Balance Matters: A neuro physical therapist’s journey to make “Sense” of Balance Erica DeMarch

Join us in this podcast episode where we explore the realms of balance and oncology rehab with specialist Derly Munoz. Get inspired by Derly’s unwavering commitment and discover valuable insights on initiating specialized oncology rehab programs. Gain empowerment through educational tips for both patients and clinicians seeking optimal care.
 
Articles and Resources:
Taking Charge of My Cancer on Apple Podcasts: Hosted by Derly Munoz and empathetic experts and individuals who have triumphed over cancer themselves, this show is a beacon of hope, inspiration, and tangible solutions for you while navigating the twists and turns after your cancer diagnosis.

exercise-guidelines-cancer-infographic.pdf (acsm.org)

Neurological Outcomes of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer: A Systematic Review and Meta-Analysis              
 Outpatient Oncology Fall Risk: A Quality Improvement Project. 
Optimal outcome measures for assessing exercise and rehabilitation in chemotherapy-induced peripheral-neurotoxicity: Systematic review and consensus expert opinion - PMC (nih.gov)
 A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms - PubMed (nih.gov)

Become a Board-Certified Oncology Specialist in Physical Therapy | APTA Specialist Certification - Governed by ABPTS
About - PORi - Oncology Rehabilitation Courses
Derly Munoz received her bachelor’s degree in physical therapy from the Rosario University in Bogota, Colombia in 1990.  She moved to the United States in 1993 and completed a postgraduate Certification in Manual Therapy in 1995. In 2012, she became the team leader for the oncology rehab program at UF Health in Gainesville, Florida, and became a Certified Lymphedema Therapist.  The Cancer Rehab program as more than doubled its size concerning clinic space, patients served, and therapists on the team since she has been the team leader.  She also received her Certification in Cranio-Mandibular Disorders from Mariano Rocabado in 2016.
Oncology being her main passion led to the opportunity to work with Dr. Singhal, with whom she developed a lymphedema surveillance program for the vascular lymph node transplant patients, as well as a lymphedema surveillance program beginning at pre-op for the breast cancer patients.  Through this work, she has been a co-author of publications on the surveillance with the transplant patients and received The Breast Journal Award in 2015.  
Derly became APTA board certify oncologist specialist in 2020.
She started her own podcast for cancer survivors and their families a few months ago call taking charge of my cancer and has been giving a lot of tools in education on her social media. 




 

I am excited for this next interview with Susan Frikken to discuss her program Ballroom Basics for Balance, as it combines 2 of my favorite things balance and dancing. 
Susan Frikken, DPT, LMT
Susan Frikken is physical therapist in private practice in Madison, Wisconsin, the co-founder and an instructor for Ballroom Basics for Balance and founding member of the Madison Area Wellness Collective [now Be Well Madison], making health and wellness choices easier through connecting practitioners and community. 
She is a graduate of the Doctor of Physical Therapy program at University of Wisconsin-Madison in 2013 and now serves as an adjunct faculty and guest lecturer at UW for the DPT program. She has been a massage therapist since 1993.  Areas of special interest are restoring optimal posture and function, conservative scoliosis management, soft tissue work (massage), and – of course! – balance and falls prevention!   She is certified leader of Stepping On, an evidence-based falls reduction program. Proudly, Most recenty I became a PK Silver Coaching Specialist and hold parkour classes with seniors. 
 Originally from metro Detroit, Susan lives in Madison with her wife and animals. Quote from Susan: “My goal is to incorporate arts and nature into therapeutic practice, helping to change the way of health and wellness care in our country. I love to dance, bicycle, be outside, and play at just about anything, so I try to stay healthy and able in case I’m invited to join in!  

Resources: 
Highlights
The Water Molecule DanceUpcoming curriculum trainingsPromo video about us (2019)Educational video about the keys to good balance and BB4BA core document summarizing the key elements of the curriculum.

Home practice video.
Flickr page from the years (photos and videos)
A pilot study of their class. 
 
