10 Best Exercises for Parkinson’s Disease

Exercise is an important part of managing Parkinson’s disease. The right exercises can help maintain strength, balance, flexibility and mobility, while supporting everyday activities such as walking, standing up from a chair and moving around more confidently.

There is no single exercise that is best for everyone with Parkinson’s. Symptoms, mobility and fitness levels vary from person to person, so an effective exercise programme will usually combine different types of movement.

In this guide, we look at 10 of the best exercises and types of physical activity for people with Parkinson’s, including walking, strength training, balance exercises, stretching, cycling and Tai Chi. We also explain how physiotherapy for Parkinson’s disease can help you choose exercises that are appropriate for your individual symptoms and abilities.

Important: If you are new to exercise, have difficulties with balance or freezing, have experienced falls, or have other health conditions that could affect your ability to exercise safely, speak to a physiotherapist or another appropriate healthcare professional before starting a new exercise programme.

Key Takeaways

• Regular physical activity can help people with Parkinson’s maintain mobility, strength, balance, flexibility and independence.
• A well-rounded exercise programme normally includes aerobic activity, strengthening, balance and agility work, and stretching.
• Walking, sit-to-stand exercises, stepping exercises, cycling, strength work and Tai Chi are all examples of activities that may be useful for people with Parkinson’s.
• Exercise should be adapted to your symptoms, fitness level and risk of falling.
• A neurological physiotherapist can assess your movement and develop an exercise programme that is appropriate for you.

Why Is Exercise Important for Parkinson’s Disease?

Parkinson’s disease can affect movement in several ways. People may experience stiffness, slower movements, changes in walking, reduced balance, changes in posture and difficulty starting or controlling movement.

Staying physically active can help maintain the abilities needed for everyday life. Exercise may help improve or maintain areas such as:

• muscle strength
• balance and stability
• walking and gait
• flexibility and range of movement
• posture
• coordination
• cardiovascular fitness
• confidence with everyday movement

Physical activity can also support general health and wellbeing. The most appropriate activity will depend on the individual, and exercise programmes may need to change as symptoms and abilities change.

What Are the 10 Best Exercises for Parkinson’s Disease?

The best exercises for Parkinson’s disease are not necessarily individual movements that everyone should perform in exactly the same way. Instead, the aim is to include different forms of exercise that address mobility, strength, balance, flexibility and cardiovascular fitness.

Here are 10 useful types of exercise that can form part of a Parkinson’s exercise programme.

1. Walking

Walking is one of the simplest ways to stay physically active and can help maintain cardiovascular fitness, leg strength and everyday mobility.

Depending on your ability, walking exercise might involve:

• regular outdoor walks
• walking indoors
• walking on a treadmill with appropriate supervision
• changing walking speed
• practising longer steps
• walking to a steady rhythm

For some people with Parkinson’s, walking can become more difficult because of smaller steps, reduced arm swing, freezing or problems with balance. In these situations, simply trying to walk faster is not always appropriate.

A neurological physiotherapist can assess your gait and help you practise strategies designed around the particular walking problems you are experiencing.

Read more about walking, tremor and gait stability in Parkinson’s.

2. Sit-to-Stand Exercises

Being able to stand up from a chair is important for maintaining independence. Parkinson’s can make this movement slower or more difficult, particularly when stiffness, weakness or reduced movement amplitude is present.

A basic sit-to-stand exercise involves practising moving from a seated position into standing and then returning to the chair in a controlled way.

When appropriate, focus on:

• placing your feet in a stable position
• moving towards the front of the chair before standing
• leaning forwards appropriately
• standing as tall as you comfortably can
• controlling the movement when sitting back down

Use a stable chair and appropriate support if needed. If standing from a chair is difficult or you are at risk of falling, practise this with a physiotherapist or another suitable person rather than attempting repeated exercises alone.

3. Marching on the Spot

Marching can be used to practise lifting the feet, transferring weight from one leg to the other and producing larger, more deliberate movements.

For some people, this can be incorporated into warm-ups or mobility exercises.

The movement can be adapted according to ability. For example, someone may practise smaller controlled marches while holding a stable support, while another person may be able to lift the knees higher or combine marching with arm movements.

Balance should always come first. If lifting one foot from the floor makes you unstable, seek advice before practising this exercise independently.

4. Large Stepping Exercises

Parkinson’s can cause movements to become smaller over time. Deliberately practising larger movements can therefore be useful within a Parkinson’s-specific exercise programme.

Stepping exercises can involve practising:

• large steps forwards
• steps backwards
• sideways steps
• changing direction
• weight shifting
• turning

These movements may help practise the skills needed for walking around the home, avoiding obstacles and changing direction.

Because stepping and turning can be challenging for people who have balance problems or freezing, this type of exercise should be adapted carefully. A physiotherapist can determine whether support or supervision is required.

5. Strength Training

Maintaining muscle strength can make everyday activities such as standing, climbing stairs, walking and getting in and out of a chair easier.

