Parkinson’s and Balance Training – 10 Proven Exercises for Better Balance

Parkinson’s and Balance Training Introduction

Parkinson’s disease, a neurodegenerative disorder, brings about a range of challenges, including issues with mobility and balance.

This can significantly impact an individual’s quality of life.

However, there is growing evidence that specialized exercise regimens can play a crucial role in managing these symptoms.

In this blog post, we’ll explore the importance of balance-focused exercises and provide a comprehensive list of targeted exercises designed to enhance stability and confidence for individuals with Parkinson’s disease.

Disclaimer: I am not a certified personal trainer, physical therapist, or medical professional. The information being shared is based on my own personal experience with Parkinson’s and Balance training, through individual work, personalized training with a certified trainer, and participation in Parkinson-focused classes. In addition, data is shared from research I conducted on Parkinson’s and Balance Training. It is essential that you review exercise or balance training with your physician or a physical therapist prior to starting any balance training.

Understanding the Importance of Balance in Parkinson’s Disease

Balance is essential for everyday activities such as walking, standing, and turning. It is also important for preventing falls. People with Parkinson’s disease often have difficulty with balance, which can increase their risk of falls.

Benefits of Balance-Focused Exercises

Parkinson’s and Balance Training – Factors Affecting Balance

There are a number of factors that can contribute to balance problems in Parkinson’s disease, including:

• Rigidity: Rigidity is a common symptom of Parkinson’s disease that causes muscles to become stiff. This can make it difficult to move smoothly and maintain balance.
• Bradykinesia: Bradykinesia is another common symptom of Parkinson’s disease that causes slowness of movement. This can make it difficult to react quickly to changes in balance.
• Tremors: Tremors are uncontrollable shaking movements that can affect any part of the body, including the head, hands, and legs. Tremors can make it difficult to maintain balance and stability.
• Postural instability: Postural instability is a loss of balance and coordination that can occur in people with Parkinson’s disease. Postural instability can make it difficult to stand up, sit down, and walk.

Balance problems can have a significant impact on the quality of life of people with Parkinson’s disease.

They can make it difficult to get around independently and participate in activities of daily living.

Balance problems can also increase the risk of falls, which can lead to serious injuries.

Parkinson’s and Balance Training – Activities for Improving Balance and Reducing Fall Risk

There are a number of things that people with Parkinson’s disease can do to improve their balance and reduce their risk of falls, including:

• Exercise: Exercise is one of the best ways to improve balance and coordination. People with Parkinson’s disease should aim for at least 30 minutes of moderate-intensity exercise most days of the week.
• Physical therapy: Physical therapy can help people with Parkinson’s disease develop a personalized exercise program to improve their balance and coordination. A physical therapist can also teach people with Parkinson’s disease how to avoid falls and how to get up safely if they do fall.
• Home modifications: Making some simple changes to the home can help to reduce the risk of falls. For example, installing grab bars in the bathroom and removing clutter from the floor can make it easier for people with Parkinson’s disease to move around safely.

Parkinson’s and Balance Training – Benefits of Balance-Focused Exercises

Balance-focused training is a type of exercise that specifically targets the muscles and systems that are responsible for balance. It can be particularly beneficial for people with Parkinson’s disease, who are at increased risk of falls.

Balance-focused training has a number of benefits for people with Parkinson’s disease, including:

• Improved balance: Balance-focused training can help to improve balance and coordination, which can make it easier to move around safely and independently.
• Reduced risk of falls: Balance-focused training can help to reduce the risk of falls by improving balance and coordination, and by teaching people with Parkinson’s disease how to fall safely.
• Increased mobility: Balance-focused training can help to increase mobility by making it easier to walk, stand, and turn.
• Improved quality of life: Balance-focused training can help to improve the quality of life of people with Parkinson’s disease by allowing them to participate in more activities and live more independently.

In addition to the above benefits, balance-focused training has also been shown to improve gait, reduce fatigue, and improve mood in people with Parkinson’s disease.

Balance-focused training can be done in a variety of settings, including at home, in a gym, or with a physical therapist.

There are many different types of balance-focused exercises, so it is important to find a program that is appropriate for your individual needs and abilities

Parkinson’s and Balance Training – Stability, Coordination, and Postural Exercises for Improving Balance

Effective Parkinson’s and Balance training targets exercises that are crucial for individuals living with Parkinson’s disease.

These exercises are specifically designed to improve stability, coordination, and posture, all of which can be severely impacted by the condition.

Incorporating exercises like standing heel-to-toe, leg raises, and one-leg stands helps strengthen the core and lower body muscles essential for maintaining a steady posture.

