269: Focused, Intense Anticipatory Postural Training Improves Multiple Balance Measures In PD With Sharanya Chavva, PT, DPT

Balance is a common challenge among people with Parkinson's disease and it can be made even more challenging when there is both a risk of falls AND a high fear of falling. What's a clinician to do to improve overall balance when your patient is too fearful to try so many things? On today's show Erin Gallardo, PT, DPT, NCS discusses exactly that predicament with physical therapists Sharanya Chavva, PT, DPT and Jennifer Lazaro, PT, DPT, NCS who share the findings of their poster from APTA CSM 2025. Their poster, which outlines a case study of a PwP, won the APTA Balance and Falls SIG first place award. Their research focuses on a unique approach to balance interventions that incorporates high intensity focused training on one aspect of balance - Anticipatory Postural Adjustments (APAs) - that demonstrates transference to other balance outcomes.

Key Highlights:
- The study centered on a patient in the early stages of Parkinson's disease who had significant anxiety about falling
- Traditional balance training methods weren't effectively improving her confidence
- They introduced a novel approach using a specific anticipatory postural adjustment (APA) training protocol
- A Zero G harness system was utilized to help the patient feel more secure during exercises

Remarkable Results:
- Patient's balance confidence (ABC score) increased from 73% to 80%
- BESTest score improved dramatically from 62% to 83%
- Patient began engaging more in daily activities like grocery shopping
- Achieved high-intensity training with up to 160 repetitions per exercise

This case study demonstrates that targeted, high-intensity balance training can significantly improve patient confidence and functional mobility. By focusing on anticipatory movements and creating a safe training environment, therapists can help PwP overcome their fear and improve their quality of life.

Check out the poster here