Transcript
Wendy Terry (00:04):
Hello, I'm Wendy Terry with Practical Neurology. I'm joined today by Dr. Nina Mosier, co-founder of Power for Parkinson's. Welcome, Dr. Mosier, to Amplifying the Patient Journey.
Dr. Nina Mosier (00:19):
Hi, Wendy. Thanks for having me.
Wendy Terry (00:21):
Excellent. Dr. Mosier, can you share the story of your father's journey with Parkinson's disease and how it inspired you to co-found Power for Parkinson's and what Power for Parkinson's is?
Dr. Nina Mosier (00:35):
Sure. I really saw my father face every symptom of Parkinson's disease throughout his journey. He probably had Parkinson's for over 16 years, so I saw everything from the early stages all the way through to the end.
There were a lot of takeaways, but one of the biggest was observing how movement really changed his life. There weren't very many resources available when I started Power for Parkinson's in 2013. Just observing him and seeing the possibilities inspired me to try to make a change.
Wendy Terry (01:27):
You said you really saw what movement did for your father. Was there something prescribed for him, or was it part of his own journey of trying to keep moving? Can you tell me a little bit more about that?
Dr. Nina Mosier (01:47):
Yes, sure. He was a very sedentary person and really did not like physical activity. That was something he never did on his own. But he was prescribed a specific type of Parkinson's-focused physical therapy called the LSVT BIG and the LSVT LOUDprogram, and on his doctor's advice he went ahead and completed it and saw a lot of progress.
What happened, though, is that like most physical therapy programs, the number of sessions was limited. When he finished what his insurance would cover, he really didn't have a way to keep it up. He was given exercises to do at home, but he wasn't motivated to continue on his own. You could see the progress he made, but after a few weeks he gradually returned to his previous state.
Wendy Terry (02:48):
As an internist with a special interest in geriatric medicine, what other gaps in care or support did you see? It sounds like he ran out of benefits for those movement programs. What other gaps were there?
Dr. Nina Mosier (03:08):
This is a problem throughout the medical world, being a doctor myself. There are communication issues and challenges in assessing the home setting, as well as the caregiver support that's available.
For my mother, who was caring for him, it was often difficult to know what resources were available, recognize what support was needed, and understand the options. I think that's an issue not only in Parkinson's disease but in many progressive neurological conditions. That can be a big issue for people.
Wendy Terry (03:55):
Great. Can you tell our audience what is Power for Parkinson's?
Dr. Nina Mosier (04:01):
Yes. Power for Parkinson's is a nonprofit organization, and we offer free exercise classes, support groups, and social opportunities for people with Parkinson's disease.
Our goal is to help people manage their symptoms and, in some cases, improve or even reverse certain Parkinson's symptoms through exercise and movement. We started as a local nonprofit in Austin, Texas. After a few years, we launched a YouTube channel in 2015 alongside our in-person programming.
Not only have our in-person classes expanded to 9 locations in our area, but our YouTube channel has grown tremendously and now reaches people around the world.
Wendy Terry (05:00):
When you started it back in 2013, did you have any idea it would become a global program?
Dr. Nina Mosier (05:10):
No, not at all. We didn't know what to expect. We started with three classes and about 30 people. Our instructors were working for free. They agreed to give it a try. I trained them about Parkinson's disease. They were group fitness instructors and had been teaching for a long time. Together we developed a process.
Locally, it caught on very quickly. Neurologists started seeing significant changes in their patients, so they became strong supporters and started sending their patients as soon as they were diagnosed.
We kept trying to grow and reach as many people as possible. One of the other gaps we recognized was transportation, which can be a major challenge for people with Parkinson's disease as they get older. As people get older and experience more mobility challenges, getting to classes becomes more difficult. We've always tried to make our programming as accessible as possible. We have multiple locations to reduce travel time, and our YouTube channel allows people who can't leave home to participate.
We never imagined how large it would become. YouTube is remarkable; the internet is remarkable. I thought we were big before the pandemic, but with the pandemic, our growth accelerated tremendously.
