[Webinar Recording] Live Well Today: Physical Therapy for Parkinson’s

physical therapy webinar with devon fulford, blonde, white, and wearing a red shirt in front of a boulder skyline, and anson rosenfeldt, white, brunette, red top on a white background.

In this video, Dr. Anson Rosenfeldt, a neurologic physical therapist, discusses physical therapy for people with Parkinson’s.

NOTES FROM THE WEBINAR 

Dr. Rosenfeldt provided a broad overview of physical therapy for people with Parkinson’s and then answered questions from the audience.  

DIFFERENCES BETWEEN PHYSICAL THERAPY AND OCCUPATIONAL THERAPY 

There is some overlap between the work of physical therapists and occupational therapists, but there are differences, too. 

One way to consider the difference is physical therapists generally focus on big movements like walking, reaching for items on a high shelf or on the ground, or sitting down and standing up from a chair. Occupational therapists typically focus on smaller movements like tying shoes, buttoning clothing, and activities of daily living like cooking, cleaning, eating, and bathing. Occupational therapists may also help you implement strategies for other practical aspects of life like managing finances or arranging transportation. 

WHEN SHOULD YOU SEE A PHYSICAL THERAPIST? 

A physical therapist can help you at any point in your life with Parkinson’s. There are good reasons to see one sooner than later, even if you don’t have an immediate need for therapy. 

Seeing a physical therapist early helps establish a relationship so that when you encounter an issue with which you need help, you will have someone there. Being familiar before an acute need arises can be helpful because it allows your therapist to approach treatment with a baseline understanding of how you were doing before you encountered the issue that caused you to call them.  

For example, suppose you fell and hurt your knee and are having trouble getting up from your chair. In that case, your physical therapist will be better able to help you if they're familiar with your ability prior to the injury. This familiarity helps them set expectations and establish a timeframe for your therapy and road to recovery. 

PHYSICAL THERAPISTS CHALLENGE YOU (IN A GOOD WAY!) 

Another reason to see a physical therapist early is that they can help you compensate for the changes Parkinson’s causes to your brain’s ability to control your movement 

The part of the brain called the basal ganglia typically initiates and sustains movement, but the basal ganglia are affected by Parkinson’s and stop optimally functioning. Physical therapists have techniques and expertise to engage other parts of the brain, which improves movement despite the effects of Parkinson’s. 

SHOULD YOU SEE A NEUROLOGIC PHYSICAL THERAPIST? 

Physical therapists are general practitioners, and any physical therapist has the potential to be a great help to you despite their familiarity with Parkinson’s. Some physical therapists—like Dr. Rosenfeldt—undergo special training in neurologic physical therapy. Such therapists are familiar with Parkinson’s and the specific strategies to help with Parkinson's unique experiences.  

You may not have a neurologic physical therapist in your area, but any physical therapist can be a great addition to your care team. Keep in mind that, as with other members of your care team, you may benefit as much from building a relationship with a provider with whom you enjoy working as you would from prioritizing a relationship with a provider who holds specialized credentials.  

To find a physical therapist, use this search tool or talk with your care team for a referral. Note that the search tool includes an option to search providers by specialty.  

RESOURCES AND INFORMATION TO SHARE WITH YOUR PHYSICAL THERAPIST 

If you are working with a physical therapist who is not a neurologic specialist, consider asking if they are familiar with the APTA guidelines for physical therapy for Parkinson’s. There are also European guidelines. 

Regardless of whether your therapist is a Parkinson’s specialist, there is information you should share with them: 

  • Your goals: Do you want to be more comfortable navigating the bumpy terrain in the park? Do you want to improve your stability when standing from a chair or getting out of the car? 
  • What motivates you: Some people thrive on having benchmarks or goals toward which they are striving. Others thrive when they are given positive feedback. Still others are motivated by being encouraged to push harder when working out. Be forthright about whether the feedback you receive from your therapist is helping you. Telling them what motivates you helps them help you. 
  • Your schedule and how much time you can commit to exercise. 

Physical therapy might not be for everyone, but knowing how it can be helpful to you allows you to make the most informed choices about your Parkinson's care.

ADDITIONAL RESOURCES 

American Physical Therapy Association: Find a PT Tool 

Three Ideas for Parkinson’s Physical Therapy 

Complementary Therapies for Parkinson’s 

Identifying Physical Therapists for Parkinson’s 

John’s Hopkins Overview of PT for Parkinson’s 

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