Additionally, practices like Tai Chi and yoga provide a holistic approach, combining gentle movements with focused breathing techniques to enhance balance and flexibility.

Modified squats and sit-to-stand exercises target the muscles needed for everyday activities, promoting confidence in tasks like standing up from a chair.

By consistently engaging in these exercises, individuals with Parkinson’s can experience a notable improvement in their ability to navigate their environment with reduced risk of falls, ultimately contributing to a better quality of life

Parkinson’s and Balance Training – Importance of Fall Prevention and Clinical Study Results

Why Parkinson’s and Balance Training Exercises are Important in Preventing Falls

Why are these Parkinson’s and Balance Training Exercises Important?

A study looking at balance and fall rates, entitled Highly Challenging Balance Program Reduces Fall Rate in Parkinson Disease, reported

•  “Sixty-eight percent of people living with PD in the community sustain at least one fall per year which is double the fall rate reported in healthy older adults.”
  • Campbell AJ, Robertson MC, Gardner MM. Elderly people who fall: identifying and managing the causes. Br J Hosp Med. 1995;54(10):520–3.
• “50.5% of fallers with PD reported recurrent falls (at least two) over a one-year period.”
  • Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry. 2002;72(6):721–725.
  • Genever RW, Downes TW, Medcalf P. Fracture rates in Parkinson’s disease compared with age- and gender-matched controls: a retrospective cohort study. Age Ageing. 2005;34(1):21–24
• “Falls are a major cause of disability and reduced quality of life in people with PD and result in devastating injuries such as hip fractures that are significantly more common in PD than in those with other medical conditions.”
  • Schrag A, Jahanshahi M, Quinn N. How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord. 2000;15(6):1112–8.
• “The economic impact related to healthcare costs is about twice as much in fallers as non-fallers with PD.”
  • Spottke AE, Reuter M, Machat O, et al. Cost of illness and its predictors for Parkinson’s disease in Germany. Pharmacoeconomics. 2005;23(8):817–836

Now that we have some background on why it is important to prevent falls in people living with Parkinson’s, let’s look at the 10 top exercises for Parkinson’s and balance training.

Parkinson’s and Balance Training Exercises & Types

These 10 Parkinson’s and Balance Training exercises can be divided into 3 categories: Vertical Stability, Posture, and Stability with Gait.

• Single Leg Stand
• Tandem Walking
• Tandem Standing
• Lateral Weight Shift
• Chair Squats (Sit to Stand)
• Single Limb Stance with Reaching
• Lunges
• Backward Walking
• Side Stepping
• Dual Tasking

Let’s look at what each category means:

• Vertical Stability
  • Vertical stability exercises are a type of balance training that specifically focuses on improving the ability to maintain an upright posture. This is important for people with Parkinson’s disease, who often have difficulty with balance and are at increased risk of falls.
  • Vertical stability exercises typically involve challenging the body’s ability to maintain balance in different ways, such as by standing on one leg, shifting weight from side to side, or reaching for objects.
  • These exercises can be done with or without equipment and can be modified to make them more or less challenging depending on the individual’s needs and abilities.
  • Vertical stability exercises can be done at home, in a gym, or with a physical therapist.
• Posture
  • Posture exercises in Parkinson’s balance training are exercises that help to improve the alignment of the body and reduce muscle stiffness.
  • This can help to improve balance, reduce the risk of falls, and improve overall quality of life.
  • Vertical stability exercises can be done at home, in a gym, or with a physical therapist.
• Stability with Gait
  • Stability with gait exercises in Parkinson’s balance training are exercises that combine elements of stability and gait exercises to improve balance and walking function in people with Parkinson’s disease.
  • Stability exercises help to improve the ability to maintain balance in different ways, such as by standing on one leg, shifting weight from side to side, or reaching for objects. Gait exercises help to improve the ability to walk safely and efficiently.
  • Stability with gait exercises combine elements of both types of exercises to improve balance and walking function in people with Parkinson’s
  • Stability with gait exercises can be done at home, in a gym, or with a physical therapist.
  • Here are some additional tips for doing stability with gait exercises safely and effectively:
    • Wear comfortable shoes with good traction.
    • Exercise in a well-lit area with plenty of space to move around.
    • Have a chair or other support object nearby in case you need it.
    • Start slowly and gradually increase the intensity and duration of your workouts as you get stronger and your balance improves.
    • Listen to your body and take breaks when needed.
    • If you feel any pain, stop the exercise immediately.

Disclaimer: Please consult your physician before starting a new exercise program to ensure that it is designed to meet your specific health needs. I am not a certified trainer so the information is based on my research and interviewing certified Fitness Professionals. These are exercises I do to help me both improve and maintain my balance.

