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Best Physical Therapy Exercises For Parkinson’s Disease

Parkinson’s Disease And Movement Disorders Center

Parkinson’s Disease Exercises: Exercise Tips

Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.

Meaningful Physical Activity For Those Impacted By Parkinsons Disease

On the Day 2 video of the Upper Midwest Parkinsons Symposium, at timestamp 1:31, you will find a one-hour talk by Dr. Kristin Pickett, PhD. She explains the difference between occupational therapy and physical therapy . She believes those diagnosed with Parkinsons disease should have PT, OT and speech therapy as part of their care team early on. Especially if you hate exercise, you can incorporate physical activity/movement into your everyday tasks. This is what she means by meaningful physical activity.

Choosing The Right Exercise Class For Parkinsons

When trying to find an exercise class to join, it can be hard to know which ones to try because there are many different types of classes that are marketed to people with PD. When you are evaluating a class, it is important to remember the following:

  • It is the components of the exercise class that are important . You do not need to specifically do boxing or dance if you can achieve these elements of exercise in other ways.
  • The instructor should have expertise in PD. APDA offers a training for fitness professionals which helps them better understand how to create exercise programs best suited for people with PD.
  • The ratio of class members to instructors should be low enough to maintain safety.
  • The class should be adaptable for people of different abilities and mobility. Many classes will offer seated options or other modifications.

It may take a few tries to find the types of exercise that suits you best so dont give up! Feel free to try different classes in your area to see what types of exercise appeal to you. It can also be motivating to take classes together with a friend or family member. You can hold each other accountable, and also have some fun together. As you find classes you enjoy, you can incorporate those modalities into your exercise schedule. For help in finding classes in your area, you can contact one of our Chapters or Information & Referral Centers. There are also many virtual classes that you can join from home.

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How Do I Find An Occupational Therapist

Referral procedures depend on where you live and treatment may or may not be accessible through your countrys national health system.

In some countries occupational therapy is prescribed by medical doctors but in others people with Parkinsons can contact an occupational therapist direct without going through their doctor.

Training and accreditation varies throughout Europe so it is best to check the experience of anyone you consult. It is helpful to be seen by someone who has experience of Parkinsons, and always ask for references and the likely costs before treatment commences.

Best Practice Guidelines are available online for occupational therapists working with people who have Parkinsons. ParkinsonNet also provides evidence based guidelines in English.

Your national Parkinsons organisation may be able to provide information based on members experiences. See also, Other Parkinsons organisations.

Strength And Resistance Training And Parkinsons


The American Academy of Neurology reports findings that show that two years of strength and weight training can considerably improve the motor symptoms of Parkinsons Disease. Balance and stretch exercises alone may not be enough to improve the symptoms as much as when they are combined with weight training.

It may be difficult to begin strength training, especially if you experience balance and motor control symptoms. However, strength with light weights or resistance training with the weight of your own body can make it easier to start.

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History Of The Role Of Exercise In Parkinsons

The benefits of exercise in PD have not always been well characterized. Despite the American Academy of Neurology encouraging the use of exercise as an adjunctive therapy for Parkinsons patients in the 1990s , systemic reviews from the Cochrane collaboration released in 2001 found insufficient evidence to support or refute the efficacy of physiotherapy in PD . Although most of the individual trials analyzed in these reviews appeared to find a beneficial effect of physiotherapy, it was determined that many of the studies had methodological flaws and biases that prevented any firm conclusions of the validity of physiotherapy . Interestingly, this led to a situation in which physicians were instructed to encourage regular exercise, despite little evidence of its efficacy in slowing disease progression or improving activities of daily living .

Physical Therapy Strategies For Parkinsons Disease

PT can improve daily functioning for people living with PD by:4

  • Improving gait, or the way a person walks
  • Improving transfers, like going from stillness to activity
  • Improving balance
  • Strengthening joints and muscles to improve physical capacity

One of the ways physical therapists help improve gait is through the use of cues. Cues are stimuli from the environment or generated by the person that they can use to facilitate repetitive movements, like walking. Cues can be:4

  • Auditory, like using a metronome or music
  • Visual, such as stepping over stripes on the floor
  • Tactile, like tapping on the hip or leg
  • Cognitive, like using a mental image of the length of a step

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The Benefits Of Yogafor Parkinsons Disease

According to the Parkinsons Foundation, yoga can help with flexibility, breathing, and posture as well as relaxation and stress reduction. Best of all, its a self-paced activity, the foundation adds, which means you dont have to perform certain exercises if your physical limitations get in the way. Bonus: Your routine can be modified depending on your needs for example, doing seated yoga in a chair.

Yoga is really my go-to, Subramanian says. Mind-body exercises are really beneficial for mental health, which is important given the risk for anxiety and depression in Parkinsons disease.

