Research shows that people with Parkinson’s disease (PD) are hospitalized more often, visit emergency rooms more frequently, and are more vulnerable to complications while hospitalized.

Exercise and physical activity not only help people with Parkinson’s maintain or improve mobility, flexibility and balance when it comes to managing symptoms, but regular movement can mean big benefits in the hospital. As a hospital patient, movement — often with support from physical and occupational therapy — is essential for preventing falls and minimizing complications.

A new study finds that staying active (inpatient mobility) in the hospital benefits people with Parkinson’s. Published in Parkinsonism & Related Disorders, the Parkinson’s Foundation-supported study looks at how University Hospitals (UH) located in Cleveland, OH, Move to Heal Program, a hospital system-wide mobility program that aims to mobilize all inpatients at least three times daily, affects patients with PD.

Inpatient mobility refers to safe movement during a hospital stay (in and out of bed) with the approval and support of a care team. Benefits include:

• Reduced muscle loss

• Better sleep

• Improved focus

A lack of mobility in older patients while hospitalized is associated with reduced mobility and increased mortality after being discharged.

Study Results 

To learn more about the outcomes of inpatient mobility for people with PD, the study used data from patients admitted at the hospital for more than 24 hours between February to September 2023, comparing 300 hospital patients with Parkinson’s to 12,000 patients without PD. Each group was further divided into an:

• Active group: three mobilizations or more per day. Mobilizations included active or passive range of motion performed in bed, sitting at the edge of the bed, sitting on a chair or bedside commode, standing and walking.

• Inactive group: less than three mobilizations per day.

Data showed that inpatients with PD in the active group had a shorter hospital stay and higher probability of returning home after hospitalization. This supports the Parkinson’s Foundation Hospital Care Recommendations, which advocates that people with PD mobilize three times a day under professional supervision.  

Notably, all patients who stayed active while hospitalized were 50% less likely to die within 30 days of being released from a hospital stay, and 30% lower odds within 90 days.

Hospitalized patients who stayed active were 74% less likely to be discharged to hospice care or die compared to inactive patients.

Overall, the study suggests that frequent mobilization significantly decreases length of stay and likelihood to be discharged home for patients with Parkinson’s, in hospitals with mobilization programs.

Highlights 

• The Parkinson’s Foundation partnered with University Hospitals to better understand how staying active in the hospital (called inpatient mobility) impacts people with Parkinson’s.

• Study data compared 300 hospitalized people with Parkinson’s with 12,000 hospitalized patients without Parkinson’s.

• People with Parkinson’s who were mobilized at least three times a day while admitted had a shorter length of stay and were more often discharged to home (rather than a care facility) than those who were not mobilized at least three times per day.

• Patients who stayed active while hospitalized had 50% lower odds of dying within 30 days of being released from a hospital stay, and 30% lower odds within 90 days.

• Both groups that were active (with and without PD) had shorter hospital stays than the inactive group, but the impact was more significant for those with PD. 

• Only the active PD group showed an increased likelihood of going home after discharge.

What does this mean? 

For people with Parkinson’s, staying mobile in the hospital can make an enormous difference when it comes to recovery and being more likely to go home instead of another care facility.

Mobility in people with Parkinson’s is an important aspect of managing PD symptoms, while at home and in the hospital. This study shows that people with PD are prone to longer hospital stays and increased mortality rates if not moving regularly in the hospital.

For many, it can be difficult to advocate for regular, scheduled movement when you are facing health concerns or complications that lead you to the hospital. This study supports Parkinson’s Foundation efforts to promote system-wide inpatient mobility programs, showing significant benefits to patients and hospitals — especially those with PD. Over time, these programs can help improve quality of care.

What do these findings mean to the people with PD right now? 

Each year more than 300,000 people with Parkinson’s receive care at a hospital in the U.S. Unfortunately, approximately one in six people with Parkinson’s are estimated to experience avoidable complications during a hospital stay.

However, there are many ways to advocate for yourself when preparing for or experiencing a hospital stay. The Hospital Safety Guide contains useful tools and information to help you during your next visit. This guide highlights five hospital care needs, with advice on how to talk with your care team regarding movement in the hospital and beyond.

Learn More 

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and mobility in our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions. 

• Safe Movement in the Hospital  

• Hospital Safety Guide

• How to Communicate Your 5 Parkinson’s Care Needs During a Hospital Visit

• For Professionals: Our Care Strategy: The Hospital Care Initiative

Living well with Parkinson’s takes a team, and some of the most valuable members may not be who you would typically expect. Healthcare professionals, such as physical and occupational therapists, are essential members of your Parkinson’s care team. They help you maintain mobility, independence and communication, working hand-in-hand with movement disorders specialists and neurologists to create a comprehensive, well-rounded care plan that supports your individual needs and overall well-being. 

To showcase these key members of your Parkinson’s care team, we’re highlighting recent podcast episodes that explore the unique benefits of working with a diverse group of medical specialists.

