36 Comments on “Perceptions of Virtual Group Exercise Classes in People with Parkinson’s Disease”
I love the adapted option in the virtual exercise video. Throughout the virtual exercise are other alterations or verbal commands given that could alter the safety perception of patients?
Hello Rachel, great question. We did a pre-class technology check before they attended their virtual class. During that meeting we asked additional safety question. If any participant seemed nervous or unsteady, we suggested that they have a chair close by to utilize that safety option. During the virtual class itself, we had an instructor performing the standing version and another performing the safer seated version that participants could change at any time regarding safety and how they were feeling. We also asked for contact information for a person that would be close on that day incase anything would happen.
Nice poster and project overall! I thought it was interesting how a high number of participants noted distance traveled and limited transportation as barriers to participating in a PD class or group exercise class in general. This is especially important when looking at rural areas of South Dakota and surrounding states where many of USD grads go on to practice. My question is was there anything in particular that surprised you throughout this research study? Do you think that patient compliance and participation would continue long term?
Hey Jordyn, thanks for enjoying our research! I know for me, the thing that surprised me the most was our wide span of participants. We had some from New York all the way to Texas and many from the Midwest. I was truly surprised how wide of area we could influence. In the grand scheme of things, I think that would be great and may even help with compliance and participation. It would hopefully allow people with Parkinson’s to have a wider variety of classes they could attend throughout the country, or even help find a group of people they connect with more by trying out different groups to help with that social connectedness even more! If a specific scheduled class in a time zone doesn’t work with their schedule, maybe they would be able to find a differing one that would help with compliance and participation more consistently.
I love that you guys were able to offer online classes for individuals with Parkinson’s to participate in and that the results showed the benefit of increased connectedness through this platform. Do you think if you were to pre-record a series of workouts that individuals with Parkinson’s could complete on their own time rather than a live workout session that 50% of individuals would still find it just as intense? Or do you think it would pose other safety risks without a live instructor to respond or correct movements?
I think this would be a great way to continue to allow them to maintain a workout routine.
Hi Tori! Yes, I do think that doing a pre-recorded workout session would allow individuals to find the workouts just as intense. I think it would be important to find out if they are a high fall risk before allowing them to participate in the workouts. If they were a high risk it would be important to recommend that someone was with them when they were doing the workouts as well as that they use the modified seated exercises in case they were to have a fall. While they would miss out on the social connectedness, and having someone to check their form by doing a pre-recorded workout I think they could achieve the same intensity. Thanks!
Great job with your poster! I found it interesting that the distance to travel was the number one reason to go virtual. I understand that there are many PD patients in rural South Dakota with limited access to in-person group exercise programs. As future physical therapists, do you think there will need to be a balance between virtual and in-person sessions to maintain connectedness?
Hey Luke, that’s a great question. I personally think that would be a great idea! During our research, the participants did respond staying they felt connected; however, I feel that could improve with in-person also. Personally again, I think it would be very beneficial to have the option of virtual class AND in-person classes to accommodate more individuals schedules, comfort level, but then also allow for some of these individuals spend more time with other participants outside of the classes themselves.
Great job on your project! When selecting participants, was it considered that some of the patients with PD may not have enough function to participate in exercises without in-person assistance? If so, were these patients excluded from the sample size?
Hello! Yes we did consider this and created a functional screening tool for participants to fill out before attending the class and we also offered alternative exercises in seated positions vs standing for those limited or who felt more comfortable performing the exercises sitting down
Hey guys, not only do I think that you did a great job with your poster, but I think that this is such a great area of research as well, especially with this day-of-age! Being as though participants reported virtual exercise being only 30% as safe as in-person exercise, what are your thoughts to help improve this percentage moving forward? Maybe this is a question that could also be a follow-up question to participants to hear what might make them, personally, feel safer with this as well?
Hello,
I think one way to improve this percentage and to make then personally feel safer would be to offer a pre-class screening by a PT or healthcare professional to assess their overall ability and to boost their confidence and or provide any modifications needed before their first class and also to answer any last questions they might have.
