An interview with Alison Geymer Physical Therapist, Big Heart Center for Parkinson’s Wellness: Beyond BIG; Comprehensive Wellness to Tackle Parkinson’s on February 28, 2024 by George Ackerman, Ph.D, J.D.
Biography
Dr. Alison Geymer has been treating the neurological population for 17 years. Since 2016, she has been running group exercise classes for people with PD. She has an undergraduate degree in kinesiology and has always believed in keeping people strong and independent throughout life. She is joined by Rachel Baugh, PTA, who has also worked with the neurological population in both inpatient and outpatient settings. They both have family members living with PD and wanted to design a wellness program that enabled their loved ones to enjoy life and thrive despite their diagnosis.
Can you tell me more about your organization?
Big Heart is the evolution of Dr. Geymer’s goal to create a total wellness option for those living with PD. She has collaborated with a client to open a full service PD wellness center that focuses on exercise, nutrition, lifestyle, sleep, pelvic health, bone health, digestion, socialization, stress management/mindfulness meditation, cognitive fitness and more! We currently provide Parkinson’s specific physical therapy, personal training, group exercise that is evidence-based, social outings, support groups, educational meetings, lifestyle change challenges and more! We are able to tailor the group programs to the needs of our clients and have the capability of adjusting/modifying for each person as needed to allow them to maintain safety, improve symptoms and remain in the class in order to engage cognition and to honor the important social aspect of our overall brain and body health. We will be adding occupational therapy and speech therapy in the near future.
What is your passion and how did you get involved in Parkinson’s awareness and hope for a cure?
Dr. Geymer’s passion has always been about fitness and maintaining one’s independence in all aspects of life. Over the course of her career, she has become certified in nutritional interventions, including functional nutrition, and believes in helping people optimize their lifestyle in order to take control of their own health. When the research started to support that exercise was a key component in slowing disease progression, this seemed like the perfect opportunity to merge exercise and therapy together.
Rachel experienced the revolving door of Parkinson’s patients returning to inpatient rehab on multiple occasions and was at a loss as to where to send them to maintain their rehab gains and to continue to make progress when they returned home. She met Nate Moyer, PTA, who had previously worked with Dr. Geymer and started her journey at Big Heart, empowering people to meet not only their rehab goals but their overall fitness and lifestyle goals as well.
We both strongly believe that lifestyle modification (including exercise and nutrition) is KEY to living well with PD and in managing overall symptoms.
What type of goals do individuals with Parkinson’s have when working with you?
Currently, our members are training for a 5K; some will be running and others will be pole walking. Another common goal is being able to get up and down from the floor without assistance. Other goals include: increased bone strength, decreased freezing of gait, increased functional strength, independence with bed mobility, halting falls, falls prevention, improved balance, decreasing fear of falling and fear of movement, improved memory and cognition, improved handwriting, being able to go out to a restaurant again, not having bladder or bowel accidents, improving nutrition knowledge and food intake, improving sleep, decreasing anxiety……
What type of training and how long are the programs?
Dr. Geymer and Rachel both are certified in PWR! Moves therapy and Dr. Geymer is also certified in LSVT BIG and Rock Steady Boxing. These are PD-specific therapeutic programs based on the research of Dr. Becky Farley. They emphasize large amplitude movements to target the effects of PD (moving small and slow) and work on improving posture, weight shifting, rotation and improved stepping ability.
While BIG is typically a protocol of 16 visits, we more frequently utilize the PWR! philosophy, which expands on variability and drives neuroplasticity and brain change. This corresponds better with our beliefs, and our clinical experience, that people need ever changing stimulation to improve both mind and body and that a protocol is not the best fit for everyone. So there is no set number of visits or length of time that we see someone for; it is based on their presentation and their goals.
In a perfect world, at minimum, we recommend that EVERYONE with PD consults with a PD trained physical therapist AT DIAGNOSIS and follows up yearly to reassess functioning and overall goals. We have a wide range of clients; some of them we see yearly for a one-on-one assessment and then they participate with group PD exercise classes for optimal forced use HIIT fitness, others we may see for a tune-up every few months (usually those with freezing of gait or history of falls) and others may need longer one-on-one sessions depending on their level of function when they started.
