Optimizing Movement. Enhancing Lives.
Proven Results.

Opening Hours : Monday - Thursday 8am - 6:30pm, Friday 8am - 1pm

  Contact : US1: 904.217.4259 Island: 904-679-3449

PD PRE-HAB

 

Parkinson’s Disease (PD)​​ is a progressive, neuro-degenerative disease that depletes the brain of certain neuro-chemicals including dopamine. ​​ Low levels of dopamine cause both motor​​ and non-motor symptoms in people with PD. ​​ The most common motor symptoms include tremor, slowness, stiffness, impaired balance, altered coordination, freezing, speech difficulty, and shuffling gait. ​​ Non-motor symptoms include loss of smell, depression, anxiety, abnormal blood pressure, bowel & bladder dysfunction, and sleep disturbances (dream re-enactment, insomnia, day time sleepiness) to name a few.

 

OUR MISSION: ​​​​ To provide a 3-pronged approach that includes one-on-one re-habilitation, community based education, and ongoing group pre-hab, that collectively reduce PD symptoms, optimize function, and improve happiness and health!

 

ONE-ON-ONE PD​​ ​​ RE-HAB ​​ 

GROUP PD PRE-HAB​​ 

 ​​​​  ​​​​ COMMUNITY BASED EDUCATION​​ 

 

 

 

ONE-ON-ONE PD RE-HABILITATION:

Our PD​​ re-habilitation program provides a comprehensive examination using standardized PD assessments twice a year. ​​ Think of it as a​​ dental model of care​​ whereby you visit your therapists for a full body “check-up” and “cleaning” every 6 months. ​​ Your therapist​​ will run a battery of tests to look at your walking speed, endurance, balance, mobility, self-care ability, freezing, cognition, and fine motor control. ​​ If all looks good, recommendations will be made and a 6 month follow up appointment will be scheduled. ​​​​ If something in your examination looks off, or a decline in function is noted, your therapist will recommend one-on-one, evidence-based PD therapy to meet your needs. ​​ This may be from one to ten weeks, depending on your individual needs and stage of disease. ​​ Rehabilitation is typically covered by health insurance. Click here to learn more about​​ PD re-habilitation.

 

 

COMMUNITY BASED EDUCATION:

Our PD support group has been meeting for over 10​​ years and includes people with PD and their care-partners. ​​ The group meets monthly to provide both socialization, resources, and education from a variety of PD specialists that work in healthcare and research. ​​ Click here for more information about our free​​ support group.

 

 

 

GROUP PD PRE-HAB:

The PD PRE-HAB program is an ongoing, year-round program that includes different types of exercises in a small group setting.

Recent research has​​ demonstrated that ongoing, targeted exercise can improve the above-mentioned PD symptoms of PD just as much as medication, and it may also slow down the progression of the disease. ​​ Hence the commonly heard phrase​​ “Exercise is Medicine”. ​​ If the exercise is stopped, the benefits are lost.

Now that the word is out, people with PD are asking “How much should I be exercising?”, and “What is the best type of exercise?”

 

Answers:​​ 

There are​​ two types of exercise​​ needed for​​ disease modification:

  • Progressive​​ aerobic exercise​​ with a dose of 2-3x per week , AND

  • Goal directed, complex mobility training​​ with a dose of 3-5x per week, based on the individual and their stage of disease.

 

Thus, in a perfect world you should be exercising, at minimum, 5 days a week,​​ and BOTH types of exercise should be included. ​​ Read on for more information.

 

Progressive aerobic exercise: ​​​​ This type of training gets your heart pumping and does not require much skill. ​​ High intensity exercise should be done for 30-45 minutes per session (2x per week). ​​ Low to moderate intensity exercise should be done for 45-60 minutes per session (2-3x per week). ​​ Aerobic exercise stimulates neuroplasticity by pushing nutrient rich blood to your brain. ​​ This allows more dopamine receptors to grow and​​ creates stronger connections between the neurons. ​​ STARS Pre-Hab​​ PEDAL 4 PD​​ is based off of these principles and designed to allow you to safely exercise and push you to an intensity that you would not likely achieve yourself. ​​ Note:​​ You should talk to your doctor before beginning a high intensity exercise program and you should always start off slow and build up to the above recommendations. ​​ 

 

