The second article discussed is titled Pain Fluctuation in Parkinson’s Disease and their Association with Motor and Non-Motor Fluctuations with an interesting finding about the type of pain people with PD typically experience, when they experience and our theories about why. Pain management is an expensive and often frustrating industry, so this is an important topic!

Find the article here: End-of-life Health Care Service Use and Cost Among Medicare Decendents With Neurodegerative Diseases

Find the article here: Pain Fluctuation in Parkinson’s Disease and their Association with Motor and Non-Motor Fluctuations

Follow Dr. Michael Okun here for PD research updates!