Hello,
One way to improve this percentage and make them feel safer would be to offer an in person screening by a PT or health care professional before their first class to boost their confidence and or to offer any modifications as needed for them before their first class and to answer any last questions
Great job with your research! I love this idea of virtual class for patient’s with PD because so many people struggle with transportation and time constraints, especially if they live in a more rural area with less resources. It would be interesting to understand why the patient’s who participated did not feel as safe and what could have been different to change that perception. Do you think it would be beneficial to have the patient come in with a caregiver for the initial exercise program so the caregiver can be trained for safety precautions and then they can continue the exercise program virtually if distance was an issue, with frequent check-ins from the PT?
I love this topic! I was able to have an internship at Rock Steady Boxing in Sioux Falls, which is specifically for those with PD. It was an amazing experience and the boxers were so much fun! Do you think virtual exercise classes could function as a stepping stone to in-person classes for those who have been recently diagnosed and may not feel comfortable with starting at an in-person class?
Hi Madison, I think that virtual classes certainly could be a stepping stone to in person classes! It would be great for people that don’t feel comfortable with starting with an in-person class as long as they are safe enough to be virtual or plan on doing modified exercises. It would also be a great choice for people that are wanting to not make trips into a clinic to transition into virtual classes as well.
Hi, I really enjoyed the idea of not only creating exercise based treatment of people with Parkinson’s but also building a network for them to communicate with each other. As PD progresses I know sometimes confusion and fear arise and in-person contact can be better, did you have any problems connecting with these participants online, would it have been easier in person to build the connections?
Hi Tessa, we did not have any problems building connections during the sessions. We were able to connect with them prior to the sessions over zoom for a technology check which helped build a relationship prior to the exercise session. I think that with more sessions we could have built a further connection but everyone seemed to get alone well on the sessions!
I enjoyed reading your research study! It is definitely a beneficial topic for rural South Dakota as it is likely that some patients have a transportation/distance barrier to PT. I understand and appreciate the modified variations for different patient needs, but would this be something that you would first suggest to see the patient with PD in clinic and then they work towards a virtual exercise program? It’s likely different for a case by case basis, but I’m curious for safety purposes. As well, if the participants that are not a part of the 30.3% stating equal safety, would they perceive virtual class as a safer option knowing that it was following PT in clinic or in conjunction with it?
Hello Rylee, good questions! For people with Parkinson’s Disease, the best practice is for them to come get one-on-one physical therapy for a while in order to get them at their best functional level and then for them to discharge to a group exercise class for people with Parkinson’s. So, yes I would first suggest a patient see a PT first and then transition into more of a group exercise class whether it’s virtual or in person. For your question about safety, I am not sure if patients would feel safer if they had PT prior. A lot of our participants had been in physical therapy before, but I could not confidently answer if that would change their safety level. The question about safety was asked to compare in-person vs online class, so it was not shocking that a lot of people perceive an in-person class to be safer. People with Parkinson’s are able to choose whichever group exercise option they prefer, but a virtual option is nice for many people who live in rural SD and do not have regular access to an in-person class.
I really enjoyed learning about your research! Great job with everything! My question for you is why did you decide to research Parkinson’s Disease? I also am wondering if you think virtual group exercises classes would be beneficial for individuals with other neurological diseases? Do you think the perceptions would change depending on disease? Thanks!
Hello we chose to research PD because it is a prevalent neurological disease in the Midwest and in this region rural towns are common making virtual classes very beneficial to those who may not otherwise have access to the classes or have to travel a long distance for classes. PD exercise classes also have studies showing the benefits of exercise and PD. Virtual classes can help overcome many of these perceived barriers. I also think that perceptions would change depending on the disease as some are more debilitating and also less debilitating and some progress faster and some slower which all would change the perception.
Hello! I enjoyed reading your study! My question is what kind of exercises were specifically included in the program? Would you modify anything looking back?
Hello Cassidy! Great question. We started with a warm-up which included some generalized stretching and activities to warm-up the body such as arm circles and hamstring stretching. Next we moved into large amplitude movements which utilized PWR! exercises. Last we did cardiovascular exercises that were aimed at getting the heart pumping including exercises such as marching and jumping jacks. The cardiovascular portion was done in a circuit with each exercise being done for 30 seconds with 3 rounds of each exercise. Lastly we did a cool down with breathing exercises and more stretches. I would not modify anything looking back since the exercises used are the current best evidence for treating people with Parkinson’s. However, it would be interesting for a future study to compare the exercises we did with more generalized exercises (general strength and cardio) and see if the Parkinson’s specific exercises perform better.
