BSN PSP/CBD Conference – Erica Pitsch


Move It or Lose It: Strategies to Stay Mobile and Stay Safe

Erica Pitsch, DPT, UCSF

  • Do’s and Don’ts
    • Don’t lose ground from deconditioning
    • Do keep moving and stay safe
    • Don’t fall
    • Do get help
    • Exercise!
  • Consequences of a sedentary lifestyle
    • Decreased endurance, strength, and bone density
    • Increased stiffness and risk of medical complications

Do people with PSP/CBD improve with rehab?

    • A four week intensive impatient program showed improvements in disease severity and gait
    • One case study of a person with mixed PSP/CBD reduced falls and preserved ambulation with a walker for 10 years of participation in a group balance class
    • Long term rehab is key
  • Recovery/Preservation
    • Balance programs are effective in improving balance performance, but not incidence of falls in people with Parkinson’s
    • Any physical therapy is better than nothing
  • Exercise Challenges
    • The earlier stages of the disease, the more you can do safely
    • The uncomfortable truth
      • Balance deficits – worries about the instant fall
      • Cognitive deficits – impaired memory (reminder to take a walk or do exercises)
    • BUT people with dementia DO respond to intense exercise
  • Activity continuum
    • Most safe (& least balance challenging) – sitting exercises, bed exercises
    • Least safe (& most balance challenging) – standing exercises, walking, multitasking
    • Most important is working on balance or endurance while being safe
  • What is the best exercise?
    • The one that is safe and challenging for you
    • In general, goal directed, FUNctional activities are more motivating
    • Music based interventions are showing more potential
      • (Hint: Arethra Franklin and “Uptown Funk” are great for this)
    • Movement based video gaming systems like Xbox Kinect may improve function
  • External focus (outside your body) is better for performance
    • If you do the movements without relating them to steps (i.e. the movement you make to shake out a towel) you are more likely to do them correctly.
    • Your disease may want you to move slowly. Anytime you can do something that can help you move fast, you’re holding on to that movement.
  • Overcoming Barriers to exercise
    • “But I’m not an athlete”
      • You don’t have to be an athlete to work out, if you want to keep your muscles, you use them
    • “I can’t find the time”
      • Put it on your calendar, set an alarm.
    • “I have a hard time getting motivated”
      • Try group classes, a personal trainer, get moving with a friend, etc..
    • Drive and Dementia
  • Environmental
    • Hazard elimination – how many fall hazards can you think of?
      • Grab bars, raised toilet sets, shower chair, etc..
  • Physical
    • Assistive devices, physical assistance, exercise
  • Do get help
    • Physician clearance, physical therapy, occupational therapy, personal trainer