Big and Loud

Driving back and forth from Dunn to Fayetteville four times a week might seem like an inconvenience, but Billy Shaw and his caregiver Carolyn McLamb call it a godsend for his Parkinson’s therapy.

“We are very fortunate to have these programs especially close by. It’s wonderful,” said McLamb.

Shaw, 74, was diagnosed at the end of July with Parkinson’s disease and started occupational, physical and speech therapy programs through the outpatient neurological clinic at Cape Fear Valley a little over two weeks later.

With therapy four times a week, McLamb said Shaw is having a return of movement and speech abilities he had lost.

“His symptoms progressed quickly after his diagnosis, but with the therapy, he is more independent now,” said McLamb.

McLamb credits the outpatient neurological clinic staff for helping her partner regain the mobility and strength that he had lost from the effects of Parkinson’s disease.

Parkinson’s disease is both chronic and progressive, attacking the part of the brain that helps control and coordinate body movements and speech. Patients often have trouble with balance, slowness of movement, tremors (or shaking) and difficulty walking. According to the Parkinson’s Foundation, more than 1 million people in the United States are living with Parkinson’s disease, and more than 60,000 people are diagnosed each year.

Current programs offered for Parkinson’s patients in the outpatient neurological clinic include speech therapies SPEAK OUT! and Lee Silverman Voice Technique (LSVT) LOUD, and occupational and physical therapies LSVT BIG and Parkinson's Wellness Recovery (PWR) physical therapy. The clinic also offers recreational aquatic therapy with a warm-water physical regimen according to Melissa Wisneski, Director of Therapy Services.

Wisneski said that while the LSVT programs BIG and LOUD are very intense, four-times-a-week programs, the rehab clinic also offers PWR physical therapy and SPEAK OUT! speech therapy for more flexibility if the patient cannot be at the rehab center several times a week.

“They all work together to create a regimen that best fits the patient’s needs,” said Wisneski.

The BIG program focuses on large movements and balance responses, according to Rachel Furnham, a physical therapist in the outpatient neurological clinic.

“With Parkinson’s disease, patients don’t realize their movements aren’t normal, so we mirror big movements in front of them. We help retrain their brains, so it becomes more automatic. We ask what trouble they have at home. It can be walking, sitting or getting out of a chair or getting out of bed,” said Furnham.

In the PWR program, therapists work on movements and posture using music or a metronome with patients.

“PWR is the same idea as BIG. Patients tend to have very small steps. They step close together and freeze at transitions at a doorway or going from tile to carpet. Using music helps them not to freeze and to walk more confidently,” said Furnham.

Furnham said that recent donations have helped the clinic get more equipment for the physical therapy programs including blaze pods, which serve as small flat targets that can be attached to a wall or used on the floor to help with step exercises, reaching up and balance, and a special walker that has a metronome and a laser light called a “u-step walker.” They also were able to add shuttle balance bars, which challenge patients to keep their balance holding on to parallel bars with an unstable base of support.

Speech is another component affected by Parkinson’s disease. Elexea Aurilio is a speech language pathologist in the outpatient clinic.

Aurilio said that SPEAK OUT! and LOUD improve patients’ vocal volume, intelligibility and overall speech clarity.

“I’ve had patients tell me that coming to a more intensive program has made them stronger. They can order in restaurants now. It gives them some of their independence back,” said Aurilio.

One of those patients is Fayetteville resident Joan Berube, 81, who was diagnosed with Parkinson’s disease three years ago.

“I did the whole program, including speech and physical therapy. It was marvelous. We did everything I would need for daily living, and I feel confident now. I can talk in a conversation without feeling embarrassed or uncomfortable. I’m still walking with a walking stick, but I’m 81 and don’t want to stumble or fall,” laughed Berube.

Berube said she was referred to the programs shortly after she was diagnosed.

“I didn’t know I had it, but my doctor had me walk down the hallway and realized right away something was wrong. As time went on, it showed up more definitively. It started with a trembling in my hand where I couldn’t hold a cup of coffee,” said Berube.

Berube’s therapies were one-on-one, which most are, but the outpatient neurological clinic staff has plans to add a new program in the fall with an emphasis on group training: Rock Steady Boxing.

The Rock Steady Boxing program is scheduled to launch in October through a substantial donation by Fayetteville residents Tony and Ann Cimaglia to the Cape Fear Valley Health Foundation’s Caring for the Future campaign bookmarked for Parkinson’s disease support and therapy.

“He wanted to bring the Rock Steady boxing program to our community. He’s passionate about this program because it works. We are excited to be able to offer this at Cape Fear Valley,” said Wisneski.

One of the first to be trained in the Rock Steady Boxing therapy program is Maria Jackson, a physical therapist assistant who has been with Cape Fear Valley for seven years.

“The Rock Steady method uses non-combat boxing techniques. It improves strength and agility to help with motor coordination and promotes neuroplasticity for slowing the progression of Parkinson’s,” said Jackson.

Jackson said that the boxing regimen is more endurance-based with repetitious movements. Using boxing gloves and punching bags, patients are empowered to “fight back” against the disease.

In her training earlier this summer, Jackson became certified to do solo training and looks forward to getting certified in the “head coach” group training.

“This program really works. It doesn’t seem like work or rehab. In the group setting, they were all having fun and not hiding impairments because they all could relate to each other,” said Jackson.

Patients can also enroll in booster programs after completing training.

“We offer a transition program at the Healthplex. Once they complete the programs, they can come back. It can be an ongoing process,” said Wisneski.

For Billy Shaw and Carolyn McLamb, it is comforting to know the programs are still available even after completion.

“He does all the exercises associated with the programs twice daily as homework. However, we also know that the programs can be taken again. Whenever he has a decrease in movement, he can go back. With Parkinson’s disease, sometimes he will be better, but when he is off, we know we have the support we need,” said McLamb.

For those living with Parkinson’s, Wisneski said it is important to keep active and that exercise programs whether for speech, balance or movement are available to help.

To receive more information on the programs available for Parkinson’s disease or any movement disorder, visit capefearvalley.com or call (910) 615-4990.