Parkinson’s Disease

Parkinson's Disease is a progressive neurological condition displaying motor and non-motor symptoms. Common signs and symptoms include tremor, rigidity, bradykinesia (slowness of movement), postural changes and altered gait pattern. All of these can contribute to an increased risk of falls which can cause significant decline in function and independence.

Physiotherapy can help to improve your balance, strength, walking and co-ordination as well as your mental and physical wellbeing. Physiotherapy can help to minimise the deterioration in balance, flexibility and strength and can help you stay mobile as the disease progresses.

You may find some movements or tasks have become more difficult or are taking you more time to complete. Our qualified physios can help teach you ways to make things easier. Research shows that regular exercise can help to reduce some of the motor symptoms of Parkinson’s.

Our physiotherapists can help you to stay active and can prescribe a tailored home exercise programme to help increase or maintain your strength and function. Regular stretches and postural work can help to reduce stiffness and improve flexibility. Regular physiotherapy can help to prevent falls and reduce the risk of severe injury and hospital admission.

How can physiotherapy help me?

Pain-

You may experience pain in the muscles associated with reduced flexibility and rigidity. Some people may have kyphosis of the spine (curving) which can limited the movement of the trunk and put more strain through the soft tissues and joints.

You may have involuntary muscle contractions (dystonia) which can cause pain.

Your physiotherapist can help assess the source of pain and assist with flexibility exercises for the joint and muscles, manual techniques and advise on the use of heat or cold to ease pain.

Mobility and movement-

Physiotherapy can help build or maintain muscle strength and fitness levels and help address changes as they arise with movement, posture and balance. Physiotherapy can be helpful with all stages of the disease.

Walking- You may walk with small shuffling steps (Parkinsonian gait), have involuntary increases in pace (festination) and experience freezing episodes which can make walking difficult. These changes can significantly increase the risk of falling and risk of serious injury.

Cueing techniques- Your physiotherapist can advise on cueing techniques to help improve your walking which act as an external stimuli to control symptoms.

Auditory cues include use of sound such as walking to the beat of metronome or music to reduce freezing episodes and make walking more fluid.

Visual cues can be used such as applying tape on the floor to increase step/stride length, using a laser or visualising stepping over something when outside (Muthukrishnan et al, 2019).

Your physiotherapist can help guide you with the best cues and techniques that work well for you. A regular, tailored exercise programme targeting key areas of strength, flexibility and balance can help maintain your independence, keep you active, prevent falls and slow down progression of the disease.

Posture-

Typically, people with Parkinson's experience changes in their posture over time which can include rounding of the shoulders, thoracic kyphosis, forward head position, flexed spine, bending of the knees and they may lean to one side.

Postural changes can lead to an increased risk of falls, difficult speaking loudly, reduction in balance, reduced strength of core muscles and reduced flexibility. Stooped posture can also affect your ability to take a deep breath (Parkinson's UK).

Your physiotherapist can help you recognise these changes and address the key areas of concern. Treatment may include use of a mirror for postural awareness and correction, strengthening postural muscles and stretches to tight muscles and joints.