Parkinson’s and Balance Training – Exercise Categories

Listed below are the 3 Exercise categories and the 10 Balance exercises divided into each of the three categories you should focus on to help maintain and improve your balance. Try to incorporate one or two exercises from each category into your balance training.

• Stability with Gait
  • Backward Walking
  • Dual Tasking
  • Tandem Walking
• Postural
  • Chair Squats (Sit to Stand)
  • Lunges
  • Single Limb Stance with Reaching
• Vertical Stability
• Side Stepping
• Tandem Standing
• Lateral Weight Shift

Postural Exercises

Parkinson’s and Balance Training can greatly benefit people living with Parkinson’s by improving their stability and reducing the risk of falls.

Here are three effective exercises to incorporate into your routine:

1) Step-ups, both lateral and forward, help strengthen the legs and challenge balance.

2) Chair squats, where you practice sitting to standing, enhance leg strength and promote better posture.

3) Single leg with reaching exercises improve balance and coordination. Remember to start slowly and consult a healthcare professional before starting any new exercise program.

Step Ups

Step-up exercises are a great way to improve balance and coordination, and they can be modified to make them more or less challenging depending on your needs.

To do a forward step up in Parkinson’s and Balance Training:

1. Stand in front of a step or platform that is about 6-12 inches high.
2. Place your right foot on the step, and then step up with your left foot.
3. Bring your right foot down to the floor next to your left foot.
4. Step back down with your left foot, and then step down with your right foot.
5. Repeat on the opposite side.

To do a lateral step-up in Parkinson’s and Balance training:

1. Stand next to a step or platform that is about 6-12 inches high.
2. Place your right foot on the step, and then step up with your left foot.
3. Bring your right foot down to the floor next to your left foot.
4. Step back down with your left foot, and then step down with your right foot.
5. Repeat on the opposite side.

To make step-up exercises more challenging:

• Increase the height of the step or platform.
• Add a weight to your hands.
• Stand on one leg while doing the step-up.
• Close your eyes while doing the step-up.

Chair Squats (Sit to Stand)

To do a chair squat in Parkinson’s and balance training:

1. Stand in front of a chair with your feet shoulder-width apart.
2. Place your hands on the back of the chair for support.
3. Slowly bend your knees and lower your body down until you are sitting in the chair.
4. Hold for a second, then slowly stand back up.
5. Repeat 10-15 times.

Tips for doing a chair squat safely and effectively:

• Wear comfortable shoes with good traction.
• Exercise in a well-lit area with plenty of space to move around.
• Keep your back straight and your core muscles engaged throughout the exercise.
• Don’t go too low, especially if you have any knee pain.
• If you feel lightheaded or dizzy, stop the exercise immediately.

Progression:

Once you can do a chair squat comfortably, you can try to make it more challenging by:

• Remove your hands from the back of the chair for support.
• Adding a weight to your hands.
• Standing on one leg while doing the chair squat.
• Closing your eyes while doing the chair squat.

Safety guidelines:

• Be sure to talk to your doctor or physical therapist before starting any new exercise program, especially if you have Parkinson’s disease.
• Start slowly and gradually increase the intensity and duration of your workouts as you get stronger and your balance improves.

Lunges

To do a lunge in Parkinson’s and balance training:

1. Stand with your feet shoulder-width apart.
2. Step forward with your right leg and lower your body down until both knees are bent at a 90-degree angle.
3. Make sure your right knee is directly over your right ankle and your left knee is aligned with your left ankle.
4. Hold for a second, then push back up to the starting position.
5. Repeat with your left leg.

Tips for doing a lunge safely and effectively:

• Wear comfortable shoes with good traction.
• Exercise in a well-lit area with plenty of space to move around.
• Keep your back straight and your core muscles engaged throughout the exercise.
• Don’t let your front knee go past your toes.
• If you feel lightheaded or dizzy, stop the exercise immediately.

Progression:

Once you can do a lunge comfortably, you can try to make it more challenging by:

• Adding a weight to your hands.
• Standing on one leg while doing the lunge.
• Closing your eyes while doing the lunge.

Single Leg With Reaching

To do a Single Leg with Reaching exercise in Parkinson’s and balance training:

1. Stand with your feet shoulder-width apart.
2. Raise your right leg off the ground and balance on your left leg.
3. Reach forward with your right arm, extending it as far as you can comfortably reach.
4. Hold for a second, then slowly return to the starting position.
5. Repeat with your left leg.

