Mandy Shintani Mandy Shintani is an occupational therapist, gerontologist and the founder of Urban Poling. Her mission is to inspire all towards active living and wellness through innovative pole designs and education.  As an avid proponent of life long fitness, she has experienced herself how Urban Poling fuels a healthy and fun lifestyle that includes, using poles with other exhilarating activities such as snowshoeing, hiking and adventure travel, which she is passionate about.  As a therapist, her design of the patented ACTIVATOR Poles was rooted in her desire to create a tool that would revolutionize mobility and rehabilitation programs.  She is an international presenter and is considered to be one of the leading experts on this activity.  She was a finalist at the YWCA Women of Distinction Awards in the category of Innovation and Entrepreneurship.Resources:https://urbanpoling.com/activator-and-urban-poling-research/

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

Benefits of Urban Poling with Mandy Shintani

Learn about vestibular rehab technology, infrared video goggles from Helena Esmonde, the co-founder of Vestibular First.  Dr. Helena Esmonde, PT, DPT, NCS, is co-founder of Vestibular First, a company that makes affordable, FDA-cleared Insight Infrared Video Goggles as well as vestibular education tools. Helena has been treating patients with dizziness, vertigo, and imbalance for 15 years and passed the Emory Vestibular Competency Exam in 2015. She became certified to treat Cervicogenic Dizziness in 2016 and achieved Board Certified Neurologic Clinical Specialist designation in 2018. Helena has taught continuing education courses on concussion, BPPV, balance assessment, and visual vertigo treatment, serves as a teaching assistant at the University of the Sciences in Philadelphia, and regularly presents at the Balance Center rounds at the Hospital of the University of Pennsylvania and the Penn Medicine Mind Your Brain Conference. Vestibular First provides Helena the best opportunity for number one goal of helping others, with already well over a quarter million patients served by vestibular care via their technologies.References:Education - Vestibular First: List of articles demonstrate how infrared video goggles and related technologies have been used in the diagnosis and treatment of vestibular disorders.  ·   Huh YE, Kim JS. (2013). Bedside evaluation of dizzy patients. Journal of Clinical Neurology. 9 (4): 203-213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840130/https://dizziness-and-balance.com/disorders/visual/visual_dependence.htm

Vestibular Rehab Technology: Eye Movements and Infrared Video Googles with Helena Esmonde

Alaina Newell, PT, DPTBoard Certified Clinical Specialist in Oncological Physical TherapyBoard Certified Clinical Specialist in Women&apos;s Health Physical TherapyAlaina received her Doctorate of Physical Therapy from the University of Pittsburgh in Pittsburgh, PA in 2012. She completed her Women’s Health residency at UPMC and joined the team in 2014. She is one of the few Board Certified Clinical Specialist in Oncology as well as Women’s Health Physical Therapy. She is also a Certified Lymphedema Therapist from the Lymphology Association of North America. She enjoys treated a wide variety of oncological diagnoses from melanoma, pancreatic, bladder, ovarian to breast cancer as well as Women’s Health needs secondary to oncological diagnosis including urinary urgency, gastrointestinal dysfunction, pelvic pain and postural dysfunction.Alaina is passionate about approaching each patient’s individual needs and desires to improve their daily function and quality of life. She integrates her understanding of the foundational understanding of the neuromuscular, integumentary, musculoskeletal, cardiovascular systems with her advanced training in gastrointestinal and urogynecological system to approach each patient. She has a strong emphasis in restoring the body to its natural alignment to allow it to optimally function. Alaina is the Pelvic, GI & Sarcoma Cancer Clinical Coordinator at Oncology Rehab as well as sitting on Oncology Rehab&apos;s Breast Cancer and Chemotoxicity & Cancer Exercise teams. Resources:Oncology Rehab - HomePORi - Oncology Rehabilitation Courses - Home-          Aggithaya MG, Narahari SR, Ryan TJ. Yoga for correction of lymphedema&apos;s impairment of gait as an adjunct to lymphatic drainage: A pilot observational study. Int J Yoga. 2015 Jan;8(1):54-61. doi: 10.4103/0973-6131.146063. PMID: 25558134; PMCID: PMC4278136.-          Doruk Analan P, Kaya E. Postural Stability in Patients with Lower Limb Lymphedema. Lymphat Res Biol. 2019 Dec;17(6):647-650. doi: 10.1089/lrb.2019.0004. Epub 2019 Jul 19. PMID: 31329503.-          Forner-Cordero, Isabel & Furtado, Fabianne & Cervera-Deval, Juan & Forner-Cordero, Arturo. (2016). Ground reaction force patterns during gait in patients with lower limb lymphedema. Acta Fisiátrica. 23. 10.5935/0104-7795.20160038.-          Forner-Cordero, Isabel & Forner-Cordero, Arturo & Maldonado-Garrido, D. & Cervera-Deval, J.. (2009). Biomechanical study of the gait in patients with lower limb lymphedema. European Journal of Lymphology and Related Problems. 20. 1-6.-          Yoosefinejad AK, Hadadi M, Eslamloo P. Evaluating the responsiveness of the fullerton advanced balance scale in patients with lymphedema secondary to breast cancer surgery. Lymphology. 2019;52(2):61-70. PMID: 31525827

