How can Vestibular Physical Therapy Help with Parkinson's Disease?
Get moving EARLY and take control! Parkinson’s does not affect everyone the same way and it is important to find the right plan that works for your individual needs. A physical therapist, trained in the treatment of people with movement disorders, can help listen to you and teach you the skills required to overcome and even prevent physical and cognitive barriers. Even if you are not experiencing many symptoms, you will benefit from an exercise program that will help minimize loss of function and mobility in the future. You will also develop long term exercise habits to help with change in the future.
What should you expect from an evaluation with a physical therapist?
It is important to seek out a physical therapist that has experience working with people who have Parkinson’s. Together you will review your medical history and medications. A physical therapist can also perform movement screens that may expose early signs or symptoms that you may or may not be aware of. Testing will include an assessment of range of motion, strength, balance, coordination, posture, walking, and endurance. Next you will work together to set up goals that fit your specific needs to improve or maintain function.
You want to learn more about how physical therapy can help you?
Call and speak with me! I would be happy to answer any questions or concerns you have.
What do I need to do before getting evaluated by a physical therapist?
Speak with your neurologist, movement disorder specialist, or primary care physician about a referral for physical therapy. Or if you need help with the process, call a physical therapist and ask for advice on how to speak with your doctor.
Concussion Baseline Testing: What Is It and Why Should We Do It?
Baseline testing should be done during pre-season. Ideally, it should take place prior to practice. Testing will be performed by a trained health care professional, such as a physical therapist who specializes in concussion management, or a trained athletic trainer. The purpose is to assess the athlete’s brain and balance function prior to injury. The information and scores gathered from baseline testing can later be used as a comparison if there is a suspected concussion. It can also help guide safe return to school and return to sport during rehabilitation. The assessment includes tests for learning, memory, concentration, and balance. It is important for the health care professional to be made aware of and note any history of prior concussion.
The ImPACT™ test is the most widely used and research validated computerized concussion evaluation system. ImPACT™ testing is a baseline screening tool that can be used prior to the start of the season and if there is a suspected concussion. It is a computerized nuerocognitive tool that will assess for attention span, working memory, attention time, response variability, problem solving, and reaction time. It will generate a score that will assist a licensed healthcare provider in evaluating the athlete for a suspected concussion and managing treatment. It is important to remember ImPACT™ testing is one tool used to assist the healthcare team in properly identifying concussion and tracking recovery, but it does not diagnose concussion and does not act as a substitute for medical evaluation and treatment.
Consider these steps prior to the start of the season:
Step 1: Baseline testing (pre-season) and injury prevention/detection education
Step 2: Concussion is suspected- remove immediately and perform sideline assessment
Step 3: Post-injury testing and follow up evaluation
Step 4: Medical treatment team develops plan
Step 5: Prepare athlete for return to non-contact play
Step 6: Determine if athlete is safe for return to play
If you or your organization are interested in baseline testing contact Great Hills ENT and The Hearing & Balance Center of Austin to schedule or speak with us about concussion baseline screening and concussion treatment. If you are outside the Austin Metro Area you can locate an ImPACT™ trained professional by clicking here.
The Connection Between Diet and Tinnitus
Whether you’ve had ringing in your ears after leaving a show at ACL, or you hear a buzzing noise seemingly louder than everyone around you on a daily basis, you have experienced tinnitus. Tinnitus is the perception of any sound-whether it’s ringing, buzzing, whooshing, or whistling-that does not originate from an external sound source. It actually arises from the ear or brain! This ringing can be acute and short-lived (think the scenario above from ACL), or chronic and possibly debilitating. For those suffering from chronic tinnitus, there are several factors that can exacerbate it. The good thing about knowing these factors is they can be adjusted to affect the perception of tinnitus. One of these factors is DIET.
The new year has just started, and most people are more aware of their health and the connection between our bodies and our diet or exercise routines. We are aware that altering your diet to be more health-conscious may reduce body fat, combat disease (i.e. diabetes, cardiovascular disease, arthritis), improve sleep quality, improve skin and hair conditions, boost energy, improve overall mood, lift “brain-fog,” improve longevity… need I go on? Okay I will. Altering your diet as a chronic tinnitus sufferer may also reduce the perception of your tinnitus!
Diet-related exacerbating factors of tinnitus include a high caffeine consumption, excessive alcohol use, high sodium or sugar intake, and excessive consumption of pre-packaged or processed foods. Let’s take a further look at how these may impact your tinnitus:
- Caffeine: There have been mixed reviews on the effect of caffeine in relation to tinnitus in recent years, but there is no question caffeine is a central nervous system stimulant and can affect proper blood flow to the inner ear. The safe bet is to limit caffeine intake.
