The Role of Physiotherapy in Managing Parkinson’s Disease

Parkinson’s disease is a chronic, progressive neurodegenerative disorder that affects the central nervous system. It is characterized by muscle stiffness and tremors, which cause difficulties in initiating, ending, and controlling movements.

After Alzheimer’s disease, Parkinson’s is the second most common neurodegenerative condition.

In addition to pharmacological therapy, physiotherapy and rehabilitation are now recognized as playing a central role: targeted exercises and specific therapies are essential to improving patients’ quality of life. Physiotherapy for Parkinson’s is an integral part of disease management and is recommended from the early stages.

The Importance of Physical Exercise for People with Parkinson’s

Regular physical activity is crucial for people with Parkinson’s disease to improve their daily quality of life. Targeted exercises can:

• Reduce muscle stiffness;

• Improve posture and balance;

• Strengthen muscles and coordination;

• Counter bradykinesia (slowness of movement);

• Reduce anxiety and depression.

Both the Italian Ministry of Health and the AIP (Italian Parkinson’s Association) emphasize the importance of specific physical activity, carried out consistently with the guidance of an expert physiotherapist.

Physiotherapy and Parkinson’s: Recommended Exercises

Physiotherapy for Parkinson’s varies depending on the stage of the disease and each patient’s individual condition. It is therefore impossible to establish universal exercises suitable for everyone; however, here is a general overview of exercises that may be included in physiotherapy for Parkinson’s:

• Joint mobility exercises: neck, shoulder, and ankle rotations, along with gentle stretches to improve flexibility;

• Balance and posture exercises: walking along a straight line, or moving from sitting to standing with control;

• Muscle-strengthening exercises: assisted squats, resistance band training for the upper limbs to promote strength and coordination, and compact ball exercises (placed between the knees) to activate the adductor muscles and improve trunk control;

• Aerobic exercises: brisk walking, swimming, or dancing, also useful for coordination;

• Breathing exercises: diaphragmatic breathing techniques and guided stretching, effective in reducing anxiety.

Physiotherapy exercises for Parkinson’s must always be personalized and supervised by qualified, specialized professionals—never improvised at home, especially in such contexts.

Beyond Physiotherapy: Rehabilitation for Parkinson’s

Rehabilitation for Parkinson’s disease does not stop at physiotherapy. In addition to the benefits of resistance band and bodyweight exercises, it is essential to incorporate other specific therapies. A multidisciplinary approach is considered ideal for comprehensive and effective management of the patient’s daily well-being. These may include:

• Psychological support: many Parkinson’s patients also suffer from anxiety and depression. Having a psychologist on the rehabilitation team can provide important emotional support;

• Instrumental therapies: alongside physiotherapy, complementary physical therapies can be included, such as Tecar therapy and magnetotherapy. The former uses high-frequency currents to stimulate circulation and metabolism, helping to relieve muscle stiffness and joint pain. The latter employs low-frequency electromagnetic fields to improve microcirculation and stimulate muscle and nervous tissue;

• Occupational therapy: maintaining a regular daily routine with normal activities is crucial. Occupational therapists teach practical methods and solutions to simplify basic movements, such as dressing, eating, or using household tools.

In addition, in Italy some centers are experimenting with the use of virtual reality and specialized applications for motor training and home-based exercises, as well as the possibility of performing physiotherapy at home with remote supervision.

Conclusion

Parkinson’s disease is a complex condition, but today we know that physiotherapy and rehabilitation can help counteract its effects and improve quality of life. When tailored to each patient, these tools can make a real difference in slowing the progression of the disease and managing symptoms.

Sources

• https://www.parkinsonnet.com/guidelines/

• https://www.parkinson.it/

• https://www.fondazionelimpe.it/parkinson-e-riabilitazione

• https://www.epicentro.iss.it/parkinson/