Simple Physical Therapy Strategies to Overcome Barriers in Patients with Parkinson’s Disease

By Kerri Bain, PT, DPT
Physical Therapist, Virginia

According to the Parkinson’s Foundation, about 90,000 Americans are diagnosed with Parkinson’s Disease each year. As physical therapists, we are likely to encounter someone with this diagnosis during our careers. Some of the major findings in patients with this neurodegenerative disorder are tremors, muscle stiffness, slowness of movement, and impaired coordination and balance. These can create barriers such as retropulsion, freezing, and poor posture which can hinder progress when treating these patients. 

The following tips and tricks can help overcome barriers to allow for the best possible outcomes and can even provide patients with tools to help them be more independent.

7 Tips to Improve Patient Outcomes 

Muscle stiffness, involuntary and uncontrollable movements, and difficulty balancing can not only make treating patients with Parkinson’s disease difficult, but it can hinder their quality of life as it inhibits their progress in therapy. 

By using simple strategies like visual cues to help with coordination, you can treat these patients more effectively and achieve better long-term outcomes. 

1. Tie a resistance band, like a theraband, horizontally across the base of the walker. This can provide the patient with a visual target to step to, improving step length and foot clearance while reducing the risk for freezing episodes.

2. Place a nametag or other item around the patient’s neck. When they perform a sit to stand transfer, instruct them to keep the item in their visual field until they achieve an upright position. This will reduce retropulsion and improve forward momentum.

3. It can be difficult for a patient with Parkinson’s disease to distinguish between surface levels. Place brightly colored tape at the bottom and top of the stairs to distinctly show where they start and stop. This can help prevent falls.

4. If a patient freezes, place your foot in front of theirs as a visual target and instruct them to “step over.” 

5. Place brightly colored tape through doorways, space the tape to approximate step length. This will allow targets to improve fluidity of movement and reduce the risk for freezing episodes.

6. Place an “X” with tape in front of their favorite chair. When the patient approaches the chair to sit, use the “X” as the destination to walk to. Instruct them to pivot on this “X” to ensure a safe distance from the sitting surface.

7. If a patient demonstrates poor posture as a result of their Parkinson’s disease, stand them in front of a mirror. This can provide visual input to them to facilitate an upright posture. 

Remember Every Patient is Different

Using these strategies can help overcome common barriers in patients with Parkinson’s Disease. However, it’s important to keep in mind that each patient is unique and may require some modification to these techniques. Tailoring your strategies to your patient’s specific needs will make your treatment plan even more effective. Take into consideration their current functional status, home environment, and personal goals.  Always ensure you are linking all interventions to a functional goal.

These strategies may seem simple, but they can be life-changing for your patients. By implementing these go-to tips and tricks, you can make more progress with your patient’s therapy and improve their quality of life.