- Alcohol: Drinking alcohol increases blood flow within the inner ear, causing the opportunity for tinnitus to be enhanced. Additionally, frequent episodes of alcohol-induced tinnitus or hearing loss may permanently alter inner ear funciton;
- Sodium: Exccess sodium in the body causes increased water retention to maintain the appropriate fluid and salt balance. This increases blood volume leading to increased blood pressure, restricting blood flow to important areas like the inner ear. This can cause a significant increase in the perception of your tinnitus and make it more noticeable.
- Pre-packaged or processed foods: We just talked about sodium... 1 cup of Chex Mix Bold Party Blend holds 400mg of sodium... and who stops at 1 cup?! The higher saturated and trans-fats in a majority of processed foods are also contributors to poor tinnitus health.
- Sugar or sugar substitutes: The blood supply to our ears and brain are quite literally feeding these structures with oxygen and glucose (sugar). Disrupting your blood sugar levels can lead to a host of issues such as increased insulin production, possibly leading to Type II Diabetes and increased tinnitus.
Now, it sounds like I just took all the best things in life away from you: coffee, margaritas, chips and salsa… This isn’t the case. It’s not about eliminating every ingredient that makes food taste delicious, but they should be monitored if your tinnitus is driving you crazy. For example, the FDA recommends no more than 2,300mg of sodium per day for an average individual, reducing that number to 1,500mg for “certain groups” such as those with hypertension (or who have tinnitus exacerbated by high salt intake). This means that rather than hitting Shake Shack for a Shackburger on your way home from work (which packs a whopping 1,610mg of sodium by the way), you head home to cook up your own burgers with whatever seasonings float your boat.
Preventative care is recommended over palliative care, but if everything I’ve said isn’t enough to convince you to change your diet to improve not only your tinnitus but your overall health, welp, you can always see your audiologist for tinnitus masking recommendations and counseling.
The Link Between Central Auditory Processing Disorder (CAPD) and Smoking
As if we haven’t been given enough reasons to refrain from smoking, The Journal of Physiology published an article this spring describing the harmful auditory effects of perinatal nicotine exposure (full article here). Based on this research using animal models, children that are exposed to nicotine both in utero and after birth may develop abnormal auditory brainstem responses. An abnormal auditory brainstem response can cause delayed or atypical development during childhood including auditory processing deficits, delayed speech development, and learning difficulties. But what does this mean?
An auditory processing deficit is not synonymous with a loss of hearing. In fact, one hallmark of auditory processing disorder is normal outer, middle, and cochlear or inner ear structure and function. The deficit lies in the transmission of sound from ear level to brain level, meaning this is a central nervous system deficit. Sound is picked up appropriately by the healthy ear, but it is not effectively discerned by the brain after traveling along the vestibulocochlear nerve and enters the neuronal structure of the auditory pathway.
So what can an auditory processing disorder look like? Symptoms can include but are not limited to:
Difficulty understanding speech in noisy environments
Difficulty differentiating between similar sounds
Unable to follow extensive list of directions or remember large amounts of information given verbally at one time
Trouble with temporal or timing cues
Requiring visual cues to understand information
Asking for repetition repeatedly
In children, the presentation of APD can be misdiagnosed as a specific language impairment (SLI), developmental dyslexia, or attention deficit disorder (ADD). Diagnosis of a child is often determined by the specialized health care professional that is seen initially, whether that is an audiologist, speech pathologist, or psychiatrist. An audiologist is the healthcare provider to perform accurate diagnostic testing and offer management options for those with a true auditory processing deficit.
TLDR; there are auditory processing deficits that occur in people with otherwise healthy ears and normal hearing. Seek the expertise of an audiologist who specializes in auditory processing disorders if you or your child are experiencing any of the symptoms above. Also…just to reiterate the starting point… nicotine exposure is harmful to children both peri- and postnatal. The more you know!
National Protect Your Hearing Month
October is a popular month. Not only is it National Audiology Awareness Month, but is also National Protect Your Hearing Month! Hearing loss can affect any individual at any age and stem from varying causes. One cause that is preventable is noise-induced hearing loss.
Noise-induced hearing loss (NIHL) is permanent and irreversible, and is the cause of hearing loss in 1 of 3 individuals suffering from a hearing impairment. Excessively loud noise can cause damage to our inner ear sensory cells and result in this type of hearing loss. Even sounds as loud as a hairdryer or blender are loud enough to cause this cell damage. We live in a noisy world, experiencing dangerously loud sounds daily from traffic noises to emergency sirens to sporting events. We must take responsibility for our hearing health into our own hands and protect our ears from dangerously loud sounds.
Ways to protect your ears and hearing include:
Wearing hearing protection when exposed to loud sounds for extended periods of time.
This includes mowing the lawn, attending concerts and sporting events, shooting guns at a range or hunting, watching fireworks, etc.
Walking away from the noise source i.e. speakers at a concert.
Maintaining safe listening levels for music and television. Turn down the volume on iPhones, iPods, and TVs.
Audiologists can assist you with selecting and creating/ordering appropriate custom hearing protection devices for your specific needs. Don’t become a statistic-protect your hearing now!
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