Balance Exercises for People with Parkinson

Transcribed from video.

Mah Shi Min, a physiotherapist from Sengkang Health introduces herself, as well as Mr Lee and Mr Ong, who have Parkinson's disease. Mr Ong will perform the simpler, modified exercises.

Living with Parkinson, you may experience some difficulty with balance. Balance re-training should be incorporated into your exercise programme. Balance training three times a week can help to reduce risk of falls as well as improve your balance.

Exercising safely

Before you begin, here are some tips on how to exercise safely:

  • Pick an appropriate time to exercise
  • Make sure you are well rested, and that your symptoms are well-controlled by your medication
  • Exercise at your own pace
  • Always have a stable support (such as a chair or table that does not move) close by, to hold on to, if needed
  • If you experience pain or difficulty with these exercises, stop and consult your physiotherapist or doctor

Firstly, we will have Mr Lee demonstrate these standing exercises. These should be done in a safe and comfortable manner.

Static standing balance

Stand upright facing a chair or a table.

Standing with your feet shoulder width apart. Hold for 30 seconds.

Stand with your feet together. Keep your body up upright. Hold for 30 seconds.

Tandem standing

Now, Stand with one foot in front of the other, so your heel and toe are in line, keep your body upright and maintain your balance. Try to look straight ahead. Hold for 30 seconds.

Repeat with the other foot in front.

You can progress this exercise into a dynamic one.

Tandem walk

Choose a spot ahead of you and focus on it to keep you steady as you walk by placing your heel just in front of the toe of your other foot.

Repeat for 20 steps.

Single leg stand

Raise one leg so you are balancing on your opposite side. Hold for 10 seconds.

Repeat with the other leg. As you feel steadier, you can balance for a longer time.

For patients whose balance are more severely affected, you may follow the modified version which Mr Ong is demonstrating, using a step board.

Now, we will move on to a series of dynamic balance exercises that involve maintaining your balance whilst moving your body.

Lateral weight shift

Stand with feet shoulder width apart.

Slowly shift your weight to the right as far as possible, without taking a step.

Return to starting position. Then repeat to the left side.

Hold each position for 3 seconds. Repeat 10 times.

Wall leans

Stand with your back against the wall with your feet some distance away.

Pull your body away from the wall using your leg strength, until your body is upright.

Slowly move your hips backwards until it touches the wall again then move your upper body to touch the wall. Your toes should lift up slightly during movement.

Repeat 10 times.

Now, we move onto a series of dynamic balance exercises that involve maintaining your balance whilst moving your feet.

Side stepping

Take a step sideways with one leg, followed by the other leg.

Continue walking sideways for 10 steps.

Repeat in other direction.

Mr Ong is demonstrating a modified version of the exercise.

Backwards walking

Step back leading with your toes, followed by your heel. Repeat on the other leg.

Continue for 10 steps.

Mr Ong is demonstrating a modified version of the exercise.

Alternate stepping

Stand close to a stable support. Place one foot on step and then place it back on the ground.

Repeat with the other leg.

Continue for 10 steps while alternating between legs.

Mr Ong is demonstrating a modified version of the exercise.

Next, we will practice taking a quick saving step, which is what needs to happen automatically if you trip or overbalance. For example, if you trip forward, you need to take a quick step forward to prevent falling over.

Saving steps

Slowly shift your weight as far forwards or sideways as possible, then take a quick step forward.

Hold balance in this position for 3 seconds, then return to start position.

Repeat 5 times.

In this instance, Mr Ong is performing a forward saving step, whereas Mr Lee is performing a side saving step.

Now we will move onto the final series of challenging dynamic balance exercises. These should only be attempted if you can do all the previous exercises without difficulty.

Figure of 8 walking

Place 2 objects about 2m apart on the floor. Walk in a figure of eight pattern and maintain your balance.

Repeat 10 times.

Dual tasking

Practice walking for 2 minutes while performing one of the following tasks:

  1. Motor tasks, such as holding a cup of water
  2. Cognitive tasks, such as:
    - Subtracting a random number by 3.
    - Naming objects e.g. animals, colours.
    - Holding a conversation with another person.

For dual tasking, primary attention should be on balancing and walking, with all other activities as secondary tasks.

Stop if balance or gait pattern is affected.

If you have Parkinson's disease and have not been referred to a neurological physiotherapist for rehabilitation, you can obtain a referral from your neurologist.

You can find neurological physiotherapists in all acute hospitals.

Remember, it is never too late to start exercising. Begin today and enjoy its benefits! If you have already been exercising daily, keep up the great work!

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