We offer year round group exercise classes as well (we currently have 9 classes/week). These include cardiovascular health – important for neuroplasticity, balance, functional skills training, strength and boxing/coordination that are designed and led by licensed physical therapists. This allows our staff to note any possible decrease in function or new issues that arise in our clients and get on top of the issue before it becomes a problem.
We also address pelvic health (especially constipation which is a frequent symptom) and cognitive health along with other lifestyle factors. Dr. Geymer also has extensive training in pelvic floor therapy and can address issues such as overactive bladder, constipation, bowel incontinence, pelvic pain, menopausal and perimenopausal symptoms, bladder incontinence, etc. We do not believe that these should be ignored just because they may be “from Parkinson’s”. Even these symptoms CAN GET BETTER.
What effect can it have on an individual with Parkinson’s?
People FEEL BETTER! They MOVE BETTER! They DIGEST BETTER! They SLEEP BETTER! People are URINATING BETTER and having BETTER BOWEL MOVEMENTS! They have LESS DEPRESSION! And more…… These are just some of the “side effects” we have seen from people in our program. We have also seen people seemingly delay and/or reverse symptoms and quality of life based on our annual assessment with assistance of the PRO PD scale by Dr. Laurie Mischley. People are IMPROVING in their symptoms rather than getting worse year after year.
What would you like to see as a future goal for your programs?
We are expanding currently and hope to add occupational therapy for further ADL, fine motor, functional cognition and lifestyle management training. We are also adding speech therapy to address voice, swallowing and cognitive function and overall wellness. We will progress our nutrition guidance and cooking classes as well as continue to add group exercise classes and overall education sessions. We are currently teaming up with a local hospital and medical rep to bring ongoing education and expanding exercise options to people in our county.
What events do you participate in?
We have participated in Moving Day DFW through the Parkinson’s Foundation for several years; leading exercise demonstrations. We have community events with our members, including our upcoming 5K and our upcoming Pickleball tournament in Arlington, TX. We have hosted Support Group meetings with local neurologists and we are planning a symposium that will have various PD experts in the field locally presenting at our facility.
How does this also assist the caregivers?
If their loved one is stronger, better balance, has improved safety awareness, needs to use the bathroom less frequently, etc; the caregiver does not have to assist as much. Caregivers can also get a break when their loved one is in therapy or is participating in group exercise (although some of our caregivers do assist during classes). They are able to learn how to better care for their loved one and themselves during our education sessions and support groups. We hope to add further caregiver services in the future.
How can someone get in touch? What is your website?
Our website is: www.bigheartwellnesscenter.com. Our address is 217 Harwood Rd., Suite 215, Bedford, TX 76021. Phone: 817-393-7740, Fax: 682-334-7510
How can others also become advocates for awareness?
Contact your local and national partners/foundations to ask how to better get involved.
If you could add any questions to this interview that you may want others to learn about, what would the question(s) be?
In your opinion what is the key to effective advocacy?
People joining together and not being out for themselves; willing to work with other providers and organizations. Our area has been very much an every man for themselves attitude. Also important is researchers teaming up with clinicians as well as patients in efforts to understand all aspects and every vantage point.
How can we better fundraise to support a cure for Parkinson’s?
Have the major national players support local players/providers in their efforts so that people can get better and more personalized advice. When it is delivered to the masses, it is too general.
Why should people who don’t have Parkinson’s care about this?
Parkinson’s is quickly becoming a global pandemic. More and more people are being affected; if it isn’t you, more than likely you will know at least one family member or friend who develops PD. The more you know about it, the easier it will be to care for them or yourself if and when that happens. There is also growing data on how direct family members can PREVENT PD in themselves if they are at a greater risk. In addition, the treatments we offer at Big Heart are also excellent treatments for other neurological disorders as well as the effects of aging.
Have you had any family members or relatives affected by Parkinson’s disease?
Dr. Geymer’s mom has PD as well as her maternal aunt. Rachel has a uncle with PD as well.
If you had one song that would tell us more about you or represent your life, which song would it be?
Our theme song for Big Heart is: “Where everybody knows your name” (theme song from Cheers).
Personally, Dr. Geymer’s theme song would be “What doesn’t kill you makes you stronger” Kelly Clarkson.
If you had one final statement or quote you could leave for the Parkinson’s community, what would it be?
“You CAN get better with Parkinson’s. Run if you can, walk if you have to, crawl if you must; just never give up! Never, ever give up!”