Contributing Author: Janet Caputo, PT, OCS
Last week we described various forms of exercise to reduce the symptoms associated with Parkinson’s disease (PD). This week we will outline a comprehensive home exercise program for people with PD. We recommend that you begin with the easiest exercises first, slowly introducing the more difficult exercises as your fitness level improves. Try to perform each movement to the best of your ability. If you fatigue easily, try exercising in the morning. Plan to perform your routine 3 times each week. For safety, all exercises can be performed while seated.
Warm-Up
- Take a slow walk or slowly march in place for 2 to 3 minutes
- If standing is difficult, march while seated
Stretching for Flexibility
- Should be gentle, pain-free, and through full available range
- Hold each position for 15 to 30 seconds and repeat 2 to 3 times
- Neck
- Look up
- Look down
- Tilt head to the right
- Tilt head to the left
- Turn and look right
- Turn and look left
- Torso
- With hands on hips
- lean slightly forward
- lean slightly backwards pushing belly forward
- Squeeze shoulder blades together
- Arms
- Raise arms
- to the front and overhead
- out to the side and overhead
- Clasp hands behind head and open elbows out to sides
- Reach behind buttocks and up the back with one hand and then repeat with other
- Legs
- While seated straighten one knee and then repeat with the other
- While seated with knee straight
- Point toes toward nose and then repeat with other side
- Point toes away from nose and then repeat with other side
- While seated, pull one knee toward chest and then repeat with other side
- While seated open and close knees
Facial Exercises
- Surprise: lift eyebrows and open mouth
- Displeasure: frown and purse lips together
- Disgust: crinkle nose
- Pleasure: make a big smile
Muscle Strengthening Exercises
-
- Perform 10 slow, full, and pain-free repetitions without weights
- Exercise both the left and right limbs
- Complete repetitions with one side then perform exercise with the opposite side
- To increase difficulty, slowly advance number of repetitions
- When 3 sets of 10 repetitions can be performed comfortably, weights can be added
- Weights with velcro straps can be purchased or household items may be used
- Soup cans or water-filled bottles
- Starting weight should allow pain-free completion of at least 10 repetitions
- Weight should not be advanced until 3 sets of 10 repetitions can be completed comfortably
- Do not advance weight more then one pound at a time
- When weight is advanced, reduce repetitions back to one set of 10 and advance to 3 sets as tolerated
- ARMS (perform these using arms simultaneously)
- Shrug shoulders up and down
- Raise arms
- out to the front but not higher than shoulders
- out to the side but not higher than shoulders
- Bend elbows up and down
- With elbows at 90°, bend wrists up and down
- Open and close fingers as if making a fist
- LEGS
- Hold onto stationary object and place feet shoulder width apart
- Keeping knee straight
- Move leg out to side
- Move leg backwards
- Bend knee
- Using both feet simultaneously
- Lift toes toward ceiling
- Rise up on toes
- While seated
- Lift knee toward ceiling
- Straighten knee
Endurance Exercise
- Start with no more than 10 minutes; gradually increase by 1 or 2 minutes, as tolerated, to 30 minutes
- Walking
- Choose flat, obstacle free terrain
- Focus on taking long strides while lifting each foot and placing the heel down first
- Counting each step can facilitate rhythm and smoothness
- Swing arms while walking
- Use a walker with wheels if balance is a problem or if pain prevents progression
- If walking is not an option, try stationary bicycling
Cool-Down
- Take a slow walk or slowly march in place for 2 to 3 minutes
- If standing is difficult, march while seated
Good luck with your exercise program! If you have any questions email Dr. Mackarey at drpmackarey@msn.com.
Janet Caputo, PT, OCS, is a physical therapist specializing in the management of orthopedic and sports injuries with a special interest in vestibular rehab and falls prevention at Mackarey Physical Therapy in downtown Scranton. She is presently a completing her doctor of physical therapy degree at the University of Scranton.
Read Part I of III on exercise and Parkinson's Disease.
Part III of III on exercise and Parkinson’s Disease