 

I am very excited to share this next podcast episode, Ask the Parkinson Expert- Take 6 for PD.  On this episode, I asked the same 2 questions to all the Parkinson experts I interviewed in April.  When I meet with many of my clients with PD, they ask me what can I do to decrease the progression of the disease?  I was curious how others would answer this question.  So, I asked Dr. Melissa McConaghy, Josepha Domingos , John Dean, Dr. Eric Rhoden, Dr. Becky Farley, Betsy Vierck, and Catherine Ross the same question.  It was fun to hear everyone’s perspectives and definitely made me think differently. 
I am also impressed with all the new emerging research on Pd, but it can be overwhelming.  So, my 2nd question to everyone was what research are they following and what they would recommend others to follow that they feel can make a difference in people’s lives? 
Throughout the conversations we had some overlapping themes, as well as new and different perspectives.
Question 1: 
12 Tips to slow the progression of the disease from PD experts!
Start exercise as soon as possible, although it’s never too late! (Dr. McConaghy)Do as much as possible that is relevant! (Dr. McConaghy) Stay updated on the exercise research! (Josepha Domingos)Clinicians should listen and watch their clients closely! (John Dean)Make sure you have intimate conversations and cater to your client, not just the disease. (Dr. Eric Rhoden)Find clinicians that are specialized in PD. (John Dean and Dr. Eric Rhoden)Treat the whole person- attach this from as many angles as possible. It’s not singularity, it’s a web, everything is interconnected.  (Dr. Eric Rhoden)Attack as many angles as you can.  How many systems in your body are your trying to optimize.  Treat the whole person (diet, sleep, exercise…) like a professional athlete for your life.  Optimize and train that way so can compete in life at your best. (Dr. Eric Rhoden)Let’s train people with PD like an athlete! (Dr. Becky Farley) Intensity is important, but so is volume!  Don’t take for granted what you do on a daily basis, move every day! (Dr. Becky Farley) Be informed of what can happen to you and what you can do to help it. (Betsy Vierck) Exercise should be goal oriented for the individual. (Catherine Ross) Here is a great article and webinar discussing if there is a way to slow Parkinson’s progression: ‘Can We Put the Brakes on Parkinson’s Progression? | Parkinson's Foundation’.
 Question 2: 
What new research do PD experts recommend following?  Various topics on research were discussed and we added some articles on each topic.  (Please see all articles and resources here: Take6forPD to increase PD awareness – Step and Connect

In this episode we have two special guests, Betsy Vierck and Catherine Ross and we discuss their new blog, Parkinson's from the Inside.   They share through their writing to increase awareness of the lived experience of Parkinson's Disease.  They dive deeper into what they want health care professionals to know, new standards of care, creativity in PD and besides a cure, their dreams for the future.  
Parkinson's From the Inside (parkinsonsfromtheinside.com)

Elizabeth (Betsy) Vierck writes frequently on a wide range of topics including aging, health delivery, health education, health spending, demographics, inflammation, arthritis, and pain. She is the author of Chronic Pain for Dummies, The Idiot’s Guide to Inflammation, The Heart Disease Handbook, Growing Old in America, and Aging America (AARP). Betsy was a long-time staff member of the US Senate Special Committee on Aging in Washington DC. Betsy began having symptoms of Parkinson's disease in 2000 and she was diagnosed in 2008.

Catherine L. Ross is a retired speech-language pathologist. Her career spanned educational, medical, clinical, and university settings. She divides her time between Wyoming and Florida and volunteers for Parkinson’s organizations. Cathy was diagnosed with Parkinson’s Disease in 2018.

Resources/Articles:
Evidence for Early and Regular Physical Therapy and Exercise in Parkinson’s Disease - PMC (nih.gov)

(PDF) Why would Parkinson’s disease lead to sudden changes in creativity, motivation, or style with visual art?: A review of case evidence and new neurobiological, contextual, and genetic hypotheses (researchgate.net)

More Than Movement: Exploring Motor Simulation, Creativity, and Function in Co-developed Dance for Parkinson’s - PMC (nih.gov)

Time for a new image of Parkinson’s? | Special Reports | Parkinson’s Life (parkinsonslife.eu)

In this episode, Dr. Becky Farley discusses how she created a comprehensive PD-specific approach that begins with the building blocks of function called PWR!Moves®.  Learn more about PWR moves and how you can incorporate motor learning principles into your sessions to optimize movement.

