Physical Therapy for Parkinson’s Disease (PD)
Parkinson’s Disease is a neurodegenerative disease that affects the dopamine producing nerve cells in a specific area of the brain called the substantia nigra.
Although Parkinson’s Disease is progressive, physical therapy and exercise can help to improve symptoms, improve your function and mobility, and slow disease progression! Exercise is medicine when it comes to Parkinson’s Disease!
Exercise doesn’t just improve your strength and flexibility- it literally changes your brain and can slow the progression of Parkinson’s Disease. Exercise causes the release of beneficial neurochemicals in your brain that promote neuroplasticity and brain health, stimulates the growth of new brain cells, and can increase blood vessel pathways in your brain! These changes can improve your motor performance (which is a fancy way of saying movement and mobility), improve your overall fitness and cardiovascular health, and reduce non-motor symptoms.
Not all physical therapy and exercise is created equal. It’s important to seek out a Parkinson’s Disease trained physical therapist to create an individualized plan for you that’s supported by up-to-date evidence. Although standard physical therapy (usually consisting of strengthening, flexibility exercises, etc.) may be helpful, Parkinson’s Disease specific rehabilitation and exercise will be the most effective and offer the most “bang for your buck.”
What does Parkinson’s specific physical therapy look like?
Rehabilitation programs will vary from person to person, depending on your unique presentation and goals. However, there are a few common symptoms and/ or principles that should be incorporated into your program in some form.
One of the most important is moderate to high intensity aerobic exercise. There is robust evidence to support the benefits of higher intensity aerobic exercise on brain changes. Aerobic exercise refers to exercise that challenges your cardiovascular system and gets your heart rate up. Fortunately, it can come in many different forms and can also be incorporated into other aspects of your exercise program. The intensity of your aerobic exercise program is more important than the mode. For example, if you go on daily walks, but it's not increasing your heart rate, doesn't feel challenging, or feels like you could go on for quite a long time, it's likely not a high enough intensity to reap all of the amazing benefits of brain- changing exercise. Moderate- high intensity exercise can come in many different forms, from a power walk, using a treadmill or other cardio equipment, jogging/ running, interval training, circuit training, exercises classes, or just adding more intensity to your other exercises! There are so many possibilities that can make it more fun, engaging, or realistic for you. Talk to your therapist to make sure you’re safely reaching the recommended intensity and to determine what mode will work best for you.
Gait and balance training will likely be another major component of your program. Gait training refers to exercises that improve your ability to walk. Parkinson’s Disease often leads to difficulty with walking, slower walking speeds, falls and difficulty with balance, smaller steps, freezing of gait (feeling like your feet are stuck to the ground), difficulty with turning, or trouble walking in crowds or through thresholds. Gait training uses specific exercises to improve your stepping, balance, and walking. Based on your presentation, this may include things like working on your balance reactions, walking in different directions, working on coordination, working on dual tasks (doing two things at once), working on eye movements and coordination to assist with turning and gait, using tools to promote bigger/ higher amplitude movements, strategies to combat freezing of gait, among many others!
Parkinson’s Disease can affect more than just your ability to walk and balance. For example, people with Parkinson’s Disease often report difficulty with moving around in bed, getting in and out of bed or chairs, getting dressed, getting on and off the floor, etc. If this sounds like you, your therapist should also be incorporating task specific exercises. As you can imagine, task specific exercises vary from person to person, but should be specific to you and the task you’d like to improve. Your therapist may incorporate elements of high intensity or large amplitude movements, tools or cues to assist with movement, or work in various positions to improve mobility, range of motion, and strength in those positions.
I’ve only scratched the surface of what Parkinson’s Disease specific physical therapy might look like for you! Bottom line, it should be specific to your unique presentation and goals, include moderate – high intensity exercise and movement, and it should be fun and engaging! It’s never too early or too late to get started. Improvement is possible.
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