Wendy Terry (06:53):
That's excellent. From a local area in Austin to a worldwide audience because of technology—that's a marvelous story. Can you talk a little bit about what types of physical improvements individuals with Parkinson's disease can expect when they begin a structured exercise program?
Dr. Nina Mosier (07:14):
Certainly. I want to start by saying that over the past 13 years, the evidence has become increasingly clear that exercise is one of the most important interventions for Parkinson's disease. Many physicians and researchers now describe exercise as "the prescription" for Parkinson's disease.
Numerous studies have demonstrated its benefits. Exercise can improve motor function. People with Parkinson's often develop a shuffling gait, and exercise can reduce shuffling, improve walking speed, and help overcome freezing of gait, when the feet feel stuck to the floor.
Exercise can also improve cognitive processing. We use aerobic activity and cognitive challenges in our classes, which may help promote neuroplasticity and support the development of new pathways in the brain. That can make everyday activities easier and more accessible.
Speech can improve as well, since many people with Parkinson's develop softer voices. We've also seen improvements in posture and overall function.
One example that stands out is a gentleman who joined us at around age 84. After about a month, he was walking with much more confidence. He also told us he could use his computer mouse again, something he hadn't been able to do before. That was a striking example and helped motivate him to keep coming back week after week.
Wendy Terry (09:22):
That's a great segue into my next question. How do different forms of exercise support different aspects of Parkinson's symptoms?
Dr. Nina Mosier (09:33):
I love that question. Exercise research is difficult to assess in general, but a lot of the Parkinson's exercise research focuses on walking, running, treadmill training, or stationary cycling, and there's strong evidence that vigorous exercise and increased exertion are beneficial.
But there are many different forms of exercise that can help. People may be familiar with boxing for Parkinson's disease, dance programs, or even table tennis. We offer both dance and table tennis as part of our program.
Many of these activities involve using opposite sides of the body and crossing the body's midline, which may help stimulate neuroplasticity. We also incorporate a cognitive component into all of our classes. Participants may be doing a movement pattern while counting by threes starting from one, for example. It's challenging for everyone, but it can make a real difference for people living with Parkinson's disease.
Overall, we see improvements in processing, coordination, and function by using these different exercise modalities. I hope that answers your question.
Wendy Terry (11:21):
That completely answers it. I also love your comment about crossing the midline. You see a lot of that in various movement traditions and exercise disciplines. It makes a lot of sense.
You've talked about fine motor skills, speech, and broader movement patterns. Beyond the physical gains, how does regular exercise affect emotional health and quality of life for people with Parkinson's disease?
Dr. Nina Mosier (11:54):
One thing I'm especially proud of at Power for Parkinson's is the sense of community we've built.
In our in-person classes, everyone is welcomed, everybody knows each other's names, and people feel connected. That's one of the great benefits of group exercise. For anybody who doesn’t have access to a Parkinson's class, a group fitness class, a senior fitness class, or something like that would be a great option.
We've also developed strong connections with people who participate through YouTube. We answer every comment and regularly communicate with people online. Sometimes our instructors will mention participants by name. People call our office with questions, and we answer the phone ourselves.
An unusual bond has developed with our virtual audience. We get to know the people, even if we don't meet face-to-face. Occasionally, we’ll do Zoom calls where we actually see the people. People like knowing that there is someone out there who is there for them who will listen to their suggestions and concerns and who respond. We always try to respond as quickly as possible. I think that social connection helps people communicate, and it makes them feel happier.
Wendy Terry (13:45):
That's excellent. You mentioned the pandemic earlier, and I think most of us now understand the effects of isolation after living through that experience. People with Parkinson's disease can often feel isolated because of the challenges they face, so having that community network is an incredible asset. Thank you for providing that service.
Dr. Nina Mosier (14:24):
Thank you.
Wendy Terry (14:25):
Power for Parkinson's offers classes completely free of charge. Why was it so important to keep the program financially accessible?
Dr. Nina Mosier (14:38):
That goes right back to accessibility. We wanted to eliminate as many barriers as possible.
To be honest, when we first started, many people didn't believe the model could work. We even presented at the World Parkinson Congress, and people would stop by and tell us there was no way participants would come.
