In this episode, host Erin Gallardo, PT, DPT, NCS interviews the Motus Nova clinical team—occupational therapists Jamie Kurtz, MS, OTR/L, Keisha Burrous, OTR/L, CBIS, Amie Canning, MS, OTR/L, and Mirasol Jacobs, PT, DPT — about the Motus Hand and Motus Foot robotic devices for neurorehabilitation. The team explains how these FDA Class I medical devices provide active-assistive, game-based training at home to help patients achieve the high repetition doses (500–600 reps per day) needed for neuroplastic change, without replacing traditional therapy. Built on pneumatic "artificial muscle" technology, the devices adapt in real time to the user's movement, address tone and spasticity, and can be customized for a wide range of neurologic conditions, from stroke and MS to Parkinson's disease and Guillain-Barré. The conversation covers who is appropriate for the devices, how they integrate with inpatient and outpatient care, real-world success stories—including improved gait, grip strength, and mental health—and the practical steps for clinicians to refer patients, arrange demos, and navigate the 13‑month rental-to-own DME model now supported by a dedicated Medicare code, which means patients can get the device through their insurance and it does not impact their ability to get other durable medical equipment (DME). Overall, the episode highlights Motus Nova as an accessible way to extend evidence-based neuro rehab beyond the clinic and into patients' homes. You will likely have a patient (or several) who come to mind while listening to this, so check it out and learn more today!

Keisha Burrous LinkedIN

Motus Nova https://motusnova.com

Therapists! Contact Motus Nova with questions, schedule an inservice, or refer a patient here: [email protected]

Do you work with people who have falls? Maybe you've seen that just training fall prevention isn't quite doing enough. In this episode hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS talk with physiotherapist Naomi Casiro, founder of NeuroFit BC and creator of the Functional Movement and Falls training paradigm about why adding falls training to an overall balance plan is imperative. We explore why traditional fall prevention—focused mainly on prevention—has not been enough, and why a two-part approach that includes both prevention and explicit "how to fall" training is crucial, especially for people with Parkinson's disease and older adults who are still falling at high rates. Naomi explains how teaching patients to roll, dissipate force, and land safely allows therapists to challenge them more intensively and functionally in rehab, while also preserving autonomy and true informed choice around mobility and assistive devices. They discuss how falls training progresses from simple, low-level skills on the mat rather than immediately falling from standing, the importance of repetition (even for those with cognitive impairment), and the central role of addressing anxiety. We also discuss how often providers themselves are scared to perform this training and what to do about it. Naomi shares how her background in martial arts and clinical experience with frequent fallers led to her "aha" moment about falls training, and previews upcoming opportunities to learn her approach through the NeuroFit Academy, an online Functional Movement and Falls Training Foundations course with NeuroCollaborative, live Q&A follow-ups, and a practical hands-on session at the World Parkinson Congress.

You can reach out to Naomi and learn more about the fall training courses she teaches for healthcare professionals here:

www.neurofitbc.com

www.neurofitbc.com/courses

Free exercise videos: www.neurofitbc.com/move

[email protected]

In this episode host, Erin Gallardo, PT, DPT, NCS speaks with Chris McElderry, PT, DPT, NCS about how dry needling can be used in neuro rehab, particularly for people post-stroke. Chris explains why he pursued dry needling, how using it in PT differs from acupuncture, and walks through what a typical session looks like, including safety, side effects, and billing considerations. He shares clinical examples of using dry needling to address spasticity, hypertonicity, pain, and range of motion limitations, and discusses current research on short-term effects for spasticity and pain reduction. Erin and Chris also clarify the differences between spasticity and hypertonicity, touch on contracture management, and highlight where dry needling can be a useful adjunct—not a standalone cure—in helping neuro clients move and feel better.

Follow Chris McElderry, PT, DPT, NCS @theneuroguy_dpt

Ebrahimzadeh M, Nakhostin Ansari N, Abdollahi I, Akhbari B, Dommerholt J. Changes in Corticospinal Tract Consistency after Dry Needling in a Stroke Patient. Case Rep Neurol Med. 2024 Sep 14;2024:5115313. doi: 10.1155/2024/5115313. PMID: 39309410; PMCID: PMC11416164.

Fakhari Z, Ansari NN, Naghdi S, Mansouri K, Radinmehr H. A single group, pretest-posttest clinical trial for the effects of dry needling on wrist flexors spasticity after stroke. NeuroRehabilitation. 2017;40(3):325-336. doi: 10.3233/NRE-161420. PMID: 28222554.

Fernández-de-Las-Peñas C, Pérez-Bellmunt A, Llurda-Almuzara L, Plaza-Manzano G, De-la-Llave-Rincón AI, Navarro-Santana MJ. Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis. Pain Med. 2021 Feb 4;22(1):131-141. doi: 10.1093/pm/pnaa392. PMID: 33338222.

