Movement Disorder Specialists   -

Pasadena, CA

Upcoming Challenges for Neurologists in the United States

Upcoming Challenges for Neurologists in the United States

With the rapidly changing economy, new healthcare laws, and a plethora of cuts from the government, neurologists and their practices should expect a severe decrease in revenue. According to JAMA Neurology Volume 70, Number 9, the sweeping changes due to Obamacare are effecting many medical institutions and practices, but for a number of reasons, neurology is in a crisis of its own. To give you an idea of impact of current neurological practices, here are some of the big cuts that’ve already been implemented:


"...as of January 1, 2013, the Centers for Medicare and Medicaid Services, by regulation, reduced the payment for nerve conduction testing services by more than 50%. Jonathan Blum, a Centers for Medicare and Medicaid Services administrator, indicated that these cuts reduce total neurologic revenue by 7% on average. Implemented March 1, 2013, sequestration cuts further reduced Medicare payments to physicians by 2%. Because the typical neurologic practice has an overhead percentage of greater than 50%, the 9% cut to revenue translates to a greater than 18% reduction in neurologist income.”
…"every deficit reduction proposal targets GME payments. The most prominent, the 2010 Simpson/Bowles bipartisan commission (updated in 2012), proposed a 60% reduction in GME payments. President Barack Obama’s recently released 2014 budget recommends a $780 million cut to GME payments, approximately a 7% cut."

Not only are current small neurology practices being short-changed, but those looking to train to become neurologists are also in trouble:


"As neurologic practices struggle to stay afloat, the viability of training programs is also imperiled. In addition to the loss of clinical revenues, 2 other sources of revenue that support the educational mission are at risk: hospital facility fees and federal graduate educational payments. The facility fee—an additional charge for outpatient services charged by hospitals that materially adds to the reimbursement for these services—is on the hit list for deficit reduction."

As if these cuts weren’t enough, research grants will also be greatly reduced:


”...new grants are projected to be sharply reduced to 17% to 18% of the proposals. Successful awardees now comprise only half of the percentage of those who succeeded in attaining them in the 1980s.”
“…Academic and research programs can find replacement for some of the lost federal revenues through well-coordinated efforts to attract charitable support.”
“...GME funding of neurology training must be protected. Finally, the president’s announced initiative provides a key opportunity to educate the public and Congress as to the need for research and access to care for this patient population.”

Unfortunately in rough economic times, science and medicine tend to get defunded. Neurological disorders are prevalent throughout the world, and as a society we understand that they need serious research and treatments. In your next email, letter, or call to your representatives, consider pressuring them to support laws that strengthen neurological science, treatments, and practices.


Visit JAMA Neurology’s site to susbcribe to their journal for further reading and sources. JAMA Neurology September 2013 Volume 70, Number 9 page 1097, 1098 written by Orly Avitzur, MD, MBA and Bruce Sigsbee, MD, MS.


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Free Confidential Memory Screenings at SoCalMDS, November 19th

Alzheimer’s Foundation of America presents the National Memory Screening Day with SoCalMDS. If you are concerned about your or a loved one’s memory, get a free and confidential memory screening with the Southern California Movement Disorder Specialists


When: Tuesday, November 19th 2013 — 10 A.M. to 3 P.M.

Where: 65. N. Madison Ave., Pasadena CA 91101; Suite 410


For more information, call (626) 792–6683


Please note that a memory screening is not used to diagnose any illness and does not replace consultations with a qualified physician or other healthcare professionals.


Free Confidential Memory Screenings at SoCalMDS November 19th

Download confidential memory screening flyer (PDF)


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Can Some Tablets Interfere With Implanted Defibrillators?

