The Benefits of Physical Therapy for Patients with Parkinson’s Disease

By: Dr. Rebecca Van Heuklon, DPT, FAFS, FMR

Parkinson’s disease is a disease that affects more than 10 million people worldwide. It is a movement disorder caused by the slow, progressive degeneration and death of the nerve cells that produce dopamine. Dopamine is a neurotransmitter that helps coordinate and control our muscles to produce smooth movement. Without dopamine, our movements cannot be well controlled or coordinated, causing symptoms like a resting tremor, slow movement, small steps, difficulty with walking and balance, rigidity, and decreased sensory awareness. It is very common to see people with Parkinson’s disease walking with small, shuffled steps, reduced arm swing, a stooped posture, and freezing episodes. Because of the slow and small movement, people with Parkinson’s disease will also present with soft speech, small hand writing, shortened stride length, start hesitation with movement, and inability to stop movement.

Although there is currently no cure for Parkinson’s disease, exercise, when combined with the appropriate medication regime, has been found to be helpful. Exercise and remaining as active as possible can help people be better equipped to deal with the changes that occur as a result of Parkinson’s disease. If we stay or become sedentary and become deconditioned, it only compounds the stiffness and slowness associated with the disease. Research even suggests that exercise may actually help slow the progression of the disease. Exercise can help make changes in the brain through the process of activity-dependent neuroplasticity. With repetitive practice, neuroplasticity allows our brain to adapt, learn, and rewire to get better at a task. Staying active has also been shown to help protect the remaining dopamine receptors, restore connections and signal pathways in the brain, slow motor deterioration, and strengthen the use of undamaged pathways, allowing for better compensation. It is important to intervene before the pathways are lost; therefore, exercise and treatment is most effective in the early stages of the disease. It is never too late to start exercising, but the sooner you start, the better!

Knowing that exercise can be helpful is great, but knowing the right approach and what to do can be difficult and overwhelming. Seeing a Doctor of Physical Therapy with experience in seeing people with Parkinson’s disease can evaluate your current level of function and create an individual treatment plan to help guide what exercises and activities would be best for you. Some goals for physical therapy might include making your overall movement easier, addressing your flexibility to reduce stiffness, increasing your walking speed and step length, improving your activities of daily living, decreasing your risk of falling, boosting your overall physical fitness, and optimizing your musculoskeletal and cardiovascular conditioning.

One of the most widely accepted exercise treatment approaches to Parkinson’s disease is called LSVT BIG. This treatment program is designed to help ease movement with its primary focus on amplitude of movement. By increasing the amplitude of movement, it teaches people with Parkinson’s disease to incorporate bigger and more efficient movements, anywhere and in any situation. Since movement in people with Parkinson’s disease becomes small and slow, the emphasis on repetitive, large, high intensity and high effort movements allows people to produce movement that is actually normal sized. Because of the brain’s neuroplasticity, this helps recalibrate the perception of what normal movement feels like. LSVT BIG is a standardized exercise program that involves regular attendance in physical therapy, as well as consistent carryover to a home exercise program.

In conjunction with formal physical therapy, there are some additional exercise options for those with Parkinson’s disease. Walking or using a stationary bike has been found to improve aerobic conditioning. Attending a gentle yoga class or a chair yoga class can help improve strength, flexibility, balance, and stress management. Taking a Tai Chi or Pilates class can focus on improving both balance and strength. In people with limited balance, an aquatic exercise class or older adult exercise class, such as an arthritis class, could also be helpful. Another activity that has been found to be beneficial in people with Parkinson’s disease is boxing, as this takes advantage of repetitive, large amplitude, high intensity movements. There are also some YMCA locations that offer Parkinson’s Wellness Recovery (PWR) classes that are specifically designed for people with Parksinson’s disease.

The Doctors of Physical Therapy at MotionWorks have extensive experience in working with patients with Parkinson’s disease. If you would like additional information on how physical therapy can help with the management of your Parkinson’s disease symptoms, contact MotionWorks Physical Therapy at 920-215-2050.