Exercise and Parkinson's Disease - A Physical Therapist's Guide to Getting Started

By now it's no secret that exercise is the most powerful thing you can be doing to manage your Parkinson's symptoms and make sure you're active and doing the things you love, now and well into the future. 

So, where do you start? 

While it's wonderful to see options grow for people diagnosed with Parkinson's, it can also be confusing and intimidating to try and choose which is the best one for you:

... Do you need physical therapy? Should they be specialized in Parkinson's?

... Should you see a personal trainer? How do you find a good one?

... What's the big deal about Parkinson's fitness classes? Are they for me?

... What do I do if I can only workout at home?

In order to make things easier for you, I put all the information we'll cover into a 1-page Getting Started Guide PDF that you can download here:

"Where do I start?"

Consideration #1: What's your Personality?

Physical Therapy & Personal Training - You prefer 1-on-1, individualized attention. Here you get feedback about your form and guidance on an intensity level that's specific to you, your body, and your health status.

Group Fitness Classes - You prefer the "tribal" feel and camaraderie of working out in a group. You're okay with general guidance on form and intensity.

Online Programs - You like to be able to workout on your own schedule or from home (or live too far from the closest PT, trainer, or gym). You're relatively self-motivated and don't feel like you need individual support.

Consideration #2: Where are you on your Journey?

Physical Therapy - You're newly diagnosed (everyone should see a Parkinson's PT immediately after a Parkinson's diagnosis), or it's been over a year since your last bout of therapy. You've had a fall, injury, or have noticed a decline in your strength, flexibility, ability to walk, get out of chairs, etc in the last 3 months. You have pain in your shoulder, neck, back, or legs (even if you think it's not related to PD!). 

Personal Training & Group Fitness Classes - You're looking for someone to hold you accountable and keep you fit and strong. You want to stay active after finishing a bout of physical therapy. You haven't had any falls, injuries, or decline in function in the last 3 months.

Online Programs - You're looking for Parkinson's-specific exercises to do on days you don't see your therapist, trainer, or go to a group fitness class. You're going to be on vacation or away from your regular program for any period of time and want to stay active while you're away.

Consideration #3: What are your Goals?

Physical Therapy - You want to learn a Parkinson's-specific exercise program that's tailored to your body, your specific health issues and physical activity level. You're looking to restore physical function that you've lost over time (due to Parkinson's, a fall, or another injury) and prevent degeneration in the future.

Personal Training, Group Fitness Classes, & Online Programs - You want to find a program that can help you improve or maintain your fitness level and prevent degeneration in the future. 


Consideration #4: What's your Budget?

Physical Therapy - You're able to use insurance for an annual bout of Parkinson's-specific exercise training. Often you're responsibility for a co-pay ($25-50) depending on your insurance. You're also able to pay privately (called "self-pay" or "cash-pay") if you want to see a physical therapist after your insurance benefits are used up OR you don't want your insurance company deciding what kind of treatment you receive from your therapist.

Personal Training - You'll pay per visit with a trainer. The average cost can range significantly, from $30 - 150/visit. Ask your trainer if there's a discount for purchasing a package of visits if you're looking for a cost-savings. 

Group Fitness Classes - You'll likely pay per class with most programs you'll find. There are great programs - like Power for Parkinson's (Austin, Texas) and InMotion (Cleveland, OH), among others - who offer Parkinson's classes for free, but they're not wide-spread quite yet. Classes at Rock Steady Boxing are available with a monthly membership or you can pay to "drop-in" for a class. 

Online Programs - There are a few online Parkinson's fitness programs (like our Booster Program) that provide exercise videos you can watch from the comfort of your own home. You'll also find a variety of DVDs, CDs, and workbooks ranging in price from $25-60. (Note: YouTube is also a great resource for free videos. Make sure to check out a ton of free Parkinson's exercise videos (and Subscribe) on our YouTube Channel here

Consideration #5: Are you looking for Expertise?

Physical Therapy - You'll find that most physical therapists have a post-graduate degree (Masters or Doctorate), which means they're trained to evaluate your health history, medication list, and understand the ins-and-outs of Parkinson's disease. You'll want to find a Parkinson's certified therapist. The two certifications that are available are the LSVT BIG Program and the Parkinson's Wellness Recovery (PWR!) Program (which is an upgraded version of the BIG Program).

Find a PWR! Certified Therapist here.

Find an LSVT BIG Certified Therapist here

Personal Training, Group Fitness Classes, & Online Programs - You'll find a lot of variety of degrees and certifications in the personal training, group fitness, and online world. You'll need to make sure to ask the trainer you find 1) What their education included, 2) What certifications they hold, and 3) If they have experience working with clients who have neurological diagnoses. If they don't, that can still be okay so long as they're willing to learn about how to best build a Parkinson's specific program for you. (Tell them they can start with our 7 Elements of a Parkinson's Specific Program video here.


Consideration #6: What's your Schedule like?

Physical Therapy - The Parkinson's-specific rehabilitation programs mentioned above have a specific protocol to be most effective for clients who complete the program. The PWR! Program is 3x/week for 4 weeks, and the LSVT BIG Program is 4x/week for 4 weeks where you'll need to go in to the clinic for each session. Of course, your therapist is able to tailor your rehab program if needed.

Personal Training - You're able to set up your training sessions to be most convenient with your schedule. On average, most clients schedule 1-3x/week. 

Group Fitness Classes - Class schedules are fixed so you'll have to find a class that works with your schedule. Typically classes are 1-3x/week but some are more frequent. 

Online Programs - This is typically the most flexible program you'll find since you can tailor it 100% to your schedule and do your workouts whenever it fits best in your schedule. This makes online programs the easiest to do daily. 

Consideration #7: How much Guidance do you need?

Physical Therapy - You'll get 1-on-1 guidance and supervision working with a therapist. They'll give you feedback on your form, intensity, and modify your exercises as you need along the way. They'll build you a program you can do at home after you finish therapy and make sure you have the resources you need to succeed. They're also trained to work with people of all physical activity levels (from independent to wheelchair bound) so you know you'll be safe and secure.

Personal Training - You'll also find 1-on-1 attention here with feedback on form and supervision for safety. Depending on how familiar your trainer is with Parkinson's, you may not get Parkinson's-specific feedback on your form, intensity, etc. Also, trainers may not feel comfortable working with someone who is more physically limited (it depends on their training) so make sure to ask before you sign-up. 

Group Fitness Classes - You'll find general feedback and cues in this setting since the trainer is typically responsible for 10+ people at once. If you have issues with balance or a history of falls, talk to your instructor before class about how to safely modify the exercises if you need. Be aware, the trainer in this class will likely not be able to stay close to you to supervise your safety. Bring a friend or family member if you feel you need more supervision.

Online Programs - You won't get any support from DVDs, CDs, or workbooks. Our online Booster Program does offer email support for its members. With all of these options, however, you'll be exercising out on your own so you'll need to ensure your safety by staying close to a counter or sturdy chair if you have issues with balance. You should recruit a friend or family member to supervise you if you have a history of falls. 


You'll likely use all of these resources at some point along your Parkinson's Journey.

The key is knowing when and how to make the best use of each of them!

If you want to dive deeper into how to get started with your Parkinson’s exercise program, this video may be helpful for you:


Now, I'd love to hear from you!

Which option is the best fit for you? Are you starting brand-new or looking to get back into a routine? Tell me in the comments section below or join the discussion on the Invigorate Physical Therapy and Wellness Facebook page