How To Treat Neurological Problems With Physical Therapy
April 1, 2016
The phrase “physical therapy” most likely stirs up images of runners, gymnasts, and bodybuilders nursing fractures and sprains.
But physical therapy also helps with conditions that disrupt the nervous system, which can occur in patient populations like seniors and those in skilled nursing facilities.
AlterG client Karen Shuler, PT, DPT, owns Lifestyle Physical Therapy, LLC in Lake Wylie, South Carolina. For most of her 24 years as a physical therapist, she has worked with people who have neurological conditions, such as Parkinson’s disease.
When patients tell her they’re not doing well, she’ll ask how often they’re doing their exercises.
The usual answer: “Eh, maybe once or twice this week.”
“I tell them, ‘No, you need to do your exercises daily,’” Karen says. “If they could understand that, they’d perform and feel so much better.”
Here’s how physical therapy can be used to treat neurological disorders.
What Are Neurological Disorders?
Neurological disorders are diseases of the central nervous system, according to the National Library of Medicine. They can cause problems with:
- Movement
- Speech
- Learning
- Breathing
- Swallowing
These disorders can also affect mood, senses, and memory.
Parkinson’s causes dying neurons in the brain to produce inadequate amounts of dopamine, a hormone that controls movement, according to the Parkinson’s Disease Foundation.
Other neurological conditions include Alzheimer’s disease and multiple sclerosis. Seniors may exhibit symptoms of a neurological disorder, such as movement and balance challenges, but they may not be severe enough for a diagnosis.
Physical Therapy’s Role In Neurological RehabPhysical therapy has such a key role in rehabilitating patients with diagnosed neurological disorders or seniors and skilled nursing facility residents that neurologic physical therapists have become a subspecialty, according to the American Physical Therapy Association.
These specialities have grown as the research has pointed to physical therapy as a way to prevent neurological problems from progressing.
According to a 2014 report from the National Parkinson Foundation, physical therapy can be used to help patients at all stages in the following ways:
- Before patients start having symptoms or motor loss, physical therapy can help keep them fit and mobile, minimizing symptoms when they do come or preventing the onset.
- During the onset of symptoms, physical therapy can help them regain movement, such as learning to rise and sit down, or relearning how to walk.
- After they’ve regained mobility, physical therapy can be used to preserve their skills and abilities.
“At the beginning of my career, the research said physical therapy didn’t do a whole lot to help Parkinson’s,” Karen recalls. “We’d help them if they were tight, but they still seemed to progressively get worse. It was kind of frustrating.”
But that changed about 10 years ago.
How Physical Therapy Stalls Neurological Disorders
New research and physical therapy techniques found ways to trick the brain, Karen says. She adopted the LSVT BIG program, which focuses on helping Parkinson’s disease patients increase effort and degree of movement.
This can also be particularly helpful for seniors and those in skilled nursing facilities who are prone to falls.
“People with Parkinson’s disease have lost the ability to calibrate themselves,” Karen explains. “Our bodies are constantly adjusting. If we’re on an asphalt surface or grassy surface, our brain constantly makes adjustments.”
“In Parkinson’s, the brain struggles with that. It struggles with transitional movements, completing movements, and holding and stabilizing movements,” she adds.
A 10- to 15-minute exercise routine creates an awakening in the brain. “They are a completely different person,” Karen says. “They are now engaged in the exercise. They’re talking. They’re happy. Their cadence changes in their movement. They have full step length.”
She uses the AlterG Anti-Gravity Treadmill™ to produce the cadence and calibration that improves patients’ step length. It also eliminates their anxiety about falling.
“With AlterG, they can relax into it,” she says. “I’ve also found that because they can’t see their feet, it forces them to feel what their body is doing.”
Where A PT Comes In
For these patients, neurological disorders are impacting more of their lives than may initially seem apparent. Seniors lose their mobility with age, but then a neurological disorder like Parkinson’s compounds it.
Patients often wind up in skilled nursing facilities because neurological conditions are more disabling than they first thought.
Exercise—so vital to health and mood—becomes difficult, painful, and even dangerous if not done in specific ways.
For those who have lost full range of motion, partial weight-bearing exercises can retrain their bodies to move more normally.
“The whole premise is to teach them that it takes a lot of effort to move normally,” Karen says. “We can teach them how to self-calibrate instead of relying on the brain to do it automatically. I can look at them and ask, ‘What was your effort like?’”
The usual answer: “Only about a 3.”
“Exactly,” Karen says. “I need a 10.”
Patients with neurological conditions require the help of a physical therapist as much as an athlete. Contact a rep to learn how to help patients with neurological conditions, and download the AlterG guidelines for patients with neurological problems.