202: How To Prevent Falls From Retropulsion in PD
Feb 26, 2024In this week’s episode we address a listener’s question about retropulsion in people with Parkinson’s. In the show we define retropulsion then provide a plethora of ideas for you to try with your clients to help them restore their ability to move backwards without falling!
- Sit to Stand (STS) and Standing Postural Issues:
- Biggest issue: inadequate weight shift forward
- Factors contributing: “off” medications, low medication with increased bradykinesia, dyskinesia “on” medication
- Postural changes are a cornerstone of Parkinson’s Disease (PD)
- Perceptual and visual changes, smaller base of support can impact retropulsion
- Medication Discussion:
- Importance of discussing medications with neurologists
- Hard to out-exercise being undermedicated
- Treatment Ideas:
- Weighted Vest:
- Balance Based Torso Weighting
- Exaggerate feeling by adding more weight behind or in front
- Aerobic Exercise:
- Intense, engaged, elevated heart rate
- Preferable on treadmill, multi-directional movement
- STS Treatment:
- Provide a target in front
- Encourage body awareness
- Challenge on different surfaces to augment error
- Use Blazepod for external cues and motivation
- Resistance Band Exercises:
- At the hips, pulling backward
- Secure attachment, various directions
- Include targets and external cues
- Repetition, variety, dual tasks, eyes closed
- Reactive Balance Training:
- Backward steps in various positions
- Posterior activation in quadruped, walking, tall kneeling, prone
- Clock Yourself App:
- Use front or back half of the clock for different movements
- Compensatory Strategies:
- Staggered stance, wider stance
- Conclusion:
- Encourage problem-solving and empowerment
- Highlight the importance of repetition, variety, and external cues
Let us know if you have more questions by sending us a DM @neurocollaborative or posting inside the NeuroCollaborative Professionals Facebook group!