Impacts of Lower Limb Lymphedema on Gait and Balance with Alaina Newell

Music can lift moods, help with studying, and make workouts more productive and enjoyable. I know I enjoy working out to music, I run further and push myself more when I listen to music.While all of those ways of listening to music are important, there is a difference between recreational music, therapeutic music, and clinical music therapy. Today we are going to learn from Sarah, a board-certified music therapist about the benefits of music therapy. Sarah&apos;s 2 tips to non- music therapists1.       Create a rhythm using words and then get your metronome to match it and try to emphasize the most difficult part.2.       Consider double priming, especially if someone is moving below 60 beats per min.Listen to learn more...Sarah Thompson, MM, MT-BC, CBIS  is a board-certified music therapist who has used music to influence movement for 17 years. She specializes in working with survivors of neurologic injuries and individuals living with neurologic diseases. She is the founder and CEO of Rehabilitative Rhythms and is currently a PhD student. She is a lifelong learner who is passionate about providing evidence-based practice in healthcare while keeping compassion and patient satisfaction a top priority. Resources : www.PossibleWithMusic.orghttp://www.jessicagrahn.com/Grahn, J. A., & Brett, M. (2007). Rhythm and beat perception in motor areas of the brain. Journal of cognitive neuroscience, 19(5), 893-906.Leow, L. A., Parrott, T., & Grahn, J. A. (2014). Individual differences in beat perception affect gait responses to low-and high-groove music. Frontiers in human neuroscience, 8, 811.Thompson, S., Hays, K., Weintraub, A., Ketchum, J. M., & Kowalski, R. G. (2020). Rhythmic Auditory Stimulation and Gait Training in Traumatic Brain Injury: A Pilot Study. J Music Ther. doi:10.1093/jmt/thaa016 

Rhythm and Movement: Beyond the Metronome with Sarah Thompson, MM, MT-BC, CBIS

Heather discusses posture assessment purpose and priorities: Posture for optimal breathing and speaking patterns. Posture for optimal head position and movement in space                                                                     Posture for optimal trunk movement and responsiveness in locomotion and direction change, and upper trunk support for skilled upper extremity function.In terms of ’tips’ or a focused approach to improvement where posture, balance, and reduced fall risk are involved, I have two pillars on which I build recommended programs: First, one must have the basic equipment or infrastructure with which to work. This is where working towards optimal posture, sufficient range of motion, maximizing proprioception, ability to accurately perceive gravity and velocity, and enough strength to move limbs in space comes in. Notice that I put strength last on the list. Second, we work towards flexibility and speed in sensory re-weighting in response to changing environmental demands. Since the human brain is naturally programmed to rely on vision above all other sensations, this may require limiting vision. Aimi L. Forsyth, BAppSc (Phty), Serene S. Paul, PhD, BAppSc (Phty)(Hons), Natalie E. Allen, PhD, BAppSc (Phty) (Hons), Catherine Sherrington, PhD, MPH, BAppSc (Phty), Victor S. C. Fung, PhD, MBBS (Hons), and Colleen G. Canning, PhD, MA, BPhtyFlexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance. JNPT  Volume 41, April 2017Jacobs, Jesse & Henry, Sharon & Horak, Fay. (2018). What If Low Back Pain Is the Most Prevalent Parkinsonism in the World?. Frontiers in Neurology. file:///C:/Users/Erica%20DeMarch/Downloads/What_If_Low_Back_Pain_Is_the_Most_Prevalent_Parkin.pdfVan der Jagt-Willems HC, de Groot MH, van Campen JP, Lamoth CJ, Lems WF. Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study. BMC Geriatr. 2015;15:34. Published 2015 Mar 28. Heather Campbell, PT, DPT, OCS has 43 years of experience integrating musculoskeletal and neurologic recovery. She earned her physical therapy degree from University of North Carolina at Chapel Hill, a master’s degree in motor control and exercise physiology from University of Denver, and a doctorate from University of Montana. Early in her career she qualified for a manual therapy competence certificate, and Board Certification as an Orthopedic Physical Therapy Specialist.Dr. Campbell has served on faculties of first professional and post-professional academic programs in physical therapy, medicine, and dentistry, as well as giving local, national and international professional education seminars. She currently serves as affiliate faculty at Regis University. With a career emphasis in musculoskeletal spine care, she focuses on postural, visual and vestibular interdependence and how to influence  central sensory processing for recovery after injury or neurologic disease. Her expertise in concussion management links cervicovestibular assessment to all other components in a multidisciplinary approach to care.She awarded Colorado’s Outstanding PT of the Year in 2019 for her tireless efforts in promoting the return to play legislation, and she consulted in creating the PT department and program for the Marcus Institute for Brain Health in 2017-2018 

