Physical and Occupational Therapy for Parkinson's

Despite medications and surgical approaches for Parkinson’s disease (PD), the disease is progressive and can cause significant disability in patients. Physical therapy and occupational therapy can help people with PD maintain their usual activities for as long as possible. Physical and occupational therapy can also increase strength, endurance, balance, and may help relieve pain.1,2

The difference between physical therapy and occupational therapy

While physical therapy and occupational therapy may be seen as interchangeable, there are some differences between the two practices. Physical therapy focuses on the physical rehabilitation of people recovering from injuries or disease with the goal of restoring mobility. Physical therapists also educate people on managing their condition to maintain long-term benefits. Occupational therapy also deals with rehabilitation and motion, but is focused more on enabling the person to engage in daily activities as seamlessly as possible. Occupational therapists also suggest adaptations and modifications to the person’s environment.3

Physical therapists focus primarily on anatomy and the person’s strength, functional capacity and motor development. Occupational therapists combine physical aspects with mental health and design exercises that teach people coping and management skills within their limits.3

When physical and occupational therapy can help in Parkinson’s disease

As PD progresses, most people experience worsening of their motor skills, including difficulties with posture, balance, and walking. The deteriorating motor skills can lead to loss of independence, inactivity, fear of falling, and increased social isolation.4

Physical and/or occupational therapy are often used along with medication for people with PD who are experiencing limitations in their activities such as personal care, work, and leisure activities. These therapies may also be recommended when the caregiver of the person with PD is experiencing difficulties supervising or supporting the person with PD during daily activities.1

Physical therapy strategies for Parkinson’s disease

Physical therapy can improve daily functioning for people living with PD by:

  • Improving gait, or the way a person walks
  • Improving transfers, like going from stillness to activity
  • Improving balance
  • Strengthening joints and muscles to improve physical capacity4

One of the ways physical therapists help improve gait is through the use of cues. Cues are stimuli from the environment or generated by the person that they can use to facilitate repetitive movements, like walking. Cues can be auditory (like using a metronome or music), visual (stepping over stripes on the floor), tactile (tapping on the hip or leg), or cognitive (using a mental image of the appropriate length of a step).4

Occupational therapy modifications for people with Parkinson’s

In addition to physical exercises, occupational therapists often recommend interventions or modifications that can enable people living with PD to maintain function and continue participating in daily activities. Some of the modifications may include:

  • Changing the nature, time, and duration of an activity
  • Simplifying activities by breaking complex actions into simple tasks
  • Arranging items to reduce situations that involve time pressure, like moving the telephone to an accessible location
  • Structuring the environment and recommending aids to reduce the risk of falling1

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Written by: Emily Downward | Last reviewed: November 2020