Parkinson’s is one of the few neurological conditions where exercise appears to do more than manage symptoms. That makes getting it right unusually important.
Why exercise matters more here
Medication in Parkinson’s manages symptoms effectively for many people. What it does not do is change the underlying course.
Exercise appears to. A growing body of evidence suggests that vigorous, sustained exercise is associated with slower progression, better function and better quality of life over time. It is currently the only intervention with that kind of evidence behind it.
Which means exercise is not an optional extra alongside the medication. It is part of the treatment.
The two principles that matter
Amplitude. Parkinson’s shrinks movement. Steps get shorter, arm swing reduces, handwriting gets smaller, voice gets quieter. Crucially, the person often does not perceive this. Movements that feel normal are objectively small.
So training deliberately exaggerates. Bigger steps than feel necessary. Larger arm swing. Consciously oversized movement. Practised repeatedly, that recalibrates what normal feels like.
Intensity. Gentle exercise is better than none but the evidence favours vigorous. Getting the heart rate genuinely up, sustained, several times a week. That is a higher intensity than most people with Parkinson’s are advised to work at, and it needs to be built up to safely, but it is the target.
What physiotherapy addresses specifically
Freezing of gait. The feeling of being glued to the floor, typically in doorways, turns, or under time pressure. Physiotherapy teaches cueing strategies, including rhythmic auditory cues, visual targets on the floor, and weight shifting techniques to break the freeze.
Falls. Falls risk is significantly elevated and balance training reduces it. This is one of the highest value things physiotherapy does here.
Turning. Turning is where a large proportion of falls happen. Wider, stepped turns rather than pivoting are trainable.
Posture. The forward stooped posture is not inevitable and responds to specific work.
Dual tasking. Walking while talking or carrying something is disproportionately hard in Parkinson’s and can be trained.
Transfers. Getting out of a chair, in and out of bed, in and out of a car. These are the movements done dozens of times daily and technique makes a real difference.
Starting earlier than feels necessary
The instinct is to wait until things are difficult. The better approach is to start when they are not.
Exercise appears to be most valuable as prevention and preservation, and the habits built early are the ones that persist. Starting a demanding exercise programme when function is already significantly reduced is much harder.
Group work
Group classes with others who have the condition tend to produce better adherence than home programmes alone, partly through accountability and partly because it is less isolating.
[CONFIRM: whether the group classes at NeuroPhysio include a Parkinson’s specific class, or whether people with Parkinson’s join the general neurological classes. This is a common search and the answer should be explicit.]
Work with your neurologist
Physiotherapy sits alongside medical management rather than replacing it. Timing exercise relative to medication doses matters, since most people function considerably better in their on periods, and that is worth planning around.
We communicate with your neurologist and GP where you want us to.
What we do
Assessment and treatment at Eastwood, at home across Adelaide, or by telehealth, plus group classes. NDIS registered.
Call 08 8331 2700.
