General Information

Although medication therapy is generally effective in the clinical management of Parkinson's disease (PD), additional improvement of some gross motor symptoms may be achieved through the use of nonpharmacological treatments, such as physical therapy and exercise rehabilitation. Despite the fact that PD is a neurological disorder, successful rehabilitation has been demonstrated with treatments that combine cognitive and physical approaches. While the exact mechanism through which these therapies obtain successful outcomes is still largely unknown, it is worthwhile to explore these adjunctive approaches to treating the motor output symptoms of PD.

What can the physiotherapist do to help someone with Parkinson’s?
Physiotherapists are trained to provide an assessment to see how Parkinson’s affects the individual. This can be done with newly diagnosed, as well as those who have been diagnosed for some time. In the earlier stages, the emphasis of treatment will be mainly focused on understanding the condition and how a person might keep up their own general levels of fitness and maintain independence for them. In the later stages of the disease, the emphasis will include a support network for the individual, involving the family and carers as part of the treatment. The assessment will indicate to the physiotherapist what combination of education and intervention is required, some examples of which are listed below:

• Teach techniques that help make some automatic movements easier. For example, the activities of walking, sitting down and standing up are some of the tasks that may become difficult as Parkinson’s progresses, but can be improved by learning new ways of doing things.

• Help the patient to maintain independence in his daily life if he is having difficulty with certain actions, such as getting up out of a chair or turning in bed. The physiotherapist may visit your home and be able to teach the patient a different way of doing the action, or could give advice on aids and adaptations that might be of use. (In many places, it is the occupational therapist that deals with this sort of problem.) The PDS recommends that advice is sought first from a physiotherapist before patient buys any piece of equipment, as no two individuals with Parkinson’s are quite alike, and what might benefit one person might be unsafe for another. See the PDS information sheet, Equipment and Disability Aids and PDS leaflet Occupational Therapy and Parkinson’s.

• Work on stiff muscles and joints to maintain a posture, keep your joints flexible and help relieve the effects of rigidity that might occur. This will help to make patient’s actions more smooth and efficient. The physiotherapist can also teach patient and his carer to do this.
• Improve or maintain muscle strength by the use of general or specific exercises, or by providing an exercise programme for the patient to follow in the hospital, or at home. A physiotherapist may help to maintain the patient’s level of fitness or advise you take up a sport, such as golf or swimming, or a class like yoga or tai chi, where the additional benefits of relaxation help to decrease stress that can worsen the symptoms of Parkinson’s.