I Love Neuro

What would you do differently if you started your business all over again today? In this episode of I Love Neuro, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, talk with NeuroBiz Coach Emily Duval Ledger, who is marking 20 years of entrepreneurship, about the lessons they'd hand to their newer business-owner selves. Claire pushes back on the premise, since you couldn't make today's decisions without the experiences that got you here, and the conversation turns to what actually matters: getting started, expecting your business to change as your life does, and learning to tell the difference between work that is simply hard and work that is a square peg in a round hole. All three open up about how the desire to be liked led them to pay early team members more than the business could support. They also cover why buying enterprise-level software or hiring consultants before you understand your own needs can drain your budget, and why you should keep at least a toe in the parts of the business you hand off, from bookkeeping to SEO. Claire shares how she uses AI tools like Claude to research market pay, map out a hiring process, and think through decisions between coaching sessions, and why her most useful thinking partner turned out to be her therapist rather than someone with strong business opinions. Emily reflects on quieting the persistent voice that says she should want more, and Erin describes searching her own brain for answers before looking outward. The episode closes with a parable about a farmer and his horse, the seasons of running a business, and a reminder to appreciate what's special about the stage you're in right now, even if that means enjoying a midday nap while your schedule is still filling up.

What if freezing of gait isn't a late-stage problem at all, but something already taking shape at the moment of a Parkinson's diagnosis? In this episode, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, talk with Becky Farley, PhD, MS, PT, founder of Parkinson Wellness Recovery (PWR!), and Jennifer Bazan-Wigle, PT, DPT, CEEAA, physical therapist at the PWR!Gym in Tucson, Arizona, about what the PWR! team learned while building their World Parkinson Congress poster on personalized freezing of gait interventions for freezers and non-freezers. Becky explains how digging into the underlying mechanisms convinced her that gait and balance must be targeted seriously from diagnosis. Those mechanisms include interference and loss of automaticity, perceptual processing dysfunction, abnormal coupling of posture and gait, and executive dysfunction. She also explains why she now adds psychological stress to that list and why stress management, medication optimization, and aerobic intensity form the foundation for building resilience. Jen describes how the PWR! team flags higher-risk patients early, how they run consecutive-day freezing intensives each month within an insurance-based model, and why group classes may be key to holding onto those gains. Claire shares how her team at Rogue screens for freezing using 360-degree turns and step counts during gait speed testing, and why anxious movers often resist the very classes that would help them most. The conversation also covers a new standardized freezing of gait assessment now in validation, a large South Korean cohort linking earlier rehab referral to lower mortality, and why the ability to control rhythm, including moving slower than comfortable, may be an underused screen and treatment target. Resources mentioned in the episode, including an image of the poster and Becky's reference list, are linked below.
https://www.pwr4life.org/fog/
Freezing of Gait (FOG) Poster, FOG Assessment & Video examples, FOG Mechanisms w/ Video Examples
FOG Resources from WPC for our FOG posters
This includes a page of NEW FOG relevant REFS and LINKS.
https://www.pwr4life.org/floortransfers/
 
References:
Gülke E, Lewis SJG. What is new in Freezing of Gait?. J Neurol. 2026;273(4):222. Published 2026 Mar 21.
doi:10.1007/s00415-026-13765-6
Gilat M, Nonnekes J, Factor SA, et al. An updated definition of freezing of gait. Nat Rev Neurol.
2026;22(3):172-181. doi:10.1038/s41582-025-01179-3
Tosserams A, Fasano A, Gilat M, et al. Management of freezing of gait - mechanism-based practical
recommendations. Nat Rev Neurol. 2025;21(6):327-344. doi:10.1038/s41582-025-01079-6
Gaveel TJ, Postma EM, Bloem BR, et al. The SENSS (Stress, Exercise, Nutrition, Sleep, Self-management)
study: study protocol for a randomized controlled trial to evaluate an integrated, personalized and stepped care
lifestyle approach for people with Parkinson's disease. Front Neurol. 2026;17:1752073. Published 2026 Mar 3.
doi:10.3389/fneur.2026.1752073
Goltz F, van der Heide A, Helmich RC. Alleviating Stress in Parkinson's Disease: Symptomatic Treatment,
Disease Modification, or Both?. J Parkinsons Dis. 2024;14(s1):S147-S158. doi:10.3233/JPD-230211
Johansson ME, Toni I, Bloem BR, Helmich RC. Parkinson's disease progression is shaped by longitudinal
changes in cerebral compensation. Brain. 2026;149(1):194-208. doi:10.1093/brain/awaf302
Lindholm B, Hagell P, Odin P, et al. Balance and gait disorders in de novo Parkinson's disease: support for
early rehabilitation. J Neurol. 2024;272(1):11. Published 2024 Dec 12. doi:10.1007/s00415-024-12804-4
Tosserams A, Bloem BR, Ehgoetz Martens KA, et al. Modulating arousal to overcome gait impairments in
Parkinson's disease: how the noradrenergic system may act as a double-edged sword. Transl Neurodegener.
2023;12(1):15. Published 2023 Mar 26. doi:10.1186/s40035-023-00347-z
Tosserams A, Fasano A, Gilat M, et al. Management of freezing of gait - mechanism-based practical
recommendations. Nat Rev Neurol. 2025;21(6):327-344. doi:10.1038/s41582-025-01079-6
Yoon, S.Y., Chang, SY., Heo, SJ. et al. Timing of rehabilitation therapy initiation and all-cause mortality in
parkinson's disease: nationwide cohort study. npj Parkinsons Dis. (2026). https://doi.org/10.1038/s41531-026-
01495-5
Zhang M, Zhang Y, Zhang Z, et al. Effects of mindfulness-based exercise on Parkinson's disease and
Alzheimer's disease: a systematic review and meta-analysis. Front Neurol. 2
Parkinson's Weekly with Dr. Bas. Bloem – Podcast
EP 36 – Think Gut: Why Parkinson's Medication Sometimes Stops Working
nosilverbullet4pd
The Brain's Backup Plan: The Power of Neuroplasicity in Parkinson's with Dr. Rick Helmich
https://youtu.be/UHXxEz88_s4?si=zHJXako9ao2LUlI5
Parkiknson's Disease: Managing Stress with Parkinson's Disease with Dr. Rick Helmich
https://youtu.be/jZDnSyr1qAU?si=IUBbWqmYZaYVP6PB

