♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet. ♪
- [Woman] Go ahead.
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet. - In our opinion,
of course, Bob. - The camera's so far away.
- I know. - I bet you guys
can barely see us.
- Yeah, this is nice though, Bob, we get some...
I feel like I'm out in Wyoming.
- Yeah, all right.
Now, today, Brad, we're gonna talk
about Parkinson's and CVA after a stroke.
The gait training or balance training, right?
- Right, this is gonna be more for people
that are up and walking.
It's not if you had a stroke
and you have a lot of weakness where you cannot walk.
You're already walking with a cane, typically.
- This is higher level balance stuff.
- Right and for people with Parkinson's,
oftentimes you get that tremor
where that one foot will feel like it's stuck.
And these are some things to get that.
So you can get back
to that pace. - Movement?
- Right, that movement that is more
the way it should- - Natural?
- Natural, exactly.
I can't find my words today, Bob.
- Yeah, you'll find them.
They'll come to you.
- Okay, now the other thing about this I like, Bob
is all of these you can do at home, you know
with a family member that's, you know
physically fit and able
to help properly. - Right
and that's not gonna fall if you fall.
- Right, exactly, you are gonna need a gait belt
or a belt that you can help with so that...
'Cause this is gonna challenge your walk
and then their balance a little bit and you wanna be safe.
- Brad, before we get started, though
if you're new to our channel, which a lot of you are,
make sure that you subscribe to us, it's free.
It's helpful.
And we upload a video every day in the evening.
So these all are gonna help you get strong,
healthy, fit, pain free.
- And safe.
- Exactly, so we'll get on with it here.
What you're gonna need is some tape and a hard floor.
You won't be able to do this on carpet so well
and you can see down on the floor,
you got this, Lonnie?
I've taken...
You can use anywhere from at least four feet of tape
or you can go longer if you want.
You'll see in just a minute, why?
And you put tape, I got these two feet apart.
They're four-foot long.
Again, longer is fine.
And we're gonna use this for visual aid,
for balance and gait.
Now Bob is gonna be- - I put my own gait belt on.
- Yeah, he's put his own gait belt on.
He's gonna be the patient.
And we'll...
Again, this could be for either stroke
or Parkinson's on this particular exercise.
Bob's gonna be using the cane.
- I bet you it's not long enough for me.
Oh, it is long enough for me, you made it long enough
for me.
- Bob, you know, and if you're
the family members instructing,
we're gonna go like this, toes right on the red line.
Yep and we're gonna go sidestep
and you don't wanna drag your feet.
Okay?
- So picking my feet up?
- Exactly, you're gonna use the cane if the person's wobbly,
that's why you got the belt on, you're gonna hold here
and you're gonna stand back- - So I go both directions,
I take it, Brad?
- Yep, both directions for sure.
Okay?
And you may find one direction
is considerably harder than the other.
So keep working it.
You can emphasize the direction that goes harder.
Bob, your toes are getting past
the red line. - Oh, I'm supposed
to stay behind it? - Yeah.
Sometimes with a stroke, the vision is impaired
and you wanna assess that as well.
- Okay? - Okay.
Now we're gonna use the same lines
and we're gonna step over the top.
Okay? - Okay.
- With Parkinson's you're gonna emphasize big step,
bring it up and over.
And we're gonna come over imagining
that the tape is a two by four and you wanna lift
over the top of it and then to here
and then we're gonna come to here
and then we're actually gonna go backwards.
Now, going backwards may not be appropriate
for some people, depends on their level.
- This is a very good exercise
for someone who has Parkinson's.
Because if they can try to visualize it,
they're gonna go over something,
it does help them get moving.
- Exactly, lot of things going on
with the person's...
How they're thinking about the task.
Go backwards, Bob.
Now Bob's going to step two pattern.
So he's going here and he's stepping to the other foot.
Go again.
If this is too easy and step over the line again, Bob.
If they're doing really well at this,
you may wanna do the step over step.