Becky G. Farley, PhD, MSPT, PT, Chief Scientific Officer & Founder, 
Parkinson Wellness Recovery | PWR!
 Dr. Becky Farley received a PhD in Neuroscience from the University of Arizona, a Master of Science in Physical Therapy from the University of North Carolina, and a Bachelor of Science in Physical Therapy from the University of Oklahoma. During her postdoc, she co-created the LSVT® BIG therapy program and completed the initial NIH research on its’ short-term benefits. She has now created a more comprehensive PD-specific approach that begins with the building blocks of function called PWR!Moves®. The deterioration of these skills leads to functional decline and interferes with all physical activity. Dr. Farley has trained over 7000 physical and occupational therapists and exercise professionals to work together on shared PD-specific functional training goals to optimize functional mobility and fitness. In 2010, she launched the PWR!Gym in Tucson, AZ – a model community facility for implementing ongoing access to cutting-edge rehabilitation, group exercise and wellness programming. 
Resources:
https://www.exerciseforbrainchange.org/category/research-update/

Parkinson Wellness Recovery | PWR! – Implementing research-based Parkinson specific exercise programs. PWR!Moves GET BETTER and STAY BETTER with Exercise. (pwr4life.org)
A physical therapy decision-making tool for stratifying persons with Parkinson's disease into community exercise classes - PubMed (nih.gov)
https://www.pwr4life.org/pwr-updates-and-news/ (Making function exercise, training PwP like an athlete, strength and agility research updates)
 Workshops overview page 
https://www.pwr4life.org/pwr-workshops/ 
 Find a PWR! Professional Directory 
https://www.pwr4life.org/professional-directory/ 
 Our Wellness Series on the third Wednesday of the month is open to anyone and we save the recordings for viewing later. 
https://www.exerciseforbrainchange.org/join-us-for-a-wellness-series/ 



 
 

In this episode we will dive deeper into deep brain stimulation for Parkinson's, the role of the health team, patient self-advocacy and the importance of effective communication.  Dr. Eric Rhoden's unique experience and expertise brings us new perspectives and ideas. 

Dr Eric. Rhoden was born and raised in San Diego, California, making Austin, Texas his home in 2016. Dr. Rhoden has always thrived on competition and learning new skills. After dabbling in many sports over the years, soccer became his primary focus. Just before playing soccer at the collegiate level, he sustained a knee injury, removing him from the sport and solidifying his desire to pursue a career in physical therapy. He graduated Magna Cum Laude with his bachelor’s in Kinesiology from California State University, San Marcos and received his Doctorate of Physical Therapy from Loma Linda University. 
Following his academic accomplishments, Dr. Rhoden has served in various institutions and corporations as an advisor for health-related products, policies, and research projects. He has over 10 years experience in wellness coaching, nutrition, and personal training. During the past 6 years, Dr. Rhoden has been a movement disorder specialist with a local neurology practice. During the height of the pandemic, he co-founded a remote COVID-19 testing company to support the community. In addition, Dr. Rhoden has also spent time providing continuing education courses throughout the US on comprehensive Parkinson’s care and enjoys presenting to local groups throughout the Austin area.

References:
Comparison of Globus Pallidus Interna and Subthalamic Nucleus in Deep Brain Stimulation for Parkinson Disease: An Institutional Experience and Review
Update on Current Technologies for Deep Brain Stimulation in Parkinson’s Disease - PMC (nih.gov)

(PDF) Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson's disease? (researchgate.net)

Physical therapy and deep brain stimulation in Parkinson's Disease: protocol for a pilot randomized controlled trial - PubMed (nih.gov)

Effects of deep brain stimulation on balance and gait in patients with Parkinson's disease: A systematic neurophysiological review - PubMed (nih.gov)