Parkinson's Outpatient Therapy Program

This overview details the Parkinson's-specific therapy programs offered by Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) at Valley Medical Neuro Outpatient Rehabilitation’s NW Pavilion, including guidance on directing patients to the appropriate services.

What specialty programs are offered for Parkinson’s patients?

Physical Therapy

• PWR!Moves
• Gait training: addressing quality and freezing of gait
• Balance training
• Return to recreational activities

Occupational Therapy

• PWR!Moves
• Handwriting program for addressing micrographia
• Vision therapy for visual-perceptual deficits like double vision
• ADL (Activities of Daily Living) skill retraining
• Adaptive equipment exploration and training

Speech Therapy

• Voice and speech therapy to improve vocal loudness and articulatory precision
• Respiratory support strategies
• Cognitive therapy for addressing changes and providing compensatory strategies

What is PWR!Moves and how can it help clients with Parkinson’s Disease?

The PWR!Moves program is:

• A large-amplitude, 1:1 therapy program
• Covered by insurance for clients with Parkinson’s Disease (or Parkinsonism)
• Tailored to individual needs with functional, progressive exercises
• Composed of up to 20 exercises performed in various positions: lying down, hands and knees, sitting, and standing
• Designed to encourage ongoing participation through annual refresher programs, supporting clients in maintaining high levels of function as their condition progresses

Which clients benefit most from the PWR!Moves program?

• Newly diagnosed clients who have not yet experienced significant mobility decline, reduced arm swing, or coordination issues
• Clients who have completed LSVT BIG and are seeking a new challenge
• Clients experiencing changes in mobility and ADLs due to bradykinesia
• Clients who thrive on structured, repetitive programs for compliance
• Clients requiring low-intensity exercises with caregiver support

How does the PWR!Moves program work?

The program identifies functional deficits and addresses them with exercises that emphasize large amplitude, high effort, and attention to action.

What types of deficits and symptoms are targeted?

• Stooped posture leading to forward balance loss
• Festinating gait, increasing fall risk
• Downward gaze affecting eye contact and posture
• Reduced movement on one side (e.g., limited arm swing or leaning)
• Difficulty maintaining center balance, resulting in swaying or balance loss
• Turning the entire body when looking behind
• Micrographia (small handwriting) causing trouble with filling out forms
• Stiff posture and rigidity hindering limb movement and body position changes
• Difficulty initiating or maintaining walking
• Freezing at thresholds (e.g., doorways), leading to near falls or actual falls
• Difficulty standing up from a seated position (e.g., chair or toilet transfers)

What is the time commitment for the PWR!Moves program?

The recommended schedule is three sessions per week for four weeks, although this can be adjusted based on the patient’s learning needs, availability, and caregiver training requirements. The client is expected to practice exercises daily during the four-week program: three times weekly with the therapist and four days independently to achieve consistent progress.

How many clinicians are certified in the PWR!Moves program?

Occupational Therapy: Cassandra Santiago, OTR/L, MOT, ATP
Physical Therapy: Kaitlyn Clugston, DPT

How can a clinician refer a client to the PWR!Moves program?

For the PWR!Moves program, the exercise protocol is consistent across PT and OT, so referrals can be written for either discipline, or as “PT/OT PWR!Moves,” allowing for treatment by the first available therapist.

If the client has specific needs, such as handwriting (OT) or gait device training (PT), the referral should specify that discipline. For all other non-PWR!Moves programs, a general referral with a PD diagnosis is recommended.

For further questions, please feel free to in-basket or email cassandra_santiago@valleymed.org.