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Balancing Exercises For Parkinson’s Patients

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Balance and Functional Exercises for patients with Parkinson disease & other movement disorders

Australian Catholic University researchers set up to investigate whether an exercise program geared to improving the strength and endurance of the trunk muscles could improve standing and walking balance in those with Parkinsons disease.

The Phase 2 study , evaluated 22 Parkinsons patients with a history of falls who were randomly assigned to either 12-weeks of exercise and fall prevention education or fall prevention education alone .

For the exercise intervention, patients had to attend a supervised 90-minute training session once a week for 12 weeks. Each session was conducted in groups of up to three subjects.

In short, the exercise-based intervention comprised three parts i) a warm-up focusing on trunk mobility exercises to improve range of motion ii) an exercise routine focusing on the endurance and stability of the trunk muscles and iii) a cool-down involving stretching and walking in a real-world environment, researchers stated.

The exercise group also received health advice , in the form of weekly educational brochures, aimed at preventing falls.

Participants in the education-only group were encouraged to continue their day-to-day lives, but received a weekly multidisciplinary health tip for 12 weeks that explained how exercise, nutrition and/or sleep quality could influence their fall risk and quality of life.

Twelve and 24 weeks after initial assessment, investigators examined patients symptom severity, balance confidence, mobility and quality of life.

Data Extraction And Analysis

Two reviewers extracted data from the selected RCT studies using pre-designed forms independently. Any conflict between these two reviewers was resolved by consensus. From the selected studies, the following parameters were extracted demographic variables , Initial and Final results of used outcome measures, and the type of intervention given along with the duration of follow-up .

Data which are suitable to meta-analysis were entered and analyzed using RevMan 5.3 software. The difference in percentage in each treatment was recorded. When there is no documented difference, it was calculated by extracting the mean change in the experimental and control group.

Chair Exercises For Parkinsons Patients

Exercises for Parkinsons patients are designed to help counter the forward slumped posture and rigidity that develops as the disease progresses. Through physical therapy, patients are able to regain their mobility and live fuller lives.

Chair exercises for Parkinsons patients can be performed in an outpatient therapy center, and even within their own home. Are you or loved one looking to improve your range of motion, balance, and overall posture? Here are three sitting exercises to perform in the comfort of your own home:

Chair Exercise 1 Improve posture in patients living with Parkinsons.

Sit in a stable chair with your back against the base.Lean forward and reach with your hands toward your feet out in front of you.Quickly and with high energy, pull back into your original seating position with your back flat against the chair.Repeat several times.

Chair Exercise 2 Regain rotation of the trunk to counter the effects of Parkinsons disease.

Sit comfortably in a stable chair and place feet shoulder-width apart.Place your hands out in front of you, with both palms touching.Take one arm and stretch out to your side, leaving the other hand at the center. Be sure to extend your arm with your fingertips are engaged, so you can obtain maximum efficiency.Quickly and with high energy, bring your stretched arm back to the center and smack the palms of your hands.Repeat these motions several times on both hands.

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Data Sources And Search Strategy

Five databases were used during article selection process from February 2015 to September 2015. An electronic database search for relevant Randomized controlled trials which examined physiotherapy techniques used to treat, BD and PI among people with PD of any duration and published in international medical journals in the English language from 2005 to June 2015was conducted. We searched articles using keywords of RCTs, Parkinsons disease, physiotherapy, postural instability, balance dysfunction, Exercise, equilibrium, postural control, and rehabilitation.

The relevance of the reviewed studies was checked based on their topic, objectives, and methodology. Preliminary assessments have been made and some articles were excluded at the first step just by looking at the topic. On the second step, abstracts have been seen and were excluded if they did not match to the current study objectives. For the rest, the whole content of the articles was accessed and selected based on the independent and dependent variables under review.

What Kind Of Exercise Is Best

Balance Workout for Parkinson

Ideally, combining a range of different fitness activities can bring the most benefit to patients, Amodeo says, since variety increases muscle learning and is more neurologically invigorating.

That said, any bit of exercise helps, she notes, adding that it also pays to build up slowly. An introductory session with a physical therapist is also recommended to help patients find the best beginning regimen for their ability level. The American Parkinson Disease Association National Resource Center for Rehabilitation runs a toll-free hotline that allows callers to speak with a licensed physical therapist who can offer advice about exercising and help connect callers to resources in their communities.

While the most important thing is finding a fitness activity you enjoy, and sticking with it, Amodeo says she’s seen benefits from a few particular types of exercises in particular such as boxing, which, she notes, combines aerobic exercise, weight training and balance all in one class, as well as yoga and tai chi, which deliver balance training and help with fluidity of movement. They’re also good for overall mindfulness and taking time for you, she notes. For those more limited in their mobility, she says a stationary bike or aquatic therapy are great options.

