There are a few key steps to successfully manage Parkinson's disease, a progressive neurological disorder.

Parkinson's disease is a neurological disorder that effects approximately 2 percent of the population. The onset of symptoms is slow and often involves one side of the body, at least in the initial stages. A small percentage of patients can develop symptoms as early as their 20s, but the average age of onset is between 50 and 60 years old.


The primary signs and symptoms that characterize this disease are tremors, stiffness, impaired coordination and loss of balance. Common secondary problems include difficulties walking, transitioning from one activity to another, and swallowing. Individuals with Parkinson's also can have a hard time making their voice loud enough, experience autonomic nervous system dysfunction, and have gastrointestinal and cardiovascular changes.


There are a few key steps to successfully manage this progressive disorder. One of the primary lines of defense against Parkinson's disease is finding the best physician who will help you navigate the road ahead. The first step is to find a movement disorder specialist -- a neurologist that specializes in Parkinson's.


A second important step is to be as educated as you can be. A starting point of information can be found at the American Parkinson's Disease Association (apdaparkinson.org). The Internet has allowed access to an overwhelming amount of information, some of it not terribly accurate or useful. Having a dependable starting place is invaluable. The APDA is a resource for the most current research, to find local support groups and to locate health-care providers that specialize in the treatment of patients with Parkinson's.


A third step relies solely on the patient. Now that you are informed and can be the best advocate for yourself, there are several important activities that will help maintain the level of mobility needed to remain active at home, work and in the community. Research has proven that people with Parkinson's disease who participate in a regular exercise program, regardless of the severity of their disease, are able to maintain their level of activity longer, have less depression, and experience an overall improved sense of well-being compared to those who aren't active.


There are three types of exercise that have shown to make the most impact on the overall improvement of mobility. These exercises simply include walking, strengthening and stretching.


Walking as an exercise provides cardiovascular wellness and, when practiced correctly, can provide lasting improvements in ease of movement. To start, pick a flat and quiet area to walk. The goal is to walk at a consistent pace that is slightly faster than your normal pace. This can be achieved best when walking while listening to fast music, while walking on a treadmill, or by making a conscious effort to take longer strides, land on your heels, and accentuate swinging of the arms.


Improving mobility at the trunk through stretching is important for maintaining an upright posture, which is necessary for good balance. Simple adjustments like sleeping on only one pillow, or reaching overhead when lying in bed can be helpful.


The stronger your muscles are, the more power you have to stand up straight, get up from a chair, walk faster, and go up and down stairs. Practice standing up from a chair several times in a row to target crucial muscles in your legs.


Simple adjustments to your daily routine combined with the medical management provided by your movement disorder specialist can make a significant impact on daily mobility.


The most difficult phase of any new routine is getting started. Tips for taking that necessary step include finding an activity that you enjoy, making a schedule, teaming up with someone, keeping an exercise journal, exercising when you feel your best, being patient with yourself and practice, practice, practice!


Lisa Brown PT, DPT, is physical therapist who specializes in the treatment of patients with neurological disorders at Massachusetts' Spaulding Framingham Outpatient Center. She holds advanced certification in neurology and the treatment of vestibular and cervicogenic disorders. She can be reached at lbrown12@partners.org or at 508-872-2200 ext. 4258.