So here and then over the other line, and then to here.
- Gotcha, so I'm going up-
- They're high steps, Bob, keep the feet up.
Good, and one verbal cue that I find helpful,
I'm working with this on one of my patients right now
she responds well to, "Think about striking with your heel."
And when the heel comes down, that just offers...
It makes people think about coming up higher.
It does with this person.
Everyone's a little bit different.
- So more of a normal gait pattern too,
a walking pattern, just to hit heel strike first.
- Exactly.
- As opposed to going toe first.
- Yep and sometimes the muscle memory kicks in
and things start going back. - And that's
what we're trying to shoot for.
- Exactly, all right.
Now, Bob, why don't you have a seat?
- Okay.
- The next one, go to the store
and just a hardware store will typically have shelf liner.
I can get the 20 square feet for about $5.
Take a plate outta your cupboard
and cut four round shelf liners.
Just like this- - This is really a good idea
by the way.
- Yeah, and the shelf - I'm really impressed, Brad.
- Yeah, the shelf liner has a couple of benefits.
Get a color that contrasts with the floor.
You're gonna put these four shelf liners here.
They grip.
So when you step on it, they don't slip
and down you go.
- Here, we spend all this money on Dycem
and we could just buy shelf liner.
- Yeah, Dycem is a product that therapists use
and it costs about 10 times as much as this
and it doesn't work too much better. (laughs)
- Right, exactly.
- Okay.
- That's a great idea, Brad.
- If you can get it in different colors, better yet,
particularly for stroke people 'cause their vision...
You might find something about their vision.
Some people have a problem with detecting a certain color.
- Sure.
- Alls I could get was black and it'll be fine for here.
We're gonna have Bob stand on here.
- Okay. - Okay.
Now you're gonna try and step all the way to this one.
And then to here.
Bob's a tall guy, so we got these farther apart.
- So normally you might start
a lot closer- - Right.
You may have these only, you know,
six inches apart to start- - To start off with?
- Yep, Parkinson's people, if they're easy
then you definitely wanna get 'em bigger
and farther apart. - Right, yep,
a big spread out program. - Exactly.
- You wanna really encourage wide movements.
Right, so these may start here
and then work their way out depending on the level
of the person - Sure.
- How good they are.
Now, we're gonna go this way, Bob, to your left, okay?
Well, this one's gonna be tough.
Yeah, going backwards, you know
'cause you do need to step backwards
and this may not be appropriate for some people.
You just skip it if it's not gonna be safe, there you go.
Good Bob, now you're gonna go the other direction.
- Oh (laughs).
- See, if you're gonna go clockwise,
you gotta go counterclockwise.
Go both directions.
And this really helps tune in all facets of movement.
- Definitely the hardest is going back,
- Yep. - For sure.
- Now we're gonna do kitty corners.
We're gonna go from here to there.
That's a big step, isn't it Bob?
- Yeah, it is.
- Yep, so this- - All right, now what?
- Now we're gonna go back,
back where you came from. - Oh good Lord. (laughs)
- There you go.
Okay, now you're gonna - I gotta go this way?
- Yep and now we're gonna complete it.
Complete the X here, there you go.
And then back again.
Good, so realistically, probably
you're gonna start - More like that-
- Exactly- - Right.
- Yeah, this would be a lot more manageable for more people
to start off than going- - Exactly-
- And then this side- - Nice work, Bob.
- I'm making quick work of it.
- And this is very similar,
if they have any dance, this is serious.
If they have any history of dance and they did the waltz.
- Sure.
- This is very similar-
- Similar steps- - To the steps in that
and that might be therapeutic in itself.
- Nice idea, Brad- - Have you been waltzing, Bob?
- Oh, I did polka when I grew up, but no waltz.
- I think you could get the polka out of that too.
Next, we're gonna get some cones.
Now at home, you probably don't have these therapy cones.
Just get some soup cans, that works just as good.
Try and get some different color soup cans,
if you can- - You can even wrap 'em-
- Sure- - In colored paper.
