Ask an Expert: Parkinson Wellness Recovery (PWR!)

Dr. Farley received a PhD in Neuroscience from the University of Arizona, a Master of Science in Physical Therapy from the University of North Carolina, and a Bachelor of Physical Therapy from the University of Oklahoma. She is currently a Physiology Associate at the University of Arizona. Using her 30 years of experience in neurorehabilitation, she founded the non-profit Parkinson Wellness Recovery | PWR!, and acts as its Chief Executive Officer (CEO).

What is Parkinson Wellness Recovery (PWR!)?

During my postdoc, I studied how muscle activation problems contribute to bradykinesia (the slowness of movement). This led to the development of the LSVT BIG exercise program and a National Institutes of Health (NIH) clinical trial to study its short term benefits. During that time I learned of compelling animal research suggesting that exercise may be disease modifying through mechanisms of “brain change”, such as neuroprotection or neuroplasticity. What was found is that any program that is going to be disease modifying needs to be proactive, ongoing, and integrated with rehabilitation and community. Furthermore, it needs to be challenging, both physically and cognitively, as well as be emotionally rewarding.

In September 2010, I founded Parkinson Wellness Recovery | PWR!. Our vision is that exercise is medicine, and that it should be a physiological tool in each individual’s fight against Parkinson’s disease - beginning at diagnosis.

What led you to develop PWR!Moves® and how does it differ from the LSVT® BIG exercise program?

I wanted to go beyond LSVT BIG to make exercise more generalizable, customizable, assessable, and modifiable. The Basic4 | PWR!Moves are flexible PD-specific exercises that allow therapists to establish the program for life practice; to modify the positions and movements for varying levels of disease severity, fitness or conditions; to progress the difficulty and complexity; and to integrate them into a comprehensive rehab program with other research approaches.

What are the Basic4 | PWR!Moves?

The Basic4 | PWR!Moves form the foundation of the PWR! program. They require high effort, whole body engagement with a distinct focus on four skills shown by research to become impaired in PD and that interfere with “function”. More specifically, they target rigidity, bradykinesia, incoordination and automaticity.

PWR! Moves can be performed in any position as instructed by therapists and fitness professionals in rehab or community settings. Furthermore, they can be combined and progressed into a stand-alone exercise program, and/or integrated into other research-based exercise approaches (dance, tai chi, boxing, agility, pole walking). This flexible, yet repetitious approach, allows for each individual to implement lifelong adherence to multiple types of exercise programming, while maintaining a focus on PD-specific skills needed for everyday function!

What makes a PWR! Program unique from other exercise programs?

PWR! is a comprehensive program that implements multiple research techniques adhering to the latest European Physiotherapy Guidelines with a focus on bigger and faster movements.

An exercise program needs to include progressive aerobics (for brain health) and skill acquisition (for brain repair and adaptation). It isn’t enough to just exercise without being engaged and challenged physically and cognitively. You need to receive reward-based feedback, and it needs to be fun. PWR! optimizes your performance and ability to learn. It provides education, empowerment and ongoing coaching for life, allowing individuals to rise to their full potential.

What is the format of the PWR! continuing education workshops? What can I expect from participating in a PWR! workshop?

Our PWR! Therapist and PWR! Instructor workshops train and certify professionals to teach PWR!Moves. Both types of workshops use interactive lectures, demonstrations with group participation and volunteers with PD. Therapists learn to create individualized comprehensive home exercise programs for all levels of disease severity, fitness and conditions. They specialize in education and empowerment to overcome barriers to inactivity and serve as a coach for life! PWR! Instructors also learn how to integrate PWR!Moves into community yoga, dance, sports and personal training sessions.

How do I find a trained PWR! Instructor and/or PWR! Therapist?

You can contact Parkinson Society British Columbia at 1 800 668 3330 or info@parkinson.bc.ca to connect with an education and support services coordinator who will be able to provide further information. Alternatively, you can visit the PWR! website and click on the “Find a PWR! Professional” button to locate a trained professional in your area.

Can I do PWR! Exercises on my own?

Absolutely! The PWR!Moves are a stand-alone exercise program. However, they need to be progressed or adapted so that you are continuously engaged and challenged. Try a PWR!Moves Group or PWR!Moves Circuit class to get ideas; visit a PWR! Therapist to have a comprehensive personalized program developed; or visit us in Tucson, AZ at the PWR!Gym® for an exercise intensive and get your own personalized program that you can take back with you to your therapist or fitness professional.

When should I begin participating in PWR! exercises?

Immediately after diagnosis or now. People don’t realize they aren’t moving well, or that they are reducing their activity levels and dropping out of their favourite activities. The sooner you learn how to practice PWR!Moves the better. You can always be challenged more physically and cognitively during exercise. Every time you have your meds adjusted you should also schedule another visit with your PWR! Therapist!

Remember stress and illness impact the nervous system in someone with a neurodegenerative disease more so than healthy controls, and can even negate the benefits of exercise! So, take care of yourself, make time for YOU. It will be worth the quality of life benefits in the long term.

This content was published in the Fall 2015 edition of our quarterly magazine, Viewpoints. The content was accurate as of this publication date.