Posture, Pain and Postural Control with Heather Campbell, PT, DPT, OCS

Are you adding vestibular rehab to your telehealth sessions? We have the honor to learn from a pioneer in telehealth rehab, Sarah Gallagher, PT, DPT, NCS, the owner of South Valley Physical Therapy, the founder of the Dizzy Clinic and founder and chair of the Vestibular SIG Telehealth Task Force.This interview was recorded a year ago prior to the pandemic when telehealth was not widespread.  COVID-19 has quickly changed the landscape of telehealth.  This interview is still extremely relevant as more clinics are transitioning to hybrid models and telehealth. This interview we mainly discuss the clinical applications regarding assessment and treatment during telehealth sessions? Tips on verbal instructions, observation skills and screening tools are discussed.Before you begin providing services via telehealth or using telecommunications modalities, consider federal and state legislation and regulations that govern your practice, billing and coding issues.  Please check the APTA’s website with up to date info on telehealth resources and tips.https://www.apta.org/your-practice/practice-models-and-settings/telehealth-practiceDr. Sarah Gallagher PT, DPT, NCS graduated with her doctorate from MGH Institute of Health Professions in Boston, MA and completed an internship at Massachusetts General Hospital in acute care. After working several years in hospital settings, focusing in trauma, she transitioned to an outpatient setting.  South Valley Physical Therapy specializes in neurologic and vestibular rehabilitation and as an owner she collaborates with regional and national experts to ensure the evidence based and cutting-edge treatment. Dr. Gallagher identified that access to expert vestibular rehab is limited due to limited expertise in the state of Colorado, long travel distances, and dizziness impeding commuting to the clinic.  This problem led her to found The Dizzy Clinic which provides vestibular rehab via videoconferencing in 2017 as well as implemented tele rehab at South Valley PT for insurance reimbursement. She lectures at the University of Colorado PT school on vestibular rehabilitation and telehealth. She has presented at national conferences including CSM and several state APTA conferences on implementing tele rehab.  She also is the founder of the Colorado Vestibular Support Group, member of: APTA, Academy of Neurology and Vestibular SIG, Vestibular Disorders Association (VeDA). She participates in the APTA FiRST Council, Telehealth track, and is founder and chair of the Vestibular SIG Telehealth Task Force.  She authored an article for VeDA on telerehab with vestibular patients, published in January 2018. In 2020, she was awarded Colorado’s Outstanding PT of the year for her advocacy and training of telehealth.References:Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer?. Phys Ther. 2020;100(8):1260-1264. doi:10.1093/ptj/pzaa093van Vugt VA, van der Wouden JC, Essery R, et al. Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial. BMJ. 2019;367:l5922. Published 2019 Nov 5. doi:10.1136/bmj.l5922Tenforde AS, Hefner JE, Kodish-Wachs JE, Iaccarino MA, Paganoni S. Telehealth in Physical Medicine and Rehabilitation: A Narrative Review. PM R. 2017 May;9(5S):S51-S58. doi: 10.1016/j.pmrj.2017.02.013. PMID: 28527504. 

