How Exercise Physiology Can Help You Stay Active and Independent with Parkinson’s Disease
Receiving a diagnosis of Parkinson's disease can bring a mix of emotions, along with plenty of questions about what the future might look like. While Parkinson's is a progressive neurological condition, there is one message that has become increasingly clear as research has expanded: exercise is one of the most effective ways to help maintain mobility, independence and quality of life.
Although medication plays an essential role in managing Parkinson's disease, it is only one part of the overall picture. A growing body of research shows that regular, appropriately prescribed exercise can improve walking, balance, strength, cardiovascular fitness and overall physical function. What is most important about this? Exercise gives people the opportunity to take an active role in managing their condition, rather than feeling that their diagnosis alone determines what they can and cannot do (Ellis & Rochester, 2018; Keus et al., 2014).
As an Accredited Exercise Physiologist, one of the most rewarding parts of my work is helping people discover that their diagnosis does not mean giving up the activities they enjoy. Some people want to keep playing sports every weekend, while others simply want to walk around the neighbourhood with confidence or continue chasing after their grandchildren. Whatever your goal, exercise is most effective when it is tailored and focused on the activities that matter most to you.
Understanding Parkinson's Disease
Parkinson's disease is a progressive neurological condition that primarily affects movement. It develops when dopamine-producing nerve cells within the brain gradually decline, reducing the brain's ability to control movement efficiently.
Everyone experiences Parkinson's disease differently. Some people first notice a slight tremor, while others become aware of changes in their walking, balance or movement speed. Over time, symptoms may include:
Slower movement (bradykinesia)
Muscle stiffness (rigidity)
Tremor
Reduced balance
Changes in walking pattern
Freezing of gait
Fatigue
Reduced cardiovascular fitness
Many people also experience non-motor symptoms such as changes in sleep, constipation, reduced mood or cognitive changes. These symptoms can have just as much impact on day-to-day life as the physical changes.
The progression of Parkinson's disease varies considerably between individuals. While there is currently no cure, remaining physically active is strongly associated with maintaining mobility, physical function and participation in everyday life. For this reason, exercise is now recognised as an essential component of best-practice Parkinson's management (Keus et al., 2014).
Why Exercise Matters
Exercise is no longer considered an optional lifestyle recommendation for people living with Parkinson's disease. It is recognised internationally as an important part of comprehensive care.
Research has consistently shown that appropriately prescribed exercise can improve:
Walking speed and endurance
Balance and postural control
Muscle strength
Functional mobility
Cardiovascular fitness
Gait quality
Overall quality of life
One of the biggest challenges following a Parkinson's diagnosis is that movement can gradually become more difficult. As a result, many people understandably become less active. Unfortunately, reduced activity often leads to further losses in strength, endurance and confidence, creating a cycle that becomes increasingly difficult to break.
Regular exercise helps interrupt this cycle. Maintaining strength, cardiovascular fitness and balance allows people to continue participating in the activities they value, while also reducing the physical deconditioning that commonly occurs as activity levels decline (Ellis & Rochester, 2018).
Importantly, there is no single "best" form of exercise. Current evidence supports a combination of aerobic exercise, resistance training, balance training and functional task practice. The most effective program is one that is individualised, enjoyable and sustainable over the long term (Mak et al., 2017).
Exercise Physiology: A Personalised Approach
One of the biggest misconceptions about Exercise Physiology is that it involves handing everyone the same exercise program.
In reality, no two people living with Parkinson's disease present in exactly the same way. Symptoms vary, medication schedules differ and every individual has their own priorities and goals.
An Accredited Exercise Physiologist develops a program based on factors such as:
Your current symptoms.
Medication timing.
Falls risk.
Previous exercise experience.
Other medical conditions.
Your personal goals.
Rather than focusing solely on symptoms, Exercise Physiology aims to improve the activities that have the greatest impact on everyday life.
For one person, success might mean improving balance to continue bushwalking with friends. For another, it may involve building enough strength to stand from a chair more easily or maintaining the endurance needed to volunteer within the community each week.
This personalised approach is one of the reasons Exercise Physiology plays such an important role in helping people live well with Parkinson's disease.
Why Starting Early Makes a Difference
A common misconception is that exercise becomes important only after Parkinson's symptoms begin to significantly affect daily life.
Current evidence suggests the opposite.
Beginning an appropriately prescribed exercise program soon after diagnosis provides an opportunity to establish healthy movement habits, maintain physical capacity and address subtle changes before they become major barriers to independence (Ellis & Rochester, 2018).
Early intervention is not about preparing for decline. It is about preserving strength, mobility and confidence so that you can continue doing the things that are important to you for as long as possible.
Building Strength, Balance and Confidence
As Parkinson's disease progresses, everyday tasks can gradually require more effort than they once did. Standing up from a chair, turning in the kitchen, carrying the shopping or walking through a busy shopping centre may all become more challenging over time.
The good news is that these are exactly the types of activities Exercise Physiology is designed to address.
Rather than focusing on isolated muscle groups or generic gym exercises, the aim is to improve movements that make a real difference to daily life. Every exercise should have a purpose and relate back to an activity that is meaningful to you.
A personalised Exercise Physiology program may include:
Progressive resistance training to improve strength and functional capacity.
