By, Julianne Bomia, SLP

Advances in neuroscience have provided neurobiological and behavioral evidence supporting the positive impact of exercise-based protocols in people with Parkinson’s Disease.  LSVT LOUD is an evidence-based Speech Therapy program that has strong potential to improve quality of voice and overall intelligibility for people living with Parkinson’s Disease.  It has been scientifically researched for the past 25+ years and has documented improved impact on multiple levels of functioning in people with Parkinson’s following treatment.

Benefits experienced after treatment include:

• Increased vocal loudness
• Improved articulation and speech intelligibility 
• Improved intonation (the rise and fall of the voice in speaking)
• Improvements in facial expression 
• Changes in neural functioning related to voice and speech 

The LSVT program consists of 60 minute sessions, four times per week for four weeks.  This combined with a home exercise program one to two times a day, helps clients with Parkinson’s to better improve their skills.  The goal is for clients to use their “LOUD” voice automatically in everyday living and for long term carryover of increased intelligibility. As with all of our therapies, sessions and schedules can be tailored to best accommodate the needs of the patient. 

LSVT BIG is a Physical Therapy or Occupational Therapy program for Parkinson’s Disease and is used to improve major motor skills for activities like walking, limb movement and balance or fine motor skills such as writing and other ADLs (activities of daily living).

Rehab Specialists has Speech Therapists, Occupational Therapists, and Physical Therapists certified in both LSVT LOUD and LSVT BIG for maximal results in treating many Parkinson’s Disease symptoms.

If you’re interested in learning more about LSVT for Parkinson’s Disease, call our office at 269-459-6212 to learn more or to set up a free consultation with one of our certified therapists.

The role of the Occupational Therapist is to determine what activities of daily living skills (ADL’s) you are having difficulties with and establish goals to improve on your level of independence in these areas.

What are ADL’s?  ADL’s include but are not limited to:

• Dressing skills (including manipulating clothing fasteners, tying shoes)
• Grooming and hygiene (brushing teeth, washing face, applying makeup, brushing hair)
• Bathing/Showering
• Feeding yourself
• Household chores
• Work
• Handwriting, computer skills

The Occupational Therapist will interview you and assess your skill levels.  The OT will identify your strengths and weaknesses.  Based upon your symptoms and strengths the OT will teach you strategies to allow you to continue to do those ADL’s that are important and meaningful to you.  Often, the OT will focus on arm movements and fine motor skills to help improve on your ADL’s.

There are also specific exercises that are highly recommended in order to help maintain and improve on your mobility.  One of these specific programs is called the LSVT BIG  program.  At Rehab Specialists we have several PT’s, Physical Therapist Assistants and 1 OT all trained in the LSVT BIG program.  This is a specific movement based program to help improve on balance and mobility for those individuals with Parkinson’s Disease.  As part of this program the patient can be seen by both OT and PT in a joint effort to improve on both upper extremity and lower extremity movement.  The goals are tailored to the individuals needs and wants and are very specific to the patient.

At Rehab Specialists we do offer free consultations.  If you would like to discuss your concerns with an Occupational Therapist please feel free to call and schedule a consultation.  You may also discuss with your Primary Care Doctor or Neurologist the option to obtain a script for Occupational Therapy.

Did you know that dancers suffer an average of 1 injury per year? Between 14-77% of those injuries are in the foot and ankle. Another fun fact: the foot and ankle consist of 26 bones in the foot and 2 lower leg bones! The foot and ankle complex is extremely important for dancers to propel themselves through space and create long, beautiful lines with their legs. 

Common dance injuries include ankle sprains, tendinitis, and hallux valgus also known as bunions. Most dancers will experience an ankle sprain at some point in their careers and a lot of them will work through an ankle sprain if it isn’t too severe. It is important to seek out care even for minor sprains to maintain the extreme ranges of motion and strength needed in a dancers foot. 

A dancer may benefit from an orthotic or heel cup to be used in street shoes while not dancing to support the foot and aid in healing. Prior to full return to dance, a dance physical therapist may recommend gradual return to dance by doing barre work in tennis shoes with supportive orthotics to ease the feet back into dance activities. For more information about how to manage foot and ankle conditions in dancers, or if you have foot and/or ankle pain, contact Rehab Specialists and ask to be scheduled with our dance specialist.

     The purpose of stretching is to decrease muscle tension or permanently lengthen a muscle that has been shortened. The most important aspect of stretching is to remain relaxed during the stretch. Stretching too aggressively or quickly can trigger the muscle to contract, which in turn decreases the person’s ability to hold the stretch. The best way to avoid this is to slowly work into a minimum to medium stretch that a person can hold for up to one minute. A medium stretch is defined as as much stretch as a person can tolerate while keeping their muscles relaxed. Once this is achieved, the key is to listen to your body- if a stretch feels good to continue to hold, then hold it longer. If your body is telling you it needs a break from the stretch, then it’s time to stop.

