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Semin Neurol 2021; 41(02): 189-205
DOI: 10.1055/s-0041-1725133
Review Article

Evidence for Early and Regular Physical Therapy and Exercise in Parkinson's Disease

Terry D. Ellis
1   Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts
,
Cristina Colón-Semenza
2   Center for Neurorehabilitation, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts
,
Tamara R. DeAngelis
2   Center for Neurorehabilitation, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts
,
Cathi A. Thomas
3   Parkinson's Disease and Movement Disorders Center, Boston University Medical Campus, Boston, Massachusetts
4   American Parkinson Disease Association Information and Referral Center at Boston University Medical Center, Boston, Massachusetts
,
Marie-Hélène Saint Hilaire
3   Parkinson's Disease and Movement Disorders Center, Boston University Medical Campus, Boston, Massachusetts
5   Department of Neurology at Boston University School of Medicine, Boston, Massachusetts
6   American Parkinson Disease Association Center for Advanced Research at Boston University Medical Center, Boston, Massachusetts
,
Gammon M. Earhart
7   Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, Missouri
,
Leland E. Dibble
8   Department of Physical Therapy and Athletic Training, The University of Utah, Salt Lake City, Utah
9   Health-Kinesiology-Recreation, The University of Utah, Salt Lake City, Utah
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Abstract

Advances in medical management of Parkinson's disease (PD) have resulted in living longer with disability. Although disability worsens over the course of the disease, there are signs of disability even in the early stages. Several studies reveal an early decline in gait and balance and a high prevalence of nonmotor signs in the prodromal period that contribute to early disability. There is a growing body of evidence revealing the benefits of physical therapy and exercise to mitigate motor and nonmotor signs while improving physical function and reducing disability. The presence of early disability coupled with the benefits of exercise suggests that physical therapy should be initiated earlier in the disease. In this review, we present the evidence revealing early disability in PD and the effectiveness of physical therapy and exercise, followed by a discussion of a secondary prevention model of rehabilitation to reduce early disability and optimize long-term outcomes.

Keywords

Parkinson's disease - exercise - physical activity - physical therapy - rehabilitation


Publication History

Article published online:
19 March 2021

© 2021. Thieme. All rights reserved.

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