– Gramos Pallaska, PT, DPT, FAFS, CEAS
Nearly 1 million people in the United States are living with Parkinson’s disease, and around 60,000 Americans are diagnosed every year.
As Parkinson’s progresses, it can cause symptoms such as shaking, stiffness, difficulty walking and loss of balance that affect movement. Fortunately, there are steps you can take to minimize these symptoms and improve your ability to move with Parkinson’s, including physical therapy.
Understanding the role of physical therapy in treating Parkinson’s disease — including which exercises may be beneficial and the kind of improvements you may see — can help you and your doctor determine if physical therapy is right for you.
How Parkinson’s Disease Affects Movement
In the initial stages of Parkinson’s, the “amplitude of movement” is what first tends to be affected. The slowing down of overall movement is a common characteristic during the progression, also known as hypokinesia. For example, a person with Parkinson’s disease may think they’re lifting their foot high enough to reach the next step, but they’re not. There’s a disconnect between what you think is happening and how your body is performing the movement.
This interruption between brain and body occurs because Parkinson’s affects nerve cells in the brain that help with movement through the production of a neurotransmitter called dopamine. When dopamine production slows or stops, movement does, too.
As the disease progresses, a person’s ability to walk may be affected, which is what causes the “shuffling” gait often associated with Parkinson’s. As balance starts to decrease, a person with Parkinson’s may also begin to lean forward to feel more secure and grounded.
The Role of Physical Therapists in Parkinson’s Patient Care
Research shows physical therapy can be very helpful for slowing down the progression of Parkinson’s, especially when it’s started as soon as possible after diagnosis.
To gauge the best starting point for therapy, a physical therapist will often start with a full body movement screening. Balance is assessed while the patient is standing still, as well as during movements such as:
- Changing directions
- Walking with head turning
- Walking and stepping over an object
- Walking around objects
Through this movement screening, a physical therapist can get an idea of how well a person with Parkinson’s is able to move — and then plan a therapy program accordingly.
A specific type of physical therapy called LSVT BIG therapy has been shown to be particularly effective for treating symptoms of Parkinson’s. Physical therapists who specialize in LSVT BIG therapy undergo extensive training to help people manage their Parkinson’s symptoms.
Goals of Physical Therapy for Parkinson’s
The main goal of physical therapists who work with Parkinson’s patients is to slow the progression of symptoms that affect movement. Therapy often involves an integrated approach, with functional and amplified movements.
Not only do these patients undergo a course of treatment with a physical therapist, but they also learn techniques and exercises to do on their own at home to maintain mobility and manage symptoms.
Whenever possible, education extends to the patient’s family and other caregivers, so that everyone is on the same page about care through physical therapy. Physical therapists also work with the patient’s other healthcare providers, as communication between providers is crucial to managing care. This is especially true in the early stages of the disease: If a patient can work with a physical therapist before they start having issues with things like balance, they may have a better chance of slowing the progression of these symptoms.
Additional Benefits of Physical Therapy
In addition to slowing the progression of symptoms that affect movement, physical therapy can help improve overall quality of life for people with Parkinson’s disease and their families.
It may help the families understand the disease and how it works, and make sure they’re adequately equipped to help their loved one. Physical therapy also helps the patient with some of their decision-making in terms of evaluating risk and giving them an understanding of their own mobility.
Whether you are a newly diagnosed Parkinson’s patient or have been living with the disease for a while, talk to your healthcare provider about whether physical therapy can help you manage your symptoms.