Parkinson’s disease is a long term disorder of the central nervous system that mainly affects the motor system. The symptoms are progressive and generally come on slowly over time. People with Parkinson’s disease require different levels of assistance and some wish to remain as independent as possible. SPD physiotherapist Ethirajulu Mahalakshmi shares some exercises for people with Parkinson’s disease.

In a community-based survey, the prevalence of Parkinson’s disease in Singapore was found to be 0.3 per cent of the population aged 50 and above. Approximately one per cent of the global population aged 60 years and older is diagnosed with Parkinson’s disease.

Parkinson’s disease is a progressive neurological disorder that affects the nerve cells in the brain that control movements. Signs and symptoms appear gradually. Parkinson’s disease appears to occur in five different stages, and the period of time at each stage varies. It is also not uncommon for patients to skip and advance in stages.

In the early stages of the disease, the most obvious symptoms include shaking, rigidity, slowness of movements, and difficulty with walking. Thinking and behavioural problems may also occur before dementia sets in at the advanced stages of the disease for most patients.

Exercise
Exercising regularly is essential in keeping a person healthy and active. It has multiple physiological, psychological and physical benefits as exercising can protect the body against age-related degeneration. Engaging in regular exercises can help to slow down the progression of Parkinson’s too, thereby minimising the risk of acquiring disabling conditions.

Physiotherapy and occupational therapy are among the most important therapies for patients with Parkinson’s disease. Complementary therapies such as yoga and tai chi are also physically and mentally beneficial.

Physiotherapy assessments and management focus on improving the physical capacity and quality of movements in daily activities of living through walking and transfer training, balance and falls education, and practicing manual activities such as reaching and grasping. The two main areas of Parkinson’s-specific physiotherapy intervention relate to exercising and movement strategy training.

Goals
Goals in physiotherapy on Parkinson’s management include improvements in the following areas:

– Posture
– Balance
– Flexibility/Stretch
– Strengthening
– Endurance

Therapists design their exercise programmes for Parkinson’s management based on the different stages of the condition and the patient’s functional status.

Here are some simple exercises:

Balance exercises

Back leg raise while standing on one foot

Single leg raise

Heel raise

Strengthening exercises

Overhead arm raise

Wall push ups

Chair dips

Flexibility exercises

Upperbody stretch

Leg stretch

Thigh stretch

Exercise Tips for People with Parkinson’s Disease
1. Take medication on time for maximum mobility.
2. Take 3 to 5 minutes to warm up at the beginning of the exercise and cool down at the end.
3. When doing balance exercises, be sure to stand near sturdy surfaces.
4. Start with short periods of exercise before gradually increasing the duration. Also, the greater the intensity, the greater the benefits.
5. Monitor fatigue both during and after activities. Feeling tired at the end of exercising is normal but do make sure that you are not overly tired or exhausted.
6. Drink water to stay hydrated.
7. Join a Parkinson’s support group.