Episode 171: Allied Health Spotlight: Physical Therapy Recommendations for Exercising Safely
Allied health professionals are a group of healthcare providers whose role and expertise complement the work of physicians. These include specialists such as physical and occupational therapists, speech-language pathologists, nutritionists, and many more. They are just as important as your Movement Disorders Specialists and Neurologists, and play a vital role in creating a comprehensive, well-rounded Parkinson’s care team that caters to your individual needs and addresses your overall well-being.
In this first episode of our Allied Health Spotlight series, we explore the benefits of including physical therapy in your care plan. Exercise is a vital component for people with Parkinson’s disease (PD) to maintain balance, mobility, and activities of daily living. It should be part of the standard practice of care for every person with PD. Research has shown that exercise is the only intervention with the potential to slow the progression of the disease. In this episode, Physical Therapist Patricia Brown, PT, DPT, NCS of Chapman University in California, who specializes in neurologic diseases, discusses some considerations for exercising safely, taking into account the particular needs of people with PD. She also talks about how to get and stay motivated to exercise and where to find classes or programs.
Released: August 13, 2024
Patricia S. Brown, PT, DPT is a licensed Doctor of Physical Therapy. She has over 30 years of experience in rehabilitation of persons with neurologic health conditions and certified by the American Board of Physical Therapy Specialists in Neurology since 1999. Currently, she is an Associate Clinical Professor teaching future health care professionals in the Doctor of Physical Therapy Program at Chapman University’s Rinker Health Science Campus in Irvine, California.
She has a passion for both rehabilitation and wellness applied to those with Parkinson’s disease. She is a certified LSVT BIG clinician and a faculty trainer for LSVT Global. She is also a certified PWR! Clinician, a graduate of the Parkinson’s Foundation Team Training for PD, and a graduate of the Parkinson’s Foundation Faculty Training Workshop. Dr. Brown is currently active with PEP4U, a non-profit providing no-fee exercise, education and social support to people impacted by Parkinson’s disease in Orange County, California.
Across the country and beyond, Parkinson’s Foundation volunteers are going out and making a difference in the lives of people with Parkinson’s disease (PD) and their loved ones. They help us spread awareness and resources to those who need it most.
The dedication from our volunteers is what makes the Parkinson’s Foundation what it is today. We are honored to recognize five exceptional volunteers at the national level, who each received a 2024 volunteer award.
Dr. Reversa Joseph - Great Lakes Chapter
Paul Oreffice Volunteer of the Year
“Volunteering for the Parkinson's Foundation is more than just a commitment; it’s a deeply personal mission. Each effort, whether it’s a presentation, a lecture, or a podcast, is a step towards improving the lives of those affected by Parkinson’s, honoring my father’s struggle, and ensuring that every patient receives the comprehensive, integrative care they deserve.”
“Along the way I have learned that there are many things, tips and tricks that the people who live the best with this disease share: exercise, positive thinking, being around others like themselves and giving back. The Parkinson’s Foundation is a great way to give back.”
As the somber saying goes, a parent should never have to bury their child. But in March 2023 Roland and Shelley Frankel had to do just that. Their son Graeme had been fighting Parkinson’s for five years and passed from an asthma-related emergency. To keep Graeme’s memory alive, the family decided to start a DIY fundraiser with the Parkinson’s Foundation.
“I really enjoy volunteering. I see it as another way to celebrate movement. I move my brain cells around; I motivate my soul to do good things; and volunteering moves forward the search for a cure.”
There are many powerful ways to get involved and support the Parkinson’s Foundation and our work to make life better for people with Parkinson's. Get started with our How You Can Help page. This page will give you options for volunteering, starting your own DIY Fundraiser, or even just donating to the cause.
You can also fill out a volunteer interest form to chat with our volunteer engagement team about how we can best put your skills to use. Help us bring life-saving information and resources to the hands of those who need them most.
Once upon a time, I started noticing a slight tremor in my right hand. My husband noticed that I did not move my right arm when jogging. I also suffered from frozen shoulder(s), insomnia, constipation, anxiety and fatigue for years.
Doctors continuously told me it was menopause related. Over time, the tremor became more noticeable, and my doctor suggested I see a neurologist, just to “be safe.”
I met with a movement disorders specialist — a neurologist with specialized training in movement disorders — and on November 11, 2015, she confirmed the diagnosis of Parkinson’s disease (PD). I will never forget that day. I was devastated and frightened.
