Home-based exercise programs for Parkinson’s disease: Accessible exercise from the comfort of home

The Bottom Line

  • Parkinson’s disease is a progressive and debilitating disease that affects the mobility and everyday lives of over six million people worldwide.
  • Exercise is important for managing Parkinson’s disease.
  • Compared to usual care, home-based exercise programs can improve walking speed and balance-related activities by a small amount in people with Parkinson’s disease.
  • Home-based and centre-based exercise programs may be equally effective in improving balance-related activities and quality of life.
  • The impacts of Parkinson’s disease can be frustrating—talk to a physiotherapist or health care provider about whether home-based exercise might be right for you.

Exercise can be a great way to manage Parkinson’s disease, but for some, sticking to an exercise plan can be a challenge. Exercising at home may remove a few of the barriers that people face, paving the way to better health outcomes.


Parkinson’s is a life-long, debilitating disease that affects the nervous system (1;2), leading to problems with balance, movement, and posture, as well as symptoms such as shaking (tremors) and muscle stiffness. These issues can increase a person’s risk of falling and tend to get worse over time (3;4). Currently, Parkinson’s affects over six million people worldwide. With this number expected to double over the next 20 years, Parkinson’s sits atop the list of the most rapidly rising neurological disorders (1;2).


Although there is no cure for Parkinson’s, physiotherapy, which includes a variety of exercises, has proven to be a useful management strategy (1;5). But for those with chronic illnesses, mobility issues, or limited access to health services, regular exercise can be difficult, particularly when it requires leaving home to exercise at a community or medical centre or facility. This is where exercise carried out at home can be extremely valuable, particularly because it can require minimal equipment and resources, and can be continued over a long period of time (1).


This brings us to two interesting questions. First, what are the benefits of home-based exercise in people with Parkinson’s? And second, how does exercising at home stack up against centre-based exercise?


What the research tells us

A recent systematic review looked at whether home-based exercise—prescribed by a physiotherapist or other health care provider—improves balance-related activities and quality of life in adults with mild to severe Parkinson’s disease, but without cognitive impairment. Home-based exercise (when almost 70% of exercise was done at home) was compared to usual care and centre-based exercise (completed at a medical centre, community centre, private clinic, etc.). Exercises included balance, walking, range of motion, and strength activities.


The review found that home-based exercise programs can improve walking speed and the ability to perform balance-related activities by a small amount immediately after the end of the program. However, these improvements appear relatively short-lived, making the case that exercise may need to be continued to see lasting benefits. Home-based exercise can also improve quality of life by a small amount. Interestingly, this benefit was not seen right away, but instead appeared at six to 46 weeks after the exercise program was completed.


What’s more, a few small studies within the review demonstrated that comparable home vs. centre-based exercise programs produced similar effects on balance and quality of life immediately after program completion (1).


If you or a loved one have Parkinson’s disease, consider speaking to a physiotherapist or health care provider about whether home-based exercise programs are a good fit for you. They can work with you to create an exercise plan that’s easily accessible, tailored, affordable, and most importantly safe.

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References

  1. Flynn A, Allen NE, Dennis S, et al. Home-based prescribed exercise improves balance-related activities in people with Parkinson’s disease and has benefits similar to centre-based exercise: A systematic review. J Physiother. 2019; 65(4), 189-199. 
  2. Dorsey E, Sherer T, Okun MS, et al. The emerging evidence of the Parkinson pandemic. J Parkinson’s Dis. 2018; 8:S3–S8. 
  3. Mehrholz J, Kugler J, Storch A, et al. Treadmill training for patients with Parkinson’s disease (Review). Cochrane Database Syst Rev. 2015; 9:CD007830. doi: 10.1002/14651858.CD004876.pub4.
  4. Johnell O, Melton LJ, Atkinson EJ, et al. Fracture risk in patients with parkinsonism: A population‐based study in Olmsted County, Minnesota. Age Ageing. 1992; 21(1):32‐38.
  5. Keus S, Munneke M, Graziano M, et al. European Physiotherapy Guideline for Parkinson’s Disease. The Netherlands: KNGF/ParkinsonNet. 2014. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.