And finally, don’t overlook a dance class as a potentially fun and beneficial type of exercise. One study showed that Argentine tango classes in particular improved PD patients balance and functional mobility.

Also Check: Parkinson’s Leaning To One Side

What Are The Best Exercises For Parkinson’s

An example of one of the best exercises for Parkinsons disease is the toe up, which gets the patient to raise his or her toes when taking a step. Stretches for the neck, arms and legs are also important, although some may be difficult for the patient to perform. Other exercises for Parkinsons include practicing being in small spaces, using small steps when turning and practicing any daily activity that is difficult.

The toe up exercise is one of the most important for people who suffer from Parkinsons disease. To perform the exercise, the person walks slowly while ensuring that the foot lands on the heel and rolls forward to the toe. Also, when performed slowly, the exercise can be used as a stretch for the lower leg muscles, which can help with leg cramps.

Practicing taking steps in the correct way is also important for someone with Parkinsons. In general, the person should use short steps only when turning, and long steps for regular walking. This can take some practice, but can reduce the chance of the patient falling over.

Types Of Exercise To Boost Coordination In Seniors With Parkinsons

By Shital Rane 9 am on November 15, 2019

Its common for elderly people with Parkinsons disease to eventually experience tremors or muscle stiffness. Over time, these symptoms can contribute to issues with balance, gait, and coordination, which can increase fall risks for seniors with this neurodegenerative condition. Below youll find five coordination exercises that can help your senior loved one with balance, stability, and dexterity.

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New Types Of Exercise For Parkinsons

Researchers are continually studying different types of exercise for PD and APDA works to keep you informed about these new findings.

Exercise And Physical Therapy

Exercises for Parkinson’s: Balance Exercises

Research has shown that regular exercise benefits people with Parkinsons disease.


  • reduces stiffness
  • improves mobility, posture, balance and gait

Aerobic exercise increases oxygen delivery and neurotransmitters to keep our heart, lungs, and nervous system healthy. General exercise may also reduce depression. Learning-based memory exercises can also help keep our memory sharp .

What types of exercise are best for people with Parkinsons disease?

There is increasing evidence that aerobic and learning-based exercises could be neuroprotective in aging individuals and those with neurodegenerative disease. Facilitating exercise programs that challenge our heart and lungs as well as promote good biomechanics, good posture, trunk rotation and normal rhythmic, symmetric movements are the best. Dancing to music may be particularly good for decreasing stiffness.

Types of exercises that do this:

  • Walking outside or in a mall
  • Dancing

Types of exercises that promote cardiopulmonary fitness:

  • Paced walking
  • Hiking using walking sticks
  • Swimming with different strokes with the eyes open and closed not only challenge motor learning but also increase heart rate and provide good cardiopulmonary conditioning.
  • New bodyweight-supported treadmills can also be helpful to protect from falling, and to facilitate easier coordinated movements for fast walking with a long stride or jogging.

Types of exercise that do NOT challenge motor planning:

Is there any value in strength training?

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How Fitness Controls Symptoms And Which Activities Doctors Recommend You Try

by Cheryl Platzman Weinstock, AARP, April 23, 2021| 0

En español | You know that exercise is good for your heart and that it strengthens your bones. But it’s also one of the more important cornerstones of managing Parkinson’s disease , the second most prevalent progressive degenerative disease of the nervous system that affects movement.

Intensive research in the past several years has found that for Parkinson’s patients, exercise can increase coordination and balance, reduce falls and improve mood. Codrin Lungu, program director in the Division of Clinical Research at the National Institute of Neurological Disorders and Stroke, a part of the National Institutes of Health , says that preliminary evidence also shows that exercise slows the progression of the disease.

To understand how that might be so, research is building on earlier studies showing that exercise in older adults increases brain volume and improves neurological connections in areas that would otherwise undergo age-related decline. Research also has shown that intensive exercise appears to increase dopamine receptors that coordinate signals from the brain to muscles. Scientists believe a lack of dopamine causes PD.

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Physical Therapy For Parkinsons Disease

Its well-known that exercise of all kinds is beneficial for patients with Parkinsons disease. But physical therapy, in particular, is key. Why? A professional can guide you through the right moves to increase mobility, strength and balance, and help you remain independent, says Denise Padilla-Davidson, a Johns Hopkins physical therapist who works with patients who have Parkinsons. Here are things a therapist may work on:

Note: Please discuss any exercise program with your physician/neurologist and get a referral to a physical therapist or trainer with expertise in Parkinsons disease before starting any specific program.

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Study Selection And Data Extraction

The study screening was done independently by two reviewers, M.T. and B.U.W., using the Covidence Systematic review software. First, the imported articles were screened based on title and abstract, then based on the full text. Any occurring conflicts on inclusion were solved by the third reviewer, S.S.D. Upon inclusion, the qualitative and quantitative information about each study was extracted into three different tables:

  • Publication: Authors, publishing year

  • Study: Study design, number of individuals in treatment and control group

  • Effect size measures: Quantitative measures on pre- and post-treatment

  • Participant demographics: Age, gender, disease duration, medication

  • Intervention characteristics: Bicycle type, cadence , treatment session duration, overall treatment duration, exercise intensity in heart rate and perceived exertion.

