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!