Strength exercises may use:

• body weight
• resistance bands
• light weights
• resistance machines
• functional movements such as repeated sit-to-stands

Exercises may focus on the legs, hips, back, shoulders and arms depending on the individual’s needs.

Strength training does not have to involve heavy weights. The amount of resistance, number of repetitions and choice of exercise should reflect your current strength, technique and medical circumstances.

If you have significant balance difficulties, joint problems, osteoporosis or another health condition that affects exercise, seek professional advice about which strengthening exercises are suitable.

6. Balance Exercises

Changes in balance are common in Parkinson’s and can increase the risk of falling. Balance training can therefore be an important part of an exercise programme.

Depending on ability, balance work may involve:

• controlled weight shifting
• stepping in different directions
• changing direction
• practising reaching
• standing with different foot positions
• combining movement with another simple task

Balance exercises need to be selected particularly carefully because an exercise that is appropriately challenging for one person could be unsafe for another.

If you have fallen previously, regularly lose your balance or need support when standing, do not practise challenging balance exercises without appropriate supervision.

7. Stretching and Flexibility Exercises

Muscle stiffness and changes in posture can make comfortable movement more difficult for people with Parkinson’s. Regular flexibility exercises can help maintain range of movement.

Common areas that may benefit from stretching and mobility exercises include the:

• chest and shoulders
• upper and lower back
• hips
• hamstrings
• calves
• ankles

Gentle trunk rotation can also be useful because rotation through the body is important when walking, turning and carrying out everyday tasks.

Stretching should feel controlled rather than painful. Avoid forcing a joint or bouncing aggressively into a stretch.

8. Cycling

Cycling is an aerobic activity that can help maintain cardiovascular fitness and leg movement.

Depending on balance and mobility, this may involve an outdoor bicycle, stationary exercise bike or another adapted form of cycling.

A stationary bike can be particularly useful for some people because it removes many of the balance demands associated with cycling outdoors.

However, cycling is not suitable for everyone. Consider balance, coordination, cardiovascular health and your ability to get safely on and off the equipment before beginning.

9. Tai Chi

Tai Chi combines slow, controlled movements with posture, balance and weight shifting. This makes it a useful form of physical activity for some people with Parkinson’s.

Tai Chi can involve:

• controlled weight transfer
• slow changes of direction
• postural awareness
• coordination
• controlled movement of the arms and legs

Classes can also provide a social way to stay active, which may make regular exercise easier to maintain.

Choose a class that matches your level of mobility and make the instructor aware of your Parkinson’s diagnosis and any difficulties you have with balance or movement.

10. Breathing and Posture Exercises

Parkinson’s can affect posture and movement through the chest and upper body. Exercises that encourage an upright posture, chest mobility and controlled breathing may therefore be useful as part of a wider exercise programme.

Examples may include:

• practising an upright seated or standing posture
• gentle shoulder and chest movements
• controlled deep breathing
• combining breathing with slow upper-body movements

Breathing difficulties can have many different causes and should not automatically be attributed to Parkinson’s. If you are experiencing new or unexplained shortness of breath, chest pain or other concerning symptoms, seek appropriate medical advice rather than relying on breathing exercises.

What Type of Exercise Is Best for Parkinson’s?

There is no single best exercise for Parkinson’s disease.

A balanced programme will normally include several different types of exercise because each has a different purpose.

Aerobic activities such as walking or cycling can support cardiovascular fitness. Strength exercises help maintain the muscles required for everyday activities. Balance and stepping exercises target stability and movement control, while stretching helps maintain flexibility.

The most effective programme is one that is safe, appropriate to your abilities and realistic enough to continue regularly.

How Much Exercise Should Someone With Parkinson’s Do?

Current Parkinson’s exercise recommendations encourage people who are able to do so to work towards around 150 minutes of moderate-to-vigorous exercise each week, incorporating different forms of aerobic activity, strength work, balance and flexibility.

However, this should not be treated as a target that every person with Parkinson’s must immediately achieve.

Your appropriate exercise level will depend on factors including:

• your current fitness
• your stage and symptoms of Parkinson’s
• balance and fall risk
• other medical conditions
• pain or fatigue
• medication and fluctuations in movement

If you are currently inactive, starting with manageable amounts of movement and building up gradually may be more appropriate than attempting a demanding programme immediately.

Exercises for Different Parkinson’s Symptoms

One of the reasons personalised exercise is important is that Parkinson’s does not affect everyone in the same way. The best exercises will depend partly on the symptoms that have the greatest impact on your everyday life.

Exercises for Parkinson’s Stiffness

Stretching, mobility exercises and larger movements may help maintain flexibility when stiffness is affecting movement.

Areas commonly addressed include the shoulders, chest, spine, hips and legs. Gentle rotational movements through the trunk may also be incorporated because rotation is important for walking and turning.

Exercises for Parkinson’s Balance Problems

Balance programmes may include weight shifting, multidirectional stepping, turning and controlled reaching.

