Physical and Occupational Therapy for Parkinson's

Despite medicines and surgical approaches for Parkinson’s disease (PD), the disease is progressive. Over time, it can cause significant disability. Physical therapy (PT) and occupational therapy (OT) can help people with PD maintain their usual activities for as long as possible. PT and OT can also increase strength, endurance, balance. Plus, they may help relieve pain.^1,2

Differences between physical therapy and occupational therapy

While physical therapy and occupational therapy may be seen as interchangeable, there are some differences between the 2 practices. PT focuses on the physical rehabilitation of people recovering from injuries or disease. The goal of PT is to restore mobility. Physical therapists also educate people on managing their condition to maintain long-term benefits.³

OT also deals with rehabilitation and motion. However, it 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. They design exercises that teach people coping and management skills within their limits.³

Physical and occupational therapy for Parkinson’s disease

As PD progresses, most people experience worsening of their motor skills. This includes difficulties with posture, balance, and walking. Worsening motor skills can lead to:⁴

• Loss of independence
• Inactivity
• Fear of falling
• Increased social isolation

PT and/or OT are often used along with drugs for people with PD who are experiencing limitations in their activities. This can include things like personal care, work, and leisure activities. These therapies may also be recommended when the caregiver of the person with PD is having difficulties supervising or supporting the person with PD during daily activities.¹

Physical therapy strategies for Parkinson’s disease

PT can improve daily functioning for people living with PD by:⁴

• 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 capacity

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:⁴

• Auditory, like using a metronome or music
• Visual, such as stepping over stripes on the floor
• Tactile, like tapping on the hip or leg
• Cognitive, like using a mental image of the length of a step

Occupational therapy modifications for people with Parkinson’s

Along with physical exercises, occupational therapists often recommend modifications to help people living with PD maintain function and continue participating in daily activities. Modifications may include:¹

• 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 falling