Phenotype to Function: Personalizing Parkinson’s Rehab (Recorded Webinar)
Presented by Mike Studer and Emily Ramon
This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from those of standard Medbridge courses.
Despite the growing body of evidence surrounding Parkinson’s disease (PD) phenotypes, many rehabilitation professionals continue to utilize a “one-size-fits-all” approach that fails to account for the distinct neurobiological drivers of the disease. This course addresses the critical clinical gap between traditional PD exercise protocols and the emerging science of neuro-phenotyping, specifically focusing on the tremor-dominant (TD), postural instability gait disorder (PIGD), and young-onset (YOPD) populations. By diving deep into the interplay between dopaminergic and cholinergic pathways, as well as the “body-first” versus “brain-first” models of progression, participants will learn to move beyond symptom management toward precision-based care. The course provides a comprehensive framework for integrating autonomic and sensory screening into the motor examination to better predict and manage challenges such as freezing of gait, orthostatic hypotension, and physiological fatigue. This session empowers clinicians to synthesize complex pathophysiology into actionable, task-specific interventions. Learners will leave with the ability to construct individualized programs that optimize functional participation and long-term neuroplasticity for the diverse spectrum of people living with Parkinson’s.
Learning Outcomes
- Interpret “body-first” and “brain-first” pathophysiological mechanisms to determine the prioritization of nonmotor symptoms and early clinical presentation
- Evaluate motor and nonmotor findings during a clinical examination to classify a patient into tremor-dominant (TD), postural instability gait disorder (PIGD), or young-onset (YOPD) phenotypes
- Design individualized intervention strategies for people with the TD phenotype of PD that specifically address the intersection of sensory processing, motor control, and fatigue
- Formulate task-specific rehabilitation plans for people with the PIGD phenotype of PD by integrating autonomic and sensory strategies into functional training
- Develop a holistic, individualized plan of care for the YOPD population that prioritizes symptom management and long-term brain health while considering unique psychosocial needs, work–life dynamics, and social connectedness
- Synthesize key principles from phenotype-specific presentations to construct a holistic management plan that addresses the long-term interaction between motor, nonmotor, and autonomic challenges across the Parkinson’s spectrum
Meet your instructors
Mike Studer
Mike Studer, PT, DPT, MHS, NCS, CEEAA, CWT, CSST, CBFP, CSRP, FAPTA has been a PT since 1991, a board certified in neurologic PT in 1995, and a private practice owner since 2005. Dr. Studer has been an invited speaker covering all 50 states, 14 countries, and 5 continents speaking on topics ranging from cognition and…
Emily Ramon
Dr. Emily Ramon is the Clinic Director of re+active physical therapy and wellness in Los Angeles, where she directs outpatient services and wellness programming specialized for Parkinson’s Disease. As a faculty member for the Schmidt Movement Disorders Fellowship, she provides advanced didactic instruction on the…
Chapters & learning objectives
1. Pathophysiology and Clinical Updates in PD
This chapter establishes the foundational neuroanatomy and neurochemistry that drive the diverse clinical presentations seen in Parkinson’s disease. By analyzing the direct and indirect basal ganglia pathways and the interplay between dopaminergic and cholinergic signaling, clinicians will move beyond symptom-level understanding to recognize the underlying biological drivers of motor and nonmotor dysfunction.
2. Phenotype Classification: Guiding Individualized Care
Learners will explore the “brain-first” versus “body-first” models of disease origin to better prioritize early detection and nonmotor symptom management. This section provides a clear framework for differentiating between tremor-dominant, PIGD, and young-onset phenotypes, shifting the therapeutic lens from a generic protocol to a precision-based rehabilitation strategy.
3. The Motor and Nonmotor Examination
This chapter redefines the traditional Parkinson’s examination by integrating autonomic, sensory, and physiological screening tools directly into the motor assessment. Clinicians will learn to decode how nonmotor drivers—such as orthostatic hypotension and sensorimotor dysregulation—actively shape motor performance and dictate exercise tolerance. This section empowers therapists to identify the true multisystem origin of functional impairment.
4. The Tremor-Dominant Subtype
Utilizing a targeted case study, this section highlights the unique participation barriers faced by individuals with the tremor-dominant phenotype. Clinicians will learn to prioritize task-specific performance over simple tremor suppression, developing individualized interventions that account for the impact of cognitive load and sensory input on motor control.
5. The Postural Instability Gait Disorder (PIGD) Subtype
This chapter focuses on the complex clinical management of the postural instability gait disorder phenotype, with a specific emphasis on freezing of gait (FOG). By connecting postural instability to autonomic and vestibular dysregulation, learners will be equipped to design sensory-enriched rehabilitation plans that maximize safety and functional mobility.
6. Young-Onset Parkinson’s Disease (YOPD)
Through the lens of a high-functioning case study, this chapter addresses the unique psychosocial and physiological needs of the younger-onset population. The discussion emphasizes “active fatigue management” and community-based wellness models, providing practical strategies to integrate high-intensity neuroplasticity principles into a patient’s long-term work and family life.
7. Translating Evidence Across the Spectrum of PD Phenotypes
The final chapter consolidates the phenotype-specific principles into a holistic, interdisciplinary framework for long-term care coordination. Participants will learn to synthesize information about patients and their presentations to improve patient advocacy, community referrals, and the overall trajectory of functional outcomes.
8. Question and Answer Session
This chapter is a viewer-submitted question and answer session facilitated by the course instructors, Emily Ramon and Mike Studer.
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