♪ Bob and Brad ♪ ♪ The two most famous ♪ ♪ Physical therapists ♪ ♪ On the internet. ♪ – [Woman] Go ahead. – Hi, I'm Bob Schrupp, physical therapist. – Brad Heineck, physical therapist. – And we are the most
famous physical therapists on the internet.
– In our opinion, of course, Bob.
– The camera's so far away. – I know.
– I bet you guys can barely see us. – Yeah, this is nice
though, Bob, we get some… I feel like I'm out in Wyoming. – Yeah, all right. Now, today, Brad, we're gonna talk about Parkinson's and CVA after a stroke. The gait training or
balance training, right? – Right, this is gonna be more for people that are up and walking. It's not if you had a stroke and you have a lot of weakness
where you cannot walk. You're already walking
with a cane, typically. – This is higher level balance stuff. – Right and for people with Parkinson's, oftentimes you get that tremor where that one foot will
feel like it's stuck.
And these are some things to get that. So you can get back to that pace.
– Movement? – Right, that movement that is more the way it should-
– Natural? – Natural, exactly. I can't find my words today, Bob. – Yeah, you'll find them. They'll come to you. – Okay, now the other thing
about this I like, Bob is all of these you can
do at home, you know with a family member that's, you know physically fit and able to help properly.
– Right and that's not gonna fall if you fall. – Right, exactly, you are
gonna need a gait belt or a belt that you can
help with so that… 'Cause this is gonna challenge your walk and then their balance a little
bit and you wanna be safe. – Brad, before we get started, though if you're new to our channel,
which a lot of you are, make sure that you
subscribe to us, it's free. It's helpful. And we upload a video
every day in the evening. So these all are gonna
help you get strong, healthy, fit, pain free. – And safe. – And safe.
– Exactly, so we'll get on with it here. What you're gonna need is
some tape and a hard floor. You won't be able to do
this on carpet so well and you can see down on the floor, you got this, Lonnie? I've taken… You can use anywhere from
at least four feet of tape or you can go longer if you want. You'll see in just a minute, why? And you put tape, I got
these two feet apart.
They're four-foot long. Again, longer is fine. And we're gonna use this for visual aid, for balance and gait. Now Bob is gonna be-
– I put my own gait belt on. – Yeah, he's put his own gait belt on. He's gonna be the patient. And we'll… Again, this could be for either stroke or Parkinson's on this
particular exercise. Bob's gonna be using the cane.
– I bet you it's not long enough for me. Oh, it is long enough for
me, you made it long enough for me. – Bob, you know, and if you're the family members instructing, we're gonna go like this,
toes right on the red line. Yep and we're gonna go sidestep and you don't wanna drag your feet. Okay? – So picking my feet up? – Exactly, you're gonna use the
cane if the person's wobbly, that's why you got the belt
on, you're gonna hold here and you're gonna stand back-
– So I go both directions, I take it, Brad? – Yep, both directions for sure. Okay? And you may find one direction is considerably harder than the other. So keep working it. You can emphasize the
direction that goes harder. Bob, your toes are getting past the red line.
– Oh, I'm supposed to stay behind it?
– Yeah. Sometimes with a stroke,
the vision is impaired and you wanna assess that as well. – Okay?
– Okay. Now we're gonna use the same lines and we're gonna step over the top.
Okay?
– Okay. – With Parkinson's you're
gonna emphasize big step, bring it up and over. And we're gonna come over imagining that the tape is a two by
four and you wanna lift over the top of it and then to here and then we're gonna come to here and then we're actually
gonna go backwards. Now, going backwards
may not be appropriate for some people, depends on their level. – This is a very good exercise for someone who has Parkinson's. Because if they can try to visualize it, they're gonna go over something, it does help them get moving. – Exactly, lot of things going on with the person's…
How they're thinking about the task. Go backwards, Bob. Now Bob's going to step two pattern. So he's going here and he's
stepping to the other foot. Go again. If this is too easy and step
over the line again, Bob. If they're doing really well at this, you may wanna do the step over step. So here and then over the
other line, and then to here.