At the suggestion of the movement disorder specialist, I signed up for the local young-onset Parkinson’s disease (YOPD) support group. I went to the first meeting and cried seeing how PD affects people. I cried every time I had to tell someone about the diagnosis. I cried thinking about how life had changed. I cried all the time. Through all this turmoil, my neurologist promised me that life was not over, but I had to take control, no matter how hard it got.
So, we took control. We retired early and moved to Florida. It is here that I signed up for Rock Steady Boxing. I am a fighter and have met the most amazing people at Rock Steady Boxing. I also attend spin classes and Pilates as part of my personal goal to keep on moving! It still felt like there was more I could do to change the trajectory of my life. Yep, there sure was. Enter Parkinson’s Foundation.
I connected with the Parkinson’s Foundation through Moving Day Chicago (my hometown). When we moved to Florida, I attended Moving Day Boca Raton and Palm Beach. I signed up for PD GENEration and three other clinical studies. I attended Foundation-sponsored seminars, which is where I met Karen Lopez and became involved in the local chapter.
Today I am a Parkinson’s Foundation Ambassador, a Board Member on the Fund Development team, and I was honored to be the Chair of a successful Moving Day Palm Beach 2024. I have also been part of our Regional Grant Review team for the past two years and I sign up for every relevant clinical trial.
I really enjoy volunteering. I see it as another way to celebrate movement. I move my brain cells around; I motivate my soul to do good things; and volunteering moves forward the search for a cure. Volunteering is really the most effective way to use one’s voice. Being awarded the Parkinson’s Foundation Community Service Award is the ultimate recognition of how important it is to advocate for ourselves and others affected by PD.
PD has changed my life. I am married to a host of medications governed by a time clock, and I deal with nasty and unpredictable symptoms, and it is truly humbling! However, living with Parkinson’s is also a true blessing in that it has given me the gift of friendship, support and has shown me the way to help advocate for others.
Many people with Parkinson’s disease (PD) try speech therapy to combat the changes in voice and speech that are often the earliest signs of Parkinson’s. But Rod Marino went a step further and purchased a karaoke machine so he could start singing on his own, in his basement.
Rod has lived with Parkinson’s for 24 years and has learned to battle the disease with a positive attitude, great sense of humor and a song. He keeps his body strong by staying active and riding a stationary bike every day. He keeps his mind sharp by being active in the community as a board member for the local senior center. He keeps his soul sharp through music.
Rod found out about the Parkinson's Foundation from one of his doctors when he was first diagnosed, who recommended visiting Parkinson.org for helpful information. Early on, Rod read that voice dysfunction and speech issues are the earliest sign of motor impairment in Parkinson’s — specifically that the voice softens as the disease progresses.
To combat the issue, he decided to take voice lessons and now sings every day! After setting up his karaoke machine and using it consistently, his voice therapy turned into passion, and he started singing in public.
Rod finds happiness in making other people happy. He does just that spending time at the local senior center, visiting with members and hosting events, like weekly bingo. He also oversees a singing group that his wife, Diane, conducts.
In time, he formed a band called the Don-Rod Duo with a friend. The band performs at the Sheila Ray Center in Elk Grove Village (IL), farmers markets and other locations in the community.
Diane introduces the duo by telling the story of how music and song have helped Rod maintain his voice. The duo takes the stage and sings a wide range of cover songs that range from Dean Martin and Neil Diamond to Frank Sinatra, adding jokes to entertain the audience.
Today he shares his music and tells his story to the audience members. Stories about his Parkinson’s sometimes come into the light, helping spread awareness about the disease.
Rod's biggest piece of advice is to be open about having Parkinson's and allow family members and friends to help whenever possible. People should not be alone on the journey, as he has found that loved ones are eager to help in any way that they can.
Rod's motto is "Don't give up and stay involved." He is a true inspiration to so many members of the community. He wishes to share his story, so that others may learn how music has helped him on his Parkinson’s journey.
Controlando los síntomas de la enfermedad de Parkinson
Hay mucho que saber acerca de la enfermedad de Parkinson. Aprenda cómo se trata y, lo más importante, cómo llevar una vida mejor con Parkinson.
El Parkinson es una enfermedad individualizada. Si bien la experiencia de cada persona con el Parkinson es única, cuanto más sepa, más empoderado estará para desempeñar un papel activo en su autocuidado y manejar su vida con Parkinson.
At 48 years old, I heard the words "Troy, you have Young-Onset Parkinson's Disease." It took me some time, but as a public speaker who invites audiences to define success and fulfillment on their own terms, I knew I had to figure out a way to start wrapping my personal stories of Parkinson’s into each presentation. And I did.
