How Physiotherapy Helps People Living with Parkinson’s Disease
If you have Parkinson’s disease, physiotherapy will be an important part of your life. That’s because Parkinson’s is a movement disorder, and physios are movement experts. While medication plays a key role in controlling the symptoms, physiotherapy is essential for maintaining independence and function.
Whether you have issues with gait freezing, stiffness, posture or balance, physiotherapy helps people with Parkinson’s disease to move more freely. Physiotherapists also train families, carers and support workers to assist people with Parkinson’s disease to remain independent and participate in everyday life.
Why physiotherapy is important in Parkinson’s disease
Parkinson’s disease disrupts communication between the brain and the muscles. This leads to movement problems such as slowness (bradykinesia), tremor, and rigidity. These symptoms can affect every aspect of daily life, from getting out of bed in the morning to taking part in home life, work, leisure and community activities.
Neurological physiotherapy is a branch of physiotherapy that focuses on supporting people with neurological conditions like Parkinson’s disease. It involves retraining the body and brain to work together as effectively as possible. A physiotherapist trained in neurological rehabilitation doesn’t just look at your strength, flexibility or balance. Instead, they assess how Parkinson’s symptoms affect your ability to function and do the things that matter to you.
This involves looking at the big picture and designing therapy to help you reach your goals. For example, your neurological physiotherapist might look at how stiffness makes it hard for you to go for a walk with friends. Then they will develop a treatment plan to not only ease your stiffness, but also support you to take part in the activity you love.
Tackling gait freezing
Freezing of gait is one of the most challenging symptoms of Parkinson’s disease. This is when your feet feel “glued” to the floor. It often happens just as you’re about to take a step, turn, or go through a doorway. Freezing can be frustrating and even dangerous, as it raises the risk of falls.
Physiotherapists use practical techniques to help people with Parkinson’s disease manage freezing episodes. These include cueing strategies that can help “re-start” movement when the brain is struggling to send the right signals to the legs. For example, they might get you to step to the beat of a metronome, count out loud, or imagine lines on the floor to step over. With practice, you can use these cues if you feel yourself starting to freeze.
Physiotherapists also use gait training drills that break walking down into smaller components (e.g. stepping forward and back), helping you deal with potential freezing situations with more confidence.
Reducing stiffness and rigidity
Stiffness is another common symptom of Parkinson’s disease. It can make everyday activities like reaching overhead, putting on a jacket, rolling over in bed, or getting out of a chair more difficult. Over time, stiffness may also lead to joint pain or muscle shortening if it isn’t managed.
Physiotherapy for Parkinson’s disease often includes targeted stretching and mobility exercises. These are specifically designed to ease rigidity and encourage freedom of movement.
Reducing stiffness is not just about making you more comfortable. When joints and muscles stay flexible, it’s easier to participate in daily tasks and social activities.
For example, if stiffness is affecting your golf swing, your physiotherapist can design exercises to improve upper body rotation and shoulder flexibility.
Improving balance and preventing falls
Loss of balance is one of the biggest contributors to falls in Parkinson’s disease. Recovering from a stumble can also be more difficult due to slower reaction times. For many families, fear of falling is a constant worry.
Physiotherapists help by designing programs to reduce falls risk. These may include:
- balance retraining – exercises that challenge stability, such as standing on uneven surfaces or practise shifting weight from one leg to the other.
- dual-task training – teaching you to manage situations where you need to walk and talk or carry items while you’re moving.
- home safety assessments – advice on simple modifications like removing trip hazards or improving lighting to lower falls risk. Your physio might also refer you to an occupational therapist if you could benefit from a thorough assessment of your function and safety at home.
Your physiotherapist can give you exercises to improve your flexibility and function
Improving posture and core strength
Parkinson’s disease often causes people to lean forward, developing a stooped posture. This not only affects appearance but can also impact breathing, digestion, and balance. Over time, it can also cause back or neck pain.
Physiotherapists use postural training and strengthening exercises to help realign the body. They may use mirrors or video feedback so you can see and correct your posture. Exercises to strengthen the back and abdominal muscles can also support upright positioning.