– Gotcha, so I'm going up- – They're high steps,
Bob, keep the feet up. Good, and one verbal
cue that I find helpful, I'm working with this on
one of my patients right now she responds well to, "Think
about striking with your heel." And when the heel comes
down, that just offers… It makes people think
about coming up higher. It does with this person. Everyone's a little bit different. – So more of a normal gait pattern too, a walking pattern, just
to hit heel strike first. – Exactly. – As opposed to going toe first. – Yep and sometimes the
muscle memory kicks in and things start going back.
– And that's what we're trying to shoot for.
– Exactly, all right. Now, Bob, why don't you have a seat? – Okay. – The next one, go to the store and just a hardware store will
typically have shelf liner. I can get the 20 square feet for about $5. Take a plate outta your cupboard and cut four round shelf liners. Just like this-
– This is really a good idea by the way. – Yeah, and the shelf
– I'm really impressed, Brad. – Yeah, the shelf liner
has a couple of benefits. Get a color that contrasts with the floor.
You're gonna put these
four shelf liners here. They grip. So when you step on it, they don't slip and down you go. – Here, we spend all this money on Dycem and we could just buy shelf liner. – Yeah, Dycem is a product
that therapists use and it costs about 10
times as much as this and it doesn't work too
much better. (laughs) – Right, exactly. – Okay. – That's a great idea, Brad. – If you can get it in
different colors, better yet, particularly for stroke
people 'cause their vision… You might find something
about their vision. Some people have a problem
with detecting a certain color. – Sure. – Alls I could get was black
and it'll be fine for here. We're gonna have Bob stand on here. – Okay.
– Okay. Now you're gonna try and
step all the way to this one. And then to here.
Bob's a tall guy, so we
got these farther apart. – So normally you might start a lot closer-
– Right. You may have these only, you know, six inches apart to start-
– To start off with? – Yep, Parkinson's people, if they're easy then you definitely wanna get 'em bigger and farther apart.
– Right, yep, a big spread out program.
– Exactly. – You wanna really
encourage wide movements. Right, so these may start here and then work their way
out depending on the level of the person
– Sure. – How good they are. Now, we're gonna go this
way, Bob, to your left, okay? Well, this one's gonna be tough. Yeah, going backwards, you know 'cause you do need to step backwards and this may not be
appropriate for some people. You just skip it if it's not
gonna be safe, there you go. Good Bob, now you're gonna
go the other direction. – Oh (laughs).
– See, if you're gonna go clockwise, you gotta go counterclockwise. Go both directions. And this really helps tune
in all facets of movement. – Definitely the hardest is going back, – Yep.
– For sure. – Now we're gonna do kitty corners. We're gonna go from here to there. That's a big step, isn't it Bob? – Yeah, it is.
– Yep, so this-
– All right, now what? – Now we're gonna go back, back where you came from.
– Oh good Lord. (laughs) – There you go. Okay, now you're gonna
– I gotta go this way? – Yep and now we're gonna complete it. Complete the X here, there you go. And then back again. Good, so realistically, probably you're gonna start
– More like that- – Exactly-
– Right. – Yeah, this would be a lot
more manageable for more people to start off than going-
– Exactly- – And then this side-
– Nice work, Bob. – I'm making quick work of it. – And this is very similar, if they have any dance, this is serious. If they have any history of
dance and they did the waltz.