On July 12, 2017, I had the opportunity to look into my own life to find strength and inspiration. After more than 18 months of chronic and debilitating pain, fatigue, tremors and other symptoms, I finally had an answer: Parkinson’s. This life-altering diagnosis put my lifelong beliefs to the ultimate test.
Over the next few years, I began finding ways to get involved and build my Parkinson’s community. I became active in organizations that support those dealing with chronic and life altering health conditions, which has helped me gain perspective on my own situation. My recent activity as a Parkinson’s Foundation Heartland Chapter board member is an extension of that work.
Continuing to be a public speaker has inspired me as I am able to incorporate the learnings from my own journey and the stories of other's journeys to provide inspiration to audiences.
I’ve had time to think of advice I’d give to others who are new to Parkinson’s, including:
First, there is not one path in navigating this journey. Each of us must make decisions that are best for ourselves and those who are present to support us.
Learn as much as possible about your symptoms and characteristics that have led to your diagnosis. Because PD manifests itself in unique paths to each person, gathering as much information and perspectives is key to making wise decisions on treatment.
Find a care team that best aligns with your needs. Don't be scared to change that team as time evolves. Your disease will evolve, and sometimes that means changing the team members is needed.
Turn to the Parkinson’s Foundation. The vast amount of information, data and research findings pushed out through emails, Parkinson.org and events has been significant in keeping me informed and hopeful.
My expertise in public speaking has been acquired through years of studying, asking questions of, presenting to and consulting with audiences and groups from Fortune 500 firms to leadership conferences. These principles and traits include hitting control+alt+delete to redefine societal defaults for success; establishing and measuring goals with specific strategies; finding wisdom to overcome adversity and inevitable change.
Now, especially after releasing my first book, Change Is Inevitable, Growth is Optional, I continue to be inspired by the tremendous stories of others who have faced adverse change and find a pathway to growth. This inspiration has led me to me to participate in such experiences as running in masters track meets, fundraising for worthy causes, and speaking before audiences to share my experiences.
Everything so far has led me to my newest way to advocate for people with Parkinson’s: becoming a Parkinson’s Champion and hosting my first fundraiser. On June 8, I will be competing as a Parkinson’s Champion in the 6 in 6 Challenge. I will compete in six track and field running events on the same day in approximately six hours.
I chose the number six because every six minutes someone is diagnosed with Parkinson’s disease. In the roughly six hours it takes me to complete the 6 in 6 Challenge, 60 people will learn of their new Parkinson's diagnosis.
Long before public speaking, running was always my passion. I have been active as a runner since my teenage years. I ran track, coached high school and middle school track, and ran a triathlon (which may be the next challenge.)
In my Parkinson’s experience, I challenge my body each day to get stronger and maintain strength so that I can delay the disease. But for many people with Parkinson's, simple physical activities are an extreme challenge. For those who can't challenge themselves to the level I still can, I am honored to take on a new physical challenge in their honor.
My Parkinson’s disease (PD) diagnosis started one morning when my wife said to me that I should see a doctor about how I was walking. She had noticed that my gait had changed, and had been searching online for reasons why. As soon as she mentioned it to me, I realized she was right, and I became very aware of how my movement had changed.
I started with my regular doctor who after watching me walk and noticing an occasional tremor in my hand told me that it was likely Parkinson’s. She told me everyone’s journey with Parkinson’s was different. She referred me to a neurologist who ordered a DAT scan that confirmed my results were consistent with Parkinson’s.
The diagnosis was confirmed on January 5, 2023, about one week before we embarked on a 111-day world cruise. My neurologist encouraged me to take the cruise and just be careful on the cobble stone streets around the world. “Just don’t fall.” It was the trip of a lifetime, and I was able to do almost everything I wanted.
After returning from the cruise, I made an appointment with a neurologist who was a family friend, and he also confirmed the diagnosis. He was in Los Angeles and a five-hour drive from my home in Las Vegas. It wasn’t practical in the long term, so he referred me to the Cleveland Clinic at the Lou Ruvo Center for Brain Health in Las Vegas.
Fortunately, my doctor at the Cleveland Clinic was also the Principal Investigator for a new Parkinson’s medication. I was accepted into the Phase three trial and didn’t think twice about participating, even though you don’t know if you’re in the placebo group or the drug group.
Participating in research led me to new opportunities, including being invited to speak about my drug trial experience at a Cleveland Clinic event. This event was also my introduction to the Parkinson’s Foundation. In just three months, I began exploring and utilizing Parkinson’s Foundation resources, which motivated me to apply to the People with Parkinson’s Advisory Council and to become a research advocate for the Foundation.
