Physical Therapy Tips for Posture Improvement in Parkinson’s Disease

Poor posture is a hallmark feature of Parkinson’s disease. This stooped positioning has been associated with increased muscle rigidity or stiffness. The typical Parkinson’s posture includes: forward head, rounded shoulders, increased thoracic kyphosis, increased flexion of the trunk, and bending of the knees.

Stooped posture

How can poor posture affect you?

  • Difficulty speaking clearly and loudly
  • Difficulty with moving your neck and upper extremities
  • Change your perception of your body’s position in space
  • Can alter balance and lead to falls from having your weight shifted forward
  • Decrease strength of postural muscles
  • Headaches and TMJ pain
  • Difficulty swallowing

How to help correct you posture!

–          Stretching:  The forward flexed posture associated with Parkinson’s disease decreases the flexibility of the muscles on the anterior side of the body including areas of the chest, shoulders, and neck.  Stretches that focus on opening of the chest, neck, and upper back will promote correction of the forward flexed posture.

–          Strengthening:  Due to the fact that the anterior body muscles decrease in flexibility, the opposing back muscles are unable to perform their jobs maintaining a straight back and tend to become overstretched. This in turn leads to weakness.  Improving the strength of your back musculature will help keep you upright for a longer period of time.

Here are some exercises that you can do at home to help correct your posture…

To perform this exercise, bring your head and neck back aligning your ears with your shoulders. Keep your chin tucked into your body. This promotes straightening of your neck to decrease forward head posturing
Chin Tuck

Chin Tuck  –  The goal of a chin tuck is to decrease forward head posture. To perform a chin tuck, sit up as straight as possible. Next move your head and neck up and back, trying to bring your ears into alignment over your shoulders. Tuck your chin in towards your body. **This tends to make the unpleasant “double chin” but also means you have successfully performed a chin tuck!** Repeat 10-20 times daily.

Scapular Retraction

Scapular Retraction – The goal of the scapular retraction is to decrease rounding of the shoulders. To perform scapular retraction, again, sit up as straight as possible. Bend your elbows at your side. Pull your elbows back behind your body as if you are rowing back. Keep your shoulders down away from your ears. As the arms move back, try to pinch your shoulder blades together. Repeat 10-20 times daily.

Thoracic extension
Thoracic extension

Thoracic Extension – The goal of thoracic extension is to decrease rounding of the upper back known as “increased kyphosis”. To perform this exercise, sit in a chair that has a low back that will act as a hinge point for your spine. Clasp your hands behind your head and open your elbows out wide. Lean up and back over the chair. Lastly tilt your head up towards the ceiling. Take a deep breath in! Exhale and repeat 5-10 times daily.

Learn more about Physical Therapy for Movement Disorders…

For more information, please contact Shands Rehabilitation at the Center for Movement Disorders and Neurorestoration @: 352-294-5385

Stretching in exercise class!                   Mr. Acton straightens up!   

Big smile from Mr. Murkerson!

Resources:

Schenkman M. Reply: A randomized controlled trial of Movement strategies compared with exercise for people with Parkinson’s disease. Mov Disord. 2010;25(4):524.

Vaugoyeau M, Viallet F, Aurenty R, et al. Axial rotation in Parkinson’s disease. J Neurol Neurosugr Psychiatry. 2006;77:815-21.

Schenkman M et al. Spinal flexibility and balance control among community-dwelling adults with and without parkinson’s disease. J Gerontol Biol Sci Med Sci. 2000;55(8):M441-5

Schenkman M, Cutson TM, Kuchibhatla M, et al. Exercise to improve spinal flexibility and function for people with Parkinson’s disease: a randomized, controlled trial. J Am Geriatr Soc.1998;46(10):1207-16.

Vaugoveau M, Hakam H, Azulay JP. Proprioceptive impairment and postural orientation control in parkinson’s disease. Hum Mov Sci. 2011;30(2);405-14

Special Thanks to Tulsi Patel, SPT for blog research & writing and the MDC Parkinson’s exercise group Allstars!

Tulsi and our all star volunteer Danielle

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