Núñez-Cortés R, Cruz-Montecinos C, Vásquez-Rosales P, et al. Effectiveness of dry needling in the treatment of spasticity in stroke patients: A systematic review. J Body Mov Ther. 2020;24(3):113-122.

Suputtitada A, et al. Emerging theory of sensitization in post-stroke muscle spasticity: Implications for dry needling and other interventions. Front Rehabil Sci. 2023;4:1169087.

Valencia-Chulián R, Heredia-Rizo AM, Moral-Munoz JA, Lucena-Anton D, Luque-Moreno C. Dry needling for the management of spasticity, pain, and range of movement in adults after stroke: A systematic review. Complement Ther Med. 2020 Aug;52:102515. doi: 10.1016/j.ctim.2020.102515. Epub 2020 Jul 16. PMID: 32951759.

In this episode, Erin Gallardo, PT, DPT, NCS interviews physical therapist Mariah King, PT, DPT from RISE Healthcare Group and Hiroki (Hiro) Kimura from Cyberdyne about the HAL (Hybrid Assistive Limb) robotic exoskeleton and its role in neurologic rehabilitation. They discuss how the HAL system reads patients' intent to move via surface EMG signals and converts those signals into assisted movement to drive neuroplasticity and functional recovery for people with spinal cord injury, stroke, TBI, Parkinson's disease, and progressive neuromuscular disorders such as MS, SMA, and muscular dystrophy. Mariah explains RISE's one-on-one outpatient model, how patients are evaluated for HAL use, typical dosing (2–3x/week over about 2 months), and the outcome measures they track, including 10-Meter Walk, 2-Minute Walk, 30-Second Sit-to-Stand, and TUG. She shares powerful case examples, including a person with MS who relies on a wheelchair for mobility progressing to prolonged standing and assisted gait, and another individual with MS whose falls dropped from several per month to just one across four months. Hiro digs into what makes HAL unique compared to other exoskeletons: its emphasis on intention-based control, the ability for therapists to visualize and shape EMG patterns (for example, reducing co-contraction), and asymmetric or joint-specific assistance tailored to each limb. They also touch on the different HAL configurations (lower limb, single-joint, lumbar), its current status as a clinic-based rehab device (not take-home), billing considerations, the new pediatric version and forthcoming wrist device, as well as opportunities for students, clinicians, and clinic owners to get involved with RISE's HAL programs.

Website: www.risehealthcaregroup.com

Instagram: risehealthcaregroup

Facebook: risehealthcaregroup

YouTube: https://www.youtube.com/@risehealthcaregroup7766

Cyberdyne USA Inc.

https://www.cyberdyne.jp/english/

[email protected]

In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS discuss a new research article, "Refining maximal heart rate estimation to enhance exercise recommendations for persons with Parkinson's disease." Parkinson's is a multi-system condition and changes to the function of the autonomic nervous system are common. At times this can present as a person with PD having trouble reaching aerobic heart rate zones calculated based on age while they're performing high intensity exercise. Claire explains the challenges they've faced using standard heart rate formulas and color-zoned monitoring apps when many clients appear stuck in a "gray zone," likely due to this autonomic dysfunction and chronotropic incompetence common in Parkinson's. After exploring but struggling to access cardiopulmonary exercise testing (CPET)—the gold standard for determining true maximal heart rate—Claire finds this new study, which uses CPET data from a cycling trial to derive a more accurate regression-based equation for people with Parkinson's: 166 − (1.15 × age) + (0.60 × resting heart rate). She describes how they are now applying this formula in practice by calculating individualized max heart rates, manually updating values in their OnBeat app, and offering a public calculator via their website so people with Parkinson's and clinicians can easily generate appropriate training zones. This shift should make target zones more realistic, motivating, and safer. Listen to the show to easily incorporate this research into your practice today!

Pull up the article here (free full text available): https://pubmed.ncbi.nlm.nih.gov/40194736/

Use Claire's calculator that uses the research-based formula here: https://www.roguept.com/cardio

In this episode of the I Love Neuro podcast, host Erin Gallardo, PT, DPT, NCS interviews physical therapist and neuro rehab residency coordinator Jennifer Lazaro, PT, DPT, NCS about evaluating and treating people with long COVID and dysautonomia. Jennifer notes the similarities in presentation for individuals who have post-COVID those with other conditions affecting the autonomic nervous system, like concussion with cognitive fog, severe fatigue, post‑exertional malaise, dizziness, and orthostatic intolerance. She walks through practical assessment strategies such as active stand testing, symptom‑mediated exercise testing, and multi‑system screening to differentiate vestibular, cardiac, pulmonary, and autonomic drivers. Jennifer outlines how she starts with education on the autonomic nervous system, diaphragmatic breathing, and strict pacing, then progresses patients from supine conditioning through graded dysautonomia protocols like the Adapt protocol, emphasizing heart rate parameters, symptom monitoring, and buy‑in to "doing less to do more." She highlights the importance of interdisciplinary care with OT, speech, cardiology, neurology, and mental health, shares a powerful success story of a college student who returned to school after structured rehab, and offers real‑world strategies for self‑management using wearables, pacing tools, and lifestyle changes in sleep, hydration, and daily routines.