Goal directed, complex mobility training: ​​ This includes rehabilitation (Physical, Occupational, and Speech therapy) and targeted exercise training that requires learning of new motor skills with varied direction changes, tempo changes, weight shifting, and large, whole-body movements. ​​ This type of training will help you live a better life by keeping you more flexible, coordinated, and better balanced. ​​ In addition, it will help you walk faster, move around in bed better, stand up and sit down more easily, sit and stand taller, write better, think better, and dress better. ​​ In short, complex mobility training will maintain or improve your quality of life.​​ 

This type of training comes in many different flavors and includes rehabilitation (see above). ​​ Non-contact boxing, dancing, agility, tai-chi and function-based training are other examples. ​​ STARS Pre-Hab​​ PUT UP YOUR DUKES,​​ GET HANDY,​​ USE IT OR LOSE IT, and​​ JACK BE NIMBLE, JANE BE QUICK​​ are all different types of goal-directed, complex mobility training classes. ​​ 

 

See below for​​ our schedule, class descriptions, and​​ pricing options. ​​ 

 

IMPORTANT NOTE:​​ Ongoing wellness is typically not covered by insurance and therefore this is a fee-based program. ​​ Grants are available​​ to subsidize your costs. ​​ 

 

LAST BUT NOT LEAST:​​ To determine your suitability for group PRE-HAB, you will need a full, re-habilitation examination (which is​​ covered by health insurance) by a STARS therapist before starting the PRE-HAB program.

 

 

PD PRE-HAB CLASS SCHEDULE – ISLAND LOCATION:

 

 

MON

 

7:45AM-8:30AM

 

PEDAL 4 PLASTICITY

Interval Training

 

 

 

 

TUES

12:15PM-1:00PM

 

PUT UP YOUR DUKES

PD Boxing & Agility

 

 

 

 

WED

7:45AM-8:30AM

PEDAL 4 PLASTICITY

​​ Interval Training

12:15PM-1:00PM

 

GET HANDY

Dexterity & Fine​​ Motor Training​​ 

 

 

 

 

THUR

12:15PM-1:00PM

 

PUT UP YOUR DUKES

PD Boxing & Agility

 

 

 

 

FRI

1:15PM-2:15PM

 

USE IT OR LOSE IT

FUNctional PWR! Moves

 

 

PRE-HAB CLASS SCHEDULE – US 1 LOCATION:

 

MON

11:30AM-12:15PM

 

PUT UP YOUR DUKES

PD Boxing & Agility

 

 

 

 

WED

1:45PM-2:30PM

 

JACK BE NIMBLE,​​ JANE BE QUICK

Agility and Gait

 

 

 

 

 

CLASS DESCRIPTIONS:

 

 

PEDAL 4 PLASTICITY: ​​ Designed to ward off PD progression by increasing your heart rate, pushing blood up to your brain for neuronal health, and neuro-protection. ​​ To get that oxygen and nutrient rich blood up to your noggin your therapist will push you beyond what you would do on your own through High Intensity Interval Training (HIIT). HIIT is a form of aerobic training that alternates short bouts of intense exercise with less intense recovery bouts.

 

What the experts say:​​ ​​ 

​​ “Cycling 3 x per week at 80-90 RPMs decreased the shuffling gait, tremors, and muscle stiffness of Parkinson’s disease as much as medication.” Dr. Jay Alberts, PhD, from the Cleveland Clinic

 

​​ “Regular aerobic-type exercise is​​ the single strategy with compelling evidence for slowing Parkinson disease progression.” Dr. Eric Ahlskog, PhD, MD, from the MAYO Clinic

 

“Only aerobic exercise improved executive functions in individuals with PD.” ​​ Dr. Carolina Silveira, PhD, from the University of Waterloo, Ontario Canada

 

“Cycling consistently 2-3 times a week is sufficient to reap the benefits” Dr. Angela Ridgel, PhD, from Kent State University

 

Side effects: ​​​​ Sweating. ​​ Lowers your risk for dementia, heart attack, and stroke.

 

What you​​ need: ​​​​ Water bottle, sweat towel, comfortable workout clothes.​​ 

 

PD Pre-Hab Motto: ​​​​ Exercise is Medicine.

 

CAP: ​​​​ This class is limited to 5 participants.

