In this guide
Parkinson’s disease slows movement, stiffens the muscles and makes walking and balance less sure, sometimes with feet that feel « stuck to the floor ». Medicines help a lot, and physiotherapy adds to them: it helps keep movements bigger, walking safer and as much independence as possible. At home, the physio works where the difficulties are: getting out of bed, going through a doorway, turning in the kitchen.
Why see a physio with Parkinson’s disease?
Physiotherapy doesn’t cure the disease, but regular work helps keep abilities longer. It is useful from the diagnosis, not only once difficulties set in. It is prescribed by the neurologist or family doctor, who sets the number of sessions.
Moving every day is part of the treatment: walking, gentle exercise or dancing, at your own pace, add to the sessions with the physio.
What the physio does in the sessions
The physio starts with an assessment: walking, balance, getting up, posture and the moments when the patient freezes. They may then:
- work on big movements and long strides, against movements that shrink;
- teach cues to get walking again: counting, following a rhythm, aiming at a line on the floor;
- train balance and turning, to reduce the risk of falls;
- make getting up easier: out of bed, up from a chair, turning over in bed;
- keep the body supple and straighten the posture, which often leans forward;
- work on breathing, and show the family how to help without taking over.
Depending on needs, a speech therapist can help with the voice and swallowing, and an occupational therapist with adapting the home.
Everyday tips
- When the feet freeze, stop, stand up straight, then start again counting or stepping over an imaginary line.
- To turn, walk round in a wide arc in several steps rather than pivoting on the spot.
- Do one thing at a time while walking: avoid talking or carrying something at the same time.
- Clear the way, remove slippery rugs and light the home well, especially at night.
- Walk a little every day, at a set time, when the medicine is working well.
What a home session looks like
A session usually lasts 30 to 45 minutes. It is best timed for the hours when the medicines work well, so the patient can make the most of it. All it takes is a little space to walk, a stable chair and, if possible, a hallway for the walking exercises.
The pace is often two or three sessions a week, with exercises to repeat every day in between. A relative who is there learns the cues that help get walking again.
Warning signs
Call emergency services at once (15 or 141) after a fall with a blow to the head or severe pain, if the person chokes while eating or breathes badly, or if one side of the body suddenly becomes weak or speech becomes difficult.
Tell the neurologist quickly about repeated falls, coughing during meals, a rapid worsening, confusion or hallucinations, or fever.
Reimbursement
When prescribed by a doctor, physiotherapy can be covered by AMO (CNSS or CNOPS) or your insurer, depending on your cover. A long-term condition such as Parkinson’s disease may give you better cover: ask your fund. You need the prescription and a care sheet filled in by the physio; on Kinezy, physios who provide one say so on their profile.
This guide gives general information. It doesn’t replace the advice of your doctor or physio, who know your situation.