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With the rising prevalence of iPads and other electronic devices with internal magnets, extra caution should be taken to ensure implanted cardioverter-defibrillators’ (ICDs) aren’t affected around the home and workplace. Modern tablet and laptops use magnets to attach convenient accessories to the device, but these magnets in the iPad were strong enough to switch settings in 30% of 26 volunteer’s ICDs. Since ICDs are mostly used to regulate the heart and it’s heartbeats, an ICD accidentally switched to it’s “magnet mode” can be fatal. With more electronic devices containing small magnets, these devices should not stay near the body during sleep if you use an implanted defibrillators.


For additional information, read Ars Technica’s overview of the study.


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Does DBS Affect Speech?

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Deep brain stimulation (DBS) treats the movement symptoms of Parkinson’s — specifically tremor, dystonia motor offs, and dyskinesia. DBS does not typically improve speech and in some cases can be associated with worsening speech. The following information may help you understand the complex association between speech changes with Parkinson’s and DBS:


  • DBS typically helps motor symptoms that also respond to medicine. Although difficult to predict, DBS may improve speech if levodopa also significantly improves speech. However, in most cases, speech is not helped by medicines which suggests DBS will also not help.
  • If speech is still responsive to levodopa, under-medication can also worsen speech. Medicines are often reduced after surgery.
  • Subthalamic (STN) DBS surgery can affect ‘verbal fluency’. This can be noticed as a difficulty ‘finding or getting the right word out’.
  • DBS programming can worsen speech as a noted side effect to over-stimulation. This is probably the most common cause of significant speech change after surgery.
  • Speech can worsen as Parkinson’s progresses over time even with DBS. This is usually a gradual decline.
  • Immediate change in speech after surgery can occur as a result of brain bleeding or another problem during surgery. This can improve over time.
  • A speech therapist can help you understand the potential impact of DBS on speech and help improve communication at any stage of your disease.

This information serves as a guide only. Only your healthcare provider can answer the questions about how DBS will impact speech for you.


Read this article from the Northwest Parkinson’s Foundation.


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Impax Laboratories Releases IPX066, a New Treatment for Idiopathic Parkinson's Disease

Impax Laboratories Releases IPX066 a New Treatment for Idiopathic Parkinson s Disease

Impax, the Hayward and technology-based generic pharmaceuticals company, in collaboration with GlaxoSmithKline, has released their new treatment for idiopathic Parkinson’s disease and it is currently being reviewed by the U.S. Food and Drug Administration (FDA). Titled “IPX066,” this extended release capsule “is intended to maintain consistent plasma concentration of levodopa for a longer duration versus immediate release levodopa, which may have an impact on fluctuations in clinical response.”


IPX066 has been researched for three and a half years “through multiple clinical studies of efficacy and safety.” IPX066 has been studied in early and advanced U.S. and European Parkinson’s patients.


Learn more about Parkinson's disease

Read this press release at ImpaxLabs.com.


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Circadian Rhythm Disruption Causes Neurodegeneration & Early Death

Circadian Rhythm Disruption Causes Neurodegeneration Early Death

New research at Oregon State University provides evidence for the first time that disruption of circadian rhythms — the biological “clocks” found in many animals — can clearly cause accelerated neurodegeneration, loss of motor function and premature death.


The study was published in Neurobiology of Disease and done by researchers at OSU and Oregon Health and Science University. Prior to this, it wasn’t clear which came first — whether the disruption of biological clock mechanisms was the cause or the result of neurodegeneration. “In these experiments, we showed through both environmental and genetic approaches that disrupting the biological clock accelerated these health problems,” said Kuntol Rakshit, an OSU graduate fellow.


There’s a great deal of interest right now in studies on circadian rhythms, as we learn more about the range of problems that can result when they are disrupted,“ Rakshit said. ”Ultimately we hope that this research will be taken from the laboratory to the bedside."


These studies were done with fruit flies, but the OSU scientists said previous research has indicated there are close parallels between them and humans. Some of the genes regulating circadian rhythms in flies are so important that they have been preserved through millions of years of separate evolution and still do the same thing in humans.