Voting On The Recommendations

Parkinson’s Disease Exercises: Strengthening and Balance

GDG members agreed on the strength of every recommendation. Recommendations were approved and adopted when a majority of 60% of the GDG voted to approve. All recommendations received 100% agreement among the quorum of the voting GDG. No disagreements were recorded during recommendation voting. When changes were made to the strength of a recommendation based on the magnitude of benefit or potential risk, harm, or cost, the GDG voted and provided an explanation in the rationale.

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What Types Of Exercise Can Help Manage Parkinsons Disease

There are several types of exercises you can do to manage Parkinsons disease. You can create a varied routine based on your specific concerns, fitness level, and overall health.

Aim to do at least a few minutes of movement each day. Include exercises that improve cardiovascular health, flexibility, and strength. If you change up your exercises every week. your body can learn new ways to move.

There are a few different types of exercise that may be especially helpful to those with Parkinsons, including:

  • physical and occupational therapy

Medical Marijuana For Parkinsons

APDA resources: Despite little clinical trial data, medical marijuana is used frequently by people with PD for various symptoms. People with PD are eager for more information on whether and how to use this treatment to help PD. To help you better understand this popular topic, we have written articles about medical marijuana and cannabidiol so you can learn what they are, how they work, and how they may, or may not help people with PD.

AAN highlight: Leehey MA et al presented Tolerability and Efficacy of Cannabidiol on Motor Symptoms in Parkinson Disease: Interim Report on Tolerability. In this poster, the preliminary results of a clinical trial investigating the use of cannabidiol for the motor symptoms of PD are presented. Cannabidiol was well tolerated by people with PD. Takeaway: We await the results of this study to inform us as to whether medical marijuana is a useful medication for treatment of motor symptoms of PD.

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Aerobic Exercise Positively Alters Parkinsons Brain

Getting regular exercise is essential to managing Parkinsons disease . It is well established that exercise promotes aerobic conditioning, strength, balance, flexibility and mobility, which can substantially improve overall quality of life.

Multiple clinical trials have demonstrated that aerobic exercisein particular, can enhance cognitive functioning, such as learning, thinking, remembering and problem solving. Further, a 2019 PD clinical trial called Park-in-Shape, investigating the effectiveness of remotely supervised aerobic exercise resulted in a reduction of PD movement symptoms.

We know brain heath and cardiovascular fitness are connected. What we dont know is how and where in the brainaerobic exercise is enhancing cognitive functions and reducing motor symptoms for people with PD.

A study recently published in the Annals of Neurology, Aerobic exercise alters brain function and structure in Parkinsons disease: A randomized controlled trial investigated how aerobic exercise may influence PD-related functional and structural changes in the brain. The study also explored the effects of aerobic exercise on the substantia nigra, which helps the brain produce with dopamine. Movement disorders specialist Bastiaan R. Bloem, MD, PhD, from Nijmegen Parkinson Center a Parkinsons Foundation Center of Excellence is one of the studys authors.

  • Functional MRIs to measure which parts of the brain are more active by measuring blood flow changes in the brain
  • Results

    Study Aims And Objective


    This protocol study aims to evaluate an innovative rehabilitation treatment based on robotics, for the older patients with Parkinsons disease, designed to improve the gait and to reduce the risk of falling. The treatment involves the use of two robotic devices: Tymo system , a wirelesss static and dynamic platform, for evaluating and rehabilitating posture, and Walker View , a treadmill equipped with a sensorised belt with eight load cells and a 3D camera.

    The primary aim is the evaluation of the effect of the rehabilitation treatment on the balance and gait of the older PD patient, as a result of the use of the Tymo system or Walker View, at the end of the treatment and at a 6months, 1 and 2years follow-up using POMA scale.

    The secondary aims are:

  • 1.

    the evaluation of the effect of the rehabilitation treatment on the gait speed of the older PD patients, as a result of the use of the Tymo system or Walker View, at the end of the treatment and at a 6months, 1 and 2years follow-up using instrumental gait analysis

  • 2.

    the evaluation of the effect of the rehabilitation treatment on the fear of falling of the older PD patients, as a result of the use of the Tymo system or Walker View, at the end of the treatment and at a 6months, 1 and 2years follow-up using FES-I short form scale.

  • In addition, the study design will include use a standardized questionnaires and instrumental gait analysis, in order to collect data on the improvements with a mix-method approach.

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    Physical Therapy Guide To Parkinson Disease

    Read Time:

    Parkinson disease is the second most common degenerative brain disorder affecting adults. People of all ethnic groups can develop PD, but it occurs less among African American and Asian populations. Parkinson disease was first defined as only a motor disease, but research has shown that it also causes nonmotor symptoms in other systems of the body. People with PD are at risk of falling and sustaining other injuries due to their movement and balance challenges. Treatment includes a combination of medication and physical therapyand in some cases surgery. Physical therapists partner with people with PD and their families to manage their symptoms, maintain their fitness levels, and help them stay as active as possible.

    Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

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    If I Exercise Will I Still Need My Parkinsons Medications

    Some people find that exercise helps them reduce the doses of Parkinsons medications over time. But exercise is not a replacement for your medications. In fact, some people need more medications so they can stay active. Dont make changes to your medications without talking to your healthcare providers.

