
Hosted by Erin Gallardo and Claire McLean · EN

What do you do when the most evidence-based intervention you have is also the one your patient is "not allowed" to receive? Constraint-induced movement therapy has decades of research behind it, yet its exclusion criteria — especially around cognitive impairment — rule out a huge share of the stroke survivors clinicians actually see. In this episode, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, talk with neuro OT Briana Elson, MS, OTR/L, BCPR, CBIS, about her decision to try modified CIMT with an 86-year-old stroke patient who had significant cognitive impairment and underlying dementia — a textbook exclusion — and why his profile, a left-handed man whose affected side was his dominant hand, made forced use feel natural and salient rather than confusing. Briana walks through how she built the protocol around safety and supervision in inpatient rehab: getting a physician order for the constraint mitt, educating and enlisting his wife, keeping a consistent daily schedule, breaking the three-to-six hours into non-consecutive blocks, and removing the mitt before late-day sundowning. She shares the outcomes that surprised even her skeptics — meeting the minimal detectable change on the Box and Block Test and a standardized motor scale within roughly thirteen days, plus real gains in grooming and feeding independence — alongside the honest caveats, including that his cognition never improved and that real-world delivery never looks as clean as the published article. It's a practical, encouraging conversation about reading the research, respecting its limits, and giving more patients a shot at an intervention they're usually told they can't have.

What happens to your neuro patients after they leave your care, and who's in their corner when the discharge falls apart? In this episode, host Erin Gallardo, PT, DPT, NCS, sits down with Kimberlie Williams-Feth, BSW, founder of Healthcare Survival Kit and a former hospital social work discharge planner who became an independent patient advocate after living the system's failures firsthand. When her husband's routine spinal fusion led to unexpected paralysis, Kimberlie navigated unsafe discharges, a "ghost network" of providers who didn't actually offer neuro care, and the months it took to find neuro PT and OT all while working full time and holding her family together. She shares the green/yellow/red scripting framework she teaches families, why a rushed discharge can leave patients financially liable the moment they say "no," and the three deceptively simple questions every clinician should ask: what did life look like before, what can you do now, and what are your goals. For neuro PTs, OTs, assistants, and students, this is a candid look at the holes in the system clinicians can't fill alone and the advocates who exist to fill them. Find an advocate by state or diagnosis at GNAnow.org (Greater National Advocates). www.healthcaresurvivalkit.com https://www.linkedin.com/in/kimberlie-williams-feth/ https://www.tiktok.com/@healthcaresurvival https://www.facebook.com/healthcaresurvivalkit/ https://www.instagram.com/healthcaresurvivalkit/ Greater National Advocates: https://gnanow.org

What if a patient who is years — even decades — out from their stroke could still make meaningful gains in their affected arm? In this episode, host Erin Gallardo, PT, DPT, NCS, talks with Mason Hearn, PT, DPT, NCS, about Vivistim, the FDA-approved paired vagus nerve stimulation system for chronic ischemic stroke, and why the "paired" piece — stimulation delivered in the same moment as intensive, task-specific therapy — is what makes it work. Mason breaks down the triple-blinded RCT behind the device, why patients an average of three years post-stroke saw two to three times greater improvement on the Fugl-Meyer, and how the real-world results coming out of clinics are landing even higher. This episode gets into what the protocol actually asks of patients (90-minute sessions, three times a week, 300–500 reps), how at-home "swiping" turns everyday tasks like getting dressed or cutting into a baked potato into neuroplasticity-building practice, who is and isn't a candidate, and how therapists can think about screening and advocacy without feeling like they're "referring someone for surgery." It's a hopeful, practical conversation about giving chronic stroke survivors real agency over the next stage of recovery and the clinicians who can open that door for them. Learn more at: Vivistim.com https://www.vivistimacademy.com/ Here is the safety profile: http://www.Vivistim.com/safety