The biological clock, in humans and many other animals, is a complex genetic mechanism tuned to the 24-hour day and regular cycles of light, dark and sleep. It influences a wide range of biological processes, from fertility to hormone production, feeding patterns, DNA repair, sleep, stress reactions, and even the effectiveness of medications. In humans, researchers have found strong correlations between disrupted clock mechanisms, aging, and neurologic diseases such as Alzheimer’s and Huntington’s disease.


The fruit flies used in this research carried two mutations, one that disrupts circadian rhythms and another that causes flies to develop brain pathologies during aging. These double mutants had a 32–50 percent shorter lifespan, lost much of their motor function, and developed significant “vacuoles” or holes in their brains far sooner than flies with a functional clock.


The decline and loss of clock function may be just the beginning of a damaging, circular process, says Jadwiga Giebultowicz, an OSU professor of zoology, member of the OSU Center for Healthy Aging Research and project leader. “When the biological clock begins to fail, rhythms that regulate cell function and health get disrupted, and we now know that this predisposes the brain to neurodegeneration. But that neurodegeneration, in turn, may cause more damage to the clock function. A healthy biological clock helps protect against this damage. When the clock fails, the damage processes speed up.”


Aging is closely associated with this process, according to Giebultowicz, but it’s not clear exactly how. Molecular clock oscillations decline during aging. Finding ways to restore them might form a possible therapy for biological clock damage and help to prevent disease, and work in that area will be part of future research.


Read about this on Medical News Today.


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Antipsychotics Vary in Mortality Risk in Dementia Patients

Antipsychotics Vary in Mortality Risk in Dementia Patients

A body of evidence has begun to fill in the details about how antipsychotics, used as treatment for dementia symptoms for example, are associated with increased risk of mortality. A recent study, published in Journal Watch Psychiatry in February, found that this increase in risk appears to differ from drug to drug—while haloperidol had the highest 6-month mortality rate, quetiapine had the lowest. In fact, it has been observed that patients taking haloperidol were more likely to be older, less healthy, and have more inpatient days, among other things. But with other studies controlling for these factors, the results are similar.


Since quetiapine has in the past demonstrated limited performance for dementia-associated aggression, risoperidone and/or olanzapine may be better options for less-sick patients.


Read the abstract and additional details on this study at Phychiatry.jwatch.org


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Arroyo Physical Therapy Presents Balance Awareness Week

Are you experiencing frequent feelings of dizziness or unsteadiness? Are you having trouble coordinating your movements? Arroyo Physical Therapy wants you to know about the 17th annual Balance Awareness Week from September 16th to the 22nd!


The goal of Balance Awareness Week is to make it easy for everyone to learn about the causes and symptoms of a balance dysfunction so that those affected by it can benefit from a quick diagnosis and effective treatment.


For more details, visit the Arroyo Physical Therapy blog. If you have any questions, call (626) 593–2283 or send them an email at info@arroyopt.com. You can also visit them at 2693 East Washington Blvd., Pasadena, CA, 91107. The Vestibular Disorders Asociation also has information on this event.


APT BalAware 2013
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Former Apple CEO Debuts VSee iPad & New VSee Search Contacts


VSee, an essential tool for collaboration over long distances, has made strides for healthcare in the area of telemedicine. VSee’s innovative video conferencing software is expanding the possibilities of medical outreach. Just recently, former Apple CEO John Sculley showed off VSee for iPad for secure on-demand healthcare consultations. The demo shows a face-to-face meeting with Dr. Steven Gurland, in which he easily shares an X-ray and lab results, while discussing it personally.


Former Apple CEO Debuts VSee iPad  New VSee Search Contacts

It’s no surprise then that VSee was an ATA Telemedicine Video Contest winner. The winning video, called “Expect Telemedicine”, shows VSee at work in Haiti, allowing thousands access to vital healthcare in the wake of a cholera outbreak and during the 2010 earthquake recovery.


Former Apple CEO Debuts VSee iPad  New VSee Search Contacts 2

For more information on telemedicine & VSee, visit the Tele-health page on the SoCalMDS website.

