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Winter Tips from the National Parkinson Foundation

Excellent information offered by the National Parkinson Foundation:

Winter often brings unexpected weather and for many, the shorter days can lead to vitamin D deficiency, increasing chances of developing seasonal depression. The good news is that NPF’s Ohio Chapter has gathered these tips to help people with Parkinson’s disease (PD) and their caregivers ensure that PD-related needs are accounted for this winter.

Falls Prevention

Parkinson’s can affect mobility, memory and thinking skills. People with PD may experience tripping or “freezing” episodes that can lead to falls. Add snow and ice to the equation and winter can be an especially dangerous time. To stay safe this winter:

  • Wear shoes with good traction and non-skid soles.
  • Take off shoes as soon as you return home. Snow and ice attach to soles and as they melt lead to slippery conditions inside.
  • Shovel the path to your door, garage and mailbox to clear them of leaves, snow or ice. If possible, ask someone to shovel for you.
  • Be realistic and ask for help walking outside when you need it. Don’t let pride lead to a fall!
  • Use salt before or immediately after a storm to melt icy sidewalks and steps. If you don’t have salt, cover the ice with something gritty or non-slippery (like sand or cat litter).
  • Replace a worn cane tip to make walking easier.
  • Allow yourself plenty of time to get where you need to go in winter weather. Taking your time reduces your risk of falling, especially if you use an assistive walking device.

Seasonal Depression

With depression as a common PD symptom, people with Parkinson’s should be conscious of their increased susceptibility to seasonal depression, which can be brought on by the cold and grey or the potential isolation of the winter months. Keep reading this and more at the National Parkinson Foundation website!

Workplace Prevention

Congratulations everyone for finishing up with courses for the semester!  We did not have a meeting November/December due to the busy nature of everyones schedules.  However, here is a small introduction of information and resources for you in regards to workplace prevention.  Some of the podcasts are really great so if you can find time (I especially recommend the Dr. Jarod Carter podcast on the practical implementation of prevention services).  Please reach out to us if you have any follow up questions/comments/etc.  Happy holidays!

In 2014 the Bureau of Labor Statistics reported that of all injury and illness cases, work-related musculoskeletal disorders comprised 32%.  350,000 cases happened at the workplace. The average time lost away from work was approximately 13 days. OSHA cost calculator estimates costs of some injuries resulting in indirect costs of 1.1-4.5x the direct cost depending on the direct cost amount.  Smaller direct cost figures have the higher multiplier values for indirect cost.   

Opportunities and Hurdles:

Workplace injury prevention represents an opportunity for therapists to interact with employers and provide prevention services.  The Duffy-Rath System is one such example that has been in place for over 20 years.  Other examples include performance of Functional Capacity Evaluation, ergonomic assessments, return to work programs, etc.  The sky’s the limit.  The issue is whether insurance will cover these?  It depends.  In the below podcasts some of these issues are discussed in more depth with some services being cash-based.  Considering the cost after an injury occurs, financially it makes more sense for employers to pay for prevention services.  As providers we need to present that information.

Insurance Breakdown:  Workers Compensation vs. Medical Insurance?

Recent changes in healthcare have brought forth the scenario of mandatory medical insurance for employees by employers. This issue is constantly addressed and in flux. In regards to workers compensation insurance this is less complicated, employers are mandated to hold a policy for their employees. Employees injured at work go through a process that allows them to be treated outside of their individual medical insurance policies. There is a process that must be followed that HR navigates employees through. Knowing more about requirements and the process allows us to better manage and guide patients.

Want to know more?

·      http://duffyrath.com/duffy-rath-system

·      http://www.mechanicalcareforum.com/podcast/74

·      http://www.mechanicalcareforum.com/podcast/2015/7/26/episode-75-wayne-and-jean-rath-part-2-not-afraid-to-fail

·     http://www.atipt.com/workers-comp-rehab

·      http://www.drjarodcarter.com/cbp-045-cash-based-industrial-pt-services/

·      http://www.orthopt.org/content/special-interest-groups/occupational-health

National Parkinson Foundation Moving Day NC Triangle


Volunteers Needed

Full Event Details:  (Click here)

We are in need of volunteers for Moving Day® NC Triangle on October 29, 2016. A number of opportunities are available and we could certainly use your help! We are currently recruiting volunteers to help with Food and Beverage, Kids Zone, Walk Route, Movement Pavilion etc. Times will vary depending on area assigned.  Last year, many local physical therapy students, including Duke DPT, came out to volunteer.  To register please visit: Click Here12764802_1057763170911527_4207138361061948900_o

The National Parkinson Foundation’s fourth annual Moving Day® NC Triangle fundraising walk, is scheduled to return to Koka Booth Amphitheatre in Cary, Nc, on Saturday, October 29, 2016.


Integrative Medical Center discussion notes

After touring the Integrative Medical Center (IMC), we had a short discussion with Dr. Adam Perlman, executive director of the IMC. Below are notes from our discussion.

Dr. Perlman on his entry into Integrative Medicine:

He originally wanted to be a martial arts instructor, but his grandmother ensured he pursued a more traditionally stable career. His time in martial arts exposed him to many eastern therapies and sparked his interests in complementary medicine. He originally trained as an internist and went on to earn his masters of public health and complete a preventive medicine residency. Early in his career he built an Integrated Medical Center in New Jersey. He turned a fitness facility into an integrative medical center at University of Medicine and Dentistry of New Jersey where a large portion of his practice were patients with fibromyalgia. He came to Duke in 2011.

What is Integrative Medicine?

Integrative medicine is becoming more popular across disciplines.Healthcare is moving away from treating disease. Traditionally, our system doesn’t pay for preventing disease. Healthcare cost is becoming astronomical and our outcomes aren’t good. The US is ranked in high 30’s of health outcomes globally, but we spend the most on healthcare. Our highest spending is treating chronic disease, which by and large are preventable or treatable by behavior modification. We are working to transition healthcare to seeing patients as a whole person, not as their disease. In this model, the patient defines success, not the provider. We are working to help patients achieve self-actualization.

Do PT’s work at the IMC?

No PT’s work at the IMC because of the Duke Sports PT next door. Don’t want to duplicate services.

Primary Care Physical Therapy

As doctors and the established movement experts, we need to continue to press for autonomy within healthcare and promote ourselves to the public as the first contact point for movement related issues. Additionally, as direct access continues to become a reality, patients will be coming to you as their primary point of care. Attending this meeting will explore what it means to be a primary care PT, why it is important to take on this role, how primary care PT is being implemented, and what we can do in our practice to better position ourselves as clinicians to further this approach.



  1. The current standard models for seeing a physical therapist: referral and direct access.
  2. What makes someone a primary care physical therapist?
  3. Three models of primary care PT: U.S. Army, Salt Lake City VA, Kaiser Permanente Northern California http://www.jospt.org/doi/pdfplus/10.2519/jospt.2005.35.11.699

Introduction Meeting

I chose to become a physical therapist to help others improve the quality of their lives through health interventions. Prevention and lifestyle medicine is the ultimate quality of life improvement. It is keeping the player in the game because they didn’t get an injury, it is grandma seeing her great grandchildren born because she didn’t die from cardiovascular disease, it is the pregnant woman that didn’t go on bedrest, it is the father that didn’t develop prostate cancer.