Physical Therapy and PD
Exercise and staying active play important roles in living well with Parkinson's disease (PD), from diagnosis throughout the course of disease. Physical therapy helps people with PD keep moving. In fact, recent research suggests that physical therapy — including gait and balance training, resistance training and regular exercise — may help improve or maintain PD symptoms.
When and Why to Find a Physical Therapist
Physical therapists can be helpful at all stages of PD. Movement impairments in the initial stages of the disease are not always obvious. By choosing a physical therapist who specializes in neurological conditions, they can help find movement issues earlier and quicker. Talk to your doctor about getting a baseline physical therapy evaluation and then continue with routine re-evaluations.
According to the Parkinson’s Outcomes Project, increasing physical activity to at least 2.5 hours a week can slow Parkinson's symptom progression. Best practices include early referral to physical therapy and encouragement of exercise as part of treatment.
A physical therapist is uniquely trained to design an exercise routine that targets specific motor impairments. Physical therapists also have an opportunity to provide frequent, direct feedback to help make you aware of how to exercise most effectively and safely.
A physical therapist can provide:
- Education and self-management advice.
- Exercise routines that have been associated with improvements in mobility, quality of life and disease severity.
- Answers to questions about the type, intensity, frequency or duration of exercise that is best for you.
- Ways to maintain safety when exercising.
- Help with:
- Normal physical activity routine
- Walking: slowness, small steps, or freezing (feeling glued to the floor or difficulty getting started)
- Balance or stability
- Moving around the house (getting up from a chair, moving around in bed)
- Getting around (in/out of a car or bus, elevators, stairs and uneven ground)
- Address fear of falling, have fallen or are worried about your safety.
- Other health problems that affect mobility, including joint or muscle pain from arthritis, problems with endurance due to a heart or lung condition, a broken bone or surgery.
Setting Movement Goals with your Therapist
Every client works with their physical therapist to set individualized movement goals. Physical therapists can help you build your exercise routine based on the latest research, re-learn challenging tasks or staying safe and independent in the home. Some of the most common movement goals for people with Parkinson’s include:
- Learning about exercises
- Improving walking, balance or posture
- Addressing fall risk
- Treating pain
Before your first visit, think about your movement goals and write down your problems and questions. This will help you to organize your thoughts.
Medicare and the “Therapy Cap” Removal
In the past, Medicare has limited the amount of physical, occupational and speech therapy a person could receive in a given year. In some years, there was an exceptions process that allowed individuals to access therapy above the limit if the services were deemed medically necessary. This process needs to be renewed by lawmakers every few years, creating uncertainty and the possibility that therapy will not be covered.
In 2018, the exceptions process was made permanent, meaning people on Medicare can no longer be denied therapy if they need it to manage their health conditions.
How to Find Your Expert Physical Therapist for Parkinson’s Disease
It is important to find a physical therapist who has specialty training and experience working with PD. You may find experienced physical therapists working in hospital outpatient departments, home health agencies, nursing homes or within the community close to your home. Ask your neurologist for a referral at your next appointment.
The Parkinson’s Foundation Helpline at 1-800-4PD-INFO (473-4636) can help you locate an experienced physical therapist near you who is trained to work with people with PD, and provide questions to ask a potential physical therapist to assess their experience.
Training Future Physical Therapists in Parkinson’s Disease
Did you know the Parkinson’s Foundation is working to better educate physical therapy students across the country to ensure better PD care for everyone?
The Parkinson’s Foundation Physical Therapy Faculty Program is improving Parkinson’s physical therapy care by training faculty leaders across the U.S. so they can, in turn, educate physical therapy students. The intensive course allows physical therapy educators to immerse themselves in learning the latest evidence-based findings in Parkinson’s research and care. Physical therapy educators can make a great impact on the lives of people with PD by bringing this knowledge back to their students, our future practitioners.