Physical, Occupational & Speech Therapies
When you live with Parkinson's disease (PD), symptoms can change as the disease progresses. Allied health professionals are medical experts from a variety of fields who can help manage your symptoms at every stage. Having an allied healthcare team is critical to living well with Parkinson’s, as they can help guide exercise, nutrition and medications.
Rehabilitation is defined as a set of treatments and therapies that can help people with Parkinson’s maintain or improve activities for daily living and independence. Rehabilitation professionals include physical and occupational therapists and speech-language pathologists skilled in PD who can keep you moving well, engaging in activities you love and communicating with the people in your life.
Rehabilitation & Parkinson’s
Research shows that rehabilitation can play a crucial role in prevention of injuries and help enhance quality of life. Most often, people with Parkinson’s are only referred to rehabilitation services when recovering from an injury, such as a fall. However, it is recommended that people with PD should begin rehabilitation at diagnosis and consistently every six to 12 months.
Rehabilitation therapies and exercise can:
- Slow disease progression
- Address movement symptoms
- Improve daily functioning
- Enhance mood and mental health
Despite mounting evidence, only 14% of people living with PD use speech, occupational or physical therapy as part of a treatment plan. Some medical centers and doctors’ offices incorporate rehabilitation and exercise into care regimens, but many do not.
Building Your Rehabilitation Team
Rehabilitation professionals are medical experts who can help manage your symptoms at every stage and maximize your quality of life. Those skilled in PD can keep you moving well, engaging in activities you love, and communicating with the people in your life. Rehabilitation specialists include:
- Physical Therapists help people with PD keep moving well, as long as possible, while enhancing the ability to move. Research shows that physical therapy — including gait and balance training, resistance training and regular exercise — may help improve or hold PD symptoms at bay.
- Occupational Therapists help people with PD continue pursuing the activities that make life meaningful and focuses on remaining independent — whether in work, hobbies, social life or in daily activities.
- Speech Language Pathologists evaluate speech, voice, communication, swallowing and memory/thinking function. They establish a treatment plan that is consistent with personal goals, such as improving specific communication skills, swallow function and thinking skills.
I cannot be strong enough in my recommendation to seek out physical therapy. The education in exercise techniques is immensely valuable.
Finding Expert PD Physical Therapy
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.
Find a Physical Therapist
The Parkinson’s Foundation Helpline at 1-800-4PD-INFO (1-800-473-4636) 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
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.
Research shows that up to 89% of people with Parkinson’s disease experience speech changes. These changes may include low volume, monotone, breathy/hoarse vocal quality, fast rate of speech, and/or reduced clarity. As a result, people with PD report they are less likely to participate in conversation or lack the confidence in social settings compared to those without PD.
Communication is a key element in quality of life and confidence for people with PD. Speech disorders can progressively diminish quality of life for a person with PD. A speech-language pathologist can help. The earlier a person receives a baseline speech evaluation and speech therapy, the more likely he or she will be able to maintain effective communication skills as the disease progresses.
Explore our Speech & Swallowing Book
Learn more about Parkinson’s and speech-related symptoms in our free book Speech and Swallowing.
People with PD can and should keep doing the activities they love to do. If PD symptoms get in the way, physical and occupational therapists and speech-language pathologists can help. Together, you will set realistic goals, identify challenges and strategize solutions.
Medicare and the “Therapy Cap” Removal
Historically, Medicare has limited the amount of physical, occupational and speech therapy a beneficiary could receive each year. In some years, Congress created an exceptions process that allowed individuals to access therapy above the cap if the services were deemed medically necessary, but this process needed to be renewed by lawmakers every few years, creating uncertainty and the potential for coverage denials.
Questions about insurance?
For more about Medicare and insurance, visit our Insurance article.
The Parkinson’s Foundation has worked with the PD community to address Medicare challenges related to services such as physical therapy, occupational therapy and speech-language therapy since 2011, including advocacy in 2014 to remove the Improvement Standard, which meant that people with Parkinson’s could no longer be denied coverage for therapy solely for lack of improvement.
As of February 2018, this exceptions process was made permanent, meaning people on Medicare can be granted continued therapy on the basis of improving or maintaining their level of functional mobility due to their Parkinson disease and other health conditions.
Page reviewed by Dr. Bhavana Patel, Movement Disorders Neurologist at the University of Florida, a Parkinson’s Foundation Center of Excellence.