- Yep, yep, exactly.
If you got duct tape, that's always kind of fun,
kinda expensive compared to construction paper
and you're gonna set 'em up in a pattern like so-
- Now- - Okay?
- Brad.
- Now we're working on turns, Bob.
I'll demonstrate first. - Okay.
I'm gonna right turn here.
A left turn here.
And we're gonna go all the way around
and then a right turn here
and then a left turn here all the way around
and we're gonna come back. - All right.
- To where we started it.
- So I'm working my way around.
- Yep.
- Taking good steps, going all the way around on this one.
- Yep, yep.
- Now this is...
You know, actually some of the tests we do on people
to determine whether or not they're a high fall risk
is we make 'em turn all the way around in a circle.
'Cause it is hard for a lot of people to do.
- [Brad] You know, it can get the...
The ears can come into effect with some dizziness, possibly,
the visual part.
- Oh, I'm going back here- - On this way, Bob.
- [Bob] And now I'm going this way.
[Brad] I was just working this week
with one of my patients and I'm right there.
I'm holding here.
I'm giving verbal cues.
'Cause a lot of times they'll forget where that one leg is.
And then, you know, tip that over.
- This is definitely gonna be a difficult thing
for a lot of people to do,
all those turns - This is...
Bob you're right in front...
- [Bob] Oh, sorry. (laughs)
- This is advanced.
This is getting someone ready to go home by themselves.
Getting ready to go out in public, okay?
Another thing I do is if I can get someone out
in the hallway where there are other people walking around
then I'll walk with them there
because- - Yes,
you want 'em distracted.
- Right, see how they do when they're distracted
by people- - We'll even have 'em walk
and even have 'em look over this way
and look down this way and look down that way
because all that throws you off when you're walking.
- Yeah, if you're all by yourself and you can concentrate
that's one scenario, but it's completely different,
you know,
in a realistic scenario. - You gonna make a call, Brad?
- No, yeah, I gotta call my wife.
She's having a baby.
I'm just kidding. (laughs)
Okay, with the cell phone technology,
you can get a metronome very easily.
Metronome app. - Okay.
- And they're free.
If you're a music person, you might have
the old fashioned mechanical metronome
that goes back and forth.
And let's see if I can get this dialed in.
- So what the metronome is gonna do
it's gonna help somebody with Parkinson's.
It seems that that very steady beat helps them walk.
And sometimes when they get stuck,
if you start playing that beat, it'll help 'em go.
- Right, I just had someone, he always gets stuck
when he goes through a narrow doorway.
His feet just lock up and he can't get his right foot going.
I walked with him with the metronome.
He went right through it without stopping.
- And nowadays with everybody having a smartphone
you could set that up on your own phone.
That even you feel like you get stuck in the door,
you could just start playing it.
- So you're probably gonna be around 80 beats per minute.
Okay?
Let's get this one going.
- Are we gonna be able to hear it?
- No, no, no, we'll find out.
I think so.
- Put it on your mic. (metronome ticking)
Oh yeah, you can hear that.
- Okay, Bob, let's get going.
You gotta find the rhythm, everyone's a little different.
Let's see what you got.
If you're at 83 beats.
Bob, you're only doing half time.
We wanna go one, two, three, four.
- Oh, I was doing half time.
- Yeah, so each step is gonna...
So right, left, right, left.
Right, left.
And you can have a little fun with this.
Get the person to laugh a little bit.
You don't dance much.
Do you, Bob? (laughs) - No, I don't. (hums)
- There you go.
But seriously, this can be a real effective tune
and it's so good- - That's a really good hint.
- Yeah, it is- - And like I said,
it's so prevalent now.
Whereas before it'd be tough to come up with these.
How do you turn it off- - You're trying
to get it to stop.
(laughs) All right.
So good luck with these at home
and I'm sure your friends
will love them. - Be safe.
Remember, always use the belt.
- Yeah, the gait belt. - All right, thanks.