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Fasting May Help Protect Against Brain Diseases

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Scientists at the National Institute on Aging have found evidence suggesting fasting can reduce the worst symptoms of movement disorders such as Parkinson’s disease as well as Alzheimer’s disease. With the correct timing and right amount of calorie-cutting, it is possible to live more comfortably with one’s neurological disorders. The study found that those who went two days while only consuming 500 calories reported being able to manage their symptoms better. Past studies found calorie cutting can greatly increase the lifespan of mice, though human studies have yet to be thoroughly done. The researchers believe that the chemicals the body produces when hungry can counteract the impact of movement disorders. The scientists at the National institute on Aging plan to perform further testing using MRI scans and other techniques.


Read this article about fasting effects on movement disorders at Guardian.co.uk.


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Neurogenic Orthostatic Hypotension Awareness Day

Neurogenic orthostatic hypotension (also known as Neurogenic OH or NOH) occurs in people with an underlying neurologic disease and may cause them to experience symptoms of dizziness, lightheadedness and/or fainting when they sit or stand up. For many with NOH, these symptoms are persistent and often interfere with everyday activities. In NOH, the symptoms occur because the nervous system is not working properly due to an underlying neurologic disorder such as Parkinson’s Disease.


What’s so critical about having a new treatment for NOH?

More than 100,000 patients in the U.S. currently suffer from NOH, and treatment options are extremely limited. The only U.S. Food and Drug Administration (FDA) approved treatment at this time is midodrine; however, this agent is not yet proven to affect symptoms associated with the disorder and it causes a range of undesired side effects. Midodrine faces FDA withdrawal from the U.S. market if it does not demonstrate symptomatic benefit with its two ongoing studies by 2014. That’s why new treatment options need to be made available now.


Treat NOH Now Advocacy Day

On October 3, 2012, Treat NOH Now took to Capitol Hill to meet with several Senate and House Congressional offices. Patients suffering from symptoms of NOH, caregivers, health care providers and NOH patient advocates met with members of Congress, to share their stories and request that they contact the FDA to urge accelerated review of new NOH treatments.


NOH’s Awareness Day has passed, but it’s a better time than ever to help find treatments. You can help finding new treatments for NOH by writing a letter to your congressman on the Treat NOH Now website.

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The Future of Parkinson's Disease Detection

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In the future, doctors may be able to diagnose early Parkinson’s disease (PD) with a colonoscopy, according to a new study recently published in Movement Disorders. In PD, a protein called alpha-synuclein forms abnormal clumps, which can kill the brain’s dopamine-producing neurons. The formation of these clumps, known as Lewy bodies, are considered a pathologic hallmark of the disorder.


Scientists have also detected alpha-synuclein clumps in nerve cells of the colon and skin of people with PD. This discovery led to a theory that PD begins in tissues outside the brain. Can the presence of alpha-synuclein aggregations in colon tissue predict PD development? Researchers at Rush University studied colon biopsy samples from three people with PD, collected by colonoscopy two to five years before the people showed symptoms of PD. They detected alpha- synuclein by staining the protein with dyes and fluorescent molecules.


Results

Alpha-synuclein protein was detected in nerve cells of colon tissue from all three people who later developed symptoms of PD. No alpha-synuclein was detected in colon tissue samples from 23 healthy people without PD.