 

NOTE: ​​ If you have a history of chest pain or heart disease, please speak with your Doctor prior to​​ initiating this class

 

 

 

 

PUT UP YOUR DUKES:​​ Physical Therapy guided, non-contact boxing will challenge you to learn new motor skills. ​​ Most people with PD have never boxed before – and that is one of the secrets of this program’s success. ​​ At first you​​ will be frustrated with your slow jab, hook, and uppercut combination drills, but learning new skills requires your neurons to ‘figure it out’. ​​ Over time new neural pathways will strengthen, and your movements will become faster and more coordinated. ​​ This is commonly known as ‘muscle memory’. ​​ Fancy foot-work drills (aka: agility) will build your stamina, and together these things will give you more freedom of movement and long-lasting energy in your everyday life. ​​ Basic boxing skills are taught and modified to target your PD symptoms.

 

What the experts say:​​ ​​ 

“While it is not a cure, it can prevent progression of the symptoms. ​​ Compared to people who choose other forms of exercise, boxers demonstrated significantly better balance and walking function over time.” Dr. Stephanie Combs-Miller, PT, PhD, from the University of Indianapolis

 

Side effects: ​​​​ Camaraderie. ​​ Muscle soreness.​​ 

 

What you need: ​​​​ Water bottle, sweat towel, comfortable workout clothes.​​ 

 

PD PRE-HAB Motto: ​​​​ Challenge = Change

 

CAP: ​​​​ This​​ class is limited to 4 participants.

 

 

 

 

GET HANDY: ​​ Do you have small, hard-to-read hand-writing? ​​ Do you avoid buttons and zippers? ​​ Do you want to change light bulbs, use a screw driver, and shuffle better during your card games? ​​ This class will focus​​ on hand and finger flexibility, dexterity, and strength through the use of everyday functional skills that utilize the motor-learning principle of repetition (practice, practice, practice).​​ ​​ Your Occupational Therapist will keep things interesting by incorporating both one-way (i.e., working alone on a task such as playing solitaire), and two-way cognitive interactions (i.e., you and another person working together on a cognitive task such as playing checkers) to keep your brain active during the training. ​​​​ You will also learn things to do at home to keep your hands moving.

 

What the experts say: ​​ 

“Long term training was beneficial for writing….intensive training to optimize writing can be included as part of neurorehabilitation for PD”. ​​ Evelien​​ Nackaerts, MSc., from KU Leuven, Belgium.

 

Side effects:​​ An​​ urge to throw away your Velcro tennis shoes. ​​ Meet new friends. ​​ 

 

What you need: ​​​​ Crappy hand-writing. ​​ A sense of humor.

 

PD PRE-HAB Motto: ​​​​ Practice makes perfect.

 

CAP: ​​​​ This class is limited​​ to 5 participants.

 

 

 

USE IT OR LOSE IT FUNctional PWR MOVES:​​ PWR stands for Parkinson’s Wellness and Recovery. ​​ This class will be delivered by a PWR-certified therapist, and is based on large amplitude, whole body movements in different positions​​ (standing, sitting, and lying). ​​ This program was developed by neuroscientist-and-Physical Therapist Dr. Becky Farley. ​​​​ It is designed to target the impairments of PD (trunk and limb stiffness, coordination, balance, and slowness) and carry over to real world functional living (walking, transfers in and out of a car, bed mobility, sit to stand, etc.).

 

What the experts say:​​ 

“PWR is a​​ research-based integrated​​ exercise and wellness programming necessary to counteract the inactivity, motor deterioration, and​​ symptoms of PD.​​ ​​ With early intervention and ongoing programming, you can​​ GET BETTER​​ and STAY BETTER. But better yet, your efforts may trigger positive brain changes (neuroplasticity) that are disease modifying and thereby, contribute to slowing the disease progression” ​​ Dr. Becky Farley, PT, MS, PhD, from PWR!Gym, Tucson, AZ. ​​ 

 

Side effects:​​ You may experience fun while exercising.​​ 

 

What you need:​​ Comfortable workout clothes.

 

PD PRE-HAB Motto:​​ Use it or lose it. ​​ 

 

CAP: ​​​​ This class is limited to 10 participants.

 

 

 

JACK BE NIBLE, JANE BE QUICK: ​​ This is a mobility training class that focuses on dynamic balance and complex movement patterns through the use of obstacle courses and agility exercises. ​​ The class will create a challenging environment to​​ ensure you can walk in the community under any environmental situation. ​​ Stepping over objects, onto soft surfaces, ducking under things, walking through narrow spaces, side stepping, backwards stepping, fall recovery strategies, turning, direction changes, stop and go, and agility ladders will keep you moving non-stop. ​​ Large, fast movements will be emphasized to combat PD slowness (i.e., bradykinesia) and smallness (i.e., hypokinesia and shuffling gait).

