Parkinson's Exercises: Movement Strategies That Make a Difference

Exercise as Medicine for Parkinson's

Exercise isn't just helpful for Parkinson's disease—it may be neuroprotective, potentially slowing disease progression. Research consistently shows:

Bottom line: Exercise is one of the most important things you can do.

Key Movement Challenges in Parkinson's

Understanding these helps target your exercise program:

Amplitude-Based Training (BIG Movements)

Research shows that people with Parkinson's have reduced movement amplitude—movements become smaller over time.

The solution: Practice BIG, exaggerated movements.

LSVT BIG Principles

1. Focus on amplitude (size) of movement

2. Use high effort and intensity

3. Practice multiple repetitions

4. Calibrate what "normal" feels like

BIG Exercises

BIG Arm Swings

1. Stand tall

2. Swing arms as big as possible

3. Front to back, side to side

4. Exaggerate the movement

5. 10-15 swings each direction

BIG Steps

1. March in place with exaggerated high knees

2. Then walk with oversized steps

3. Swing arms deliberately

4. Think "BIG" with each step

5. Practice daily

BIG Sit-to-Stand

1. Sit in chair

2. Lean forward dramatically

3. Push up with full force

4. Stand as tall as possible

5. Sit down with control

6. 10 repetitions

BIG Reaching

1. Reach arms overhead—higher than feels necessary

2. Reach to sides—wider than feels natural

3. Reach forward—farther than seems needed

4. 10 reaches each direction

Balance Exercises

Falls are a major concern in Parkinson's. Practice balance daily:

Weight Shifts

1. Stand with feet hip-width

2. Shift weight fully to one side

3. Return to center

4. Shift to other side

5. 10 each direction

Tandem Standing

1. Stand heel-to-toe

2. Hold 30 seconds

3. Switch feet

4. Progress: reduce support, close eyes

Single Leg Stance

1. Hold support as needed

2. Lift one foot

3. Hold 30 seconds each leg

4. Progress: less support, eyes closed

Backward Walking

1. In a safe space with support available

2. Walk backward with deliberate steps

3. 10-20 steps

4. Challenges balance differently than forward walking

Multi-Directional Stepping

1. Step forward, return to center

2. Step backward, return

3. Step to each side, return

4. Step diagonally, return

5. 5 steps each direction

Gait Training

Cueing Strategies

External cues can help overcome freezing and improve gait:

Visual Cues

Auditory Cues

Cognitive Strategies

Walking Practice

Everyday Walking

1. Think "BIG steps, heel first"

2. Swing arms deliberately

3. Stand tall

4. Use cues if needed

Treadmill Training

Nordic Walking

Dual-Task Training

Parkinson's affects ability to do two things at once. Practice:

Start simple, progress complexity. This matters for real-life function.

Flexibility and Stretching

Combat rigidity with daily stretching:

Trunk Rotation

1. Sit or stand

2. Rotate upper body fully to each side

3. Hold 20-30 seconds

4. Keep hips stable

Chest Opener

1. Stand in doorway

2. Arms on frame

3. Lean forward to stretch chest

4. Hold 30 seconds

Hip Flexor Stretch

1. Kneeling lunge position

2. Push hips forward

3. Hold 30 seconds each side

Spinal Extension

1. Lie face down

2. Prop on elbows

3. Or press up with hands

4. Hold 20-30 seconds

Strength Training

Weakness worsens all PD symptoms. Build strength:

Squats

1. Sit to stand from chair

2. Progress to deeper squats

3. 2-3 sets of 10-15

Step-Ups

1. Step up onto sturdy step

2. Stand tall at top

3. Step down with control

4. 10-15 each leg

Resistance Band Exercises

Weight Training

Research supports resistance training for Parkinson's. Work with a trainer if possible.

High-Intensity Exercise

Emerging research supports higher intensity:

Cycling

Boxing

Power Training

Voice Exercises (LSVT LOUD Principles)

Voice changes are common. Practice:

Sustained "Ah"

1. Take a breath

2. Say "Ah" as loud as you can

3. Hold as long as possible

4. Repeat 3-5 times

Loud Counting

1. Count 1-10 as loud as possible

2. Exaggerate mouth movements

3. Repeat 3-5 times

Reading Aloud

1. Read a passage LOUD

2. Exaggerate pronunciation

3. Practice daily

Sample Weekly Program

Daily (20-30 minutes):

3x/Week (30-45 minutes):

1-2x/Week:

Tips for Success

1. Exercise during "on" time when medications are working

2. Stay consistent—daily movement matters most

3. Challenge yourself—intensity matters

4. Think BIG—amplitude is key

5. Work with a PT knowledgeable about Parkinson's

6. Join a group—social support helps

The Bottom Line

Exercise is one of the most powerful tools for managing Parkinson's disease:

The evidence is clear: people with Parkinson's who exercise do better than those who don't.

Foundational Rehab provides movement programs designed to support neurological health and function.