What does it take to get a piece of high-performance sports tech out of the soccer world and into the living rooms of people with Parkinson's? In this episode, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, talk with Christoph Dressel, founder and CEO of Mimofit about the reaction-based light-pod system his team built after clinical trials in Spain showed real gains in dual-task performance, gait speed, and reaction time for people with Parkinson's. Christoph walks through the surprising finding that reaction-speed improvements only showed up once a timeout was added to force time-pressure. Plus he shares how Mimofit's coach-versus-home-use model differs from other tools on the market, how the devices are built rugged enough to step on yet simple enough for everyone, why they market direct to consumer, the newer symbol- and number-based cognitive games rolling out through app updates, the affordability as well as HSA/FSA eligibility, and his partnership with Rock Steady Boxing — plus an open invitation for coaches and clinicians to shape which games get built next.
Linkedin: https://www.linkedin.com/company/mimo-fit/
Instagram: https://www.instagram.com/mimofit.parkinsons/
Facebook: https://www.facebook.com/people/Mimofit/61572605414962/
Email: chris@mimo.fit

What if the key to helping a patient with Parkinson's find their voice again isn't more repetition, but movement? In this episode, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, talk with Jessica Ackerman, MS, CCC-SLP, RYT, speech-language pathologist and founder of Speak Steady, about why the classic Parkinson's presentation so often goes untreated, and how a technique born out of a pandemic-era Zoom yoga class became a clinically validated, self-paced communication program. Jessica walks through the neuroplasticity and motor-learning principles behind pairing each spoken word with a movement, how posture and breath mechanics directly power vocal loudness, where Speak Steady differs from voice-isolated approaches like LSVT LOUD, and why so few people with Parkinson's ever make it into speech therapy in the first place given long wait times and a national shortage of SLPs. The conversation also touches on early, easy-to-miss signs of swallowing difficulty and how PTs and OTs can use Speak Steady as a low-lift referral option for patients who may never see a speech therapist otherwise.
Speak Steady: www.jessicaackerman.com
Link to Speak Steady: The Parkinson's Voice Reset : www.jessicaackerman.com
Info flyer Speak Steady: https://drive.google.com/open?id=1bigUtWvw6taGpgc2d2jglYQfVHkI-pVz
Instagram: https://www.instagram.com/breathespeakmove/

Have you ever worked with a stroke survivor or patient with spinal cord injury who had swollen limbs and not been sure what to actually do about it? Maybe you tried something, maybe you didn't because you didn't realize you should.  In this episode, host Erin Gallardo, PT, DPT, NCS, talks with Rachel Walker, PT, DPT, GCS, CLWT, CBIS about why edema is so common — and so consequential — in the neuro population. Rachel walks through why unmanaged edema leads to pain, joint contracture, and long-term functional loss; how to run a full assessment (girth measurements, skin and lymphedema staging, and a bedside ABI to rule out arterial insufficiency before compressing); and what actually gets patients to stick with their compression, from donning aids to garment length and brand selection. Whether edema management has felt like an afterthought in your practice or you're looking to sharpen your clinical reasoning around it, this conversation gives you a clear, practical framework to start using right away.