Balance exercises to improve stability and reduce the risk of falls.
Aerobic exercise to improve cardiovascular fitness and endurance.
Functional movement practice, including sit-to-stand transfers, stepping and turning.
Flexibility and mobility exercises to help manage stiffness and improve movement quality.
Research consistently shows that structured exercise programs can improve balance, walking ability, mobility and overall quality of life for people living with Parkinson's disease (Mak et al., 2017; Shen et al., 2022).
One of the most rewarding parts of working with people living with Parkinson's disease is seeing confidence return alongside physical improvements. As strength and balance improve, many people begin doing things they had gradually stopped doing, whether that's walking through the local markets, visiting friends, travelling or simply feeling more comfortable moving around their own home.
Walking and Freezing of Gait
Changes in walking are among the most recognisable symptoms of Parkinson's disease, but they don't affect everyone in the same way.
Some people notice that their steps become shorter, while others experience slower walking speed, reduced arm swing or difficulty turning. For some, episodes of freezing gait can occur, where it temporarily feels as though the feet are stuck to the floor despite wanting to keep walking.
Although freezing can be frustrating, there are a number of evidence-based strategies that may help reduce its impact.
Exercise programs often incorporate:
Balance training.
Stepping practice.
Turning drills.
Walking over obstacles.
Cueing strategies, such as rhythmic counting or auditory cues.
Functional practice within everyday environments.
These approaches aim to improve confidence and movement efficiency while reducing the impact that freezing may have on daily activities. Importantly, strategies should always be individualised, as techniques that work well for one person may not be effective for another (Keus et al., 2014).
What to Expect During Your First Appointment
Every person living with Parkinson's disease has a unique experience, which is why your first appointment is about much more than simply discussing your diagnosis.
We'll take the time to understand how Parkinson's is affecting your day-to-day life, the activities that are becoming more difficult and, most importantly, the goals that are meaningful to you.
This typically includes discussing:
Your medical history and current symptoms.
Your medication schedule.
Previous rehabilitation or exercise experience.
Your current activity levels.
Falls or concerns about balance.
The hobbies, work or community activities that are important to you.
We'll also complete an assessment tailored to your needs. Depending on your circumstances, this may include looking at your balance, walking pattern, strength, mobility, cardiovascular fitness and functional capacity.
From there, we'll develop an individualised exercise program that is safe, evidence-based and designed specifically around your goals. As your symptoms, confidence and physical capacity change over time, your program should continue to evolve alongside you.
Looking Beyond the Diagnosis
A Parkinson's diagnosis can understandably feel overwhelming, particularly in the early stages. However, it is important to remember that many people continue living active, fulfilling and independent lives for many years after diagnosis.
While Parkinson's disease is progressive, the way a person responds to it is influenced by many factors. Staying physically active, maintaining strength and cardiovascular fitness, and continuing to challenge the body through appropriate exercise all play an important role in supporting long-term function and quality of life.
One thing I often tell people is that rehabilitation is not about trying to "beat" Parkinson's disease. It's about giving yourself the best opportunity to keep doing the things that make life enjoyable, whether that's travelling, spending time with family, getting out into the community or simply feeling confident walking around your own home.
Progress doesn't always happen overnight, and there will inevitably be good days and more challenging days. However, small improvements made consistently over time often add up to meaningful changes in independence, confidence and overall wellbeing.
Final Thoughts
Exercise is one of the most effective non-medication treatments currently available for people living with Parkinson's disease. Research consistently shows that appropriately prescribed exercise can improve mobility, balance, strength, physical function and quality of life, while helping people remain active and engaged in the activities they value most (Ellis & Rochester, 2018; Mak et al., 2017).
At Take Back Movement, my goal is to make high-quality Exercise Physiology as accessible as possible by bringing evidence-based rehabilitation directly into people's homes and communities across Brisbane and the northern Gold Coast.
Every person has different goals, different challenges and a different story. That's why every exercise program should be just as individual.
If you're living with Parkinson's disease, or you're supporting someone who is, I'd encourage you to remember that there is always value in continuing to move. The right exercise program won't change the diagnosis, but it can make a meaningful difference to how you live with it.
References
Ellis, T., & Rochester, L. (2018). Mobilizing Parkinson's disease: The future of exercise. Journal of Parkinson's Disease, 8(Suppl. 1), S95-S100. https://doi.org/10.3233/JPD-181489
Keus, S. H. J., Munneke, M., Graziano, M., et al. (2014). European Physiotherapy Guideline for Parkinson's Disease. KNGF/ParkinsonNet. https://www.parkinsonnet.com/professionals/parkinsonnet-guidelines/
Mak, M. K. Y., Wong-Yu, I. S. K., Shen, X., & Chung, C. L. H. (2017). Long-term effects of exercise and physical therapy in people with Parkinson disease. Nature Reviews Neurology, 13(11), 689-703. https://doi.org/10.1038/nrneurol.2017.128
Shen, X., Wong-Yu, I. S. K., & Mak, M. K. Y. (2022). Effects of exercise on falls, balance, and gait ability in Parkinson's disease: A systematic review and meta-analysis. Neurorehabilitation and Neural Repair, 36(2), 99-111. https://doi.org/10.1177/15459683211062443