Vestibular Rehab and Telehealth with Sarah Gallagher

“I think of optokinetics like I would think of a hammer.  A hammer can both drive a nail and pull it out. Optokinetics can push the vestibular system or it can make it challenging to use for your balance.” -Kenda FullerKenda Fuller Bio:Kenda Fuller, PT, was a pioneer in the practice of vestibular and balance rehabilitation in the 1980’s, certified by the American Board of Physical Therapy Specialists as a neurological specialist in 1990. She is responsible for the neurologic content in Pathology: Implications for Physical Therapists, Elsevier. She contributed to Umphred’s Neurological Rehabilitation by writing chapters on Balance and Vestibular Disorders.Education has been a strong focus of her career as affiliate faculty at both University of Colorado and Regis University. She has provided extensive continuing education on balance dysfunction throughout the US. Invitations to give international lectures were associated with NeuroCom International, Inc which gave her access to interact with medical practitioners throughout the world.  She was instrumental in the development of testing and treatment software for the Proprio 5000, used to identify balance impairments and determine functional limitations. She created the Vestibular and Balance exercise program for Physiotools (https://www.physiotools.com), an electronic exercise product used worldwide.As co-owner of South Valley Physical Therapy from 2002 to 2020, her independent practice has been focused on the care of patients with complex neurologic and orthopedic conditions causing imbalance. She understands the need to identify the impairments that lead to imbalance and determine best interventions to enhance functional status. References:Use of optokinetics based OKCSIB protocol in restoring mobility in primary progressive MS. Use of optokinetic chart stimulation to restore mobility and reduce ataxia in a patient with pseudo-Cushing ataxia. Repetitive optokinetic stimulation induces lasting recovery from visual neglect Randomized controlled trial on hemifield eye patching and optokinetic stimulation in acute spatial neglect. Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case.Study of Optokinetic Stimuli as Treatment for Mal de Debarquement Syndrome. The effect of repeated exposure to visual motion stimuli on visual dependence in normal healthy subjects The Use of Optokinetic Stimulation in Vestibular RehabilitationThe Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients. 

Optokinetics (OPK) with Kenda Fuller

The Relationship between Saccades and Locomotion with Dr. PolitzerDr. Politzer bio: Dr. Politzer is a leading optometric expert in diagnosing and treating vision problems in neurologic disease. For more than 38 years he has been caring for patients and presently staffs and runs his own private practice, Neuro-Sight Visioncare and vision clinics at multiple hospitals in Colorado and is also a consultant to many groups. He has had numerous presentations and publications on Neuro-Optometric Rehabilitation. He also has many inventions which include:·The Vufine Visual Field Awareness System: a novel digital approach for enhancing visual field awareness after loss. ·The Beam Splitter: a novel approach for enhancing visual field awareness after loss. A SONAR based approach to enhance awareness of visual field loss. ·The Cyclo Prism for treatment of rotational strabismus following Cranial Nerve IV injury. ·The Spot Patch, partial and selective occlusion for the treatment and management of double vision  Dr. Politzer said when he was teaching a course with a colleague a few years ago, he walked into Mayo hospital and he saw their moto which expresses his feeling  about health care.  "The Best interest of the Patient is the Only Interest". And I hope this is why everyone is listening today. To learn more for the interest of our patients or if you are a patient to learn and empower what you can do for yourself.Resources:If you want to watch eye movement videos about a wide range of problems and neurologic disease go to the, NOVEL, website.  https://novel.utah.eduTo view Shirley Wray&apos;s lecture   https://novel.utah.edu/Wray/ocular_motility.php.  Other great resources on gaze training •Gunn SM, Lajoie K, Zebehazy KT, Strath RA, Neima DR, Marigold DS. Mobility-Related Gaze Training in Individuals With Glaucoma: A Proof-of-Concept Study. Transl Vis Sci Technol. 2019;8(5):23. Published 2019 Oct 9. doi:10.1167/tvst.8.5.23.•  Lajoie K, Miller AB, Strath RA, Neima DR, Marigold DS. Glaucoma-related differences in gaze behavior when negotiating obstacles. Trans Vis Sci Tech. 2018;7:10      

The Relationship between Saccades and Locomotion with Dr. Politzer

Join Erica DeMarch, founder of Step and Connect and inventor of Balance Matters as she interviews leaders in medicine, health and wellness to give you up-to-date information re: balance tips, resources and exercises to implement in your practice.www.stepandconnect.com

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Balance Matters: A neuro physical therapist’s journey to mak...

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