Parkinson’s Disease Physiotherapy in Burlington: Guide to Treatment & Exercises

Cogent Rehab Blog

Folarin Babatunde PT PhD MScSEM MScPT BScPT

February 21, 2025

Introduction

Parkinson’s disease (PD) is the second most common degenerative brain disorder after Alzheimer’s disease, affecting more than 6.2 million adults worldwide. In Canada, over 110,000 people live with Parkinson’s, and this number is expected to double by 2031. Each year, about 6,600 Canadians are newly diagnosed—most over age 60, but about 10% develop symptoms before 50.

Because PD affects movement and balance, people are at higher risk of falls and related injuries. While there is currently no cure, treatment options include medications, surgery, physiotherapy, and community-based exercise programs. Physiotherapists play a key role by helping people with PD manage symptoms, stay active, and maintain independence.

Physiotherapist guiding a person with Parkinson’s disease through elbow exercises to improve strength and endurance

What Is Parkinson's Disease?

Parkinson’s disease is a chronic, progressive neurological condition linked to the loss of nerve cells in the brain that produce dopamine—a chemical messenger essential for movement, mood, decision-making, and coordination.

Low dopamine levels lead to symptoms such as tremors, stiffness, slowness of movement, and difficulty walking. Though the disease worsens over time, most people with PD do not die from it.

The course of PD varies:

• Some people experience gradual decline over 20–30 years.

• Others may progress more quickly within 5–10 years.

While the exact cause is unknown, risk factors include family history, aging, and exposure to toxins.

Common Signs and Symptoms of Parkinson's Disease

Parkinson’s disease symptoms are grouped into motor symptoms (movement-related) and non-motor symptoms (affecting other body systems).

Motor Symptoms of Parkinson’s Disease

These affect movement, posture, and coordination. They often begin subtly and worsen over time.

Motor Symptom	Description
Tremors	Involuntary shaking, often starting in one hand or limb at rest. Present in up to 100% of cases.
Rigidity	Muscle stiffness that can be painful and limit movement.
Akinesia/Bradykinesia	Slowness of movement, difficulty starting motion, or “freezing.”
Postural Instability	Balance problems leading to a higher risk of falls.
Shuffling Gait	Short, small steps with reduced arm swing.
Stooped Posture	Rounded back and forward-leaning stance.

Non-Motor Symptoms of Parkinson’s Disease

These may appear years before movement problems and can impact mood, sleep, and daily function.

Non-Motor Symptom	Description
Mood and Cognition	Depression, anxiety, memory issues, or slowed thinking.
Sleep Problems	Insomnia, vivid dreams, or restless sleep.
Autonomic Dysfunction	Bladder urgency, constipation, or low blood pressure.
Speech Changes	Softer voice, slurred speech, or difficulty projecting.
Swallowing Difficulties	Trouble eating, drinking, or swallowing safely.
Fatigue	Persistent tiredness not relieved by rest.

How Is Parkinson’s Disease Diagnosed?

There is no single test for PD. Diagnosis is based on consideration of multiple factors including:

• Medical history and neurological exam.

• Motor symptoms (Tremors, Rigidity, Akinesia, Postural Instability due to balance issues).

• Symptom improvement with PD medications.

• Symptoms starting on one side of the body.

Referral to a neurologist is often necessary when Parkinson's disease is suspected.

Stages of Parkinson’s Disease (Hoehn & Yahr Scale)

Stage One - Mild symptoms, one side of the body affected

During this initial stage, the person has mild symptoms that generally do not interfere with daily activities. Tremor and other movement symptoms occur on one side of the body only. Changes in posture, walking and facial expressions occur.

Stage Two - Symptoms on both sides, walking and posture changes

Symptoms start getting worse. Tremor, rigidity and other movement symptoms affect both sides of the body or the midline (such as the neck and the trunk). Walking problems and poor posture may be apparent. The person is able to live alone, but daily tasks are more difficult and lengthier.

Stage Three - Mid-stage, balance loss, mild to moderate disability

Considered mid-stage, loss of balance (such as unsteadiness as the person turns or when he/she is pushed from standing) is the hallmark. Falls are more common. Motor symptoms continue to worsen. Functionally the person is somewhat restricted in his/her daily activities now, but is still physically capable of leading an independent life. Disability is mild to moderate at this stage.

Stage Four - Severe symptoms, significant help needed, may use cane/walker

At this point, symptoms are fully developed and severely disabling. The person is still able to walk and stand without assistance, but may need to ambulate with a cane/walker for safety. The person needs significant help with activities of daily living and is unable to live alone.

Stage Five - Advanced stage, bedridden or wheelchair-bound, full-time care required

This is the most advanced and debilitating stage. Stiffness in the legs may make it impossible to stand or walk. The person is bedridden or confined to a wheelchair unless aided. Around-the-clock care is required for all activities.