What Does This Mean for PD

The detection by Dr. Shannon’s team of alpha-synuclein in the colon tissue samples of people who later developed PD, supports a hypothesis that the disease may possibly begin in neurons of the intestinal wall and later spread to the brain. This study is the first to show alpha-synuclein in colon tissue before onset of PD. Currently, diagnosis of Parkinson’s disease depends on the appearance of such cardinal features as tremor, slowed movement, rigidity and gait problems. The clinical diagnosis can be difficult early in the disease, and as many as 10 percent to 20 percent of patients may be misdiagnosed. Studies have shown that by the time primary symptoms appear, many patients with Parkinson’s disease will have lost 60 percent to 80 percent or more of dopamine-producing cells in the brain. If the findings from this very small study are replicated in studies involving larger samples, it may be possible one day to use colonoscopy to predict who will develop PD. Because doctors already recommend that people age 50 and older have a colonoscopy every few years, it would be relatively easy to test colon tissue biopsies for the alpha-synuclein protein. Alternatively, colonic tissue could be collected using flexible sigmoidoscopy, a technique that, unlike colonoscopy, requires no colon cleansing preparation or sedation and can be performed in 10 minutes. Early detection of PD would help facilitate a search for a cure, or for interventions that slow the disease. But first, it will be important to confirm the results in larger populations of people with and without PD.

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Dance Class Gets Parkinson's Patients Moving

Pasadena is home to the Lineage Performing Arts Center, a refuge for people with Parkinson’s disease. Lineage offers a variety of outreach classes where members can train to regain control of their body while learning to dance. Their free class, Dancing with Parkinson’s, is one of the few programs that blurs the line between art and physical therapy, and people of all ages are welcome. Every year, Lineage hosts a dance show where members get to show off their skills.



Even though Parkinson’s disease is a movement disorder that causes uncontrollable tremors, pain, rigidity, and problems with stability, depression is not uncommon. Students of the class insist it improves their lives. 48-year-old Trish Low has had intense pain ever since undergoing an invasive surgery in which a pacemaker that generates electrical impulses was implanted in her brain. She sought the class to “find some joy” and ended up with friends and increased self-confidence. “To know that I can still shake my booty a little bit, it’s good for my soul.” It has become not only a movement for health and physical fitness, but also for well-being, personal fulfillment, and a meaningful aesthetic experience.


Over two years ago, the company was already performing benefit concerts for medical nonprofits across the country, but in 2009 when dance instructor Michelle Kolb saw footage in a documentary about a dance class from the Mark Morris Dance Group (MMDG), she was inspired to bring David Leventhal, program manager of MMDG’s Dance for PD program, to Pasadena for a training workshop. To this day, they now have more than 1,500 students and a lively community.



At the end of the day, dancers and people with Parkinson’s disease have a lot in common. Professionally-trained dancers are experts in strength, balance, and rhythm. They know about the power of dance as a force of meditation on movement, mind, and body. Dance for PD began as a support group and grew into a catalyst in creating other Parkinson’s communities where participants can explore well-being through singing, yoga, and various performance arts. "Although participants from all over the world tell us they find elements of the class therapeutic, the primary goal of our program is for people to enjoy dance for dancing’s sake in a group setting—and to explore the range of physical, artistic and creative possibilities that are still very much open to them,” says Leventhal.



Lineage Dance

You can take the Lineage Dancing with Parkinson’s class for free at the Lineage Performing Arts Center on Wednesdays at 2:00 pm. They also offer Dancing through Cancer and Dancing with Down Syndrome. Visit LineageDance.org for more information.


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Discovery of New Gene Provides Opportunity to Better Understand Focal and Generalized Dystonias

Discovery of New Gene Provides Opportunity to Better Understand Focal and Generalized Dystonias

Published online December 9 in Nature Genetics, the findings describe the GNAL gene, the first primary torsion dystonia gene that directly points to signal transduction pathways in the dopamine system as the origin of pathophysiology. Genetic testing in volunteers from two dystonia families revealed mutations in GNAL. Further screening of 39 additional families identified another six mutations in this gene. This discovery will help development of genetic tests to confirm diagnosis, identify unaffected adult carriers, and provide greater reproductive health options for affected families. The research also unveils a new potential therapeutic target and thus an opportunity for developing new treatments.