Throughout my research experience, I have learned that it’s challenging to enroll participants in drug trials for many reasons. I didn’t think twice about participating in the trial because it is an opportunity to not only help my own Parkinson’s symptoms, but to help other people who will be diagnosed with PD in the future.
I found myself constantly checking for any change in my condition to see if I could tell which trial group I was assigned. After 27 weeks of phase three participation, I will move to the Phase four trial and receive the new drug for an entire year.
In the last two months I’ve joined a gym and started playing racquetball again. I’ve noticed my better days are the active ones. Staying active really makes a difference for me. I think of exercise as important as medication for my Parkinson’s journey.
I have started attending Parkinson’s events and grow my participation in the PD community here in Las Vegas. I find that events let me meet other people with PD, which is different than reading about someone’s journey online. I find it helpful to reading about PD news and studies to help me understand the state of the disease.
I would encourage everyone to see a neurologist as early as possible when you display early symptoms, such as the loss of sense of smell and active/restless sleep. I had these symptoms more than 10 years ago but never understood they would be the early steps towards Parkinson’s.
Find a PD-trained neurologist using our In Your Area search feature or by calling our Helpline at 1-800-4PD-INFO (1-800-473-4636).
No importa en qué punto se encuentre en su recorrido por la enfermedad de Parkinson, el movimiento habitual es una buena medicina. Los estudios demuestran que la incorporación de una rutina de ejercicio es esencial para el manejo de los síntomas de la enfermedad de Parkinson.
Cindy Finestone does it all. The on-the-go, soon-to-be first-time grandmother serves on community boards, enjoys the challenge of cooking a Sunday feast for her three adult children with minimal warning, goes to the gym six days a week and fundraises for causes she believes in. And she does it all fighting Parkinson’s disease (PD).
Cindy was diagnosed with Parkinson’s 10 years ago. She’s heard enough misdiagnosis stories to know she is “one of the lucky ones.” After ruling out carpel tunnel, her neurologist told her to return if she noticed a tremor or funny feeling in her hand. “A lot of times people put things off and don’t address health problems right away, making it worse. A year after my initial visit, I began trembling in one hand. It happened twice in one day, so I got it checked out,” Cindy said.
Cindy thought it was unusual that her doctor was standing at the exam room door waiting for her. She later found out he was observing her gait and whether her arm was swinging. “He asked me questions like ‘Do you notice yourself drooling?’ and ‘How is your sense of smell?’ I left with a Parkinson’s diagnosis, an Azilect® prescription and a referral for a movement disorders specialist.”
Shortly following her diagnosis, Cindy began experiencing severe cervical dystonia (sustained and repetitive muscle spasms or cramps). The pain caused her to constantly look up and had an impact on her daily life. Her movement disorders specialist started Cindy on Botox injections, every three to five months, in her neck. “Parkinson’s caused the muscles in my neck to atrophy, so I started exercising like I never had before to strengthen my body,” Cindy said.
Fast forward to 10 years later, Cindy goes to the gym six days a week, sometimes seven. Once she found Rock Steady Boxing classes, her life changed for the better. “I don’t think she knows we have Parkinson’s,” a fellow boxing student once told her during a class. Cindy wouldn’t have it any other way. She now works with the Rock Steady Boxing instructor two times a week, in addition to her four weekly group boxing and core stretching classes.
“Exercise is not just about physical health, but mental health. I believe that the more you push yourself when exercising, the better your movements will be every day,” Cindy said. “I used to exercise before being diagnosed, but nothing like now. If I don’t go to the gym, I feel like something is not right.”
Between her treatments and her Rock Steady Boxing instructor focusing on strengthening her neck muscles (one of which was making her hold a tennis ball under her chin) Cindy’s dystonia dramatically improved. She was feeling better and ready to get involved in the PD community.
Community engagement is nothing new for Cindy. She grew up with parents who valued volunteering, she was a classroom mom, PTA leader and served on numerous local boards. She eventually found the Parkinson’s Foundation walk, Moving Day Rochester, NY. “I didn’t ask anyone to go with me. I didn’t feel comfortable asking people for money. I went by myself for years.”
One day her son’s teacher was diagnosed with Parkinson’s, and he asked Cindy if she had heard of Moving Day. He could not believe his mom had been attending alone and insisted on not only going with her, but helping her team. Rock Steady Boxing Flower City was launched, and Cindy went into planning mode. She created jewelry and T-shirts to raise funds, along with her first Facebook account and page — and raised $5,000 in four weeks.
