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Parkinson's Disease: Physical Therapy in Brooklyn to Keep You Moving

By Dr. Jack Engelberg, PT, DPT · · 4 min read

A Parkinson's diagnosis raises many questions, and one of the most empowering answers is this: exercise matters. Research consistently supports regular physical activity and physical therapy as an important part of living well with Parkinson's disease. A physical therapist can help you stay strong, keep moving with bigger, more confident steps, improve balance and reduce the risk of falls at every stage of the condition.

What Is Parkinson's Disease?

Parkinson's disease is a progressive neurological condition in which nerve cells in a part of the brain that produces dopamine gradually decline. Dopamine helps control smooth, coordinated movement, so as levels drop, movement becomes affected. Parkinson's also has non-movement symptoms. It progresses differently in every person.

Common Movement Symptoms

  • Slowness of movement (bradykinesia) — movements become smaller and slower
  • Tremor — often a resting tremor in one hand
  • Rigidity — stiffness in the limbs and trunk
  • Postural changes — a stooped, forward posture
  • Balance problems — especially as the condition advances
  • Walking changes — shorter, shuffling steps, reduced arm swing, and difficulty turning
  • Freezing of gait — feeling as if the feet are glued to the floor, often in doorways or when turning
  • Smaller handwriting and softer voice

Non-Movement Symptoms

Sleep disturbances, fatigue, constipation, changes in mood, loss of smell, lightheadedness when standing, and changes in thinking can also occur. Your physician and care team help manage these.

How Physical Therapy Helps Parkinson's

Medications can improve many movement symptoms, and exercise and physical therapy complement them. Your physical therapist focuses on keeping you as active, independent and safe as possible.

Evaluation

Your therapist will assess strength, flexibility, posture, balance, walking (including turning and freezing), transfers like getting up from a chair or bed, and your fall history, and talk with you about your goals and daily routine.

Treatment May Include

  • Amplitude training — practicing big, exaggerated movements to counter the tendency for movements to become small. Some programs, such as LSVT BIG, are built around this idea.
  • Gait training — longer steps, heel strike, arm swing, and turning strategies
  • Freezing strategies — using cues like counting, rhythmic music, stepping over a line, or shifting weight to get moving again
  • Balance training — static and dynamic balance, reactive stepping and dual-task practice (walking while talking or carrying something)
  • Strength and power training — especially for the legs and trunk
  • Flexibility and posture — stretching and exercises for the chest, hips and spine to counter stooping
  • Aerobic exercise — walking, cycling or treadmill training at challenging but safe intensities
  • Fall prevention — home safety and strategies to get up from the floor (see balance and fall prevention)

Occupational therapy, available at our Boro Park office, can also help with handwriting, dressing, fine motor tasks and home setup.

What You Can Do at Home

  • Exercise regularly. Aim for a mix of aerobic, strength, balance and flexibility exercise most days, as cleared by your physician.
  • Think big. Take big steps, swing your arms and practice large, deliberate movements.
  • Use cues for freezing. A metronome app, a rhythm in your head, or tape lines on the floor in tricky areas like doorways can help.
  • Turn in a wide arc rather than pivoting in place.
  • Time activity with medication. Many people move best when their medication is working well ("on" time).
  • Make your home safer. Remove loose rugs, improve lighting, and add grab bars in the bathroom.
  • Stay social and engaged. Group exercise classes can be motivating.

When to See a Physical Therapist

Physical therapy can help at any stage:

  • Soon after diagnosis — to establish a baseline and a good exercise routine
  • When you notice changes — in walking, balance, posture or daily tasks
  • After a fall or near fall
  • When freezing begins
  • After a hospital stay or a period of reduced activity

Contact your physician promptly for sudden changes in symptoms, frequent falls, confusion or hallucinations, or significant changes in swallowing.

Frequently Asked Questions

Can exercise slow Parkinson's?

Research suggests regular exercise improves mobility, balance and quality of life in people with Parkinson's. Scientists are still studying whether it changes the disease's progression, but its everyday benefits are well supported.

What type of exercise is best?

A combination: aerobic exercise, strength training, balance work and flexibility. Choose activities you enjoy so you'll stick with them.

How often should I see a physical therapist?

Many people benefit from periodic "tune-up" sessions to update their program as needs change, plus a consistent exercise routine in between.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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