Thank you for sharing your knowledge and all of this information! How do you think your study would differ if it was more individuals with other terminal illnesses besides Parkinson’s?
I do think this study would differ a lot if it was with a different diagnosis besides Parkinson’s. Most of our questions and our interventions in the virtual exercise class were tailored towards people with a Parkinson’s Diagnosis, so doing a different diagnosis would change the study a lot! I do things that the ideas behind this study could be used with different diagnosis if it was tailored towards that disease.
Hello, I really enjoyed reading this study! I had one question for you all. I know that Parkinson’s disease is a disease that varies greatly between patients in symptoms and severity did this have any effect in your inclusion or exclusion criteria?
Hello Troy, great questions! We did have inclusion/exclusion criteria, however severity of symptoms was not apart of our criteria. For Stage 1 of our project (which was just the survey), the participants could take the survey if 1) over 18 years old, 2) had a diagnosis of Parkinson’s or parkinsonism. For Stage 2 of our study (which included involvement in the virtual exercise class), they had to 1) over 18 years old, 2) had a diagnosis of Parkinson’s or parkinsonism, 3) have access to internet and a web based communication platform (Zoom), 4) have the capacity to participate in one hour’s worth of exercise, and 5) pass our fall risk/exercise tolerance tool.
I really enjoyed reading about your study, great work! It seemed as though a common theme among the smaller sample size was feeling unsafe. Do you feel as though this is a skewed perspective from a smaller sample size, or a larger problem, and how would you tackle this problem virtually? I was also wondering what the activities/exercises performed virtually were, and if this would lead to the cost of a home gym being a barrier for people with PD to workout from home?
Hello Jack, great questions! I am not sure if the feeling unsafe would potentially be different if we had a larger sample size, that would be a great follow-up study to see how it differed! However, when we asked that questions we were asking them to compare it to in-person class so I do feel as if a lot of people would consider an online class less safe than an in-person class. Our main way we tackled safety it in this study was providing a modified version of the exercises where the participants were able to do the exercises seat in order to make participants feel more safe. We did also screen the participants prior to the class to make sure they were appropriate. For your next question, all the activities we did in this virtual session did not require any equipment. A lot of our exercises where from the LSVT-BIG/ PWR! which do not require any equipment except for a chair if they opted for the modified version. I do not believe that cost effectiveness for a home gym would be a problem considering no equipment was used.
Great job on the poster! I think the concept of virtual exercise classes can definitely be intimidating for older adults, especially in rural South Dakota. One question I have for you guys would be: What did you guys do or what could you guys have done to incentivize more participants to get them to follow up or complete the workout class so that the sample size would increase?
Hello Joesph, good question! We did nothing to incentivize participants in terms of providing compensation for participation, we just tried to get the information out to as many people with Parkinson’s as we could! We did an advertisement through the SD Parkinson’s Association, put up posters at local physical therapy clinics, and did some recruiting through the Research Match website. If we had more resources for this project, we potentially could have incentivized being apart of study by providing some sort of compensation for being involved. Another idea for getting more participants without using compensation could be using social media more to advertise the project or contacting more states Parkinson’s Associations such as Nebraska and Iowa to try and get our research out to more people.
Hi! I saw on your poster that one of the results recorded was that the participants of the class felt like the class could increase connectedness with others just as much as an in-person class does. How did the intervention accomplish this through a virtual class? Also, in your research did you find that connectedness is an important factor in adherence for people with PD or how did you choose to include that as a survey question? Thank you!
Hello Kendra, good question! One way we really focused on promoting connectedness was before we started with exercises, we provided a time for everyone in the zoom to introduce themselves to and to converse amongst themselves. We also encouraged everyone to have their cameras on during the session in order to increase that feeling of connectedness. From the beginning, one of our research questions was whether the perceptions of connectedness was different on a virtual class vs an in-person class since having a community has shown to be very important for people with Parkinson’s which is why we included multiple questions in our surveys about the feeling of connectedness with virtual classes.
PD-5 programme from natural herbs centre has done wonders for me. I even learned a few simple exercises I do daily to keep my back from hurting. It didn’t take very long before I started to get relief.
USD PT Research 
I love the adapted option in the virtual exercise video. Throughout the virtual exercise are other alterations or verbal commands given that could alter the safety perception of patients?
