19/08/2026
Parkinson’s disease (PD) is a progressive neurological disorder that primarily affects movement. It occurs when nerve cells in an area of the brain called the substantia nigra progressively degenerate, leading to reduced production of dopamine, an important chemical involved in movement control.
Common motor features that you will see
Bradykinesia – slowness of movement
Rigidity – muscle stiffness
Resting tremor – shaking that commonly occurs when the limb is at rest
Postural instability – impaired balance and increased risk of falls
Reduced step length and shuffling gait
Difficulty initiating or changing movements
Non-motor symptoms may also occur, including fatigue, sleep problems, constipation, depression, anxiety and cognitive changes.
What are the causes and Risk Factors??
The exact cause of Parkinson’s disease is usually unknown.
It is thought to result from a combination of genetic and environmental factors.
Possible contributing factors include:
Age risk increases with advancing age
Genetic factors some of certain gene mutations can increase susceptibility
Environmental prolonged exposure to certain toxins or pesticides has been associated with increased risk
Oxidative stress and neurodegeneration
Abnormal accumulation of alpha-synuclein in affected brain cells
Most cases are considered idiopathic Parkinson’s disease, meaning no specific cause can be identified.
How Physiotherapy manage?
Physiotherapy plays an important role in maintaining mobility, independence, strength, balance and quality of life.
1. Exercise Therapy
Strengthening exercises
Cardiovascular/aerobic training
Flexibility and stretching
Functional exercises
Repetitive movement practice
Large-amplitude movement exercises
Regular exercise can help maintain physical capacity and functional independence.
2. Gait Training
Short and shuffling steps
Reduced arm swing
Difficulty initiating walking
Turning difficulties
Freezing of gait
External cues such as visual lines, rhythmic sounds, counting or verbal cues may help improve movement initiation and gait.
3. Balance and Fall Prevention
Static and dynamic balance exercises
Weight-shifting activities
Turning and stepping practice
Functional reaching
Safe transfer training
Fall-prevention education
4. Posture and Mobility
Thoracic extension exercises
Trunk rotation exercises
Postural awareness training
Flexibility exercises
Functional movement practice
5. Transfer and Functional Training
Bed mobility
Sit-to-stand
Getting in and out of chairs
Stair climbing
Turning in bed
Community mobility
6. Cueing Strategies
External cueing can be particularly useful for patients experiencing freezing or difficulty initiating movement.
Visual cues
Auditory cues
Verbal cue
Cognitive strategies
7. Patient and Caregiver Education
Physiotherapists can educate patients and caregivers regarding
Home exercise programmes
Fall prevention
Safe mobility
Appropriate walking aids
Energy conservation
Maintaining independence in daily activities
Overall Goal of Physiotherapy
The main goal is not to cure Parkinson’s disease, but to maintain function, slow physical decline, reduce complications and help the person remain as independent and active as possible.
