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Unlocking Mobility and Independence: The Role of Physical Therapy  in Parkinson’s Disease

By Jessica Lowy PT, DPT, CMTPT, DN, McKenzie A-D,  Advanced Schroth Certified SSOL

And Michal Porath PT, MPT, McKenzie A-D, Advanced Schroth Certified SSOL

The month of April is Parkinson awareness month and in honor of that we are dedicating this informational article on Parkinson’s disease. Parkinson’s disease (PD) is a neurodegenerative disorder that affects millions of people worldwide, impacting their mobility, coordination and quality of life. While there is currently no cure for Parkinson’s, there are various treatment modalities aimed at managing its symptoms and improving daily functioning. Among these, physical therapy stands out as a vital component in enhancing mobility, promoting independence, and mitigating the progression of the disease.

Understanding Parkinson’s Disease

Parkinson’s disease primarily affects the central nervous system, particularly the dopamine-producing neurons in the brain. Dopamine plays a crucial role in regulating movement, and its deficiency in individuals with PD leads to symptoms such as tremors, bradykinesia (slowed movement), muscle stiffness, and postural instability. These symptoms progressively worsen over time, making even routine tasks challenging for those living with the condition.

The Importance of Physical Therapy

Physical therapy is a cornerstone in the multidisciplinary approach to managing Parkinson’s disease. It focuses on improving flexibility, strength, balance, and overall functional mobility. Parkinson’s disease can cause stiffness and reduced range of motion in muscles and joints. Physical therapy interventions such as stretching exercises, range of motion exercises, and joint mobilizations help counteract these effects, maintaining flexibility and preventing contractures.  Balance impairments are common in individuals with Parkinson’s, predisposing them to falls and injuries. Physical therapists include  balance training exercises, proprioceptive drills, and gait training to enhance stability and coordination, reducing the risk of falls and improving confidence in movement.  Muscle weakness is another hallmark of Parkinson’s disease, leading to decreased functional capacity and increased fatigue. Through resistance training, aerobic exercises, and cardiovascular conditioning, physical therapy aims to build strength and endurance, enabling individuals to engage in daily activities with greater ease and efficiency.  Walking difficulties often arise in Parkinson’s due to bradykinesia, freezing of gait, and postural instability. Physical therapists include various strategies such as cueing techniques, visual and auditory cues, and external aids (e.g., canes, walkers) to facilitate safer and more efficient walking patterns.  Poor posture is prevalent in Parkinson’s, leading to stooped posture, forward head posture, and decreased trunk rotation. Physical therapy interventions target postural correction through strengthening exercises for core muscles, proprioceptive retraining, and ergonomic education.

Physical therapists assess each individual’s specific impairments, functional limitations, and goals, tailoring treatment plans accordingly.  Physical therapists design exercise programs tailored to address the unique needs and abilities of each individual. These programs may include a combination of stretching, strengthening, balance, and aerobic exercises, adapted to accommodate varying levels of mobility and fitness.  Therapy sessions focus on practicing functional tasks relevant to daily life, such as getting out of bed, standing up from a chair, and navigating obstacles. By simulating real-world scenarios, individuals with Parkinson’s can improve their ability to perform these activities independently and safely.  Physical therapists educate patients and their caregivers about Parkinson’s disease, its impact on mobility, and strategies for managing symptoms. This may include instruction on proper body mechanics, energy conservation techniques, fall prevention strategies, and home exercise programs to promote long-term adherence and self-management.

Exercise is increasingly recognized as an important  intervention in Parkinson’s disease management, with growing evidence supporting its neuroprotective effects and symptomatic benefits. Physical therapy serves as a conduit for prescribing and supervising tailored exercise programs, ensuring safety, efficacy, and adherence. Regular physical activity has been shown to:

  • Stimulate Neuroplasticity: Exercise promotes the brain’s ability to adapt and reorganize, potentially slowing the progression of Parkinson’s disease and mitigating its impact on motor function.
  • Boost Dopamine Production: Certain types of exercise, particularly high-intensity aerobic exercise, may increase dopamine release in the brain, temporarily alleviating motor symptoms and enhancing mood and cognition.
  • Improve Quality of Life: Engaging in regular exercise not only improves physical function but also enhances mood, reduces stress and anxiety, and fosters social connections, contributing to overall well-being in individuals with Parkinson’s.

