Physical and Occupational Therapy for Parkinson’s Disease: Is It Right for You?

Physical therapy is a program that helps you build strength, flexibility, balance, and coordination. It starts with an evaluation of your current abilities to locate the areas of movement causing you problems.

The therapist will teach you exercises and other techniques to improve your strength, coordination, balance, and movement. During physical therapy sessions, you might learn to:

• get in and out of bed or a chair more easily
• stretch your muscles to improve your range of motion
• avoid a fall
• walk more smoothly, without shuffling
• go up and down stairs
• use a cane or a walker to help you get around

To get the most out of your physical therapy sessions, find a therapist with experience treating Parkinson’s or similar disorders. Therapists who are board-certified neurologic specialists (NCS) should have this type of training. Ask your neurologist to recommend someone.

Certain types of physical therapy can help with movement issues caused by Parkinson’s disease. Here are a few of them.

Amplitude training

Parkinson’s progressively makes your movements smaller. This is called hypokinesia. Over time, walking becomes a shuffle, and your arms can no longer swing freely. Amplitude training, also called LSVT BIG, enlarges or amplifies your movements to make them more comfortable.

In this program, you follow your therapist as they move through a series of exaggerated motions. You might lift your knee high in the air while taking a step and swinging your arms in a big arc. Over time, these exercises retrain your muscles to broaden your range of motion and reverse some of the changes Parkinson’s is causing to your body.

Balance work

Parkinson’s can disrupt the coordination between your eyes, inner ears, and feet that keeps you balanced. If you feel unsteady on your feet, you may not want to go anywhere for fear of falling.

When you stop walking, you can get deconditioned and become even more unsteady on your feet. A physical therapist can teach you exercises to improve your balance and help you regain the confidence you may have lost.

Reciprocal pattern training

Parkinson’s disease can change the movements you do in tandem with one another, like how you swing your arms when you walk. This therapy helps you retain those arm-and-leg movements. You learn exercises that move your arms and legs at the same time.

Reciprocal pattern training can include:

• using an elliptical machine
• using a stationary bicycle
• taking a dance class
• doing tai chi

Strength training

Both age and Parkinson’s disease can weaken and decondition your muscles. Physical therapy strengthens your muscles using exercises that use light weights or resistance bands. Having strong muscles will help keep you balanced and mobile. If you like to swim, some physical therapists offer pool-based therapies.

Stretching

Parkinson’s makes your muscles tight, especially the ones in your hips and legs. A physical therapist can teach you exercises to lengthen and loosen up rigid muscles.

When you have Parkinson’s disease, limited mobility can make simple tasks like getting dressed or taking a shower much harder. Occupational therapists teach you the skills you need for daily life — whether you’re at home, work, or out with friends.

A therapist will evaluate your home, office (if you work), and daily routine to pinpoint areas where you could use help. Some things an occupational therapist can teach you include:

• how to use a walker, cane, and other walking aids if you need them
• how to keep your balance when you walk (for example, by turning slowly when you need to change direction)
• tips to stay focused when you walk to avoid falls
• easier ways to get in and out of bed, and out of the shower or tub, without falling
• tricks to get dressed, bathe, and do other self-care tasks with the help of grabbers and other assistive devices
• tips to make daily activities such as cooking, eating, and housecleaning easier

An occupational therapist can also recommend useful changes to your home. These changes will make your home safer. Examples of these changes include:

• a roll-in bathtub if you use a wheelchair
• lower counters
• rails next to the toilet and in the shower
• non-skid mats
• wider doorways
• a shower chair or bench
• a raised toilet seat
• motion-activated nightlights

Your doctor has treatments to help you manage your Parkinson’s symptoms. Along with taking medication, doing physical therapy can improve your strength, mobility, and balance. Occupational therapy can teach you ways to help you accomplish daily tasks more easily and safely.