Physiotherapy for Parkinson's Disease in Burlington

Builds muscle power and reduces motor impairment. May involve weights, resistance bands, or aquatic therapy.

Patient with Parkinson’s disease performing strength training with a physiotherapist using resistance bands.

Balance and Flexibility Training in Burlington Physiotherapy

Balance exercises improve stability and reduce fall risk. Stretching helps offset stiffness in hips, hamstrings, and calves.

Gait Training and Cueing for Parkinson’s Patients

Strategies improve stride length, walking speed, and help overcome “freezing.”

Amplitude Training (LSVT BIG) in Parkinson’s Physiotherapy

Exaggerated movements retrain muscle control and reduce shuffling.

Community-Based Parkinson’s Exercise Classes in Burlington

Programs such as dance, cycling, and boxing provide both physical and social benefits.

Group of people with Parkinson’s disease participating in a community exercise class to improve mobility and social connection.

Can Parkinson’s Disease Be Prevented?

Currently, there is no way to prevent PD. However, research shows that regular, supervised exercise:

• Improves walking, balance, strength, and flexibility.

• Enhances mental well-being.

• Slows decline in physical function.

It’s important to maintain exercise long-term, as benefits fade when programs stop. Working with a physiotherapist and joining community exercise classes can help maintain progress.

Regain Your Balance and Independence

At Cogent Physical Rehabilitation Center in Burlington, our physiotherapists provide evidence-based care to help people with Parkinson’s disease in Burlington and Halton region maintain independence and improve quality of life. Don’t wait until symptoms progress — start physiotherapy for Parkinson Disease in Burlington today.

Visit us at 3077 New Street, Suites 300-302, Burlington, Ontario

Call us today: (905) 635-4422

Email: contactus@cogentrehab.com

Learn more about our Neurological Physiotherapy Services and Senior Care Physiotherapy Programs.

Book An Appointment Today

FAQs About Parkinson’s Disease Physiotherapy in Burlington

Q1: Can physiotherapy slow the progression of Parkinson’s disease?

Physiotherapy cannot cure PD, but targeted exercise slows physical decline, improves mobility, and supports independence.

Q2: What is the best exercise for Parkinson’s disease?

Aerobic training, strength training, balance work, and programs such as LSVT BIG are proven effective.

Q3: How often should someone with Parkinson’s disease see a physiotherapist?

It varies by stage. Early stages may require weekly sessions; advanced stages often need ongoing support.

Q4: Can community-based exercise classes help with Parkinson’s disease?

Yes. Programs such as dance, cycling, and boxing improve mobility, mood, and social engagement.

Q5: When should someone with Parkinson’s disease start physiotherapy?

Physiotherapy is beneficial at all stages, but starting early builds habits that delay decline and support long-term independence.

Sources

1. Palamara G, Gotti F, Maestri R, et al. Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of balance dysfunction in Parkinson disease: a randomized controlled study with 6-month follow-up. Arch Phys Med Rehabil. 2017;98(6):1077–1085.

2. Keus S et al. On behalf of the Guideline Development Group. European Physiotherapy Guideline for Parkinson’s Disease. 2015.

3. Rajan R, Brennan L, Bloem BR, et al. Integrated care in Parkinson's disease: a systematic review and meta‐analysis. Mov Disord. 2020;35(9):1509–1531.

4. States RA, Sweeny TL, Rossi A, et al. Physical functioning after 1, 3, and 5 years of exercise among people with Parkinson's disease: a longitudinal observational study. J Geriatr Phys Ther. 2017;40(3):127–134.

5. Rafferty MR, Prodoehl J, Robichaud JA, et al. Effects of 2 years of exercise on gait impairment in people with Parkinson disease: The PRET-PD randomized trial. J Neurol Phys Ther. 2017;41(1):21–30.

6. Voet NB, van der Kooi EL, van Engelen BG, Geurts AC. Strength training and aerobic training for muscle disease. Cochrane Database Syst Rev. 2019;12:CD003907.

7. Schootemeijer S, van der Kolk NM, Bloem BR and dr Vries NM. Current Perspectives on Aerobic Exercise in People with Parkinson's Disease. Neurotherapeutics. 2020;17L1418-1433.

8. Jansen AE, Koop MM, Rosenfeldt AB and Alberts JL. High intensity aerobic exercise improves bimanual coordination of grasping forces in Parkinson's disease. Parkinsonism Relat Disord. 2021;87:13-19.

9. Rosenfeldt AB, Koop MM, Penko AL, Hastilow K, Zimmerman E, Schindler D and Alberts JL. Community-based high-intensity cycling improves disease symptom in individuals with Parkinson’s disease: A six-month pragmatic observational study. Health Soc Care Community. 2022;30:e6122-e6134