Who should we talk to next? Let us know

Speech-Language Pathologist

Episode 176: The Challenges of Speech and Swallowing Issues

Parkinson’s affects more than just movement, it can also impact the small muscles in the face, mouth, throat and chest. These changes may impact your ability to eat, speak and swallow, and can influence your confidence in conversations.  A speech-language pathologist will assess speech and swallowing challenges and create a treatment plan to help manage these symptoms.

Melissa Grassia Chisholm, MS, CCC-SLP, a licensed speech pathologist and a voice-swallow airway expert, talks about the importance of getting a baseline evaluation with a speech-language pathologist early on in your PD diagnosis and explains how personalized treatment plans can help address speech and swallowing challenges as your needs evolve.

Physical Therapist

Episode 171: Physical Therapy Recommendations for Exercising Safely

As Parkinson’s progresses, overall movement, balance, and coordination may become more challenging. A physical therapist helps you stay active by developing a custom training plan that meets your goals and physical needs.

Patricia S. Brown, PT, DPT, NCS, of Chapman University in California, a physical therapist who specializes in neurological diseases, shares her recommendations on staying motivated and choosing an exercise program that matches your lifestyle goals.

Pharmacist

Episode 167: Exploring Carbidopa-Levodopa for Treating Parkinson’s Symptoms

Managing Parkinson’s symptoms often involves taking multiple medications, making ongoing conversations with your doctor essential. When questions arise, pharmacists can be readily accessible experts who can help address concerns, identify potential drug interactions, and make you feel more confident about your medications.

Emily Peron, PharmD, MS, and Leslie Cloud, MD, MSc, from Virginia Commonwealth University, a Parkinson’s Foundation Center of Excellence, explain the long-term use considerations of carbidopa-levodopa, the different formulations available, and how to recognize when medication adjustments may be needed.

Episode 181: What to Know Before Taking Nutritional Supplements for Parkinson’s

In addition to prescribed Parkinson’s medications, people with PD may explore complementary or alternative therapies, such as herbs or nutritional supplements. Although often available without a prescription, these supplements can pose risks, especially when taken alongside PD medications. That’s why it’s always advisable to speak with your healthcare provider before starting a new medication or over-the-counter supplement.

Angela Hill, Pharm. D., CRPh, a pharmacist and professor at the University of South Florida, a Parkinson’s Foundation Center of Excellence, talks about the potential side effects and drug interactions that can happen with nutritional supplements, and offers tips for reading and evaluating food labels so you can better understand what you’re taking.

Social Worker

Episode 179: Understanding Depression, Anxiety, and Apathy

Social workers are often the go-to resource for connecting you with specialists and services that can help you navigate the day-to-day realities of Parkinson’s. They offer a wealth of guidance and support to ensure that your voice is heard.

Lauren Zelouf, MSW, LCSW from Penn Medicine’s Parkinson’s Disease & Movement Disorders Center, a Parkinson’s Foundation Center of Excellence, tackles the often-overlooked topic of mental health. She breaks down the differences between depression, anxiety and apathy, and offers coping strategies for managing symptoms and finding support.

Managing Parkinson’s involves a team-based approach. Each healthcare professional brings specialized expertise that can help you move better, speak more confidently, and feel better supported throughout your Parkinson’s journey.

Coming Soon: We’re excited to feature another essential member of the Parkinson’s care team—an occupational therapist—in an upcoming episode.

Subscribe to our podcast. Search for “Substantial Matters: Life and Science of Parkinson’s” on your favorite podcast platform.

Listen to every episode at Parkinson.org/Podcast.

For many, living with Parkinson’s disease (PD) can make it harder to leave the house on a daily basis, let alone travel to a new time zone. However, as with any trip, planning and preparing can help. This article covers how to factor Parkinson’s into your itinerary.

Check out these eight tips for traveling with Parkinson’s.

1.   Plan to bring all Parkinson’s medications and assistive equipment.

• Wherever you travel, pack all the medications and dosages you need, plus extras, in your carry-on bag.
• Familiarize yourself with our Hospital Safety Guide (and download guide components).
• Remember to pack snacks, a water bottle you can fill at the airport and throughout your trip, and anything else you need to take with medication. 
• Write your list of essentials before packing.
• Remember to pack your go-to outfits that make getting dressed a little easier — wrinkle-free items, shorts, pants with elastic waistbands — and assistive devices you regularly use.

2.   Before your trip, check in with your Parkinson’s doctor.

Before jetting off, speak to your Parkinson’s doctor to ensure that you have all the medications you need.

3.   Request assistance in airports.

A few days before you fly, consider requesting special assistance at airports, such as a wheelchair or an electric cart service to help with luggage. This can make traveling much smoother and reduce stress. A physician’s written certificate of need may be required, so call the airline ahead of time.

4.   Call hotels to inquire about accessibility and special accommodations.

When staying at a hotel, call ahead to request a room with accessibility features, such as a room near the elevator or with wheelchair access. Additionally, if traveling from an airport, ask about transportation services ahead of time.

