Miriam “Mia” Boelen, Physical Therapist at NorthShore and author of “How to Live Well with Parkinson’s: Advice from a Physical Therapist” and “Health Professionals Guide to Physical Management of Parkinson’s Disease,” discovered her passion straight out of high school. After visiting an uncle who had been diagnosed with Parkinson’s disease 10 years earlier, she knew that helping people in similar situations was what she wanted to do with her life.

Mia tells us why physical therapy is such an important part of Parkinson’s disease treatment and shares stories of success that she attributes fully to the strength and determination of her patients:

How long have you been working as a physical therapist?
I have been a physical therapist since 1978 and have been working with people with Parkinson’s disease (PD) since 1990. 

What attracted you to the field of physical therapy, in particular specializing in the treatment of those with Parkinson’s disease?
I became interested in physical therapy when I traveled to the Netherlands after high school to visit my uncle. He had been diagnosed with Parkinson’s a decade earlier. It was the first time I assisted an individual with walking and realized I wanted to help other people who had similar physical challenges. 

In 1988, I started working at Glenbrook Hospital. Later, I volunteered to help a movement disorder neurologist who was searching for a physical therapist to treat his patients with Parkinson’s disease. I quickly developed a passion for treating people with Parkinson’s and similar movement disorders. 

Why is physical therapy for the treatment of Parkinson’s disease so important?
Physical therapy is important for people with Parkinson’s from the time the individual is initially diagnosed and functioning well through all the stages of PD. In the early stages, we teach prevention—it is less work to prevent muscles from getting weak/tight than it is to “catch up” later. Exercise is critical to controlling the motor symptoms of Parkinson’s. The physical therapist helps to create the optimal exercise program for patients, which often requires an individualized approach since PD affects everyone differently.  

Parkinson’s affects the part of the brain that controls movement so it requires individuals to pay more attention to their movements, even walking and getting in and out of chairs and bed. Movements are typically smaller and can require more effort to normalize. In therapy, we teach people how to effectively use their attention to improve all aspects of moving, which results in reduced difficulties with walking and transfers. Some people with Parkinson’s may need more assistance and in such cases the therapist can teach both the individual and his or her caregiver/spouse how to assist so there is less strain.

What would you say is the biggest challenge you often have to work with your patients to overcome in terms of physical therapy for Parkinson’s disease?
The biggest challenge is often helping individuals understand the benefits of using an assistive walking device such as a cane or walker/rollator. There are some individuals who opt to become sedentary to avoid falling or feeling very unsteady. Or, worse, they fall and become injured. Becoming more sedentary to avoid falls is not necessarily done deliberately but this situation results in a progressive loss of strength and further decline of balance. All of this can be avoided by using a walking aid that allows an individual to become more active in a safe way. This is important because remaining active has a multitude of functional and health benefits.

What do you find most rewarding about your job?
I frequently see individuals who are stressed about how Parkinson’s affects them and the lack of control or knowledge they have about PD. My ability to see my patients for consecutive appointments, one-on-one, addressing all of their questions, allows me to see much of their uncertainty and stress dissolve to a more manageable level for them. I simply guide these individuals. After that, I pass the baton to them so they can self manage. It’s very rewarding to see them improve physically and emotionally, to impart a greater sense of control over a situation they previously thought they couldn’t control.

Do you have a favorite story of success that you could share?
Over the years, I have accumulated many success stories and every one of them is due to the hard work and perseverance of my patients. I have the easy job; my patients do the hard work. 

Here are just a few moments of success: 

• Patients who questioned their ability to travel to their country of origin to visit relatives and were able to make the trip after treatment.
• A father who wanted to walk his daughter down the aisle without a walking aid and with treatment was able to do so. 
• A woman who thought she’d lost her ability to walk regained her confidence and mobility with the help of a walking aid. 
• The many spouses and family members who felt overwhelmed before starting therapy were able to come to a better understanding of how to manage daily activities and reduce their stress levels.
• An individual who was incapable of lifting his head, but due to his hard work (after I discharged him), he returned and surprised me with his head held high!

Find out more about Mia Boelen and her work with Parkinson's disease on her blog here and more information on the treatment options for Parkinson's disease at the NorthShore Neurological Institute here.