Gait Training and Balance Exercises in Parkinson’s Rehabilitation

Walking and maintaining balance can come as a challenge for people suffering with Parkinson’s Disease. Prospective studies show that between 45% and 68% of people with Parkinson’s will fall each year, with a large proportion (50-86%) falling recurrently. By practicing gait training and balance exercises, individuals can improve posture and walking ability, decreasing the likelihood of falls or injury.

What is Gait Training and How Does It Help Those with Parkinson’s?

Gait training refers to specific movements and exercises to improve an individual’s walking pattern. Common motor symptoms of Parkinsons include difficulty walking. Studies from the Unit of Neurology in Università Campus Bio-Medico di Roma show that those with Parkinson’s use a modified ankle joint motion before lift-off, and land with weight shifted posteriorly. This paired with other common gait impairments contribute to the increased risk of falls and fractures.

Other gait impairments associated with Parkinson’s include:

• Hypokinesia (decreased step length with decreased speed)
• Decreased coordination
• Festination (decreased step length with increased cadence)
• Freezing (the inability to produce effective steps at the initiation of gait or the complete cessation of stepping during gait)
• Difficulty with dual tasking during gait 

Re-learning how to walk without risk of falling or injury is an important part of physical therapy to improve physical symptoms of Parkinson’s. Gait training can help improve flexibility and range of motion, using corrective movements and cues to improve the walking pattern and increase stability.

Gait Training and Physiotherapy

Gait training by professional physiotherapists working with Parkinson’s patients often takes a two-pronged approach. Exercises to improve muscle strength and flexibility are practiced to help tackle coordination issues, and exercises involving cues are taught to help prevent freezing, festination, and hypokinesia.

Cueing strategies to retrain gait impairments can be auditory or visual. By concentrating on specific aspects of the gait and practicing walking visualisation, patients can turn the movement into a cognitive task which they can control.

Music is sometimes used by physiotherapists as an auditory cue to help reduce shuffling, improve walking speed, and reduce freezing of gait. This technique uses rhythmic auditory stimulation (often the beat of music or a metronome) to treat gait disturbances in Parkinson’s Disease.

How Balance Exercises Aid Parkinson’s Rehabilitation

Alongside gait disturbance, impairments in balance and postural stability also contribute to the number of falls suffered by those with Parkinson’s. The basal ganglia (part of the brain essential for balance) is significantly affected by the disease, leading to postural changes and weight shifts, which when paired with gait impairment, contributes to a large number of falls every year.

Balance exercises outlined by professional physiotherapists such as the team at Therapies on Thames can improve the confidence of those with Parkinson’s, improve gait, and reduce the risk of falls. Some examples of balance exercises used with Parkinson’s patients include:

• Static standing balance (standing upright with feet shoulder width apart)
• Tandem standing (standing with one foot ahead of the other with heel and toe in line)
• Single leg stand (raise one leg so you are balancing on your opposite side)

Physiotherapy can improve the quality of life of those suffering with Parkinson’s Disease through a variety of gait and balance exercises. These services allow them to maintain their independence and confidence for longer, without the need for full time care. By focusing on specific exercises and choosing specialised physiotherapists, we can establish a healthier and safer environment for those with Parkinson’s.

About Therapies on Thames

Therapies on Thames offers specialist rehabilitation services for the elderly across the UK. With a head office located in Berkshire, and inpatient centres in Surrey and Gloucestershire, our team provides inpatient and home visit services for those who need physiotherapy or occupational therapy.

All physiotherapists at Therapies on Thames are registered Charted Physiotherapists with the CSP (Charted Society of Physiotherapy) and are registered with the Health & Care Professionals Council. For added peace of mind all our physiotherapist are Disclosure and Barring Service (DBS) checked.

A charted physiotherapist is a title that only a fully qualified physiotherapist registered with the CSP (Charted Society of Physiotherapy) can use. Charted Physiotherapists have undergone intense training and have a 3–4-year university degree or equivalent and are recognised by medical professions and the Department of Health.

If you or a loved one is suffering from Parkinson’s and needs assistance in regaining or maintaining an active life, contact us today by completing our contact form.