243: Using A Sensory-Based Approach For Treating Functional Neurological Disorders
Release Date: 12/09/2024
306: Clients Can Maximize Hand Function And Foot Drop At Home With Motus Nova
I Love Neuro
In this episode, host Erin Gallardo, PT, DPT, NCS interviews the Motus Nova clinical team—occupational therapists Jamie Kurtz, MS, OTR/L, Keisha Burrous, OTR/L, CBIS, Amie Canning, MS, OTR/L, and Mirasol Jacobs, PT, DPT — about the Motus Hand and Motus Foot robotic devices for neurorehabilitation. The team explains how these FDA Class I medical devices provide active-assistive, game-based training at home to help patients achieve the high repetition doses (500–600 reps per day) needed for neuroplastic change, without replacing traditional therapy. Built on pneumatic “artificial...
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305: How To Overcome The Fear Of Falls Training With Naomi Casiro
I Love Neuro
Do you work with people who have falls? Maybe you’ve seen that just training fall prevention isn’t quite doing enough. In this episode hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS talk with physiotherapist Naomi Casiro, founder of NeuroFit BC and creator of the Functional Movement and Falls training paradigm about why adding falls training to an overall balance plan is imperative. We explore why traditional fall prevention—focused mainly on prevention—has not been enough, and why a two-part approach that includes both prevention and explicit “how to fall”...
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304: Dry Needing For Spasticity With Chris McElderry, PT, DPT, NCS
I Love Neuro
In this episode host, Erin Gallardo, PT, DPT, NCS speaks with Chris McElderry, PT, DPT, NCS about how dry needling can be used in neuro rehab, particularly for people post-stroke. Chris explains why he pursued dry needling, how using it in PT differs from acupuncture, and walks through what a typical session looks like, including safety, side effects, and billing considerations. He shares clinical examples of using dry needling to address spasticity, hypertonicity, pain, and range of motion limitations, and discusses current research on short-term effects for spasticity and pain reduction....
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303: Hybrid Assistive Limb (HAL) + Neuroplasticity = Improved Outcomes For Individuals With Neurologic Conditions
I Love Neuro
In this episode, Erin Gallardo, PT, DPT, NCS interviews physical therapist Mariah King, PT, DPT from RISE Healthcare Group and Hiroki (Hiro) Kimura from Cyberdyne about the HAL (Hybrid Assistive Limb) robotic exoskeleton and its role in neurologic rehabilitation. They discuss how the HAL system reads patients’ intent to move via surface EMG signals and converts those signals into assisted movement to drive neuroplasticity and functional recovery for people with spinal cord injury, stroke, TBI, Parkinson’s disease, and progressive neuromuscular disorders such as MS, SMA, and muscular...
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302: Applying A New Calculation For Max Heart Rate In PD
I Love Neuro
In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS discuss a new research article, “Refining maximal heart rate estimation to enhance exercise recommendations for persons with Parkinson’s disease.” Parkinson’s is a multi-system condition and changes to the function of the autonomic nervous system are common. At times this can present as a person with PD having trouble reaching aerobic heart rate zones calculated based on age while they’re performing high intensity exercise. Claire explains the challenges they’ve faced using standard heart rate...
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301: Multi-System Approach To Treating Individuals With Long COVID Currently With Jennifer Lazaro, PT, DPT, NCS
I Love Neuro
In this episode of the I Love Neuro podcast, host Erin Gallardo, PT, DPT, NCS interviews physical therapist and neuro rehab residency coordinator Jennifer Lazaro, PT, DPT, NCS about evaluating and treating people with long COVID and dysautonomia. Jennifer notes the similarities in presentation for individuals who have post-COVID those with other conditions affecting the autonomic nervous system, like concussion with cognitive fog, severe fatigue, post‑exertional malaise, dizziness, and orthostatic intolerance. She walks through practical assessment strategies such as active stand testing,...
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300: Clinical Takeaways From Dendrite Expansion Days You Can Apply Today
I Love Neuro
In this 300th episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS invited long-time collaborator JJ Mowder-Tinney, PT, PhD, NCS to join so we could recap the best takeaways from Dendrite Expansion Days (DED), NeuroSpark’s three-day, fully experiential education event for OTs and PTs. We share how Naomi Castro’s “falling well” course progressed clients from floor work to standing falls in one session, describe hands-on equipment stations featuring frictionless sheets, BlazePod, Rifton, Saebo, UprightVR, and more, and highlight real client stories—especially...
