June 24, 2021

This blog is to raise awareness and increase education about this debilitating disease that affects more than 10 million people worldwide.

Parkinson’s disease is a progressive neurological disorder. It is a disorder of the nervous system which mainly affects the motor system.

The brains control over our motor functions is managed by groups of nerve cells (neurons) which are located within the substantia nigra in the brain. This is the area of the brain where the neurotransmitter dopamine is created.

Dopamine is responsible for the smooth and coordinated muscle movements of the body, and is vital for the regulation of the bodies movements.

When someone has Parkinson’s disease, the neurons of their substantia nigra have suffered damage and progressive degeneration. And as a result, the decreased amount of dopamine available creates a biochemical imbalance, which manifests with symptoms of movement and motor disorders such as tremor, rigidity, poor balance and coordination.

The cause of this damage to the nerve cells in the substantia nigra, the damage to the neurons that causes lowered dopamine levels, is currently unknown.


The exact cause of Parkinson’s is unknown. Though it is thought that it may have both genetic and environmental components.
Some scientists also think that viruses can trigger Parkinson’s.

While there’s no known cause, research has identified risk factors, including:

  • Environment and toxins: research has shown a link between exposure to certain chemicals and toxins, that may increase the risk of  Parkinson’s disease.
  • Genetics: people who have family members with Parkinson’s disease may be more likely to develop Parkinson’s themselves.
  • Age: Parkinson’s disease usually appears in those around 60 years of age, and though it can come on earlier it only occurs before the age of 40 in 5-10 percent of cases.
  • Sex: Men are 1.5 times more likely to get Parkinson’s disease than women.
  • Head injury: people who experience head injuries or repeated blows to the head may be at a higher risk of developing Parkinson’s disease.


The symptoms of Parkinson’s disease usually develop slowly over years, and the progression of symptoms will often vary from person to person, due to the diversity of the disease.

The main symptoms of Parkinson’s disease are:

  • Shaking or tremor
  • Muscle rigidity or stiffness
  • Slowing of body movements
  • Poor posture
  • Balance problems

Parkinson’s disease is a progressive disease, which means the symptoms of the disease often progress in stages and peoples condition will typically worsen over time.

As the disease continues to progress, additional symptoms can occur such as speech changes, difficulties with handwriting, trouble chewing and/or swallowing, memory loss, constipation, trouble sleeping, loss of bladder control, anxiety, depression, inability to regulate body temperature, sexual dysfunction, decreased ability to smell, restless legs and muscle cramps.

Disease Stages:

During the first stage of Parkinson’s disease, symptoms can be mild and may go unnoticed as they may not interfere with daily life.

The second stage of Parkinson’s is when people will often experience the classic symptoms of tremors, shaking, and muscle stiffness. These symptoms can begin to interfere with daily life and regular daily activities may begin to take longer. Changes in posture, gait and facial expressions may also become more pronounced during this stage too.

During the third stage of Parkinson’s symptoms will often become even more pronounced. Movements and daily activities will become noticeably slower, and balance problems may begin to cause a higher incidence of falls.

The fourth stage of Parkinson’s is often when symptoms become increasingly prominent and begin to interfere with independence and the ability to live alone or carry out daily activities without aids and assistance. The fifth stage of Parkinson’s is the most most advanced stage, where severe symptoms will usually confine people to a wheelchair, and may even induce confusion, delusions, or hallucinations. At this stage, full time care will often be a necessity.


There’s no specific test for diagnosing Parkinson’s disease. Diagnosis is made based on health history, a physical and neurological exam, as well as a review of signs and symptoms.
Whilst it is true that many of the symptoms of Parkinson’s can also be indications of various other disorders, it is always best to visit your doctor if you have any unexplained symptoms of tremors, stiff muscles, lack of balance or changes in your movement.

Treatment & Management:

There is currently no cure for Parkinson’s disease. Unfortunately it is a chronic disease which worsens over time.

Due to the diversity of the disease, Parkinson’s treatment regimes are often tailored to the individuals needs. Though it is generally agreed that a multi-disciplinary approach, with a team of medical and health professionals, is best.

This team will often include a general practitioner, a neurologist, a physiotherapist, a psychologist, a dietitian or nutritionist, and other complimentary medicine practitioners.

Whilst there is no cure for Parkinson’s disease, symptoms can be treated and managed with success.


Parkinson’s & Physiotherapy:

Due to the fact that many of the symptoms of Parkinson’s disease are related to disorders in movement, Physiotherapy is a vital aspect of Parkinson’s management.

In the management of Parkinson’s disease, Physiotherapy aims to maintain and improve levels of function, independence, and quality of life. Mainly focusing on exercise and education, along with movement and motor skill training.

Exercise has been proven to maintain the health and well-being of those who have Parkinson’s. Physical and aerobic activity can slow down motor skill degeneration and combat depression.
Whilst strength and resistance training can improve balance, gait, and physical performance. And can also decrease the speed of the progression of the disease stages and movement changes.

Research has shown that exercising for at least two and a half hours a week can slow the progression of Parkinson’s disease. And has even shown that certain cardiovascular exercises can aid in retraining large and everyday movements.

Physiotherapy also focuses on motor skill training, such as focusing on the processes of everyday tasks, in order to retrain the brain and body to accomplish these skills.
Also dual task training, which is a targeted retraining practice of completing two things at the one time. A task that is particularly difficult for those with Parkinson’s and has been proven to be effective in improving and maintaining cognitive function.

And last but certainly not least, as Parkinson’s disease impairs balance and coordination- therefore significantly increasing falls risk, balance training and falls education are another vital element of Physiotherapy’s management of Parkinson’s.

Overall, Physiotherapy is a highly important element in the treatment and management of Parkinson’s disease. As it not only works to slow the progression of and manage the symptoms of the disease, but it also increases the quality of life of patients with Parkinson’s.

Another great resource for information on Parkinson’s disease is through Parkinson’s NSW website. Please check out their Parkinson’s Information Sheets

If you are concerned about your health and wellbeing, or if you have questions about any symptoms you or a loved one may be experiencing. Please know that our team of professional mobile Phsyiotherapists are here to help. We have years of experience in the management of Parkinson’s disease, and we are here to answer any questions you may have, or to help you in any way that we can.
Stay safe, active, and well!

Danielle Meldrum
Director and Senior Physiotherapist
MoveWell 2 LiveWell

0405 557 100

Please note that the information contained within this blog is not intended as a substitute for professional medical advice, diagnosis, or treatment. And that MoveWell 2 LiveWell advises to always seek the advice of your Physiotherapist, doctor, or other qualified healthcare providers with any questions or concerns that you may have about your health and your medical condition.