In this 300th episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS invited long-time collaborator JJ Mowder-Tinney, PT, PhD, NCS to join so we could recap the best takeaways from Dendrite Expansion Days (DED), NeuroSpark's three-day, fully experiential education event for OTs and PTs. We share how Naomi Castro's "falling well" course progressed clients from floor work to standing falls in one session, describe hands-on equipment stations featuring frictionless sheets, BlazePod, Rifton, Saebo, UprightVR, and more, and highlight real client stories—especially Connor, a young man with severe ataxia who gained new independence and freedom using a transfer pole and the Rifton Pacer overground gait trainer. The conversation emphasizes why equipment can be a powerful ally in neuro rehab, the importance of collaborating with vendors and fellow clinicians, and how community events like DED spark practical, immediately applicable ideas for improving outcomes and patient autonomy. You'll gain insights to use in your practice today!

Do you feel ready for that next big step? A transition in your career like leaving your job to start your own business, or transitioning your side gig to full time, or hiring your first employee. Neither did any of us! In this episode hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS have a discussion with NeuroBiz coach Emily Duval Ledger about what it really means to be "ready" for big transitions like starting a business, leaving a job, or hiring your first team member. We share our stories like Claire and Emily opening brick-and-mortar gyms, Erin and Claire starting and building NeuroCollaborative, Erin transitioning from working in the clinic to going full time in NeuroCollaborative, and all of us navigating business entities, taxes, and imperfect systems. This discussion will help you see the way we worked through fear, uncertainty, and messiness. Learn from the mistakes we share and how we fixed them like when Claire's corporation paperwork was filed wrong. The episode closes with encouragement for listeners who are "ready-adjacent" to take the next step and an invitation to connect, join our biz group, or come on the podcast to talk through your ideas with us.

Join the NeuroBiz Besties free slack group!

Set up a discovery call with Emily here!

DM us on IG if you want to discuss your business questions

In this episode of the I Love Neuro podcast, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS discuss a major Lancet Public Health systematic review and meta-analysis on daily steps and health outcomes in adults, shared from a post by movement disorders neurologist Dr. Michael Okun. Claire explains that the study, which pooled data from multiple cohorts using device-measured steps, found the number of steps per day that is associated with substantial health benefits, including about a 47% lower risk of all-cause mortality compared to less steps. This amount also demonstrated reductions in cardiovascular disease, dementia, depressive symptoms, type 2 diabetes, and falls, with some benefits even for people already living with chronic conditions like cardiovascular disease or cancer. Although 10,000 steps can still be a good target, the number revealed is both evidence-based and more realistic for many people, especially those with Parkinson's or other comorbidities that limit high-intensity exercise. We offer practical coaching strategies such as using wearables or phones to track steps, first establishing a baseline, then increasing by roughly 500–1,000 steps per day over weeks rather than rushing, and using accountability systems, step challenges, and percentage-of-goal metrics to keep motivation high and inclusive. Walking is our top exercise recommendation—accessible, adaptable, socially engaging, and powerful for long-term health and functional mobility—and we encourage clinicians to share the article with patients and help them set individualized, achievable step goals.

Find the full text article here: https://www.thelancet.com/action/showPdf?pii=S2468-2667%2825%2900164-1

In this week's episode, host Erin Gallardo, PT, DPT, NCS is joined by OT mentor Briana Elson, MS, OTR/L, BCPR, CBIS to dive into one of the most essential topics in spinal cord injury rehab: bowel and bladder care. We unpack why every rehab professional (not just nursing) plays a role, how unmanaged bowel and bladder can lead to serious health issues, and practical strategies to support independence, dignity, and community reintegration. Brianna shares equipment ideas, education tips, and real-world problem-solving for both bladder and bowel programs, plus how this all connects to intimacy, relationships, and quality of life after SCI.

Resources:

• Follow Mason Ellis on YouTube and share with your patients!

• Find a peer mentor through Christopher and Dana Reeve Foundation

• facingdisability.com

• https://www.sexualitysci.org/

• https://otafterdark.com/

• https://msktc.org/sci/factsheets/sexuality-sexual-functioning-after-sci

• https://craighospital.org/resources/sexual-function-for-women-after-spinal-cord-injury

**As a note there are a couple of corrections in the episode we wanted to make clear:

Bri may have misspoke… suprapubic catheters are placed below the belly button, not above.

She may have said you can wear a bag with it, but you don't always have to. Disclaimer would be to defer to urology.