– Sure. – This is very similar- – Similar steps-
– To the steps in that and that might be therapeutic in itself. – Nice idea, Brad-
– Have you been waltzing, Bob? – Oh, I did polka when
I grew up, but no waltz. – I think you could get
the polka out of that too. Next, we're gonna get some cones. Now at home, you probably
don't have these therapy cones. Just get some soup cans,
that works just as good. Try and get some
different color soup cans, if you can-
– You can even wrap 'em- – Sure-
– In colored paper. – Yep, yep, exactly. If you got duct tape,
that's always kind of fun, kinda expensive compared
to construction paper and you're gonna set 'em
up in a pattern like so- – Now-
– Okay? – Brad. – Now we're working on turns, Bob. I'll demonstrate first.
– Okay. I'm gonna right turn here. A left turn here. And we're gonna go all the way around and then a right turn here and then a left turn
here all the way around and we're gonna come back.
– All right.
– To where we started it. – So I'm working my way around. – Yep. – Taking good steps, going all
the way around on this one. – Yep, yep. – Now this is… You know, actually some of
the tests we do on people to determine whether or not
they're a high fall risk is we make 'em turn all
the way around in a circle. 'Cause it is hard for
a lot of people to do. – [Brad] You know, it can get the… The ears can come into effect
with some dizziness, possibly, the visual part. – Oh, I'm going back here-
– On this way, Bob. – [Bob] And now I'm going this way. [Brad] I was just working this week with one of my patients
and I'm right there. I'm holding here.
I'm giving verbal cues. 'Cause a lot of times they'll
forget where that one leg is. And then, you know, tip that over. – This is definitely
gonna be a difficult thing for a lot of people to do, all those turns
– This is… Bob you're right in front… – [Bob] Oh, sorry. (laughs) – This is advanced. This is getting someone ready
to go home by themselves.
Getting ready to go out in public, okay? Another thing I do is
if I can get someone out in the hallway where there are
other people walking around then I'll walk with them there because-
– Yes, you want 'em distracted. – Right, see how they do
when they're distracted by people-
– We'll even have 'em walk and even have 'em look over this way and look down this way
and look down that way because all that throws you
off when you're walking. – Yeah, if you're all by
yourself and you can concentrate that's one scenario, but
it's completely different, you know, in a realistic scenario.
– You gonna make a call, Brad? – No, yeah, I gotta call my wife. She's having a baby. I'm just kidding. (laughs) Okay, with the cell phone technology, you can get a metronome very easily. Metronome app.
– Okay.
– And they're free. If you're a music person, you might have the old fashioned mechanical metronome that goes back and forth. And let's see if I can get this dialed in. – So what the metronome is gonna do it's gonna help somebody with Parkinson's. It seems that that very
steady beat helps them walk. And sometimes when they get stuck, if you start playing that
beat, it'll help 'em go. – Right, I just had someone,
he always gets stuck when he goes through a narrow doorway. His feet just lock up and he
can't get his right foot going. I walked with him with the metronome. He went right through it without stopping. – And nowadays with
everybody having a smartphone you could set that up on your own phone. That even you feel like
you get stuck in the door, you could just start playing it. – So you're probably gonna be
around 80 beats per minute. Okay? Let's get this one going. – Are we gonna be able to hear it? – No, no, no, we'll find out.
I think so. – Put it on your mic.
(metronome ticking) Oh yeah, you can hear that. – Okay, Bob, let's get going. You gotta find the rhythm,
everyone's a little different. Let's see what you got. If you're at 83 beats. Bob, you're only doing half time. We wanna go one, two, three, four. – Oh, I was doing half time. – Yeah, so each step is gonna… So right, left, right, left. Right, left. And you can have a little fun with this. Get the person to laugh a little bit. You don't dance much. Do you, Bob? (laughs)
– No, I don't. (hums) – There you go. But seriously, this can
be a real effective tune and it's so good-
– That's a really good hint. – Yeah, it is-
– And like I said, it's so prevalent now. Whereas before it'd be
tough to come up with these. How do you turn it off-
– You're trying to get it to stop.
(laughs) All right. So good luck with these at home and I'm sure your friends will love them.
– Be safe. Remember, always use the belt. – Yeah, the gait belt.
– All right, thanks..