 

What the experts say:​​ 

“The sensorimotor agility approach to mobility training is intended for prevention of mobility disability”. ​​ Dr. Laurie King, PT, PhD, and Dr. Fay Horak, PT, PhD, from Oregon Health and Sciences University​​ 

​​ 

Side effects:​​ Feelings of athleticism.

 

What you need: ​​​​ A water bottle, sweat towel, and comfortable workout clothes.

 

PD PRE-HAB Motto: ​​​​ Expect more.

 

CAP: ​​​​ This class is limited to 4 participants.

 

 

COMMON TO ALL PD PRE-HAB CLASSES:

 

 

  • Delivered by a Physical Therapist (PT) or Occupational Therapist (OT) who has specialized​​ training in PD. ​​ In addition, there will often be PT and OT students helping out

  • Blood pressure check-ins

  • Use of loud voices during sessions

  • Socialization

  • High effort​​ 

  • Dual tasking (i.e. doing 2 things at once. ​​ For example, exercising and counting​​ backwards by 3s)

  • Posture training

  • A warm up, and a cool down that includes relaxation to calm ourselves and fight the anxiety that sneaks into our lives

 

 

PRICING OPTIONS:

 

1.​​ One class each week: ​​ $80/month​​ 

 

2.​​ Two classes each week: ​​ $144/month

 

3. Unlimited classes each week: $200/month

 

 

Consistency is critical to reap the benefits of PD-targeted exercise. ​​ 

 

A mix of both aerobic and​​ mobility training leads to the best results for slowing disease progression and maintaining function without falling. ​​ 

 

 

 

Please call​​ 904.679.3449​​ to​​ sign up for your classes.  ​​​​ Classes are small to maintain a safe environment and to allow for​​ individualization to your ability level

 

All payments must be made on a monthly basis on the 1st​​ of each month.

 

 

 

Worried that you can’t afford to participate? ​​ Fear not, STARS PD PRE-HAB has partnered with​​ The Parkinson’s Wellness Fund, an​​ organization that is committed to financially assisting people with PD:​​ 

 

“The Parkinson’s Wellness Fund provides individuals with Parkinson’s access to the services they need to live an improved quality of life, today. ​​ Free of Charge”

 

Click here to learn more about the organization:​​ http://parkinsonswellnessfund.org/

 

Click here for a link to apply for a Wellness Fund:​​ http://parkinsonswellnessfund.org/families/general/application/

 

 

REFERENCES FOR PD EVIDENCED BASED PRACTICE:

 

Ahlskog, JE. ​​ Aerobic Exercise:​​ Evidence for a Direct Brain​​ Effect to Slow Parkinson Disease Progression.​​ Mayo Clinic Proceedings. 2018; 93:360-72.

Combs SA, Hiehl MD, Chrzastowski C. ​​ Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. ​​​​ NeuroRehabil. 2013:32:117-24.

Giselle MP, Fisher BE, McEwen S et al. ​​ Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s Disease. ​​​​ The Lancet Neurology. 2013;12:716-26.

King LA, Horak FB.​​ Delaying Mobility Disability in People With Parkinson Disease​​ Using a Sensory Agility Exercise Program.​​ Phys Ther. 2009;89:384-93.

Nackaerts E et al. ​​ Relearning ​​ of writing skills in Parkinson’s disease after Intensive amplitude training. ​​​​ Mov Disord. 2016;31:1209-16.

Giselle MP, Fisher BE, McEwen S et al. ​​ Exercise-enhanced neuroplasticy targeting motor and cognitive circuitry in Parkinson’s Disease. ​​​​ The Lancet Neurology. 2013;12:716-26.

Ridgel Al, Phillips RS, Walter BL. ​​ Dynamic High-Cadence Cycling Improves Motor Symptoms in Parkinson’s Disease.​​ ​​ Front​​ Neurol. 2015;194:97.

Silveria CRA, Roy EA, Intzandt B, et al. ​​ Aerobic exercise is more effective than goal based exercise for the treatment of cognition in Parkinson’s disease. ​​​​ Brain and Cognition. 2018;122:1-8.