202: How To Prevent Falls From Retropulsion in PD

In 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!