Parkinson's disease (PD) is a neurological disorder that can have an effect on motor planning and can cause changes in movement control. Physical therapy treatment often centers on improving safe functional mobility and maintaining ease of movement in people with PD. Exercise is one facet of treatment that can help control symptoms of the disease and improve movement.
If you have PD, your doctor may refer you for a physical therapy evaluation to assess changes in motor control that may occur with the disease. After the evaluation, your physical therapist may recommend specific strategies and exercise to help control the symptoms of PD and to improve safe functional mobility.
The main goal of exercise for people with PD is simply to promote physical activity. Exercise can also improve or control primary PD symptoms. If you have PD, be sure to speak with your doctor and physical therapist to ensure that exercise is safe for your specific condition and to learn the best exercises for you.
Exercise to improve walking. Since gait and walking ability are often impaired with PD, exercises to improve walking should be included in a treatment program. These exercises should promote normal steps and stride length. Strengthening exercises for the hips, knees, and ankles are recommended. Exercises to improve balance can also help improve walking ability and improve safety when standing and walking.
Your doctor and physical therapist may determine that walking aids and assistive devices, such as walkers and canes, are not indicated for your specific condition. Arm and hand tremor may be present, making such devices difficult to control.
Strengthening exercises. Exercises to improve and maintain muscular strength are important to consider if you have PD. By keeping your trunk, arm and leg muscles strong, you may be able to improve coordination and smoothness of movement.
Balance exercises. If you have PD, changes in your posture, walking, flexibility and motor control may make keeping your balance difficult. Performing balance exercises may help you to maintain control during functional mobility and improve safety.
Aerobic exercises. Since endurance may be compromised in people with PD, exercises that promote improved cardiovascular and pulmonary fitness may be recommended. Treadmill walking, stationary bike riding and arm endurance exercises are good choices to help improve or maintain aerobic fitness. Aerobic exercise can also help improve mood and promote a sense of well-being, which may be important if you are suffering from anxiety or depression due to your condition.
Postural exercises. If you have PD, you may notice that your posture has become flexed forward. This can make breathing difficult. It can also move your center of gravity forward, leading to increased risk of falls.
Postural exercises to help stretch tight chest and arm muscles and to improve contraction of the muscles that support the shoulder blades in the back should be considered. Working to attain and maintain good posture can make breathing easier, improving endurance.
Range of motion and flexibility exercises. Rigidity is a common symptom of PD. You may feel tightness in your muscles and joints if you have PD. Exercises to improve range of motion around your joints are recommended. Gentle flexibility exercises of the arms and legs are also indicated to help ensure that your muscles and joints can move freely.
Parkinson's disease causes changes in many different body systems. A multidisciplinary approach to care is often necessary to maintain a high quality of life. Exercise is one important facet of the treatment plan that may help preserve functional mobility and maintain safety for as long as possible.
Carr, J. H. (2000). Neurological rehabilitation: optimizing motor performance. Oxford: Butterworth Heinemann
Umphred, D. A. (1995). Neurological rehabilitation. (3 ed.). St. Louis: Mosby.