For someone with significant balance problems, these exercises may need to be completed with a physiotherapist, next to a suitable stable support or with another person present.

Exercises for Walking and Gait

Walking exercises may work on stride length, direction changes, arm movement, posture and rhythm.

Some people with Parkinson’s also benefit from movement strategies or external cues when walking becomes difficult. The appropriate approach depends on the particular gait problem being experienced.

We explain these difficulties in more detail in our guide to Parkinson’s walking problems and gait stability.

Exercises for Strength

Strengthening the legs and hips can support activities such as walking, standing and climbing stairs, while upper-body exercises may help with posture and everyday tasks involving the arms.

A strengthening programme should be progressive but appropriate to the person’s abilities.

Exercises for Coordination

Coordination can be challenged through activities that involve deliberate arm and leg movements, stepping patterns or combining movements.

Some people may also practise dual-task activities, where a movement is combined with another task. However, multitasking can increase difficulty and may not be appropriate for someone who already has significant balance problems.

Is Walking Good for Parkinson’s Disease?

Walking can be an excellent form of exercise for people with Parkinson’s who can do it safely.

It provides aerobic activity while also practising a movement that is essential for everyday independence.

However, Parkinson’s can affect walking through symptoms such as shorter steps, shuffling, freezing, reduced arm swing, changes in posture and difficulty turning.

If these problems are present, a walking programme should address them rather than focusing purely on distance or speed.

Can Exercise Help With Parkinson’s Tremors?

Exercise is an important part of managing Parkinson’s overall, but it should not be presented as a treatment that will necessarily stop tremor.

The main benefits of an exercise programme may instead include maintaining strength, mobility, coordination, balance and confidence with movement.

If tremor is interfering significantly with everyday activities, discuss it with your Parkinson’s healthcare team so that your wider management plan can be reviewed.

How Can Physiotherapy Help With Parkinson’s?

Physiotherapy can play an important role in helping people with Parkinson’s maintain movement and independence.

Parkinson’s-specific physiotherapy can be particularly useful for people experiencing problems with balance, walking or everyday motor function. Physiotherapists with experience in neurological conditions can assess how Parkinson’s is affecting your individual movement and identify areas that need particular attention.

A neurological physiotherapy assessment may look at areas such as:

• walking and gait
• balance
• strength
• posture
• flexibility
• transfers such as getting in and out of a chair
• falls and fall risk
• movement strategies
• your current exercise routine

The physiotherapist can then build an exercise programme around your specific goals, symptoms and abilities rather than using the same programme for everyone.

Find out more about the types of physiotherapy used for Parkinson’s disease.

How to Exercise Safely With Parkinson’s

Exercise should challenge you appropriately without creating unnecessary risk.

Before starting or progressing an exercise programme, consider:

• whether you can complete the exercise without losing your balance
• whether you need a stable support or supervision
• how fatigue affects your movement
• whether medication fluctuations affect when you move most comfortably
• whether you have experienced falls or freezing
• other health conditions that could affect exercise
• whether the exercise environment is safe and free from trip hazards

Your abilities may also change over time. An exercise programme that worked well previously may need to be reviewed if your movement, balance, symptoms or general health changes.

Tips for Staying Active With Parkinson’s

Consistency is more valuable than choosing an exercise programme that is so difficult it quickly becomes unsustainable.

Try to find activities you genuinely enjoy and can realistically make part of your week. You might prefer walking outside, exercising at home, attending a class, cycling or working with a physiotherapist.

Other ways to make exercise easier to maintain can include:

• setting a regular time for activity
• exercising with a friend, partner or family member
• breaking activity into manageable sessions
• varying the types of exercise you do
• keeping track of your activity
• choosing activities that have a clear purpose or goal

If you struggle to know which exercises to choose, a neurological physiotherapist can help you establish priorities and build a manageable programme.

Parkinson’s Physiotherapy in Birmingham and the West Midlands

At Miranda’s Physio Steps, we provide specialist neurological physiotherapy for people living with Parkinson’s disease and other neurological conditions.

Treatment is tailored to the individual and may include work on strength, balance, walking, flexibility, posture and everyday movement depending on the difficulties you are experiencing.

We support people across Birmingham and the surrounding areas, helping individuals work towards practical goals that matter to their everyday lives.

Learn more about our neurological physiotherapy in Birmingham or contact Miranda’s Physio Steps to discuss whether neurological physiotherapy may be suitable for you.

Summary

Exercise is an important part of living well with Parkinson’s disease. Walking, strengthening, balance work, stretching, cycling, Tai Chi and other targeted movements can all have a place within an exercise programme.

The key is not to find one “perfect” Parkinson’s exercise. It is to build a varied programme that matches your current abilities, symptoms and goals and that can be adjusted as your needs change.

If Parkinson’s is affecting your walking, balance, strength or everyday movement, specialist neurological physiotherapy can help identify the areas that need attention and create a personalised plan to help you stay as active and independent as possible.