Physical Therapy for Parkinson’s Disease

Physical Therapy cannot absolutely cure Parkinson’s disease (PD) but can help patients with managing certain movement-related PD symptoms. Many studies have shown that Physical Therapy holds certain short-term benefits, including improved walking, balance, strength, and flexibility in PD, however, which approach of Physical Therapy is most effective is still unclear.

PD management through Physical Therapy can be primarily achieved by prescribing specific exercises to address issues related to posture, gait balance, strength and flexibility. The aim is to enable people with PD to improve existing level of mobility, activity, and independence by maximising physical ability over the whole course of the disease. It’s important to participate in a regular exercise program and work with your physical therapist to develop good long-term exercise habits.

The combination of physical therapy, learning-based memory training and aerobic exercise are often suggested as essential for a range of neurodegenerative disease. This is why it is important for the therapists to maintain learning-based exercise activities (in addition to physical exercises) for their clients to improve their ability to multitask while maintaining safety.  

How does Physical Therapy help in Parkinson’s?

Following a PD diagnosis, a therapist conducts a comprehensive evaluation to examine the PD fighter’s posture, strength, flexibility, walking endurance, balance and coordination competency.  Based on the results, the therapist develops an individualized therapy plan for better posture and trunk rotation. Depending on a patient’s severity level based, the treatment program focus on:

  • Improving fitness level, strength, and flexibility
  • Decreasing the risk of falling
  • Improvising the smoothness and coordination of walking
  • Improving the ability to perform hand movements
  • Improving the ability to rotate trunk and change directions more efficiently
  • Improving multitasking skills

All physical therapists specializing in neural disorders calibrate a score to track the symptoms of Parkinson’s. This score, known as Unified Parkinson’s Disease Rating Scale (UPDRS), is used to follow the longitudinal course of the disease. The UPDRS helps therapists track an individual’s progress.  

Most Common Physical Therapy Interventions

Physical Therapy, focusing on gait retraining and motor control relearning, may help the PD fighter overcome postural instability. He can be trained to focus on foot positioning to stabilize base for posture and gait. Instructing the PD fighter to deliberately take longer steps may also help him overcome the effects of freezing.

Another technique includes teaching the PD fighter to turn around in a wide arc. The patient is asked to avoid pivoting to avoid the risk of loss of balance and postural instability.

The therapy program also includes aerobic conditioning (swimming, walking, cycling) to improve endurance, strengthening of back extensor and abdominal muscles for a more upright posture, and stretching of trunk flexor muscles.

Commonly Prescribed Exercises

Relaxation techniques to decrease rigidity include gentle stretching exercises to prevent contractures, quadriceps and hip extensor. Apart from Stationary bicycle (to help train reciprocal movements), the most common exercises for PD patients include:

  • Neck and trunk rotation exercises
  • Back extension exercises
  • Pelvic tilt
  • Proper sitting and postural control (static and dynamic)
  • Breathing exercises that stress on inspiratory and expiratory phase