Parkinson's Disease Physiotherapy

Parkinson’s disease can affect the way the brain starts, controls and adapts movement. Slower movement, muscle stiffness and reduced postural reactions can influence walking, turning, balance and the ability to complete everyday physical tasks.

Some people begin taking shorter or shuffling steps, lose arm swing or find it difficult to change direction. Others experience freezing of gait, where the feet temporarily feel stuck to the floor. Freezing may be triggered by turning, doorways, crowded spaces, time pressure, multitasking, anxiety or changes in medication response.

These movement changes can make getting out of a chair, rolling in bed, using stairs or walking in the community more difficult. They may also increase falls risk and cause people to reduce their activity because they feel less confident.

Neurological physiotherapy is not limited to general strengthening. A Parkinson’s physiotherapy assessment examines the specific reasons movement has become difficult and identifies which approaches are most appropriate. Treatment may involve aerobic exercise, challenging balance training, gait retraining, cueing strategies, task-specific practice and exercises designed around the person’s daily activities.

Balance problems in Parkinson’s disease are not always addressed effectively by simple or gentle exercises. Balance retraining needs to challenge the particular systems used when standing, walking, turning and responding to an unexpected loss of balance.

Effective exercises our Brisbane physiotherapists commonly included:

• Stepping in different directions
• Practising faster or larger corrective steps
• Reaching beyond the usual base of support
• Turning and changing direction
• Motor agility exercises
• Anticipatory balance activities
• Reactive balance training
• Walking around or over obstacles
• Carefully selected dual-task activities
• Practice of movements linked to previous falls or near falls

These exercises can be related to real situations, such as turning in a kitchen, stepping off a kerb, moving through a crowded environment or carrying something while walking.

Balance exercises should be difficult enough to stimulate improvement, but the challenge must be carefully controlled. Someone with mild balance changes may be able to complete demanding exercises with limited assistance. A person with frequent falls, freezing, cognitive changes or more advanced Parkinson’s may require closer supervision, walking-aid assessment, environmental changes and involvement from family or other health professionals.