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Therapy leads to results for Parkinson’s patients (sponsored)

Moving Big & Loud Meets weekly at SNMH Neurological Rehab Center

1345 Whispering Pines Lane Includes 45 minutes movement therapy and 30 minutes vocal therapy First class is free $60 for eight sessions Call SNMH Neurological Rehab Center at 530-274-6170 for information.

Every week, they gather together. Some move through their exercises with relative ease, while others struggle with each movement. Regardless of their capabilities, each person offers the others encouragement, applauding success and commiserating the challenges as they face the diagnosis that unites them all — Parkinson’s Disease.

This weekly gathering is the Moving Big & Loud class — just one of the treatment options available at the Outpatient Neurological Rehab Center of Dignity Health Sierra Nevada Memorial Hospital for those living with Parkinson’s.

Sometimes the class has a handful of participants, sometimes there are nearly two dozen. But they always meet with the same goal: To ease their journey with Parkinson’s through physical activity and emotional support.



“The feeling of being in a group of people who understand what you are going through and support you unconditionally is invaluable,” explained class instructor and SNMH physical therapist Maggie Edwards. “Parkinson’s can be an isolating and lonely condition. This group is one step toward counteracting that.”

Parkinson’s is a chronic and progressive movement disorder, meaning symptoms continue and worsen over time. While symptoms can vary from person to person, common effects of the disease include tremors of the hands, arm, legs, jaws and face, slowness of movement, stiffness in the limbs or torso, and impaired balance and coordination.




As many as one million Americans are living with Parkinson’s, according to the Parkinson’s Disease Foundation. Approximately 60,000 people will be newly diagnosed every year.

Here in Nevada County, the need for Parkinson’s treatment and support is great.

“Over the years we’ve been surprised at the large number of people in our small community who have accessed our services due to their Parkinson’s diagnosis. And, in addition, we know that there are even more people out there who could benefit from the services and expertise we offer,” said Edwards.

The Parkinson’s-related services offered by SNMH include physical, occupational and speech therapy.

The process starts with a referral from the patient’s doctor, followed by an individual evaluation with one or more of the SNMH Neuro Rehab staff.

Recommendations for therapy generally follow one of two paths. Patients may choose to participate in one or more of the therapies one to two days a week for a prescribed number of weeks working on activities, exercises, and strategies focused on their predominant impairments or challenges.

For those willing and able to make the time commitment, SNMH therapists also offer an intensive program referred to as the “4×4”.

“We call it the 4×4 as it refers to therapy sessions provided four days a week for four weeks,” explained Edwards. “It is a pretty strict program. With the help of certified therapists, the program targets movement patterns, exercises and carryover assignments for home that help patients to overcome the small, slow movements and low, soft voice that often accompany Parkinson’s. For patients able to commit to it, the 4×4 can be very beneficial.”

Once patients complete their initial, individualized program, they can continue therapy in a group setting by attending Moving Big & Loud classes.

“When working with one of our physical and/or occupational therapists we have our patients focus on BIG movements because a common trait of Parkinson’s is that the brain doesn’t accurately transmit messages about how the body is moving,” said Edwards. “So a person may feel as though their movements are big enough, but they actually aren’t. This can lead to difficulties getting out of a chair, walking, balancing, and it increases the risk for falls.”

Another common complaint of those living with Parkinson’s is that their friends and loved ones can’t hear them.

“People living with Parkinson’s often have low volume, monotone speech and monotone pitch,” explained Anthony Garafolo, Speech Pathologist at SNMH. “They come to me saying, ‘People can’t hear me, I have to repeat myself.’ It’s frustrating and can affect their relationships. In therapy, we work on having a big voice, focusing on functional phrases they can use all the time, like ‘I love you.’ It’s really remarkable the relief this can bring our patients. It allows them to re-engage in their own lives.”

Moving Big & Loud incorporates many of the current evidence-based therapies shown to be effective for people with Parkinson’s.

“We use vocal strengthening exercises, Tai Chi, dance, boxing — anything that has been identified as helping to minimize Parkinson’s symptoms,” said Edwards. “We always try to make the activities fun because, as with most things, people are more motivated to stick with activities that they enjoy.”

Edwards and Garafolo agree that while therapy can help Parkinson’s patients at any stage, the greatest benefit is seen when therapy begins early in the diagnosis.

“One of our greatest challenges is to get patients referred to us as soon after initial diagnosis as possible rather than waiting until things get bad — years of falling, years of not being heard,” said Edwards. “But Because research has shown that the sooner you learn the techniques to counteract some of the most common impairments, the better chance you have of slowing down the decline and negative impacts of the disease.”

In fact, according to Edwards, research has shown that intense exercise can provide similar benefits as those received with common Parkinson’s medications.

One more reason that this small weekly gathering is having a big impact on people’s lives.

“We hear all the time about the positive impacts that therapy and the Moving Big & Loud class has on our patients’ lives,” said Edwards. “When they return from a vacation and tell us that they were able to keep up with their family members and they weren’t limited by their Parkinson’s … Well, that is pretty wonderful!”

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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