What happens to a family when "wellness" stops meaning saunas and cold plunges and starts meaning keeping the lights on? In this episode, host Erin Gallardo, PT, DPT, NCS, talks with Russell Meyerowitz, founder of the Parkinson's Wellness Fund, about how the needs of families living with Parkinson's have shifted from health-and-wellness support toward urgent emergency relief — and what that means for the clinicians who serve them. Russell shares why his organization issues no-judgment relief grants for everything from walkers and ramps to groceries and utility bills, why they're now fielding two to three applications every 24 hours, and how those years on the front lines led to the launch of Raya Health, a subscription-based care-coordination platform that keeps a family's medications, appointments, documents, and clinical notes in one shared place. He and Erin dig into the continuity-of-care gaps neuro clinicians see every day, why care coordination is crucial, and the forthcoming "Ask Raya" feature for surfacing medication and exercise trends over time. It's a warm, candid conversation about being proactive instead of reactive — and about having a stranger in your corner when Parkinson's makes life feel like survival. Links mentioned: Parkinson's Wellness Fund — parkinsonswellnessfund.org Raya Health — raya-health.com Instagram: Parkinson's Wellness Fund and Raya Health HQ Use this promo code for 100% free access to Raya Health! RAYALOVESNEURO

Are the heart rate formulas we've been using actually working for our patients with Parkinson's? In this episode, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, discuss with Cielita Lopez-Lennon, PT, PhD candidate in Rehabilitation Science at the University of Utah, her recently published research on refining maximal heart rate estimation for people with Parkinson's disease. The conversation digs into why standard formulas like 220 minus age systematically overestimate max heart rate for people with autonomic dysfunction, what chronotropic incompetence actually means in practice, and how Claire has been applying — and adapting — the research findings in real time at Rogue. If you're prescribing high intensity exercise to your neuro patients, this episode will change how you think about whether they're actually hitting the dose. www.linkedin.com/in/cielita Research article: Refining Maximal Heart Rate Estimation to Enhance Exercise Recommendations for Persons With Parkinson Disease — https://www.archives-pmr.org/article/S0003-9993(25)00626-4/fulltext Listen to the previously recorded episode where Claire shares the rationale and the formula she created (which you get access to!) Episode 302: https://www.neurocollaborative.com/blog/applying-a-new-calculation-for-max-heart-rate-in-pd

What would it look like if your patients stopped fearing the floor? In this episode, hosts Erin Gallardo, PT, DPT, NCS, and Claire McLean, PT, DPT, NCS, discuss with Naomi Casiro, physiotherapist and founder of Neuro Fit Academy, what happened when her falls training sessions at World Parkinson Congress drew over 100 attendees in a room designed for 40. They dig into why patients with Parkinson's are starting to demand falls training themselves, and how that overwhelming response reflects a massive gap in what clinicians are currently being taught. Naomi recently launched her FMF — Functional Movement and Falls Training — Foundations online course through Neuro Fit Academy — a six-hour program built for PTs, OTs, and any neuro rehab clinician who wants practical, immediately applicable falls training skills without needing to wait for an in-person course to come to their city. The course includes PDF clinical guides, problem-solving resources, and twice-yearly office hours with Naomi directly. If you've ever felt unsure about how to actually teach a patient to fall safely, this course was built for you. Learn more about the course here! www.neurofitacademy.org

