Parkinson’s Disease (PD) is a degenerative disorder of the central nervous system. It most commonly impairs one’s ability to gauge and execute movements (pivoting, turning, reaching, and stepping, to name a few). The Parkinson’s Foundation estimates that over 10 million people worldwide are living with PD every year. Physical and Occupational Therapy are standard interventions for PD, with programs like LSVT BIG leading the way. To supplement such programs, 5 balance exercises favorites are listed below from the Haas Balance Book: 100+ Exercises for PTs and OTs):
- Standing + Reaching Across Midline [Exercise 15] reinforces trunk rotations and improves balance during reaching to the side or behind midline. Targets are positioned laterally or posteriorly (behind patient) to challenge range of motion and balance. Functional carryover includes improved safety and ability to prepare meals, take showers, don clothes, etc.
- Reaching Overhead [Exercise 13] emphasizes standing and raising arms above one’s head, similar to motions of changing a lightbulb. This exercises challenges balance (center of gravity moves posteriorly) while also helping improve trunk extension and arm flexion motions. To integrate cognitive challenges with overhead reaching, add Balance Games [Exercises 88-93 & 95-97].
- Randomized Turning [Exercise 78] requires patient to pivot, turn and face the colored target called out by therapist. Colored cards are used to randomize color order. The benefit of this exercise is on improving safety and stability when changing directions in standing and walking.
- Stepping On/Off Obstacle [Exercise 57] helps improve steadiness when lifting and setting foot on an obstacle, such as a curb or step. The patient is asked to set their foot on the obstacle and then return it back to the starting position while attempting to minimize balance deviations. The sequence is then repeated with the opposite foot. Selecting higher obstacles (second or third steps) is helpful for increasing step height and reinforcing movements into hip and knee flexion.
- Randomized Stepping (with Balance Dots) [Exercise 73] or Clock Yourself App [Exercise 75]. Random cues help simulate reactionary movements. Steadiness, quickness, and strength with stepping movements are important for balance recovery and fall prevention. For more information on stepping strategies see previous blog titled “Tips to Improve Stepping Strategies.”
Other Balance Exercise Groups: