Course Description:

The PWR!Moves® curriculum is an extension of Dr. Farley’s pioneering research in whole-body amplitude training using a singular attentional focus to target bradykinesia. But now, therapists will use different methods of instruction for a multi-symptom approach. Whole-body movement training is replaced with targeted whole-body functional skill-training with the goal to preserve functional mobility, functional fitness and participation. Instead of a strict protocol, therapists will be able to design and implement a flexible intervention framework that allows for clinical reasoning, personalization, adaptation and learning principled motor-cognitive progressions across disease severity. Finally, the curriculum is evidenced-informed and designed to be updated when new research becomes available.
To guide physical therapists in how to develop comprehensive plans of care that retrain functional mobility we have created a motor learning framework with three training levels that progress in difficulty and complexity (i.e., part to whole practice) and provide different methods of instruction to address multiple symptoms of PD. In Level 1, functional mobility is deconstructed into four fundamental skills (Basic 4 | PWR!Moves®) that address motor control deficits related to axial extension, weight shifting, axial mobility, and transitions. The focus is on two instructional methods: Prepare, the mindful rehearsal of each of these skills in different positions using whole-body large amplitude movements to target rigidity; and activate, the progression of these skills into high-effort repetitive “exercise” to target bradykinesia and strength. In Level 2, the focus shifts to rebuilding action sequences using these basic skills to simulate meaningful multidirectional overground movements and transitions (mobility) and daily physical activities (functionalities); an instruction method we call Flow to target incoordination and balance. In Level 3, therapists use Level 1 & 2 skills to target goals and to retrain personalized functional mobility goals determined in their rehabilitation plan of care. Throughout the part to whole, retrain functional mobility framework, therapists will learn to skillfully apply evidenced- informed learning techniques to exploit goal-directed and habitual pathways to increase success in real-life functional mobility conditions.
Recent advances in Parkinson disease (PD) basic and clinical science research suggest both physical rehabilitation and exercise have symptomatic benefits, increase the efficacy of antiparkinsonian medication, and result in motor and cognitive improvements. However, maintenance of physical activity and exercise habits is necessary to slow the motor and cognitive deterioration and lower mortality. Our goal is to prepare PD-specialized physical and occupational therapists to collaborate with their local PD-specialized exercise professionals and to include them as part of their clients’ healthcare team to keep persons with PD moving back and forth from rehab to exercise and back to rehab for life. We believe that by focusing on the same fundamental PD-specific skills and methods of training in rehab and group exercise, it may be possible to extend the benefits of rehabilitation and reap the additive and complementary benefits of group exercise programs necessary to slow motor and cognitive deterioration and lower mortality.