Should I Talk To My Healthcare Provider Before I Start Exercising If I Have Parksinson’s Disease

Find a Physiotherapist

Talk to your neurologist and your primary care provider before starting a new exercise regimen. They can:

  • Counsel you on how intense your exercises can be.
  • Recommend exercises appropriate for your individual health.
  • Refer you to a physical therapist to create a personal exercise program.
  • Warn about exercises to avoid based on your particular challenges or limitations.

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Qualitative Analysis Of The Effect Of Physiotherapy Interventions On Different Outcomes

The effects of postural adjustment, fall prevention strategies, and balance training exercises on near falls and quality of life have been done by a study done in Southampton. The results showed that there was a tendency towards a reduction in fall events and injurious falls .

An RCT conducted in Italy brought that balance training showed significant improvements in declining PI and improving balance in patients with PD .

Another study conducted in the USA showed that Gait and step perturbation training can result in a reduction in falls and improvements in gait and dynamic balance for patients with PD .

According to a RCT conducted in Sweden, a HiBT regimen that incorporated both dual-tasking and PD-specific balance components significantly benefited balance and gait abilities when compared with usual care and showed promising transfer effects to everyday living .

Another comparative RCT done in Germany found that it is effective to use both coordinated resistance and balance training to improve balance and postural control for patients with PD .

A study done in china on the effectiveness of technology-Assisted Balance and Gait training found that the balance and gait training program assisted by technological devices reduced the number of fallers and the fall rate compared with the strength training program. It supported the clinical use of balance and gait training for reducing fall events in people with PD .

Choosing The Right Exercise Class For Parkinsons

When trying to find an exercise class to join, it can be hard to know which ones to try because there are many different types of classes that are marketed to people with PD. When you are evaluating a class, it is important to remember the following:

  • It is the components of the exercise class that are important . You do not need to specifically do boxing or dance if you can achieve these elements of exercise in other ways.
  • The instructor should have expertise in PD. APDA offers a training for fitness professionals which helps them better understand how to create exercise programs best suited for people with PD.
  • The ratio of class members to instructors should be low enough to maintain safety.
  • The class should be adaptable for people of different abilities and mobility. Many classes will offer seated options or other modifications.

It may take a few tries to find the types of exercise that suits you best so dont give up! Feel free to try different classes in your area to see what types of exercise appeal to you. It can also be motivating to take classes together with a friend or family member. You can hold each other accountable, and also have some fun together. As you find classes you enjoy, you can incorporate those modalities into your exercise schedule. For help in finding classes in your area, you can contact one of our Chapters or Information & Referral Centers. There are also many virtual classes that you can join from home.

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Characteristics Of Included Trials

All 8 trials involved a total of 483 participants and investigated the effectiveness of physiotherapy treatment and Exercise on improving postural stability and balance in Persons with Parkinsons disease. All trials were conducted in between September 2005 and June 2015 .


The mean PEDro scores of the included trials were 7. Three studies blinded participants, two studies blinded therapists and the other five trials did not, due to innate difficulties. Concealed allocations of participants were stated clearly in only two studies and the intention to treat analysis was considered by only three studies . The quality assessment scores and the decisions of each item for the included trials are shown in Table .

Table 3 PEDro criteria and summary of quality assessment scores of Included studies



The experimental groups were treated with different treatment approaches. Five studies used postural adjustment and falls prevention strategies and balance training ,three studies used strengthening exercises , three studies applied gait training through overground walking and treadmill training only one study used PNF exercise and coordination training has been given for another one study .

Outcome measures

Table 4 Summary of results of included randomized controlled trials

Simple Balance Exercises To Do At Home

Balance Exercises for Parkinson’s Disease Series (2020): Session 1

Here are some simple exercises you can do at home, to help with muscle strengthening in order to help prevent falls.


1. Single Leg Balance

Stand near a chair or stable object. Hold with both hands. When steady take one hand off, if steady lift one leg, hold for 10 seconds. If still steady take other hand off and hold. Build up holding the hands free for 45 seconds.

Repeat with other leg.

2. Tandem Balance

Stand near a stable object and hold for stability. Put one foot directly in front of the other. Lift one hand and try to hold that position for 10 seconds. If stable, lift the other hand and hold that position for 10 seconds gradually build up to holding 30 seconds.

Repeat with other foot in front

If the having one foot directly in front of the other is too difficult. Take a big step forward. Try to not hold onto anything and hold for 1 minute. When you improve with this exercise, try with one foot directly in front of the other.

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