“The technique used for the identification of the GNAL gene-called exome sequencing-is a powerful and efficient tool that will accelerate the pace of dystonia gene discovery and, consequently, our understanding of the pathways involved in primary torsion dystonia.” says Laurie Ozelius, PhD, of Mount Sinai School of Medicine, who led the research team. “Any new gene offers the potential to develop new therapeutics, but because GNAL belongs to a well-studied pathway, other components in this pathway may also be targets for drug development” adds Tania Fuchs, PhD, Instructor in the Department of Genetics and Genomic Sciences of Mount Sinai School of Medicine, who is first author of the paper.


Jan Teller, MA, PhD, Science Officer of the DMRF says, “Every time researchers identify a gene, another piece of the puzzle falls into place to clarify our understanding of dystonia. The protein associated with the GNAL gene may hold important clues about how dystonia originates in the brain and potential new strategies for treatment. ”


Primary torsion dystonia is a movement disorder characterized by repetitive twisting muscle contractions and postures that can affect the face, neck, arms, legs, or torso. Common symptoms include tremors, voice problems, or a dragging foot. Primary torsion dystonia may be adult onset or childhood onset. Symptoms can be focal, segmental or generalized. The disorder is dominantly inherited with reduced penetrance, making it difficult to predict which family members may at risk without genetic screening. Three additional genes associated with primary torsion dystonia have been identified: DYT1, THAP1, and CIZI.


Dyst int found

Visit The Dystonia Foundation to learn more about their research efforts.

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2nd Annual Pasadena Parkinson's Symposium - May 4th

2013 2nd Annual Pasadena Parkinson s Symposium


Neurologists and movement disorder specialists in Los Angeles will be providing free Parkinson’s presentations and workshops at this one of a kind event. Join us for fair exhibitors, speakers, and demonstrations related to symptoms and treatment options, nutrition and exercise, and more. Food, refreshments and door prizes will be available. Join us, celebrity host Michael Gross, and Mayor Richard J. Ward for this special event!


Download PDF flyer for additional details.

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Mild Hypertension: Garlic, Drugs, or Cocoa?

Mild Hypertension Garlic Drugs or Cocoa

One review of four trials that comprised nearly 9000 participants looked at how well antihypertensive drugs prevent cardiovascular events and death in people with mild hypertension, defined as systolic blood pressure of 140–159 mm Hg or diastolic pressure 90–99 mm Hg (or both). All participants were free of cardiovascular disease at baseline.


No effects were seen over four to five years, compared with placebo, for overall mortality (relative risk 0.85, 95% CI 0.63 to 1.15), coronary heart disease (1.12, 0.80 to 1.57), stroke (0.51, 0.24 to 1.08), or total cardiovascular events (0.97, 0.72 to 1.32). One in 10 people stopped taking antihypertensives because of adverse effects, a fivefold increase over placebo. The review did not report effects of drugs on blood pressure, if any. Another review found two small trials that compared garlic powder with placebo in people with mild hypertension. Garlic might help reduce blood pressure—possibly by about 10 mm Hg for systolic blood pressure and a little less for diastolic blood pressure. However, the confidence intervals were wide, and no data were available on which to assess the potency of garlic to prevent cardiovascular events. Cocoa is rich in flavanols, which cause blood vessel dilatation and are thought to reduce blood pressure. Most of the 20 trials (about 850 participants) tested a daily dose of 500–750 mg of flavanols ingested through chocolate or cocoa products. Most participants were healthy and normotensive at baseline, and most trials lasted only about a month.


Small reductions in blood pressure were seen with cocoa, compared with placebo: −2.77 (−4.72 to −0.82) mm Hg for systolic pressure and −2.20 (−3.46 to −0.93) mm Hg for diastolic blood pressure. One in 20 people allocated cocoa had adverse effects, compared with one in 100 of those receiving placebo. Gastrointestinal effects and a dislike of the product’s taste were the most common problems.


