Parkinson’s disease and physiotherapy

Daniel Smit | Physiotherapist

A practical guide to movement, exercise and support

Parkinson’s disease can affect movement in different ways and at different times. Physiotherapy can help you work towards the activities that matter to you, with an individual plan for mobility, balance, strength, fitness and confidence. The right approach depends on your symptoms, health, goals and safety needs.

What is Parkinson’s disease?

Parkinson’s disease is a progressive neurological condition associated with changes in the brain that affect movement. Symptoms and their impact vary from person to person. Medication and support from a multidisciplinary team can help manage symptoms; physiotherapy is one part of this care.

Movement changes can include slowness, stiffness, tremor, smaller movements, reduced arm swing, changes in posture, balance difficulties, shorter steps, or freezing (a brief feeling that the feet are stuck, often when starting, turning or passing through a narrow space). Not everyone experiences all of these.

Parkinson’s can also affect sleep, energy, mood, thinking, speech, swallowing, pain, blood pressure, bladder or bowel function. Tell your GP or specialist about changes, even when they do not seem directly related to movement.

How can physiotherapy help?

A physiotherapist can assess how Parkinson’s affects your daily activities and develop a plan with you. This may include:

• practising walking, turning, getting up from a chair, bed mobility and stairs;• balance, strength, flexibility, aerobic fitness and posture exercises;• movement strategies and external cues, such as a visual target, rhythm or a clear verbal prompt, for small steps or freezing;• advice on pacing, falls risk, walking aids, footwear, home setup and safe ways to stay active; and• a home or community exercise plan that fits your routine and changes as your needs change.

Exercise and staying active

Regular physical activity is encouraged for people living with Parkinson’s. Exercise can support mobility, fitness, strength, balance, function and quality of life. A physiotherapist can help choose activities and progress them safely, especially if you have fallen, freeze, feel dizzy, have osteoporosis, or have other health conditions.

A balanced program may include aerobic activity, strength training, balance and agility practice, movement with larger and more purposeful actions, and flexibility work. The amount and intensity should be individualised. If you are inactive or have complex health or safety concerns, seek advice before starting vigorous or challenging exercise.

Choose activities you enjoy and can maintain. Walking, cycling, dancing, tai chi, swimming or a supervised exercise class may suit some people. If balance is reduced, use an appropriate support or supervision and avoid practising challenging balance tasks alone.

Practical strategies for freezing and small steps

If your feet feel stuck, pause and reset rather than rushing. Try one strategy at a time, such as shifting your weight, looking at a clear target, stepping over an imagined line, counting aloud, or following a steady rhythm. A physiotherapist can help identify which cues work for you and practise them in the places where freezing occurs.

When turning, try making a wider curve with several deliberate steps instead of pivoting quickly. Keep pathways clear, allow time at doorways and when changing direction, and avoid carrying objects that block your view or hands if this affects balance. These strategies are not a substitute for an individual assessment.

What happens at an appointment?

Your physiotherapist will ask what you want to keep doing or find easier, review your movement and falls history, and assess relevant activities such as walking, balance, transfers, strength and mobility. You may be asked about medication timing and how your movement changes through the day. Wear comfortable clothing and bring your usual walking aid, footwear and a current medication list if available.

Together, you can set practical goals and agree on treatment, a home plan and review timing. Your plan may be coordinated with your GP, neurologist, occupational therapist, speech pathologist or other members of your care team, with your consent.

When to seek help

Contact your GP, neurologist or treating team if you notice a new or worsening change in walking, balance, falls, dizziness, pain, swallowing, memory, mood or ability to manage daily activities. An unexpected change may have causes other than Parkinson’s and should be assessed.

If someone has a serious injury, cannot be woken, has sudden facial droop or weakness, sudden difficulty speaking, chest pain, or severe breathing difficulty, call 000 in Australia.

Physiotherapy at Strides Health Group

Strides Health Group provides individualised physiotherapy in Narre Warren for adults with neurological conditions and movement difficulties. If you would like to discuss whether physiotherapy may suit your goals, contact the clinic or book an appointment. NDIS participants should contact the clinic to discuss service suitability before booking.

426 Princes Hwy, Narre Warren VIC 3805 | 0411 876 851 | admin@strideshealth.com.au | strideshealth.com.au

Download the parkinson’s disease and physiotherapy handout (PDF)

References and further reading

Related resources and physiotherapy support

Explore Neurological & Disability physiotherapy in Narre Warren. Selected appointments are available in Nunawading. View appointment and booking information or ask us about your needs.

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