LikeLike
Hello Rachel, great question. We did a pre-class technology check before they attended their virtual class. During that meeting we asked additional safety question. If any participant seemed nervous or unsteady, we suggested that they have a chair close by to utilize that safety option. During the virtual class itself, we had an instructor performing the standing version and another performing the safer seated version that participants could change at any time regarding safety and how they were feeling. We also asked for contact information for a person that would be close on that day incase anything would happen.
LikeLike
Nice poster and project overall! I thought it was interesting how a high number of participants noted distance traveled and limited transportation as barriers to participating in a PD class or group exercise class in general. This is especially important when looking at rural areas of South Dakota and surrounding states where many of USD grads go on to practice. My question is was there anything in particular that surprised you throughout this research study? Do you think that patient compliance and participation would continue long term?
LikeLike
Hey Jordyn, thanks for enjoying our research! I know for me, the thing that surprised me the most was our wide span of participants. We had some from New York all the way to Texas and many from the Midwest. I was truly surprised how wide of area we could influence. In the grand scheme of things, I think that would be great and may even help with compliance and participation. It would hopefully allow people with Parkinson’s to have a wider variety of classes they could attend throughout the country, or even help find a group of people they connect with more by trying out different groups to help with that social connectedness even more! If a specific scheduled class in a time zone doesn’t work with their schedule, maybe they would be able to find a differing one that would help with compliance and participation more consistently.
LikeLike
I love that you guys were able to offer online classes for individuals with Parkinson’s to participate in and that the results showed the benefit of increased connectedness through this platform. Do you think if you were to pre-record a series of workouts that individuals with Parkinson’s could complete on their own time rather than a live workout session that 50% of individuals would still find it just as intense? Or do you think it would pose other safety risks without a live instructor to respond or correct movements?
I think this would be a great way to continue to allow them to maintain a workout routine.
LikeLike
Hi Tori! Yes, I do think that doing a pre-recorded workout session would allow individuals to find the workouts just as intense. I think it would be important to find out if they are a high fall risk before allowing them to participate in the workouts. If they were a high risk it would be important to recommend that someone was with them when they were doing the workouts as well as that they use the modified seated exercises in case they were to have a fall. While they would miss out on the social connectedness, and having someone to check their form by doing a pre-recorded workout I think they could achieve the same intensity. Thanks!
LikeLike
Great job with your poster! I found it interesting that the distance to travel was the number one reason to go virtual. I understand that there are many PD patients in rural South Dakota with limited access to in-person group exercise programs. As future physical therapists, do you think there will need to be a balance between virtual and in-person sessions to maintain connectedness?
LikeLike
Hey Luke, that’s a great question. I personally think that would be a great idea! During our research, the participants did respond staying they felt connected; however, I feel that could improve with in-person also. Personally again, I think it would be very beneficial to have the option of virtual class AND in-person classes to accommodate more individuals schedules, comfort level, but then also allow for some of these individuals spend more time with other participants outside of the classes themselves.
LikeLike
Great job on your project! When selecting participants, was it considered that some of the patients with PD may not have enough function to participate in exercises without in-person assistance? If so, were these patients excluded from the sample size?
LikeLike
Hello! Yes we did consider this and created a functional screening tool for participants to fill out before attending the class and we also offered alternative exercises in seated positions vs standing for those limited or who felt more comfortable performing the exercises sitting down
LikeLike
Hey guys, not only do I think that you did a great job with your poster, but I think that this is such a great area of research as well, especially with this day-of-age! Being as though participants reported virtual exercise being only 30% as safe as in-person exercise, what are your thoughts to help improve this percentage moving forward? Maybe this is a question that could also be a follow-up question to participants to hear what might make them, personally, feel safer with this as well?
LikeLike
Hello,
I think one way to improve this percentage and to make then personally feel safer would be to offer a pre-class screening by a PT or healthcare professional to assess their overall ability and to boost their confidence and or provide any modifications needed before their first class and also to answer any last questions they might have.
LikeLike
Hello,
One way to improve this percentage and make them feel safer would be to offer an in person screening by a PT or health care professional before their first class to boost their confidence and or to offer any modifications as needed for them before their first class and to answer any last questions
LikeLike
Great job with your research! I love this idea of virtual class for patient’s with PD because so many people struggle with transportation and time constraints, especially if they live in a more rural area with less resources. It would be interesting to understand why the patient’s who participated did not feel as safe and what could have been different to change that perception. Do you think it would be beneficial to have the patient come in with a caregiver for the initial exercise program so the caregiver can be trained for safety precautions and then they can continue the exercise program virtually if distance was an issue, with frequent check-ins from the PT?
