243: Using A Sensory-Based Approach For Treating Functional Neurological Disorders
Release Date: 12/09/2024
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,...
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296: How AI Documentation Will Change Your Life
I Love Neuro
We’re getting techy!! On this week’s episode hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS share a new tool that’s changing everything at Rogue, Claire’s wellness gym for people with PD. Claire confesses to using paper documentation until recently and is now entering the 21st century. What’s propelling her into the “now” is a new tool she’s been trying for a couple of weeks called the Plaud NotePin. It’s a small, wearable, and HIPAA-compliant AI device designed for healthcare professionals that helps with documentation either in-session or via dictation...
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295: What Clinicians Should Know About ENT Vestibular Testing With A Neuro-Otologist
I Love Neuro
This week’s episode is a little different. We wanted to give you a full view inside a VestiBesties mentorship call where Christina Garrity, PT, DPT, NCS interviewed a neuro-otologist she works with in Ohio, Dr. Jimmy Prueter. Dr. Prueter was invited to the conversation to help clinicians better understand when, why and which tests people with vestibular conditions should be getting. The conversation-style interview is between Christina and Dr. Preuter, taken straight from a VestiBestie webinar so you can have exclusive access! In the discussion they outlined the challenges associated with...
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294: Myoelectric Functional Orthosis: Myomo And Upper Extremity Rehabilitation
I Love Neuro
In this episode of the I Love Neuro podcast host Erin Gallardo, PT, DPT, NCS talks to Christian Leonakis, PT, DPT, Alanna Wathen, PT, DPT, and Danielle Parmenter, MOT, OTR/L, SCLV about Myomo and the MyoPro upper extremity myoelectric orthosis. The world of neurological rehabilitation, innovation continues to push the boundaries of what's possible for patients recovering from stroke, traumatic brain injury, and other neurological conditions. Enter Myomo, a groundbreaking myoelectric orthosis that's changing lives one arm movement at a time. This isn't just another medical device—it's a...
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293: Navigating Dystonia With Leann Vitale, MS, OTR/L
I Love Neuro
Is treating dystonia making you stuck? Dystonia remains one of the most challenging neurological conditions for clinicians to understand and treat. In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS talk to occupational therapist Leanne Vitale, MS, OTR/L about her holistic approach that goes far beyond traditional treatment methods. Dystonia isn't just a movement disorder; it's a complex interplay of neurological, psychological, and sensory experiences. Leanne emphasizes that understanding dystonia requires looking beneath the surface—much like an iceberg,...
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292: Balance Reimagined Using The Gibbon SlackBoard With Derek Mikulski
I Love Neuro
Are you looking for tools to challenge dynamic balance? Duh! Check out what makes the Gibbon SlackBoard different and how it can transform balance outcomes. In the episode, host Erin Gallardo, PT, DPT, NCS interviews Derek Mikulski, BS, CSCS, CPT, National Director of Commercial Sales for Gibbon about what makes the SlackBoard different from other balance tools clinicians use, like foam pads and BOSU balls. Derek described his entrepreneurial journey that led him to Gibbon. The SlackBoard was born from a passion for fitness and personal transformation, and brings slack lining technology into...
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291: Let’s Have A Chat About Your Biz Finances With Emily Duval Ledger
I Love Neuro
On today’s episode hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS talk with NeuroBiz coach Emily Duval Ledger about a topic many clinicians and business owners find intimidating: Money. This is exactly why we need to talk about it! Are you investing, saving, or putting systems into place in your business for money management and your future? If not, we understand. And we also want to help make this less overwhelming. Learn how to break down your financial goals and understand your true needs so you can create a business that supports both your professional passion...
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290: Brace Yourself: AFOs After Stroke With Dr. Jennifaye Brown, PT, MSPT, PhD, NCS, CAPS
I Love Neuro
Ankle Foot Orthoses (AFOs) are essential in neuro rehab yet can be an area clinicians feel a lack of knowledge. This episode is for the clinician who is both - super knowledgeable about AFOs, AND the clinician who could use more education. Hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS interview Dr. Jennifaye Brown, PT, MSPT, PhD, NCS, CAPS about her work transforming the way we think about ankle-foot orthoses (AFOs) for stroke survivors. Her approach goes far beyond traditional medical practice, focusing on personalization, functionality, and patient empowerment. Her level...
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289: How Not To Abandon The Hemiplegic Arm In Every Treatment Session With Dr. Melissa Kimmerling, EdD, MOT, OTR/L
I Love Neuro
How well are you incorporating the hemiparetic arm of your client into every treatment technique? Do you know when to use remediation vs compensation techniques? Let’s talk about it! On today’s episode host Erin Gallardo, PT, DPT, NCS and Dr. Melissa Kimmerling, EdD, MOT, OTR/L dive into strategies for upper extremity recovery, focusing on patients with limited arm function after neurological injuries. Dr. Kimmerling, an occupational therapy expert, shares invaluable insights into helping patients maximize their arm's potential, even when movement is minimal. The discussion centers on the...
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.