Cindy eventually applied and was selected to serve on the Parkinson’s Foundation People with Parkinson's Advisory Council, a group of dedicated people in the PD community who advise and collaborate with the organization on a volunteer basis. She is also president elect and serves on the board of the Parkinson’s Foundation New York New Jersey Chapter.
“Being involved in the Parkinson’s Foundation makes me feel like I’m doing something that’s helping. Everything I do is somehow related to the Foundation. I attend a PD support group of 60 women, some of whom have become my closest friends—and I found this group through the Foundation. I call the Helpline for referrals. I go on Parkinson.org every time I feel a new symptom coming."
Cindy often gets asked about Parkinson’s because of the Parkinson’s Foundation lanyard she wears for her keys. She doesn’t shy away from hard topics and always advocates for finding your community, volunteering, and exercising.
“Somedays Parkinson’s is more emotional than physical. You just don’t want to exercise; you want to get off the ‘train.’ But then I start thinking ‘What am I going to stay home for?’ You can modify everything you do based on how you feel,” Cindy said.
Cindy considers living with Parkinson’s to be a non-stop job. She even tailors her hobbies to find activities that can help with symptom management. While she notices that Parkinson’s has slowed her down, especially in the morning, she doesn’t let it stop her from living life. “I love being outside, golfing, and taking brisk walks. I play mahjong, do pottery and knitting classes — classes that can help in fine motor skills. I love cooking and spending time in my craft room, but volunteering is what keeps me busy, it keeps me aware.”
This April, help the Parkinson’s Foundation advocate for Parkinson’s Awareness Month. Learn More.
Rehabilitation Care & Parkinson’s: Start Early and Assess Often
A serious misconception about Parkinson’s disease (PD) is that rehabilitative care should only come into play in the later stages of the disease. In fact, rehabilitation can play a crucial role in managing and improving PD symptoms, function, and quality of life and reducing disability from day one.
In January 2024, the Parkinson’s Foundation published a paper on the importance of delivering rehabilitation care in Parkinson’s in the Journal of Parkinson’s Disease. This paper was written by the Parkinson’s Foundation Global Rehabilitation Medicine Task Force, which was formed to help healthcare professionals incorporate rehabilitation into PD care.
“Our goal is to raise awareness of the importance of rehabilitation care in PD. We want to motivate people living with Parkinson’s to advocate for their best care, and that means knowing that they can start rehabilitative care at any point in their disease. We also want to motivate professionals to include evidence-based rehabilitation interventions when providing care to every person with Parkinson’s,” said Jennifer Goldman, MD, MS co-chair of the Parkinson’s Foundation Rehabilitation Medicine Task Force.
Parkinson’s rehabilitation services should start early and be assessed every year.
Rehabilitation is defined as a set of treatments and therapies that can help people with Parkinson’s maintain or improve activities of daily living and independence. PD rehabilitation can include:
Trained rehabilitation professionals provide care with the goal of keeping people with PD communicating well, engaging in activities they love and moving well. Rehabilitative care plays a crucial role in PD care and improving health outcomes, with growing evidence showing the benefit for movement and non-movement symptom management, activities of daily living and quality of life.
Key Highlights
The Parkinson’s Foundation Global Rehabilitation Medicine Task Force published the following takeaways regarding rehabilitative care and PD:
Rehabilitation should involve the person with PD and care partner and should incorporate shared decision-making to promote symptom management and independence.
Care coordination and communication among the rehabilitation team, the entire PD care team, the person with PD, and care partner are critical for best results.
Rehabilitative care professionals should have knowledge and expertise in treating people with Parkinson’s disease.
Since Parkinson’s is a progressive disease, rehabilitative care should be offered at diagnosis and regularly throughout the disease course with repeated assessments and interventions adapted to changes in a person’s condition or needs.
Rehabilitative interventions are critical in treating PD, alongside medical, surgical and other PD-related interventions.
What is the takeaway for people with Parkinson’s?
More than half of people with PD are never referred to rehabilitative therapy in their lifetime. Research shows that these therapies help with symptom management and help people with PD stay independent longer. Many healthcare professionals and people with PD remain unaware of the potential impact of rehabilitative care, thereby limiting their use and availability in the PD community. These therapies are greatly under-utilized for people living with PD.
The Parkinson’s Foundation recommends that every person with PD ask their PD doctor at least once a year if they can benefit from rehabilitative services.
Learn more about Physical, Occupational & Speech Therapies. For a referral to a rehabilitation expert near you, call our Helpline at 1-800-4PD-INFO (1-800-473-4636).