LikeLike
Hello,
I think those would all be a great way to improve their feeling of safety.
LikeLike
I love this topic! I was able to have an internship at Rock Steady Boxing in Sioux Falls, which is specifically for those with PD. It was an amazing experience and the boxers were so much fun! Do you think virtual exercise classes could function as a stepping stone to in-person classes for those who have been recently diagnosed and may not feel comfortable with starting at an in-person class?
LikeLike
Hi Madison, I think that virtual classes certainly could be a stepping stone to in person classes! It would be great for people that don’t feel comfortable with starting with an in-person class as long as they are safe enough to be virtual or plan on doing modified exercises. It would also be a great choice for people that are wanting to not make trips into a clinic to transition into virtual classes as well.
LikeLike
Hi, I really enjoyed the idea of not only creating exercise based treatment of people with Parkinson’s but also building a network for them to communicate with each other. As PD progresses I know sometimes confusion and fear arise and in-person contact can be better, did you have any problems connecting with these participants online, would it have been easier in person to build the connections?
LikeLike
Hi Tessa, we did not have any problems building connections during the sessions. We were able to connect with them prior to the sessions over zoom for a technology check which helped build a relationship prior to the exercise session. I think that with more sessions we could have built a further connection but everyone seemed to get alone well on the sessions!
LikeLike
I enjoyed reading your research study! It is definitely a beneficial topic for rural South Dakota as it is likely that some patients have a transportation/distance barrier to PT. I understand and appreciate the modified variations for different patient needs, but would this be something that you would first suggest to see the patient with PD in clinic and then they work towards a virtual exercise program? It’s likely different for a case by case basis, but I’m curious for safety purposes. As well, if the participants that are not a part of the 30.3% stating equal safety, would they perceive virtual class as a safer option knowing that it was following PT in clinic or in conjunction with it?
LikeLike
Hello Rylee, good questions! For people with Parkinson’s Disease, the best practice is for them to come get one-on-one physical therapy for a while in order to get them at their best functional level and then for them to discharge to a group exercise class for people with Parkinson’s. So, yes I would first suggest a patient see a PT first and then transition into more of a group exercise class whether it’s virtual or in person. For your question about safety, I am not sure if patients would feel safer if they had PT prior. A lot of our participants had been in physical therapy before, but I could not confidently answer if that would change their safety level. The question about safety was asked to compare in-person vs online class, so it was not shocking that a lot of people perceive an in-person class to be safer. People with Parkinson’s are able to choose whichever group exercise option they prefer, but a virtual option is nice for many people who live in rural SD and do not have regular access to an in-person class.
LikeLike
I really enjoyed learning about your research! Great job with everything! My question for you is why did you decide to research Parkinson’s Disease? I also am wondering if you think virtual group exercises classes would be beneficial for individuals with other neurological diseases? Do you think the perceptions would change depending on disease? Thanks!
LikeLike
Hello we chose to research PD because it is a prevalent neurological disease in the Midwest and in this region rural towns are common making virtual classes very beneficial to those who may not otherwise have access to the classes or have to travel a long distance for classes. PD exercise classes also have studies showing the benefits of exercise and PD. Virtual classes can help overcome many of these perceived barriers. I also think that perceptions would change depending on the disease as some are more debilitating and also less debilitating and some progress faster and some slower which all would change the perception.
LikeLike
Hello! I enjoyed reading your study! My question is what kind of exercises were specifically included in the program? Would you modify anything looking back?
LikeLike
Hello Cassidy! Great question. We started with a warm-up which included some generalized stretching and activities to warm-up the body such as arm circles and hamstring stretching. Next we moved into large amplitude movements which utilized PWR! exercises. Last we did cardiovascular exercises that were aimed at getting the heart pumping including exercises such as marching and jumping jacks. The cardiovascular portion was done in a circuit with each exercise being done for 30 seconds with 3 rounds of each exercise. Lastly we did a cool down with breathing exercises and more stretches. I would not modify anything looking back since the exercises used are the current best evidence for treating people with Parkinson’s. However, it would be interesting for a future study to compare the exercises we did with more generalized exercises (general strength and cardio) and see if the Parkinson’s specific exercises perform better.