Enhancing mobility in Parkinson’s disease
Mobility – the ability to move around independently – is central to independence. Physiotherapists focus on maintaining and improving mobility in Parkinson’s through functional exercises. These might include:
- gait training – structured walking practice using cues, obstacles, and different speeds to improve stride length and coordination.
- task-specific training – practise of everyday activities such as getting out of bed, standing from a chair, climbing stairs or turning quickly.
- movement amplification techniques or programs (e.g. LSVT BIG) – which encourage you to make large, exaggerated movements to counteract the natural tendency towards smaller, slower motions in Parkinson’s disease.
As the condition progresses, your physio may recommend you use an assistive device such as a walking stick, walker or wheelchair. The aim is not to reduce your independence, but to extend it – helping you remain as mobile and safe as possible for as long as possible.
Maintaining or improving your mobility can have a flow-on effect. It supports you to engage in social activities, exercise, and community life, which all contribute to your overall wellbeing.
Parkinson’s exercises: Movement as medicine
Exercise is increasingly recognised as one of the most powerful interventions for Parkinson’s disease. Research shows regular physical activity not only improves movement but may also slow the progression of some symptoms (i,ii,iii). Physiotherapists play a key role in prescribing Parkinson’s exercises that are safe, effective, and enjoyable.
These may include:
- aerobic training – such as walking, cycling, rowing or swimming to boost cardiovascular health and stamina.
- strength training – using resistance bands, gym equipment or appropriate weights to maintain muscle strength.
- agility and coordination drills – such as stepping over obstacles, changing direction, or practicing quick turns.
The benefits of exercise are wide-ranging: improved mood, better sleep, greater independence, and slower progression of movement decline.
For example, appropriate exercise can help someone who has been struggling to get out of a chair to regain the strength and technique to stand up smoothly. Another person may find they can walk further without fatigue.
Staying mobile can improve your quality of life and wellbeing.
By tailoring Parkinson’s exercises to each individual, physiotherapists help ensure that movement becomes part of a sustainable routine. Accredited exercise physiologists can also design safe, effective exercise programs for people with Parkinson’s disease.
Supporting families and carers
Physiotherapy doesn’t just help the person with Parkinson’s – it also supports families. Neurological physiotherapists can teach carers safe ways to assist with movement, such as helping with transfers or encouraging exercises at home.
This can help to reduce stress and risk of injury for carers, while reinforcing the benefits of therapy for the individual with Parkinson’s disease.
Physiotherapy for Parkinson’s disease
At Active Ability, our neurological physiotherapists design therapy plans to help you manage Parkinson’s symptoms such as freezing gait, stiffness, balance issues, posture changes, and reduced mobility.
Our physios will support you to achieve goals that are important to you. They will tailor your program to fit with your lifestyle and preferences and update it as your situation changes. They can also train your supports to help you with it if needed.
With no waiting list, you can get started with us as soon as you’re ready. We also have clinical dietitians, accredited exercise physiologists and occupational therapists on our team. This means we can provide comprehensive support to help you live well with Parkinson’s disease.
To discover more about how we may be able to help you, contact our friendly team on (02) 8678 7874, email [email protected] or complete our contact form.
References
[i] – Ahlskog, J. Eric. Aerobic Exercise: Evidence for a Direct Brain Effect to Slow Parkinson Disease Progression. Mayo Clinic Proceedings, Volume 93, Issue 3, 360 – 372.
[ii] – Langeskov-Christensen M, Franzén E, Grøndahl Hvid L, Dalgas U. Exercise as medicine in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2024;95(11):1077-1088. Published 2024 Oct 16. doi:10.1136/jnnp-2023-332974.
[iii] – Oliveira de Carvalho A, Filho ASS, Murillo-Rodriguez E, Rocha NB, Carta MG, Machado S. Physical Exercise For Parkinson’s Disease: Clinical And Experimental Evidence. Clin Pract Epidemiol Ment Health. 2018;14:89-98. Published 2018 Mar 30. doi:10.2174/1745017901814010089.
