People with Parkinson’s may find that they have problems with everyday movements, such as walking or getting in and out of a chair or bed.
This information looks at what difficulties you may experience and how physiotherapy can help. It also discusses what advice physiotherapists might give carers.
What is a physiotherapist?
A physiotherapist (often called a physio) is a healthcare professional who helps keep people moving and functioning as much as possible when they are affected by injury, illness or long-term conditions, such as Parkinson’s. They are part of the multidisciplinary team who can help you manage your condition.
Physios work in a wide variety of settings, including hospitals and outpatient clinics, as well as community settings, such as care homes, GP surgeries and visiting people’s homes.
Like many other health professionals, physios take additional training to specialise in different areas of practice − some work specifically with people who have neurological conditions, such as Parkinson’s.
Clinical guidelines recommend that physiotherapy should be available for people with Parkinson’s. We therefore recommend that you are referred to a physio by your GP or specialist as soon as possible after your diagnosis. You can also be referred by your Parkinson’s nurse.
How can a physio help me?
A physio will assess how Parkinson’s is affecting your movement and your ability to carry out everyday tasks. This can be done whether you are newly diagnosed, or have been diagnosed for some time.
In the early stages of Parkinson’s, your physio can give you advice, education and support in keeping up your fitness levels and maintaining a good posture to help you remain independent.
As the condition progresses, your physio may focus on your walking, posture and balance. They may also start to work with your support network − involving your family and carers as part of your treatment.
These are some of the ways your physiotherapist may be able to help you.
Helping you keep fit
A physio can help you to maintain your fitness by providing an exercise programme for you to follow at home. They may also give advice on suitable sports activities, such as golf, or an exercise class like yoga or t’ai chi.
They can show you how to stretch, how to position stiff muscles and joints to maintain good posture, and how to keep your joints flexible. This will help you to move more smoothly, and will relieve stiffness.
Exercise can also help with stress. The evidence is building that exercise may have extra benefits for people with Parkinson’s, such as helping you to walk more quickly and improve your balance.
Helping you to move about
Physios can use occupational therapy to teach you techniques that make some automatic movements, such as walking, sitting down and standing up, easier. These things may become more difficult as your Parkinson’s progresses.
Helping you to maintain independence
If certain movements are difficult, such as getting out of a chair or turning in bed, a physio can teach you different ways of doing these things. This may be done in a physiotherapy department or the physio may visit you at home. They can also give advice on aids and equipment that you could use, or alterations you could make to your home, to make getting around easier and safer. In some cases, it may be an occupational therapist that deals with home adaptations.
Always check with a physio before you buy a piece of equipment or an aid. No two people with Parkinson’s are alike, so what might work for one person might not suit someone else.
Helping you to prevent or manage falls
The physio may work with you on strength and balance training, and improving your ability to walk. This training will improve your confidence and help to reduce falls and freezing. They can also teach you techniques to help you get up if you fall.
Often a physio will work with an occupational therapist to make sure your home is hazard free.
Providing pain relief
There are five main types of pain that are associated with Parkinson’s. These are pain in the muscles and bones, involuntary muscle spasms, primary or central pain, nerve pain and restlessness, or being unable to keep still.
Your physiotherapist can assess your pain to try to find the cause. They can then use methods such as manual therapy or applying heat or cold to help relieve pain. They can also use therapeutic ultrasound to reduce uncomfortable nodules that can be caused by use of the Parkinson’s medication apomorphine.
More therapists are being trained in complementary techniques, such as acupuncture, which may also help to reduce pain.
Helping you improve your breathing
Parkinson’s can cause stiffness and weakening of the chest muscles, which may lead to chest infections. A therapist can use positioning or other techniques to help clear the phlegm and keep your chest clear.
Breathing exercises can also help if your voice has become softer.
Helping you to prevent circulation problems
Physios can teach you different ways to sit or lie to help prevent problems with your circulation. If your movement is very restricted this may affect your circulation as your muscles won’t be pumping blood around the body as they contract.
What advice can a physio give carers?
If you are a carer and you help a person with Parkinson’s move around, it is vitally important that you get advice from a physiotherapist about caring for your own body, especially your back. They can provide guidance on the best way to help the person you are caring for to move.
If it becomes necessary to have equipment in the house to help you with these tasks, a physio or an occupational therapist can advise you on the most suitable pieces of equipment to use and the best places to put them.
How do I find a physio?
You can be referred to a physio by your doctor or nurse. In some areas, you can refer yourself at your local hospital or community health clinic, depending on the type of service available. You may find you have to wait for an appointment, as most NHS physiotherapy departments have waiting lists.
Speak to your Parkinson's local group, as some have group physiotherapy sessions.
There are also a growing number of private physios who run clinics and make home visits. When you contact them, make sure that they have specialist knowledge of dealing with people with Parkinson’s.
Be aware that, unlike NHS physiotherapists, those in private practice will charge for their services. To find a private physio, visit the Chartered Society of Physiotherapy.
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Straight from the expert
Physiotherapist Fiona explains how her work helps people with Parkinson's, like Carole, to carry on with everyday activities.
Last updated January 2014. We review all our information within 3 years. If you'd like to find out more about how we put our information together, including references and the sources of evidence we use, please contact us at [email protected].