Neurological Physical Therapy and Parkinson's disease.

A neurologic physical therapist is a physical therapist who specializes in the evaluation and treatment of individuals with movement problems due to disease or injury of the nervous system.

(Ref: ANPT)

Neurological physical therapy is based on principles of neuroplasticity > these were described by Kleim and Jones in 2008 as , 1. Use it or lose it, 2.use it and improve it, 3.pecificity matters, 4.intensity matters, 5.repetition matters. 6.time matters,7.salience matters,8.age matters,,9.transference 10.interference.

Parkinson’s disease is a progressive neurodegenerative disease. it affects dopaminergic neurons cells in basal ganglia . (1)

Studies performed in animals and inhumans have confirmed the benefits of ongoing exercise in improving the physical and cognitive function in people with parkinson’s disease. Moderate intensity exercise improves motor symptoms such as gait, functional mobility, balance and posture (2)

WHO and NIH have developed an exercise prescription for people with parkinson’s disease. (3)

the recommendation is to start exercise early in the disease process and continue regular exercise.

the exercise should include:

Endurance training at moderate intensity for 30 minutes 5/week. examples are walking, swimming, cycling and many others.

Strength training: exercise all muscle groups 2-3/week. practice strength training every other day.

Flexibility training 2-3/week

balance training 2-3/week

Neurological Physical Therapist assess , strength , balance, flexibility, muscle tone, coordination , various transfers (in and out of bed, in and out of care, get down and up from the floor etc. ) gait and stairs. We also check standardized outcome measures such as 10 meter walk test, functional gait speed, 6 minute walk test, Berg balance scale.

The treatment plan is developed based on findings of the examination and goals and concerns of the patient. Treatment interventions include exercises and activities to improve the deficits . We will practice exercised and therapeutic activities in office and assign an exercise program to be practiced at home.

If you have specific questions, please contact Dr. Chitale from the contact page or email

References :

1.Galvan A, Wichmann T. Pathophysiology of parkinsonism. Clin Neurophysiol. 2008;119(7):1459–1474. doi:10.1016/j.clinph.2008.03.017

2. Lauzé M, Daneault JF, Duval C. The Effects of Physical Activity in Parkinson's Disease: A Review. J Parkinsons Dis. 2016;6(4):685–698. doi:10.3233/JPD-160790

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Priti Chitale