Physiotherapy and Parkinson’s Disease

Parkinson’s Disease (PD) is a progressive, neurodegenerative disorder presenting later in life. PD is characterised by motor and non motor symptoms which impact the affected individual’s quality of life. While medications play a crucial role, motor symptoms can be managed by Physiotherapy and Parkinson’s disease. Physiotherapy acts as a powerful adjunct to other therapies when addressing functional impairments, to improve overall well-being. 

Understanding Parkinson’s Disease

Parkinson’s disease occurs due to the degeneration of dopamine producing neurons in the brain. Dopamine, commonly known as the happy hormone, also plays a role in controlling movement, helps with focus and sleep. Degeneration of these neurons leads to a dopamine deficiency which characterises itself in the various symptoms people face when affected with Parkinson’s disease. 

Motor symptoms include:

Bradykinesia or slowness of movement;

Rigidity or stiffness

Tremor

Gait disturbance

Postural instability or lack of balance

Non-motor symptoms include: 

Fatigue

Cognitive changes

Sleep disturbances

Loss of smell

Mood disorders

It is important to note that Parkinson’s disease presents slightly differently in all those affected, some people may present differently to others. 

Physiotherapy goals in Parkinson’s disease

Physiotherapists will give an individual physical assessment in order to work on motor and functional challenges presented by the disease. They will aim at strengthening muscles and improving balance in order to help decrease falls and maintain as much function as possible. Primary goals include:

Improving mobility and flexibility

Enhancing balance and coordination

Reducing falls risks

Maintaining independence during daily activities

Mitigating pain and discomfort

Physiotherapy intervention for Parkinson’s Disease

Gait retraining 

Walking difficulties often present in PD as a result of the deficient dopamine causing various motor impairments. Difficulties occur such as shuffling steps or freezing when walking in tight spaces or through doorways. 

Strategies such as cueing techniques will be provided to improve gait and gait speed but also balance training and strength training to increase step length and frequency. 

Balance and postural training

Postural instability is a leading cause of falls in Parkinson’s. Balance training is a major factor of redressing this problem.

Exercises are designed at improving coordination, balance and reaction times. 

Strength training utilising balance beams or wobble boards in a safe environment will help to challenge balance and proprioception.

Flexibility and Strengthening

Rigidity and reducing movement amplitude are key factors affecting mobility in Parkinson’s disease. 

Targeted stretching routines will aim to alleviate stiffness and enhancing joint flexibility, building muscle strength will allow better support during functional tasks and also alleviate stooped postures. 

Functional task practice

Physiotherapists will simulate daily activities undertaken by patients, educate and provide essential exercises to help with efficient completion of these tasks.

Tasks may include navigating stairs, getting in and out of chairs and performing household activities. The tasks given are likely to mirror the physical activity that will be engaged in during normal life.

Dual task training

Dopamine is a key player in automatic movements such as walking and talking. When there is a dopamine deficiency, it can affect how people perform two tasks at once.

Physiotherapists will help with dual task training, providing exercises which require movement with a cognitive task to help strengthen dual task function. 

Speech and respiratory exercises. 

Speech is typically addressed by speech therapists, but physiotherapists will assist in breathing exercises and aerobic exercise to improve breathing support for speech and reduce the risk of aspiration.

Education and self-management

Empowering patients and caregivers is essential. Physiotherapists will provide guidance on safe movement strategies, home modifications to reduce falls risks and community resources for exercises class and Parkinson’s support groups.

The benefits of early physiotherapy intervention

Physiotherapy intervention is the most effective when initiated early. Early intervention can slow functional decline but also build up enough strength to ensure there is more of a decline to occur before becoming more dependent. Slowing functional decline will allow patients to maintain their independence for longer and adapt to disease progression in their daily living more effectively. 

FAQ’s

Which therapy is best for Parkinson’s Disease?

Physical therapy, occupational, and speech therapy play a critical role in the comprehensive care of individuals with Parkinson’s disease.

Physiotherapy focuses on improving mobility, balance, and gait, while guiding patients toward evidence-based exercise therapy proven to slow the disease’s progression.

Occupational therapy helps patients optimise fine motor skills and adapt daily activities, promoting independence and better quality of life.

Speech therapists address communication challenges and swallowing difficulties, enhancing speech clarity and reducing the risk of aspiration.

This multidisciplinary approach empowers individuals with Parkinson’s to manage motor symptoms effectively and maintain their functionality.

What factors can worsen Parkinson’s disease symptoms?

Several factors can contribute to the worsening of Parkinson’s disease symptoms, and being aware of them is key to effective management.

Stress, anxiety, and depression are common triggers, often leading to increased symptoms. Poor sleep quality, dehydration, and inadequate nutrition can also significantly impact energy levels and overall health, exacerbating it’s progression.

Additionally, low blood pressure (orthostatic hypotension), intercurrent infections, or other medical conditions may affect symptom stability. Environmental factors, including geography, high altitude, and extreme weather, can pose additional challenges.

Many of these issues are treatable, so it is essential to communicate any changes with your healthcare provider. By addressing these factors proactively, individuals with Parkinson’s can better manage their condition and maintain their quality of life.

What happens if you don’t exercise with Parkinson’s?

Deconditioning is a common issue that occurs when a person’s motor function declines due to prolonged inactivity or a sedentary lifestyle. This condition can lead to several challenges, including difficulty walking, increased pain, joint stiffness, and shortness of breath during physical activity.

Over time, deconditioning can contribute to reduced mobility, muscle weakness, and a higher risk of falls, significantly impacting overall health and quality of life.

Maintaining physical activity and engaging in regular exercise is crucial for maintaining strength, flexibility, and cardiovascular health, particularly for individuals managing chronic conditions such as Parkinson’s disease.

What is the most disabling symptom of Parkinson’s Disease?

Approximately 50% of individuals living with Parkinson’s disease report that fatigue significantly impacts their daily lives, with nearly one-third identifying it as the most disabling symptom of the condition.

Fatigue in Parkinson’s is often described as overwhelming and persistent, making it one of the most challenging factors to manage. It can interfere with physical activity, mental focus, and overall quality of life, underscoring the importance of recognising and addressing this symptom as part of comprehensive Parkinson’s care.

Physiotherapy management plays a vital role in holistic management of Parkinson’s Disease. By addressing both any challenges, individuals are able to navigate their journey with Parkinson’s disease more confidently. The reality of it is, Parkinson’s is a progressive disease involving a multitude of factors, thus it takes a team of professionals to alleviate the problems and allow for the best outcomes for a patient. 

If you or a loved one has Parkinson’s, consider reaching out to West Pennant Hills Physiotherapy who can help with Parkinson’s disease management to explore how tailored interventions can make a difference to your health.

Contact us today on 0298753760, or book online to learn more about how we can support you on your journey.