Parkinson's DiseaseMovement & Balance Support
Learn common features and how physiotherapy supports mobility, balance and daily independence across disease stages.
What is Parkinson's and how does physiotherapy help?
Parkinson's is a progressive neurological condition affecting movement and balance. Symptoms vary and change over time. Physiotherapy supports mobility, fall‑prevention and maintaining activity.
Care includes cueing, strengthening, balance, posture and gait strategies, with home practice embedded into daily routines.
Common symptoms
- Tremor, slowness and rigidity
- Balance problems and shorter steps
- Posture and gait changes
Related symptoms: Tremors, Muscle stiffness, Balance problems, Walking difficulties
How can physiotherapy help?
- Cueing and amplitude‑based movement practice
- Strength, balance and gait training
- Falls‑prevention and environment strategies
- Education for pacing, fatigue and daily routines
Effective treatments
Exercise therapy
Strength, balance and amplitude work.
Education
Cueing, pacing and routines.
Task practice
Transfers, turning and dual‑task.
Lifestyle
Walking plan, aids and environment.
Assessment and staging
Core assessment
- Balance (MiniBEST, Timed Up & Go)
- Gait speed, step length, turning
- Transfers (bed, sit-to-stand)
- Posture and trunk mobility
Non‑motor considerations
- Fatigue, sleep and pain
- Cognition and dual‑tasking
- Fear of falling and confidence
Staging & planning
Physiotherapy goals are tailored across early, mid and later stages to maintain activity and independence.
Treatment focus by stage
Early stage
- Education and habit‑building
- Amplitude‑based practice ("think big")
- Strength, posture, flexibility
- Walking plan and community activity
Middle stage
- Cueing for freezing and turning
- Balance and dual‑task progression
- Task‑specific practice (stairs, bed mobility)
- Home safety & assistive devices
Later stage
- Safe transfers and pressure care
- Seated/standing exercise circuits
- Caregiver training
- Falls‑prevention and fatigue pacing
Movement and cueing strategies
For freezing of gait
- Stop → reset posture → take a big step over a visual line/tape
- Count 1‑2‑3 or step to a metronome/beat
- Shift weight side‑to‑side before stepping
Posture and turning
- Think “tall chest, long steps” (amplitude emphasis)
- Use U‑turns with small steps; avoid pivot turns
- Practice bed mobility with segmented rolling
Recommended exercises
Amplitude drills
Big reach and step drills, seated/standing “BIG” movements, handwriting practice with large letters.
Strength & balance
Squats to chair, sit‑to‑stands, step‑ups, tandem stance, single‑leg support with counter support.
Gait & endurance
Interval walking with cues, treadmill with harness if needed, cycling or seated pedals for stamina.
Aim for most days of the week. Intensity and supervision should be tailored by your physiotherapist.
Falls prevention and daily living
Home safety
- Remove trip hazards, add grab rails and night lighting
- Footwear with good grip; walking aid if prescribed
- Arrange furniture to create wider walking paths
Daily routines
- Time exercise for when medications are “on” if advised
- Break tasks into smaller steps with rest between
- Use external cues (visual, auditory) for consistency
Measuring progress
Outcome measures
Timed Up & Go, 10‑metre walk test, Five Times Sit‑to‑Stand, fall frequency and activity logs.
Goal setting
Clear functional goals (walk to shops, climb stairs, get out to community class twice weekly).
Review frequency
Regular reviews adjust programmes as needs change. Speak to your physiotherapist about timing.
Medical Disclaimer
This information is for educational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.