Tips for doing a Single Leg with Reaching exercise safely and effectively:

• Wear comfortable shoes with good traction.
• Exercise in a well-lit area with plenty of space to move around.
• Don’t lean too far forward, especially if you have any balance problems.
• If you feel lightheaded or dizzy, stop the exercise immediately.
• Progression:
  • Once you can do a Single Leg with Reaching exercise comfortably, you can try to make it more challenging by:
  • Standing on a step or platform while doing the exercise.
  • Adding a weight to your reaching hand.
  • Closing your eyes while doing the exercise.

Vertical Stability Exercises

Side Stepping

To do side-stepping exercises for Parkinson’s and balance training:

1. Stand with your feet shoulder-width apart.
2. Step to the side with your right foot, keeping your left foot planted.
3. Bring your left foot next to your right foot.
4. Step to the side with your left foot, keeping your right foot planted.
5. Continue stepping sideways back and forth for 10-15 steps.

Progression:

Once you can do side-stepping exercises comfortably, you can try to make them more challenging by:

• Adding a weight to your hands.
• Closing your eyes while doing the exercise.
• Stepping sideways over obstacles, such as cones or pillows.

Tandem Standing

To do tandem standing in Parkinson’s and balance training:

1. Stand with your feet shoulder-width apart.
2. Place one foot directly in front of the other, with your heel touching the toe of your back foot.
3. Keep your back straight and your core muscles engaged.
4. Raise your arms out to the sides at shoulder height.
5. Hold for 30 seconds, then switch legs and repeat.

Progression:

Once you can do tandem standing comfortably for 30 seconds on each leg, you can try to make it more challenging by:

• Closing your eyes while doing the exercise.
• Standing on a step or platform while doing the exercise.
• Adding a weight to your hands while doing the exercise.

Lateral Weight Shift

To do lateral weight shift exercises in Parkinson’s and balance training:

1. Stand with your feet shoulder-width apart.
2. Place your hands on your hips.
3. Shift your weight to your right foot, bending your right knee slightly.
4. Keep your left leg straight and your left foot planted on the ground.
5. Hold for a second, then shift your weight back to your left foot and bend your left knee slightly.
6. Continue shifting your weight back and forth between your feet for 10-15 repetitions.

Progression:

Once you can do lateral weight shift exercises comfortably, you can try to make them more challenging by:

• Adding a weight to your hands.
• Closing your eyes while doing the exercise.
• Standing on a step or platform while doing the exercise.

Stability With Gait Exercises

Walking Backwards

To do walking backward with Parkinson’s and balance training, follow these steps:

1. Stand with your feet shoulder-width apart and your back straight.
2. Place your hands on your hips or at your sides.
3. Take a small step backward with your right foot.
4. Shift your weight back to your right foot and lift your left foot off the ground.
5. Place your left foot behind your right foot.
6. Continue walking backward by shifting your weight back and forth between your feet.

Progression:

Once you can walk backward comfortably, you can try to make it more challenging by:

• Closing your eyes while doing the exercise.
• Walking backward over obstacles, such as cones or pillows.
• Walking backward on a treadmill.

Gait with Dual Tasks

Dual tasks with gait in Parkinson’s and balance training are exercises that involve performing two tasks at the same time, one of which is walking. This type of training can help to improve balance and coordination, and it can also help to reduce the risk of falls in people with Parkinson’s disease.

Here are some examples of dual tasks with gait that can be incorporated into a Parkinson’s and balance training program:

• Walking while talking
• Walking while carrying an object
• Walking while turning your head
• Walking while counting backward
• Walking while singing a song

Progression:

Once you can do dual tasks with gait comfortably, you can try to make them more challenging by:

• Increasing the speed of your walking
• Adding more complex tasks, such as walking while reciting a poem or doing math problems
• Walking in different environments, such as outdoors or in a crowded grocery store

References and Resources

Highly Challenging Balance Program Reduces Fall Rate in Parkinson Disease

Sparrow, D., DeAngelis, T. R., Hendron, K., Thomas, C. A., Saint-Hilaire, M., & Ellis, T. (2016). Highly Challenging Balance Program Reduces Fall Rate in Parkinson Disease. Journal of Neurologic Physical Therapy : JNPT, 40(1), 24. https://doi.org/10.1097/NPT.0000000000000111

Parkinson’s Foundation

Michael J Fox Foundation

Davis Phinney Foundation

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Conclusion

Balance exercises play a crucial role in the management of Parkinson’s disease.

With numerous benefits, including improved stability, increased confidence, and reduced risk of falls, integrating balance training into the daily routine can greatly enhance the quality of life for individuals with Parkinson’s.

Whether through postural exercises, vertical stability drills, or stability with gait movements, seniors and individuals with Parkinson’s can effectively enhance their balance and overall well-being. So, let’s embrace these balance exercises and embark on a journey towards greater stability and vitality!

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