LikeLike
Thank you for sharing your knowledge and all of this information! How do you think your study would differ if it was more individuals with other terminal illnesses besides Parkinson’s?
LikeLike
I do think this study would differ a lot if it was with a different diagnosis besides Parkinson’s. Most of our questions and our interventions in the virtual exercise class were tailored towards people with a Parkinson’s Diagnosis, so doing a different diagnosis would change the study a lot! I do things that the ideas behind this study could be used with different diagnosis if it was tailored towards that disease.
LikeLike
Hello, I really enjoyed reading this study! I had one question for you all. I know that Parkinson’s disease is a disease that varies greatly between patients in symptoms and severity did this have any effect in your inclusion or exclusion criteria?
LikeLike
Hello Troy, great questions! We did have inclusion/exclusion criteria, however severity of symptoms was not apart of our criteria. For Stage 1 of our project (which was just the survey), the participants could take the survey if 1) over 18 years old, 2) had a diagnosis of Parkinson’s or parkinsonism. For Stage 2 of our study (which included involvement in the virtual exercise class), they had to 1) over 18 years old, 2) had a diagnosis of Parkinson’s or parkinsonism, 3) have access to internet and a web based communication platform (Zoom), 4) have the capacity to participate in one hour’s worth of exercise, and 5) pass our fall risk/exercise tolerance tool.
LikeLike
I really enjoyed reading about your study, great work! It seemed as though a common theme among the smaller sample size was feeling unsafe. Do you feel as though this is a skewed perspective from a smaller sample size, or a larger problem, and how would you tackle this problem virtually? I was also wondering what the activities/exercises performed virtually were, and if this would lead to the cost of a home gym being a barrier for people with PD to workout from home?
LikeLike
Hello Jack, great questions! I am not sure if the feeling unsafe would potentially be different if we had a larger sample size, that would be a great follow-up study to see how it differed! However, when we asked that questions we were asking them to compare it to in-person class so I do feel as if a lot of people would consider an online class less safe than an in-person class. Our main way we tackled safety it in this study was providing a modified version of the exercises where the participants were able to do the exercises seat in order to make participants feel more safe. We did also screen the participants prior to the class to make sure they were appropriate. For your next question, all the activities we did in this virtual session did not require any equipment. A lot of our exercises where from the LSVT-BIG/ PWR! which do not require any equipment except for a chair if they opted for the modified version. I do not believe that cost effectiveness for a home gym would be a problem considering no equipment was used.
LikeLike
Great job on the poster! I think the concept of virtual exercise classes can definitely be intimidating for older adults, especially in rural South Dakota. One question I have for you guys would be: What did you guys do or what could you guys have done to incentivize more participants to get them to follow up or complete the workout class so that the sample size would increase?
LikeLike
Hello Joesph, good question! We did nothing to incentivize participants in terms of providing compensation for participation, we just tried to get the information out to as many people with Parkinson’s as we could! We did an advertisement through the SD Parkinson’s Association, put up posters at local physical therapy clinics, and did some recruiting through the Research Match website. If we had more resources for this project, we potentially could have incentivized being apart of study by providing some sort of compensation for being involved. Another idea for getting more participants without using compensation could be using social media more to advertise the project or contacting more states Parkinson’s Associations such as Nebraska and Iowa to try and get our research out to more people.
LikeLike
Hi! I saw on your poster that one of the results recorded was that the participants of the class felt like the class could increase connectedness with others just as much as an in-person class does. How did the intervention accomplish this through a virtual class? Also, in your research did you find that connectedness is an important factor in adherence for people with PD or how did you choose to include that as a survey question? Thank you!
LikeLike
Hello Kendra, good question! One way we really focused on promoting connectedness was before we started with exercises, we provided a time for everyone in the zoom to introduce themselves to and to converse amongst themselves. We also encouraged everyone to have their cameras on during the session in order to increase that feeling of connectedness. From the beginning, one of our research questions was whether the perceptions of connectedness was different on a virtual class vs an in-person class since having a community has shown to be very important for people with Parkinson’s which is why we included multiple questions in our surveys about the feeling of connectedness with virtual classes.
LikeLike
PD-5 programme from natural herbs centre has done wonders for me. I even learned a few simple exercises I do daily to keep my back from hurting. It didn’t take very long before I started to get relief.
LikeLike