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299: What To Do When You Don’t Feel Ready
I Love Neuro
Do you feel ready for that next big step? A transition in your career like leaving your job to start your own business, or transitioning your side gig to full time, or hiring your first employee. Neither did any of us! In this episode hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS have a discussion with NeuroBiz coach Emily Duval Ledger about what it really means to be “ready” for big transitions like starting a business, leaving a job, or hiring your first team member. We share our stories like Claire and Emily opening brick-and-mortar gyms, Erin and Claire starting and...
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298: What Is The Right Number Of Steps To Improve Health Outcomes? It’s Not 10,000
I Love Neuro
In this episode of the I Love Neuro podcast, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS discuss a major Lancet Public Health systematic review and meta-analysis on daily steps and health outcomes in adults, shared from a post by movement disorders neurologist Dr. Michael Okun. Claire explains that the study, which pooled data from multiple cohorts using device-measured steps, found the number of steps per day that is associated with substantial health benefits, including about a 47% lower risk of all-cause mortality compared to less steps. This amount also demonstrated...
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297: Best Practice For Managing Post-SCI Bowel And Bladder With Briana Elson, MS, OTR/L
I Love Neuro
In this week’s episode, host Erin Gallardo, PT, DPT, NCS is joined by OT mentor Briana Elson, MS, OTR/L, BCPR, CBIS to dive into one of the most essential topics in spinal cord injury rehab: bowel and bladder care. We unpack why every rehab professional (not just nursing) plays a role, how unmanaged bowel and bladder can lead to serious health issues, and practical strategies to support independence, dignity, and community reintegration. Brianna shares equipment ideas, education tips, and real-world problem-solving for both bladder and bowel programs, plus how this all connects to intimacy,...
info_outlineWorking with clients with Functional neurologic disorders (FND) can be confusing and challenging. If you’re stuck and aren’t sure how to help your clients you’ve gotta check out this episode! Occupational therapists and industry leaders in the treatment of FND Julie MacLean and Jessica Ranford discuss their expertise in using a sensory-based approach to treatment. In their work they noticed certain patterns emerging for people experiencing FND.
By conducting detailed sensory profiles and histories, the OTs were able to identify patterns in how these patients processed sensory information. Many exhibited heightened sensory sensitivity, sensory avoidance, and low sensory registration - leading to cognitive, emotional, and motor control issues.
The OTs developed a multi-step treatment approach focused on:
1) Increasing patient self-awareness of their sensory processing and arousal levels
2) Exploring individualized sensory strategies to self-regulate
3) Creating personalized "sensory diets" of activities to maintain balance
This sensory-based framework, combined with motor retraining when needed, has been effective in helping FND patients improve their symptoms and expand their participation in daily life.
Overall, this discussion highlighted the valuable role occupational therapy can play in assessing and treating the complex sensory processing difficulties experienced by many individuals with functional neurological disorders.
FND specific resources:
Overcoming Functional Neurological Disorders Workbook, Reset and Rewire: The FND Workbook
OT and sensory processing specific resources:
Living Sensationally: Understanding Your Senses by Winnie Dunn
Sensory Modulation & Environment: Essential Elements of Occupation by Tina Champagne
The Sensory Connection Program and Workbooks by Karen Moore
Recent OT publications:
McCombs KE, MacLean J, Finkelstein SA, Goedeken S, Perez DL, Ranford J.
Neurol Clin Pract. 2024 Jun;14(3):e200286.
Ranford J, MacLean J. Neurol Clin. 2023 Nov;41(4):695-709. doi: 10.1016/j.ncl.2023.02.008. Epub 2023 Apr 20
Sensory Processing Difficulties in Functional Neurological Disorder: A Possible Predisposing Vulnerability? Ranford J, MacLean J, Alluri PR, Comeau O, Godena E, LaFrance WC Jr, Hunt A, Stephen CD, Perez DL.Psychosomatics. 2020 Jul-Aug;61(4):343-352.
Occupational therapy consensus recommendations for functional neurological disorder.
Nicholson C, Edwards MJ, Carson AJ, Gardiner P, Golder D, Hayward K, Humblestone S, Jinadu H, Lumsden C, MacLean J, Main L, Macgregor L, Nielsen G, Oakley L, Price J, Ranford J, Ranu J, Sum E, Stone J. J Neurol Neurosurg Psychiatry. 2020 Oct;91(10):1037-1045.