Keeping Step with Parkinson's: Balance, Posture and Gait

Balance, posture and gait issues are some of the most troublesome and difficult to treat Parkinson's symptoms. While tremor and muscle rigidity can be treated with dopamine replacement therapy, these medications are less useful when it comes to how you walk and maintain your balance.

Dr. Chris Hass of the University of Florida says patients can better control their balance, posture and gait symptoms through motor therapies, exercise and physical therapy.

“It concerns me that in many cases we wait to treat gait and balance until the patient has fallen versus seeing a physical therapist well in advance of falling,” says Dr. Hass, “so it’s important to almost 'pre-hab' the system. “

10 Replies

  • I waited for 2 years to get into the movement disorder neuro who has now left, and he never once mentioned physical therapy, exercise, vocal therapy, sleep neuro, balance, gait etc. etc. Just simply did the same diagnostic tests the 3 times I visited with him and wrote prescriptions. I tracked these down myself.

    Pre-hab the system, if only. Glad I was tech savvy enough to check it out. I'm still learning every day.

    Thank you all for your input.


  • Ditto the UK despite referral to Physio being recommended by the official NICE guidelines. I have to go through the so-called PD savvy clinic - can't self refer to the normal NHS provision. I have twice resorted to requesting this referral (My PD nurse forgot both times and had to be reminded) I got a lengthy assessment but the hip problems which lead me to request referral were not addressed at all which only dawned on me when I got home. Any sense that we might engage in Pre-hab related to my PD was totally absent.

    There are one or two multi-disciplinary PD clinics but none near where I live.

    Neither my neuro nor my PD nurse have ever initiated any discussion about exercise in the six years I have been dx. with PD.

    Some useful discussion on this and other PD topics at

  • Yes, despite all the 'support' services in the UK for PWP, there's very little 'pre-hab' or preventative stuff that I have encountered. I'm grateful for our healthcare system, particularly when I read how many PWP can't get their insurance to pay for Aziclet in the States, whereas it was prescribed for me straight off the bat. Swings and roundabouts, I guess. I'm fortunate in that I have some financial resource, so can pay for gym membership, yoga classes and some private physio where I need it. I find this site very helpful for 'tips'. My stiff hand has responded rather well to the camphor oil massage someone here suggested. No healthcare professional has suggested how beneficial exercise is in managing PD yet I find it vital.

  • what meds do you take

    I take sinemet (CARBIDOPA/LEVODOPA) and it relieves my stiffness and the pain in my right hand. It returns to almost normal. Hand writing also is 95% of normal.

  • Bowen Technique...Acupuncture? The latter of those two help me the most.

  • I have been diagnosed for 11 year, am now 74 years. Looking back to the first few years, biggest thing I had going for myself was that that I was involved with Tai Chi, which I continued to practice at a studio I belonged to. Knowing it and its associated Mindfulness, has made a world of difference in balance issues. Five years ago, was lucky to find LSVT BIG. Takes on Movement Issues head on. Learning "free walking" will provide stunning benefits later. Should your symptoms evolve to where you experience feneistration of freezing. Look to the MOVE IT, program developed by Kevin Lockette PT. Shows the way to resolve gait problems.

    Looking back, to when I was diagnosed, was the failure of the value of LSVT BIG and MOVE IT to have been brought to my attention, and the resulting loss of opportunity

    to be better now, only if I could have learned them in the beginning!.


  • Hi I know it's 2yrs ago since you posted, just wondered what is 'free walking'

  • budsey

    a lot has gone on. for my convenience, would prefer to correspond via email. Contact me at []

    to continue.


  • I know you've heard it from me before but the LSVT Big program has really helped my gait, I'd recommend it to anyone.

  • I have a lot of trouble with my balance

You may also like...