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    Spotlight On Parkinsons Disease: Staying Healthy Keeping Fit

    In this 45-minute webinar Terry Ellis, PhD, PT, shares which Parkinsons symptoms are reduced by what types of exercise, the intensity of exercise required to have an impact on PD symptoms, how to overcome resistance to exercising, and tips for implementing an effective exercise routine. In the last 15 minutes of the webinar Dr. Ellis answers listener questions.

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    Try Seated Exercises If You Have Limited Mobility

    Parkinson’s Disease Exercises: LSVT BIG Movements

    Performing strength and flexibility exercises while sitting can help you stay fit and improve your range of motion all with minimal stress and wear and tear on your muscles and joints.

    An example of a seated stretching routine recommended by the Parkinsons Foundation is the hamstring stretch. To do this stretch:

  • Sit tall in a chair and place one leg straight out on another chair.
  • Keep your toes pointed upward, your knee flat, and your back straight.
  • Gently reach for your toes with both arms.
  • Only reach as far forward as you can without bending your knee and without feeling strain.
  • Switch legs and repeat.
  • An example of a strength exercise you can perform while sitting down is the shoulder blade squeeze. To perform this exercise:

  • Sit with your back straight and your buttocks forward on the edge of a chair.
  • Open your arms out to the sides, with your fingers spread.
  • Pull your arms back and squeeze shoulder blades together.
  • Your physical therapist can recommend additional seated exercises.

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    Flexibility / Stretching Exercises

    1. Body TwistSit on the edge of a seat. Sit tall. Turn your shoulders to the right. Place your right hand behind you. Twist your body and head to the right as far as you can go without any pain, only a stretched feeling. Hold. Try to relax and breathe.

    2. Wall HangFace a wall and stand with your feet about 30cm from the wall. Lift your hands straight above your head and place palms on wall, as high as possible. Lean forward without arching your back. The stretch should be felt under the arms and in your chest. If this is too easy, take the feet further back from the wall.

    If you can reach, rest your hands on the frame at the top of the door. Keeping your arms straight, slowly lean forward until you feel a gentle stretch. Hold. Do not over-stretch.

    3. Doorway Bend

    Stand near a doorway. Lift your arm to the side, up to shoulder height. Bend your elbow to 90 degrees and place the entire forearm on the door frame. Gently turn your body away from the arm and feel a stretch in the shoulder and chest. Hold. Repeat on the other arm.

    4. Side Bend

    Sit tall in a chair that doesnt have arms.Lift one arm over your head and curve your body to the side.Keep your buttock firmly on the seat so you dont tip the body.A stretch should be felt on the side of the body. Hold. Repeat for the other side. Do not lean forward or backwards.

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    When Should Someone With Parkinsons Start Exercising

    After youve been diagnosed with Parkinsons, try to start an exercise regimen as soon as possible, says the Parkinsons Foundation. The foundation calls this the pre-habilitation stage, and warns against waiting until you start to have pain or problems with your movements to begin an exercise regimen.

    Still, its never too late to start. People who have advanced Parkinsons and exercise have better health-related quality of life than people who dont exercise, so its important to stay active and even try new routines as your condition progresses.

    There are so many benefits to exercise with Parkinsons disease, Subramanian says. In addition to all the positive effects on symptoms and progression, there are other benefits as well, including social ones, if you work out as part of a group. Exercising will also likely help you to sleep better, which is important for overall health.

    Really, she continues, the more physical activity the better, as long as youre safe. And if youre worried about staying motivated, a general rule is that any exercise that you love is something youre going to keep doing.

    Dont hesitate to try different things, too, which will challenge your brain and your body. Youll see the positives right away, she says.

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    Parkinsons Home Exercise Program

    You dont need to join a gym or purchase expensive fitness equipment to stay active with Parkinsons disease. On the contrary, there are many great exercises that you can do from the comfort of your home, regardless of which stage of the disease you are in. Take a look at some great examples in the sections below.

    Fitness Tips To Manage Pd Symptoms

    Parkinsons  Midway Motion &  Fitness
    • Choose an exercise program that you will actually do! Dont design a great, Parkinsons-specific program and then skip it because its too hard or not fun.
    • Follow a varied routine. Perform simple stretches and posture exercises daily, and make sure to include aerobic and strengthening exercises several times per week.
    • Keep intensity at a level that feels somewhat hard for you.
    • Consider joining an exercise class or group. Classes are good motivation and also provide an opportunity to socialize. Trained instructors give clear guidelines and offer modifications.
    • Try exercise videos or home exercise equipment if it is difficult to get out.
    • Music can enhance performance by providing rhythm to coordinate movement.
    • Be creative with your fitness. Challenge yourself and have fun!
    • Consider attending Moving Day, a Walk for Parkinsons, in your area to keep moving and strengthen your PD fitness community.

    Sponsored by Kyowa Kirin. Content created independently by the Parkinson√Ęs Foundation.

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