In this episode, host Erin Gallardo, PT, DPT, NCS interviews BioXtreme CEO Eyal Samuel Shachar and researcher Dr. James Patton, PhD about BioXtreme's robotics-based neurorehabilitation devices, with a focus on their Plaxtream hand system. Inspired by founder Nini Bluman's experience helping his father recover hand function after a stroke, Plaxtream combines robotic hardware, engaging game-based activities, and an AI-driven, adaptive error augmentation approach to improve grasp, release, pronation, and supination. Dr. Patton explains how error augmentation—strategically amplifying movement errors within an optimal "sweet spot"—can accelerate neuroplasticity and learning, and he shares clinical findings showing functional gains using standardized measures like Fugl-Meyer and Wolf Motor Function tests. The guests discuss how the device personalizes training based on each person's range of motion and strength, supports patients from early to chronic stages (with both active and assistive modes), and is designed for in-clinic use. They also highlight BioXtreme's rapid, feedback-driven development process, the importance of close collaboration between engineers and clinicians, and new opportunities for therapists to get involved in research, education, and U.S. market expansion efforts. Learn more here! https://www.bioxtremerobotics.com/ https://www.linkedin.com/company/3138999/admin/dashboard/ Find Dr. Patton here: sites.google.com/uic.edu/pattonj

In this episode hosts, Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS share their excitement and plans for attending the 2026 World Parkinson Congress (WPC) in Phoenix, Arizona, a unique international conference that brings together people with Parkinson's, care partners, therapists, physicians, and researchers. Drawing on their past experiences at WPC in Montreal, Portland, and Kyoto, they describe how special it is to attend this event as a full team this year, staying together in an Airbnb and connecting with colleagues and members from around the world. They highlight what makes WPC stand out from typical scientific meetings: its interdisciplinary focus, community-centered vibe, extensive wellness and exercise programming, creative projects, and direct involvement of people with Parkinson's in scientific discussions. Claire and Erin also walk through the rich scientific and wellness schedule—from plenary lectures on cutting-edge research and prevention to workshops, round tables, debate-style "controversy" sessions, and a robust wellness program featuring exercise, meditation, and caregiver support. They close by emphasizing how WPC advances both research and advocacy, and by promising a follow-up conversation after the congress to share key takeaways and lessons learned. We recorded this before heading to WPC — stay tuned for our follow-up episode with everything we learned!

Is work-life balance an elusive concept you have yet to master while running your life and neuro biz? In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS discuss the topic with NeuroBiz Coach, Emily Duval Ledger. Many clinicians start businesses to escape traditional job burnout but then recreate the same patterns by overworking and glorifying busyness. In the show we talk about recognizing when "busy" becomes unproductive, using tools like time-blocking, planners, and realistic daily priorities to focus on high-impact tasks and reduce urgency overload, but, really, it is about much more than just "tools." The topic of metacognition—noticing and questioning automatic thoughts about productivity—comes up. We encourage business owners to listen to signals like dread and frustration, realign work with the clients and tasks that energize you and continually adjust your business models to support long-term well-being for yourself and your team.

Dive into AI tools in your personal life, work life and business by learning what to use, how to use it and how NOT to use it. In this episode, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS talk with physical-therapist-turned-entrepreneur Dr. Shanté "Movement Maestro" Cofield, PT, DPT, OCS about what AI is and how it can practically support health and fitness professionals. Shanté explains AI in simple terms as powerful computer programs called large language models (LLMs) that use math and probability to predict the most likely next word, making it possible for us to just "talk" to a chatbot and get useful outputs, even though the AI itself doesn't truly understand what it's saying. The conversation covers how AI can help with everyday, non-hands-on tasks like writing recommendation letters, drafting emails, creating presentations, automating small workflows (like forwarding utility bills), and building custom dashboards, all of which save time and let clinicians focus more on people instead of paperwork. The episode also touches on valid concerns about privacy and environmental impact, with Shanté encouraging a nuanced, "both-and" mindset: be informed and cautious, but also recognize that many of our tools already use AI and that the biggest gains come from offloading repetitive, non-client-facing work while keeping human creativity and connection front and center. The episode closes with resources for learning more, including Shanté's AI-focused project "Prompting Curiosity" and her main platform, The Movement Maestro, and an invitation for clinicians to simply start experimenting so they can see for themselves where AI helps and where it falls short. Prompting Curiosity website - www.promptingcuriosity.com Instagram: https://www.instagram.com/themovementmaestro/