LSVT Big is a specialized treatment program designed for individuals with Parkinson’s disease which was developed by physical and occupational therapists. LSVT Big focuses on improving movement amplitude, speed, and quality through intensive and repetitive exercises. The LSVT Big program is grounded in the principles of neuroplasticity, which suggest that the brain has the ability to reorganize and form new connections in response to learning and experience. LSVT Big consists of structured exercises that target large amplitude movements, such as reaching, stepping, and balance activities, tailored to each individual’s specific needs and abilities. By emphasizing exaggerated movements and enhancing sensory awareness, LSVT Big aims to address the motor symptoms of Parkinson’s disease and improve functional mobility, posture, and overall quality of life.

For individuals with Parkinson’s disease, LSVT Big offers a range of potential benefits. One of the primary goals of the program is to counteract the characteristic movement patterns associated with the condition, such as reduced range of motion, stiffness, and slowness of movement. Through intensive and focused exercises, LSVT Big helps individuals improve their ability to generate larger, more efficient movements, facilitating everyday tasks and activities. Moreover, the program aims to enhance confidence and self-efficacy by empowering individuals to take control of their movements and navigate their environments more effectively. Beyond physical improvements, LSVT Big may also have positive effects on mood, cognition, and communication, contributing to a holistic approach to managing Parkinson’s disease. By addressing motor symptoms and promoting overall well-being, LSVT Big plays a valuable role in optimizing function and enhancing quality of life for individuals living with Parkinson’s disease.

Interdisciplinary collaboration among healthcare professionals, including neurologists, physiatrists, occupational therapists, and speech-language pathologists, ensures comprehensive care that addresses the diverse needs of individuals with Parkinson’s disease.

Parkinson’s disease poses significant challenges to mobility and independence, but physical therapy offers a ray of hope for those living with the condition. The physical and occupational therapists at Prime Orthopedic Rehabilitation can  target mobility impairments, balance deficits, and postural abnormalities and empower individuals with Parkinson’s to lead more active, fulfilling lives. We develop  personalized exercise programs including the LSVT Big treatment, functional training, and education because physical  and occupational therapy serves as a cornerstone in the holistic management of Parkinson’s disease, promoting optimal function and quality of life for individuals across the disease spectrum.

At Prime Orthopedic Rehabilitation, we have both male and female therapists.  Our therapists all hold advanced certifications to help with your specific needs, including LSVT (BIG) for Parkinson’s treatment and OCS certifications, Orthopedic Certified Specialist.  We offer general outpatient physical and occupational therapy, both in our offices, in Tenafly and in Northvale, and In-Home, but we also offer specific approaches such as McKenzie rehab for neck and back issues, Schroth approach for scoliosis, Vestibular rehab for dizziness, balance issues and vertigo, Sports rehab for sports injuries such as those from pickleball,basketball or hockey, as well as therapists certified in dry needling, cupping, instrument assisted soft tissue mobilization (IASTM) and other approaches.  Prime also has seventy 5-star google reviews and offers more one on one time than most other offices.  Call us today to ask how we can help you 201-503-7173

Jessica Lowy, DPT, CMTPT, DN, Mckenzie A-D, Advanced Schroth Therapist and Michal Porath, MPT, Mckenzie A-D, Advanced Schroth Therapist are owners of Prime Orthopedic Rehabilitation in Tenafly, NJ. They treat necks and backs in their clinic, in addition to general orthopedic and post surgical patients. Call (201) 503-7173 for an appointment.

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