If you have a Parkinson’s diagnosis, physiotherapy can help in key areas such as walking, balance, falls, transfers, and daily activities. Parkinson’s physiotherapy aims to keep you moving safely and independently. The benefits, both physically and mentally, are significant and supported by substantial evidence.
Working in hospital and community settings, as well as in people’s homes, a physiotherapist can provide treatment to prevent, stabilise or reduce any problems you experience relating to your general mobility and the way you function in your daily activities.
Physiotherapist (and President of Parkinson’s Europe) Josefa Domingos – who has spent decades specialising in physiotherapy for Parkinson’s – has approved the following advice.
When to see a physiotherapist
A physio can provide expert advice and suggest strategies to help, no matter what stage of your Parkinson’s. It’s recommended that you talk with a physiotherapist as soon as possible after your diagnosis. They can support you to self-manage your Parkinson’s.
You should also talk with a physiotherapist if:
- You find regular exercise difficult, or you are uncertain about what type of exercise to do.
- You have queries about the frequency, intensity and safety aspects of exercising.
- You experience walking problems, for example slowness, shuffling, hesitation or ‘freezing’ (when your feet feel glued to the floor).
- You experience balance problems resulting in falls, nearly falling or fear of falling.
- You find it difficult to get out of a chair, bed or car, or if turning in bed is difficult.
- You experience pain, for example in your neck, back or shoulders.
You should always let your neurologist know if you are seeing a physiotherapist.
How can a physio help in the early stage of Parkinson’s?
In the early stage of Parkinson’s physiotherapy is focused on maintaining fitness levels, preventing inactivity, improving physical ability, muscle strength and joint mobility. Your physiotherapist may provide an exercise programme that you can follow on your own or in a group.
How can a physio help in the mid stage of Parkinson’s?
There are many different ways physiotherapy can help in the mid stages of Parkinson’s.
Through a variety of exercises physiotherapy will aim to improve upper limb function like reaching and grasping, as well as helping with posture and balance.
In addition to suggesting cueing strategies to improve gait and overcome freezing, physio can focus on cognitive movement strategies to improve daily activities such as getting out of a chair, turning in bed or getting out of a car. These help break down complex movements into manageable sequences of individual movements, you can follow step by step.
How can a physio help in the late stage of Parkinson’s?
In the late stage, physiotherapy aims to prevent complications that may arise because of using a wheelchair or being bedridden. For example, physios can help with maintaining breathing, preventing pressure sores and helping carers to ensure they position you correctly when lifting. They can also teach you tips and tricks to overcome daily challenges.
How do I find a physiotherapist?
Parkinson’s can be complex to manage, which is why it is important you see a physiotherapist who has experience of the condition.
Physiotherapy referral procedures vary depending on where you live – in some countries physiotherapy is prescribed by a doctor, but in others you can contact a physiotherapist directly.
Training and accreditation varies throughout Europe so you should always check the experience of anyone you consult – and the likely costs – before treatment starts.
Consider telerehabilitation as an option for accessing an expert physiotherapist.
Your national Parkinson’s organisation may be able to provide information based on members’ experiences.
Additional thanks: much of this information is taken from the European Physiotherapy Guideline for Parkinson’s Disease. Our thanks to ParkinsonNet and the Royal Dutch Society for Physical Therapy (KNGF), the Netherlands, for permission to use this information.