That has proven to be false. People do keep coming back. We wanted to make these services accessible, and we've been fortunate. More than 90% of our funding comes from community support, and people are very appreciative of what we do.
Wendy Terry (15:37):
That's remarkable. You mentioned the 84-year-old participant who was able to use his mouse again. Do you have any other stories that stand out about participants who benefited from the program?
Dr. Nina Mosier (15:55):
We have so many stories.
One woman, Bonnie, came to us using a walker. She was largely managing on her own. She participated in one of our dance classes and a brain-and-body class. After a month or two, she noticed she kept leaving her walker behind after class because she felt secure enough that she didn't need it.
Another story that has always stayed with me came from a caregiver. Her husband had not been able to put on his own jacket because he couldn't reach back and place his arm into the sleeve. After about three weeks, he could do it again. That may sound like a small accomplishment, but it was very important because it restored some of his independence.
Wendy Terry (17:07):
Are you seeing these kinds of changes only in people who are newly diagnosed, or also in people who have been living with Parkinson's disease for a long time and may have lost more function or mobility?
Dr. Nina Mosier (17:22):
We see it across the board.
I think a really important thing for people with Parkinson's to recognize is that it could be somebody who's been active and newly diagnosed, they can make a lot of changes. Those individuals may end up doing extreme sports, especially if they were diagnosed at a younger age, and may go on to participate in marathons or other demanding activities, which is great if they're able to do it.
But that's not required. We see people of all ages and all stages of Parkinson's disease make meaningful improvements simply by attending classes regularly.
I also think it's important to emphasize that even people with advanced Parkinson's disease can experience significant benefits. I’ve seen this time and time again. I saw that firsthand with my father. Toward the end of his life, he could not walk consistently, even with a walker. He experienced severe episodes of freezing of gait and tremors that often prevented him from feeding himself. That doesn’t happen to everyone; he had a very severe case.
I would put on one of our videos, and we might do only 10 minutes of exercise. I was always amazed because afterward he could get up, walk to the table, and feed himself. The tremor would be controlled enough that he could do it. I've seen the benefits firsthand, and I've heard similar stories from many other families.
Wendy Terry (19:27):
That's great.
Dr. Nina Mosier (19:28):
It's never too late.
Wendy Terry (19:30):
And that's such an inspiring story—seeing the decline, but then when he moves, he is able to have that independence again, which is so important. For physicians, healthcare professionals, caregivers, and patients who are listening, what's the best way for them to get involved with Power for Parkinson's?
Dr. Nina Mosier (19:59):
They can always contact us through our website at www.powerforparkinsons.org. Our phone number is listed there as well.
I would also encourage people to explore and share our Power for Parkinson's YouTube channel. We have a separate Spanish-language channel, Power for Parkinson's en Español, dedicated to Spanish-speaking communities.
We also offer a course called Introduction to Parkinson's Symptom-Focused Exercise. It's designed primarily for fitness instructors, but it's open to anyone interested in learning more. We teach people how to design exercise around Parkinson's symptoms rather than focusing only on muscle groups.
We're also planning to launch a full certification course, which may allow people to start Power for Parkinson's classes in their own communities.
Wendy Terry (21:27):
That's excellent. I already have a few people in mind who would benefit from that information.
Finally, is there anything else you'd like to share with our listeners that we haven't covered today?
Dr. Nina Mosier (21:40):
I think the most important message is that exercise matters. Whether you have Parkinson's disease or know someone who does, it's important to understand how powerful exercise can be.
Our channel is also available to people with other mobility challenges. Most of our classes are seated exercises, although we offer standing formats as well.
It's a great way to strengthen the mind-body connection. We work hard to make the classes engaging, enjoyable, and high quality. It's a valuable resource for people living with Parkinson's disease and for anyone looking for accessible exercise programming.
Wendy Terry (22:34):
Excellent. Dr. Mosier, thank you so much for your time today. It's been a pleasure talking with you about Power for Parkinson's and the impact it's having on people living with Parkinson's disease. We wish you continued success moving forward.
Dr. Nina Mosier (22:50):
Thank you so much for having me.
