On Tuesday, January 13, members of the Nuvance Health team visited Newtown Senior Center to talk about Parkinson’s disease and the stigma surrounding it head-on. Alyson Iolin and Olivia Longo, two occupational therapists for Nuvance Health, presented an in-depth presentation about how Parkinson’s can affect people differently.

“As people age, people become more familiar with Parkinson’s, but it does, in fact, impact people who are younger as well,” Iolin said. She also noted that the disease is now “more widely recognized” than in years past.

Longo described the disease as a “progressive, neurodegenerative movement disorder caused by the loss of dopamine-producing neurons in the brain.” Longo explained that while most people know dopamine to be mood-related, it also plays a key role in ensuring smooth and in-control movements.

“Without that dopamine, you’re going to see certain signs and symptoms of movements that are not as smooth and controlled,” Longo said.

Iolin explained some physical symptoms of Parkinson’s people can experience. She explained that bradykinesia, or slow movement, is often a sign of Parkinson’s. The brain can sometimes struggle to “initiate movement,” and when movement is initiated, it can be slower than a regular walking pace. Rigidity, postural instability, and balance issues can also affect people with Parkinson’s.

“As occupational therapists, a lot of our patients come in due to frequent falls. We like to see our patients before the falls happen and work towards educating on fall prevention,” Iolin told the crowd. However, fall recovery is also part of Iolin and Longo’s work.

Iolin expanded on this thought, saying a lot of people associate Parkinson’s with freezing or tremors, but cognitive symptoms are often just as characteristic of the disease as motor symptoms. Sleep disturbances are one of the most common cognitive symptoms people with Parkinson’s experience. In fact, it is usually the first symptom neurologists hear about from patients.

Emotional changes, like depression or anxiety, can also show up as a person battles with Parkinson’s due to the lack of dopamine. Some patients also experience issues with memory, concentration, or multitasking.

“We’ll hear patients say, ‘I used to get up and used to be able to pay the bills and take my meds and manage my whole medical calendar kind of subconsciously. That was just part of my routine, now things are taking longer. I’m getting a little bit confused,’” Iolin said.

As occupational therapists, Iolin and Longo try their best to help patients adjust and “function [as] safely and independently as possible in your home routine,” as Iolin said. The therapist and patient work together to modify the environment and create safety within the home.

Some patients take photos or videos of their bathrooms, hallways, stairwells, and other areas of their homes to show the therapist. The occupational therapist can then see exactly what the patient struggles with or needs help modifying to continue the patient’s independence and ensure safer daily living.

Energy conservation is also a big part of managing Parkinson’s. Iolin suggested patients take a look at all their activities and daily responsibilities and spread them out throughout the day so that “you’re not stacking all of your really taxing activities at the front of the day.”

Patients also need to be implementing these strategies at home because occupational therapy requires patient work and consistency outside of the office to really take hold. Sometimes a caregiver will be brought into the picture, some therapists have patients say things out loud, and some create checklists as extra reminders.

Then, the hour presentation went from lecture to full-on workout. The LSVT Big program, or Lee Silverman Voice Treatment, is a structured, highly intensive program that helps reteach the brain how “normal movement should feel,” as Longo put it.

Longo said that occupational therapists see “objectively huge improvements from day one of the session to day 16.” The program is 16 sessions: four times a week for four weeks straight. Patients are then encouraged to continue working on the LSVT Big program at home, ideally every day.

“This is one of my favorite treatments to be working with patients on because you see such a big change, not only in their motor control, but also their affect, their mood, their confidence, and just their motivation to get back into activities that previously were daunting or scary,” Longo said.

She then instructed the crowd to push their chairs back from the table and began with some LSVT Big movements. The program combines movement, thinking, and speaking to reconnect patterns in the brain to keep people living with Parkinson’s moving. The idea behind the movements is to make them as big as possible, hence the “Big” in the treatment title. Patients are also encouraged to count their reps loudly, as voice control can be lost with the development of Parkinson’s.

The first movement Iolin and Longo walked the crowd through is called “floor to ceiling.” While seated in a chair, participants spread their arms out in front of them as far as they can go, then touch the floor, if possible, with their hands. Then, participants reach nice and high to the ceiling. The arms then get stretched out to each side with the fingers spread apart as well — this pose is held for ten seconds.

Then, Iolin and Longo showed the group the “side to side” exercise. This is another seated exercise. Participants reach out with one arm, and then swing the arm over to the other side. As they swing, their body twists and the leg comes into a supported lunge pose. The arm reaching out is then pulsed up and down ten times, with participants counting each rep out loud. Then this exercise is repeated on the other side.

After the brief exercise, Iolin and Longo explained that sometimes patients come back to the LSVT Big program to “recalibrate” the brain. The two shared that they see a lot of positive changes in patients who go through the training.

“With the commitment and the proper compliance, we always see some sort of gain, even if it’s just awareness of symptoms,” Iolin said. Iolin and Longo then talked a bit more about the difference between occupational therapy, physical therapy, and speech therapy to help patients manage Parkinson’s symptoms.

Occupational therapy is function, while physical therapy is for mobility, strength, and endurance. Speech therapy helps patients with their speech and communication, but also with swallowing, as Parkinson’s can affect a person’s ability to swallow safely and successfully.

The program ended with Iolin and Longo suggesting some places where patients can find support. One of those places is Trumbull YMCA; the Y offers “Rock Steady Boxing,” a program designed to help those with Parkinson’s through non-contact boxing. Classes are ongoing and are completely free. YMCA membership is not required. For those who are interested and would like more information, contact Joanne Orenstein at jorenstein@cccymca.org.

Newtown Senior Center also offers a Parkinson’s support group on the first Wednesday of the month, 1:30 pm.

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Reporter Sam Cross can be reached at sam@thebee.com.