Information sourced from BMJ:

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Cochrane Database Syst Rev2012;8: CD007653

Cochrane Database Syst Rev2012;8:CD008893

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12 Caregiving Tips for People with Alzheimer’s

12 Caregiving Tips for People with Alzheimer s
  • Alzheimer’s affects language. Often times the person may substitute words, such as “I need a fork,” when he or she meant to say, “I need a spoon.” Just give them the spoon, don’t try to correct them as this doesn’t achieve anything.

  • Use simple words and short sentences. Speaking in a gentle, calm tone of voice can produce positive results.

  • Avoid baby talk when talking to a person with Alzheimer’s. Its ineffective and can come off as rude. Speak respectfully in a normal voice as one adult to another.

  • Bathing can be a frightening and confusing experience for some individuals with Alzheimer’s. It’s important to prepare everything in advance and gently begin coaching him/her to begin the process. Help as much as needed but allow him/her to do as much of it as he/she can themselves.


  • When assisting someone with Alzheimer’s to dress, lay two choices of clothing out and let them decide.

  • Individuals with Alzheimer’s may become paranoid and or suspicious of others. It’s important to ease the worry by redirecting the conversation to a neutral or non-threatening subject.

  • Mealtime can be a challenge so choose dishes and eating tools that promote independence. Using bowls instead of plates or using straws for drinking can be a simple way to make mealtime easier.

  • When attempting to engage in difficult chores such as bathing and grooming use gestures and other non-verbal cues. You can distract the person with enjoyable activities such as singing in order to lead the person into the activities they dislike.


  • Find ways to soothe the person with Alzheimer’s concern. If an elderly women asks “where are my babies?” it is ok to say that the babies are sleeping. Or if the person asks the whereabouts of a spouse who is deceased, it is ok to say that they are running an errand.

  • Be patient! Expect things to take longer. Schedule more time to complete even the simple tasks so as not to hurry and confuse the person with Alzheimer’s.

  • If the person with Alzheimer’s suffers from incontinence, it’s helpful to have a routine for taking the person to the bathroom. For example, take the person to the restroom every 3–4 hours during the day.

  • People with Alzheimer’s disease can’t control what is happening to them. It is the caregiver who must adapt and change. As a caregiver you can learn news ways to relate to the person with Alzheimer’s.

Hello home

This article was written by Hello! Home Care Office Manager Jenelle Bossett.

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Lift Stride: An App for Parkinson’s Disease

Lift Stride An App for Parkinson s Disease

Lift Stride, a new app by Lift Labs has been designed to help those with gait problems walk more effectively by creating a metronome on a smartphone. It acts as a personal metronome that can help those with Parkinson’s Disease or other movement disorders walk better. Details below:


A lot of our friends and family who have Parkinson’s Disease have a hard time moving, mostly with walking. In many cases they can only take small shuffling steps, and in the most extreme cases, a total loss of motion occurs where they feel like their feet are actually stuck to the ground.


There are several solutions that are in existence for Parkinsonian mobility problems including drugs (L-dopa) and Deep Brain Stimulation (DBS), though they have their limitations. To help with this, other gait improvement strategies have been researched, and it has been found that sound or visual cues happen to make a difference. Floor markers have been shown to increase stride length, as well as gait initiation. Auditory cues generated by a metronome tend to help when they are set slightly above the user’s typical cadence.


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The problem, though, is that metronomes are expensive, bulky, and loud. You can easily buy one online, but most don’t like using them. One of our friends told us that his wife quickly became bothered with the incessant ticking coming from his pocket. While metronome units come with headphones, but they don’t have a volume adjustment, and have long obtrusive wires that get tangled. People are also embarrassed with having some machine attached to them.


