This area is intended for both the client and the therapist to jointly develop an exercise program and adapt this program over time. Programs for people with Parkinson Disease are unique in that activity is focused on walking, balance, transitional movement, speaking and mood. It appears that exercise and movement help to produce improved outcomes and improve function. An experienced therapist should recheck clients every six months using the tests listed in the Assessment area. Results can be compared over time.
A video of the current class
The treadmill has been used in studies to determine its effectiveness in improving walking ability in people with Parkinson Disease. In "More Information on Treadmill Exercises" (see below) there are two articles by Cochrane which review treadmill and therapy interventions. The optimal intensity, frequency, duration, handhold procedure, and dual tasking (talking and walking) used for walking both forward and backwards training have not been determined. Most therapists have clients work at a challenging speed for 20-30 minutes at least twice a week, with minimal use of hands, and then upgrade the program. Backward walking is a skill problem in people with Parkinsons Disease. This problem can be seen on the Functional Gait Assessment test. An article can be found in "More Information on Treadmill Excercises" below. Clients may walk backward on the treadmill to increase hip extensor strength, stretch the hip flexors and improve skills in the backward direction.
Resistive Exercise is a very important component for the client to improve or maintain function. With Parkinson Disease the client is pulled forward into a flexed posture, with the head forward rather than straight above the shoulders. Ears should be in line with the shoulders. The upper back is often bent forward, referred to as a forward (kyphotic) posture. At the hips, the client is often bent forward, as if gravity is pulling the client forward. Thus, strength training needs to focus on extensors of the neck, back and hips. Clients can exercise on power equipment, including the back extensor machine, hip extensor machine, rhomboid machine and pull downs with the arms. These all help the back side of the body. Most of the time clients DO NOT need to do bicep curls, pectoral pulls, abdominal exercise and hip flexor strengthening.