Photo by Alora Griffiths on Unsplash

By, Megan Bly, DPT, CLT

Did you know the warm up and cool down of any workout is just as important, if not more important, than the workout itself? In order to prevent injury, a proper warm up is necessary and should be fairly dynamic in nature. A good warmup also helps rev up your cardiovascular system to warm the body and increase blood flow to your muscles but should not leave you exhausted. A warmup should be performed right before working out, focusing on large muscle groups, with a low intensity. The warmup could include a short walk prior to starting a run, jogging in place, or doing jumping jacks before doing a cardio workout or lifting weights. Exercise or sport specific movements may also be necessary. Here are a few examples:

• To warm up for a brisk walk, walk slowly for 5 to 10 minutes
• To warm up for a jog/run, walk briskly for 5 to 10 minutes
• To warm up for a weight lifting session, perform similar motions without weights and through partial range of motion

Similarly, the cool down helps the body recover to its pre-exercising state of decreased heart rate and blood pressure. The cool down can include more static type stretches, or activities that are very similar to the warm up. Specific static stretching should be performed following your workout, when muscles are warmed up. Stretching can help to improve flexibility and range of motion. It may further aid in performing your sport better as your joints can move through their full range of motion. Here are a few examples you can incorporate as part of your cool down:

• After going for a brisk walk, walk slowly for 5 to 10 minutes
• After going for a run, walk briskly or slowly for 5 to 10 minutes
• After performing a cardio or weight lifting workout, perform specific stretches for large muscle groups

If you find that you’re having difficulty or pain with any of these, give us a call! 269-459-6212

By, John Stephen, PT, PPD, COMPT, Cert. MDT

You are probably reading this article because you have low back pain or have experienced it at some point in your life. You’re not alone. It is estimated that 8 out of 10 Americans will have back pain in the next two years and that after the common cold, it’s the next most common reason for missed time at work. 75% of people experience some sort of back pain in their life. It costs almost 90 billion dollars a year, draining the American economy.

The lumbar spine bears the most weight on the 5 vertebrae and discs which over time undergo degenerative changes. There are so many reasons you could have low back pain. Some of the common reasons you may have back pain are:

● Lumbar strain
● Lumbar spondylosis (degeneration/arthritis)
● Spondylolisthesis (slipping of vertebrae)
● Lumbar stenosis (narrowing of the spinal canal/foramina where the nerve exits)
● Lumbar disc protrusion, herniation, or extrusion
● Sciatica
● Sacro-iliac joint pain

Low back pain could also arise due to kidney stones and other systemic reasons. A trained physical therapist or medical provider would be able to perform a differential diagnosis to determine if this is the case.

Many people nowadays think a $4k MRI is the answer to low back pain. While an MRI may confirm or rule out a diagnosis, it never resolves your pain. Research has shown that many individuals may have an abnormal MRI but with no symptoms at all.

Additionally, surgery should always be the last resort for low back pain or radiculopathy. Conservative treatment such as spine physical therapy has been clinically proven by research for resolving back pain long-term. Surgery should be considered only when conservative methods have failed. Many complex low back issues could be addressed by orthopedic manual therapy and evidence based non-surgical methods like the Mckenzie method, which is what we use at Rehab Specialists.

If you have low back pain which has lasted more than a week, do not ignore it. Most low back strains may resolve within a week with activity modifications, and NSAIDS. However, you may need immediate attention if you have bowel or bladder issues with onset of back or leg pain (call your physician immediately or go to the nearest emergency room).

Pain is the body’s way of telling you something is wrong and I often find people trying to diagnose their pain by using google. The biggest mistake people make is to ignore the pain or alter it by taking pain killers, narcotics, or steroid injections.

Prevention is the best strategy and often results in avoiding surgery. Core stability is the key to a healthy back. What exactly are the core muscles? Contrary to what many think, it is not your tummy muscles. Your core is made up of deeper muscles on the front, side and back of your spine. These muscles make a corset around your spine and protects them. Over time, poor posture and lack of exercise lead to weakness and thus causing uneven wear and tear of vertebrae.

By seeking care for your back at the right time from a spine specialty trained physical therapist or physician, you are taking care of yourself and preventing costly surgeries and disabilities for life.

Allyson Lowis, PT, DPT, LSVT is a specialist in treating Parkinson’s Disease through the LSVT BIG program at Rehab Specialists in the Portage/Kalamazoo Area. Rehab Specialists offers Physical, Occupational, and Speech Therapy for Parkinson’s Disease all under one roof through the LSVT BIG and LOUD protocols. To learn more about LSVT, visit LSVT Global.

LSVT includes a series of exercise programs that can be tailored to an individual’s abilities and daily life activities to improve their movements, balance, and their overall independence in their everyday lives. Anyone interested in the Parkinson’s Therapy at Rehab Specialists should consider scheduling a free consultation with one of the specialists. Patients and their loved-ones can talk to a therapist about their concerns and hopes and decide if LSVT is right for them. The consultations are always free. To schedule a consult, call 269-459-6212.

Allyson Lowis, PT, DPT, has been dancing for 26 years and for her it has become much more than just a hobby. While in undergrad for exercise science at Hope College, she also leaped her way into a Dance Minor. During school, she danced for a semi-professional modern dance company. After graduating with her Doctorate in Physical Therapy, she has continued dancing with the Grand Rapids Dance Ensemble. Beyond her dance skills, she excels in choreography as well. This love of dance inspires her to work with young dancers as well as helping them with their physical therapy needs. Allyson specializes in Dance Therapy here at Rehab Specialists in Portage, Michigan.