PWR Functional Mobility & Movement Strategies 2 — Questions and Answers
Question 1: Which PWR! Move is specifically designed to improve axial mobility and trunk rotation in individuals with Parkinson's disease?
- PWR!Up
- PWR!Rock
- PWR!Twist (Correct answer)
- PWR!Step
Correct answer: PWR!Twist
PWR!Twist targets axial mobility and trunk rotation, which are commonly impaired in Parkinson's disease due to rigidity.
Question 2: A client with Parkinson's disease consistently freezes at doorways. Which cueing strategy is MOST effective for overcoming this freezing episode?
- Verbal encouragement to walk faster
- Visual floor cues such as tape lines or laser projection (Correct answer)
- Reducing the width of the doorway
- Asking the client to count backwards
Correct answer: Visual floor cues such as tape lines or laser projection
Visual floor cues provide external attentional focus that can help override the freezing response at doorways and narrow spaces.
Question 3: In PWR! training, what is the primary purpose of incorporating large-amplitude movements?
- To increase cardiovascular endurance
- To counteract hypokinesia and retrain normal movement size (Correct answer)
- To build upper body strength exclusively
- To improve balance reactions only
Correct answer: To counteract hypokinesia and retrain normal movement size
Large-amplitude movements directly address hypokinesia—the reduced movement size characteristic of Parkinson's disease—by retraining the nervous system's perception of normal movement.
Question 4: Which positional progression is used in PWR! to systematically challenge functional mobility from least to most demanding?
- Standing → sitting → floor level
- Floor level → sitting → standing → walking (Correct answer)
- Sitting → standing → floor level → walking
- Walking → standing → sitting → floor level
Correct answer: Floor level → sitting → standing → walking
PWR! uses a floor-to-standing progression (floor → sitting → standing → walking) to systematically build postural control and mobility against gravity.
Question 5: A PWR! client demonstrates festination during gait. Which intervention is MOST appropriate to address this symptom?
- Increase step frequency with metronome cues
- Use rhythmic auditory stimulation to regulate cadence and step length (Correct answer)
- Encourage the client to lean forward while walking
- Focus only on upper extremity exercises
Correct answer: Use rhythmic auditory stimulation to regulate cadence and step length
Rhythmic auditory stimulation (RAS) has strong evidence for regulating gait cadence and improving step length in individuals who festinate.
Question 6: When teaching a client with Parkinson's disease to perform a sit-to-stand transfer, which strategy is MOST consistent with PWR! principles?
- Moving quickly to use momentum before rigidity sets in
- Scooting forward to chair edge, leaning trunk forward, then pushing through legs with large deliberate movement (Correct answer)
- Using arm push-off from armrests as the primary driver
- Keeping the head and trunk upright throughout the entire transfer
Correct answer: Scooting forward to chair edge, leaning trunk forward, then pushing through legs with large deliberate movement
PWR! sit-to-stand technique emphasizes scooting to the chair edge, deliberate trunk flexion forward, and large-amplitude leg extension to optimize the transfer.
Question 7: Which cognitive strategy is recommended in PWR! to help clients with Parkinson's disease manage dual-task challenges during functional mobility?
- Always perform two tasks simultaneously to build tolerance
- Simplify the environment and focus attention on movement when safety is at risk (Correct answer)
- Avoid any mental tasks when walking
- Increase walking speed to reduce the duration of dual-task exposure
Correct answer: Simplify the environment and focus attention on movement when safety is at risk
PWR! recommends reducing environmental complexity and directing attentional focus to movement during high-risk situations, rather than eliminating or always performing dual tasks.
PWR Functional Mobility & Movement Strategies 2
Which PWR! Move is specifically designed to improve axial mobility and trunk rotation in individuals with Parkinson's disease?