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?
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- 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
- “But I’m not an athlete”
- Environmental
- Hazard elimination – how many fall hazards can you think of?
- Grab bars, raised toilet sets, shower chair, etc..
- Hazard elimination – how many fall hazards can you think of?
- Physical
- Assistive devices, physical assistance, exercise
- Do get help
- Physician clearance, physical therapy, occupational therapy, personal trainer