5.   Continue to take medication as prescribed when changing time zones.

It is extremely important to take prescribed medications using your everyday intervals between doses. Set (or keep) your medication alarms the same as when you’re home. Speak to your doctor if you have any questions.

6.   Call our Helpline to find local resources.

If you're planning a longer stay, call the Parkinson’s Foundation Helpline at 1-800-4PD-INFO (1-800-473-4636) to find local Parkinson’s exercise classes and support groups in the area you are visiting.

7.   Check your medical insurance policy.

Be sure to check in with your health insurance before traveling so you are aware of any coverage or lack thereof.

8.   Take your time, relax and enjoy.

Give yourself extra time for everything — it's vacation after all. Enjoy longer meals, take breaks between the sites and activities, rest your legs at a coffee house, and try a sightseeing bus tour. Plan to see fewer sites so you enjoy them more, and when possible, book tickets for sites online ahead of time so you can minimize lines.

Traveling with Parkinson's can come with added challenges; however, planning can help reduce stress and anxiety. Explore our Traveling with Parkinson’s page for our full list of tips.

For many people with Parkinson’s disease (PD) healthcare appointments with a specialist are often far apart, short on time and packed with information. Learning to be an active member of your care team — prioritizing your concerns, questions and needs before and during every healthcare appointment — can help you optimize the value of each visit.

The following article is based on a Parkinson’s Foundation Wellness Wednesday expert discussion Taking Charge: Strategies for Meaningful Healthcare Visits. Speakers include: Taylor Rush, PhD, health psychologist at Cleveland Clinic, a Parkinson’s Foundation Center of Excellence; Kathleen Blake, MD, MPH, People with Parkinson's Advisory Council vice chair and retired cardiologist; and Muhammad Mahdi Nashatizadeh, MD, neurologist at the University of Kansas School of Medicine, a Parkinson’s Foundation Center of Excellence.

Your Voice Matters

Because no two people experience Parkinson’s the same way, diagnosis and treatment can be complex. Further, accessing expert Parkinson’s care can be difficult. While more than one million people in the U.S. live with PD, research shows that there are less than 700 neurologists trained in movement disorders nationwide. Most of these specialists are concentrated in urban areas, and it can take several months to get an appointment.

Parkinson’s visits can be fast-paced, heavy on information and the gap between appointments can be significant. The priorities you want to cover might be different than those your doctor plans to discuss. It can be frustrating to leave an appointment without talking through your top concerns or fully understanding your doctor’s recommendations. Taking an active approach to your healthcare can address this frustration and help you get more out of each appointment.

Parkinson’s care is a partnership. Your healthcare team brings medical expertise to the relationship while you bring your own expertise — your unique experience living with Parkinson’s and the knowledge of what is most important to your daily life and well-being. You know how Parkinson’s is getting in the way of the things you want or need to do.

“Remember, you are the one going through the process, so you're the expert on what your experience is — your healthcare team relies on you to share what your concerns may be and what the priorities will be,” said Dr. Nashatizadeh.

Active Participation is Key to Empowered Care

Self-advocacy — understanding what you need, gathering information to make good choices and speaking up for yourself — is a skill; one that gets stronger with practice. Research shows people who speak up about their needs and actively participate during their healthcare appointments experience improved outcomes, increased satisfaction and more cost-efficient healthcare.

“Self-advocacy matters because you are the only consistent member of your healthcare team. You are present throughout your journey, not just during the clinical visits but between the visits,” said Dr. Blake, who is living with Parkinson’s.

More Tips for Optimizing Your Care

If you are comfortable including someone, bringing a companion to healthcare visits can be invaluable. Discuss roles before the appointment, so your companion or care partner knows how you prefer them to participate. Participation can help your companion gain a deeper understanding of Parkinson’s. They may also be able to take notes, share unique insights or help you follow through with any recommendations.

While movement symptoms can take center-stage at a PD appointment, Parkinson’s impacts more than movement. Mention any non-movement symptom concerns to your doctor. Anxiety or depression, common in Parkinson’s, can impact your ability to follow through on treatment recommendations. Talk to your neurologist about persistent feelings of sadness or worry.

“Mood should certainly not be discounted or minimized because it's not a motor symptom,” said Dr Rush. “It affects motor symptoms, it affects quality of life, and it affects relationships and functioning.”

Finding the right provider can be a process. If you feel like your healthcare provider isn’t hearing you or addressing your needs, or you leave appointments frustrated, it’s important to take action.

Try addressing your concerns by:

• Expressing your needs and expectations at the beginning of each appointment. Bring a written list of your top three discussion topics or ask your doctor about sending your list through the patient portal ahead of your next visit.

• Having a friend in your corner. Consider asking a companion to support you or to help explain the details of how PD symptoms, challenges or care needs are impacting you.

• Calling the Parkinson’s Foundation Helpline. Our Helpline team can help you prepare ahead of a visit, brainstorm solutions to challenges, or help you explore other care options.

Visit our Making the Most of Your Parkinson’s Care page to discover resources to help you prepare for your next visit.