With almost half of the US owning a smartphone (and quickly growing), we thought there had to be an elegant solution that we could offer. So, we came up with Lift Stride – a free smartphone app for parkinson’s disease (available for iphone and android). Our app is very simple. All you have to do is turn it on, adjust the cadence to just above your walking speed. You can play around with the setting until you find a pace that works right. The app works best with a Bluetooth headset (which is very discreet and does not look like a medical aid). We are keeping the app free (with zero ads). Our hope is that it will help spread awareness of our company, our talent, and our exciting upcoming products. Download the app here:


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LiftLabsLift Labs, part of Lynx Design, is a group of highly talented people
who are working to create new technologies for the social benefit.
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LiftWare’s Active Tremor Cancellation Technology



LiftLab's LiftWare products are recommended for those who have hand tremors. With clever ideas and implementation, LiftLabs have created a helpful product for tremor patients. Here are the details:


Through our research and conversations with people living with tremor, we know that forcibly suppressing a person’s tremor can cause pain and discomfort. We developed a uniquely effective and compact device that uses active tremor cancellation to 1) reduce the amount of force we need to counteract and 2) implement a control system that can quickly filter out unintentional tremor while preserving intentional hand movement.


Overcoming the forces generated by a trembling hand or arm typically requires large, awkward structures such as braces or weights. We were able to miniaturize LiftWare relative to other technologies by inventing a system that stabilizes only the bowl of the spoon, requiring much less force than a system that suppresses hand tremor. And by allowing the hand to tremor, using LiftWare feels natural and is comfortable to use.


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Since we aren’t forcing the hand to be still, we needed a technology that could respond quickly to a person’s tremor, and also tell the difference between intentional motion (such as moving the spoon to your mouth) and unintentional tremor. Sensors embedded in the spoon detect motion, and a microcontroller uses sensor data to determine the best response. The microcontroller continuously directs motors in the handle of the device to move the spoon and cancel tremor both horizontally and vertically. Since we know that almost all Essential and Parkinsonian Tremor occurs between 4 and 7 cycles per second, we optimized our control system to only cancel motion in that range. As a result, food is kept steady in the bowl of the spoon through our active tremor cancellation technology.


The video clip shown below illustrates the effectiveness of a very early device working in the lab. The prototype is filled with granola while attached to an apparatus that simulates tremor. You can see that with the system turned off, the granola will immediately fly out of the bowl of the spoon, while turned on the granola is held indefinitely. We’ve come a long way since then, and are very proud of our final product.


LiftLabsLift Labs, part of Lynx Design, is a group of
highly talented people who are working to create new technologies for the social benefit.

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Tremor Measurement and Monitoring App

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LiftLabs recently released a very useful free iPhone app for those with Essential Tremor and Parkinson’s Disease. Here are the details:


We’ve been listening to a lot of patients with Essential Tremor and Parkinson’s Disease these days, and it seems like a lot of people have a desire for a tremor measurement and monitoring app. Since many people have smart phones (and because of the computing power they now have), we thought it would be useful to create an app that can do just that.


Lift Pulse is a highly intuitive, yet powerful app that is calibrated to measure your tremor frequency and amplitude. To get a reading, hold your phone in your hand and press record. The gray bar will begin to fill as the recording begins. Once the bar is full (after about 10 seconds) the app will move to the analysis screen.


There, you can see a frequency spectrum. Your tremor measurement should appear as a peak between 5 and 10 Hz as shown in the figure above. The tremor measurement and monitoring app automatically finds this peak and integrates it to calculate your overall tremor amplitude in centimeters. The app senses tremor in all directions (x,y,z) of the phone and calculates your overall magnitude.


Lift Pulse allows you to compare your tremor to a pre-set baseline. To set your baseline (this could be on an average day for you), take a reading and then tap on the circle showing your amplitude in Cm. Any future tremor measurement and monitoring readings will be compared to this saved baseline and the circle showing your amplitude will change (from blue to red) depending on how much above or below the baseline you are.


The best news is that this tremor measurement and monitoring app is currently free! It is our hope to spread goodwill and generosity in order to support those in need of help. If you have any suggestions, please leave a comment or contact us at info@lynx-design.com.


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LiftLabsLift Labs, part of Lynx Design, is a group of highly talented people
who are working to create new technologies for the social benefit.
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