This blog is the fourth in a series detailing the roles of each member of a comprehensive care team. Read the other posts in the series, on social work, occupational therapy and speech-language pathology. Learn more about the healthcare professionals that are part of a comprehensive care team and how you can put your care team together today.
The ability to move around and stay active is important for people with Parkinson’s disease (PD), from diagnosis throughout the course of the disease. The role of physical therapy, called physiotherapy if you are in Europe or Canada, is to help you keep moving as well and as long as possible, while enhancing the ability to move.
What Are Your Movement Goals?
Some of the most common movement goals for people with Parkinson’s include learning about exercises; improving walking, balance or posture; addressing fall risk; and treating pain. However, every client works with their physical therapist (PT) to set individualized movement goals. PTs can help you optimize your exercise routine based on the latest research, re-learn challenging tasks or stay safe and independent in the home.
When and Why to Find a Physical Therapist
People used to go to physical therapy because of an injury or physical issue, but physical therapists can be helpful at all stages of PD. Here are some reasons to find a PT:
- For education and self-management advice.
- To learn about the exercise routines that have been associated with improvements (or slower declines) in mobility, quality of life and disease severity.
- If you have questions about the type, intensity, frequency or duration of exercise.
- If you have questions about safety when exercising.
- If you have noticed changes or problems with the following:
- Your normal physical activity routine
- Walking: slowness, small steps, freezing (feeling glued to the floor or difficulty getting started)
- Balance or stability
- Moving around the house (getting up from a chair, moving around in bed)
- Getting around in the community (in/out of a car or bus, elevators, stairs and uneven ground)
- If you are afraid of falling, have fallen or are worried about your safety.
- For other health problems that affect your mobility, including joint or muscle pain from arthritis, problems with endurance due to a heart or lung condition, a broken bone or surgery.
How to Find Your Expert Physical Therapist for Parkinson’s Disease
It is important to find a physical therapist who has specialty training and experience working with people who have PD. You may find experienced physical therapists working in hospital outpatient departments, home health agencies, nursing homes or within the community close to your home.
How to find an expert physical therapist depends on where you live. The Parkinson’s Foundation Helpline at 1-800-4PD-INFO (473-4636) is one way to locate an experienced PT near you. Helpline specialists can help you find PTs who have been trained to work with people with PD, as well as give you some questions to ask a potential PT to assess their experience.
Other places you can look include local chapters for PD advocacy and support and professional organizations for PT. For example, in the United States, physical therapists can become board-certified in neurologic physical therapy. The American Physical Therapy Association maintains a list of physical therapists where you can find neurologic specialists. In the United States, you can also call your insurance company to find out which physical therapists are “in-network” for your insurance plan. Then you will need to learn which of your in-network physical therapists have the expertise you need.
It is always okay to ask about your physical therapist’s experience. The best time to ask is when you are scheduling your first appointment. However, if the sessions don’t feel right to you, don’t be afraid to ask later or switch to a different therapist. The relationship you develop with your PT can be important, as you are likely to work with him or her on and off throughout your journey with Parkinson’s.
Preparing for Physical Therapy
Before your first visit, think about your movement goals and write down your problems and questions. This will help you to organize your thoughts. You can do this for future visits, too.
On your first visit, wear comfortable shoes and clothes. Your physical therapist will evaluate your movement. This evaluation may include your strength, range of motion, walking speed, endurance, balance, posture and pain. If there is time, the physical therapist will provide you with some exercises or tips to help you right away. Together you will set attainable goals.
During your follow-up visits, you will learn exercises that focus on your needs, while practicing tasks that you find difficult. Always wear comfortable clothes and shoes. If it is safe for you, it is ideal for people with Parkinson’s to exercise at a moderate to vigorous level, so your physical therapist may have you work up a sweat!
Miriam Rafferty, PT, DPT, PhD, NCS, is a board-certified neurologic physical therapist. She is a postdoctoral fellow at Northwestern University, completing an integrated fellowship in health services and outcomes research at the Center for Education in Health Sciences, Feinberg School of Medicine. She is also a Flex Staff Physical Therapist at the Shirley Ryan AbilityLab.
Amy Watt, PT, DPT, is a physical therapist and member of the Parkinson’s Disease and Movement Disorder team at the Shirley Ryan AbilityLab.