Balance Isn’t Optional in Parkinson’s Disease
- Dr. Alex Armitage
- Dec 22, 2025
- 4 min read
Updated: Jan 2
By Dr. Alex Armitage, DNP, CNL, APRN, FNP-BC., Passionate advocate for holistic well-being.
Try something for a moment...
Stand up and see if you can balance on one foot without holding on. Can you do it? It may seem like such a simple challenge that it hardly feels worth trying — but I dare you. You might be surprised to find yourself reaching for the wall, wondering when something that once felt automatic became harder.
Balance is easy to take for granted — until it isn’t. And in Parkinson’s disease, it often changes earlier and more subtly than people expect.
That’s why balance deserves more attention than it usually gets.
Exercise is the only disease-modifying treatment we currently have for Parkinson’s disease. Medications help symptoms. Procedures can help selected symptoms. But exercise — especially intentional, targeted movement — is what has been shown to change the trajectory of the disease over time.
And balance is not separate from that conversation.
It is the conversation.
In Parkinson’s, balance does not decline because you are “doing something wrong.” It changes because the brain systems that control posture, reflexes, and automatic movement are affected by the disease itself. That means balance has to be trained — on purpose.
Let’s talk about what actually helps.
1. Task-Specific Balance Training in Parkinson's
Balance improves when you practice the very skills that challenge it. Research consistently shows that task-specific balance training improves postural stability and reduces fall risk in Parkinson’s disease.
This includes simple, intentional practices such as:
Standing on one leg (near a counter or wall for safety)
Heel-to-toe walking to steady gait
Weight-shifting side to side and front to back
Practicing turns slowly and deliberately
Dual-task training (walking while counting or talking), because real life is rarely one task at a time
Programs such as Tai Chi, yoga adapted for Parkinson’s, and Parkinson’s-specific physical therapy all have strong evidence for improving balance, flexibility, and confidence.
A helpful rule: consistency matters more than intensity. Five to ten minutes most days is far more effective than one long session once a week.
2. Strength Protects Balance
Balance is not just a neurological issue — it is also a strength issue.
In Parkinson’s, people commonly lose strength in the hips, ankles, and core. This matters because those muscles are what help you recover when balance is challenged.
Progressive resistance training has been shown to improve mobility and reduce fall risk in Parkinson’s disease. Practical examples include:
Sit-to-stand practice
Calf raises
Core stabilization, seated or standing
Think of strength as your margin of safety. Strong muscles act like shock absorbers, buying you precious seconds to regain control instead of falling.g.
3. Gait, Posture, and “Automatic Movement” Matter
One of the less obvious effects of Parkinson’s is that automatic movement becomes smaller and slower. Arm swing shrinks. Steps shorten. Posture tips forward. Turning takes more effort.
These changes affect balance in important ways:
Shuffling increases tripping risk
Reduced arm swing alters center of gravity
Stooped posture shifts weight forward
Freezing of gait increases fall risk during starts and turns
Cueing strategies can help bypass impaired automatic pathways:
Visual cues like lines on the floor
Auditory cues such as rhythm or a metronome
Verbal cues like “big steps” or “stand tall”
Physical therapists trained in Parkinson’s care (such as LSVT BIG or PWR!) are especially helpful here. When you move, think bigger — lift the feet, swing the arms, exaggerate the motion.
4. Non-Motor Symptoms Can Undermine Balance
Balance is not only about muscles and movement. Several non-motor symptoms of Parkinson’s directly affect stability, including:
Drops in blood pressure when standing
Vision changes, including double vision
Fatigue that reduces strength and reaction time
Anxiety, which increases stiffness and cautious movement
Hydration, medication timing, slow position changes, and regular vision checks matter more than many people realize. If dizziness, lightheadedness, or near-falls are happening, those are signals — not inconveniences. They deserve medical attention.
5. Clean Up Your Environment
Even good balance can be defeated by a poor environment.
Simple changes can dramatically reduce fall risk:
Remove loose rugs and clutter
Improve lighting, especially at night
Install grab bars in bathrooms
Use chairs with arms for easier transfers
Wear supportive shoes; avoid socks or slippers on slick floors
This is not about “giving in.”It is about protecting independence so energy can be spent living, not recovering. To download a Falls Prevention Worksheet to help secure your environment go to https://www.inyangahealth.com/guides-worksheets. This is a great tool to help fall-proof your home.
The Bigger Picture: Balance Is Brain Health
Balance training helps the brain adapt and remodel. It strengthens the reflexes that keep us upright and engaged in the world.
Balance is something you practice, protect, and strengthen over time. Keep at it!
Trusted Resources
· Inyanga Health: Practical education, worksheets and resources to help manage Parkinson's every day InyangaHealth.com fall-prevention resources👉https://www.inyangahealth.com/guides-worksheets
· Parkinson’s Foundation: Practical education, exercise guidance, and fall-prevention resources👉 parkinson.org
· American Parkinson Disease Association: Safety tips, local programs, and educational materials👉 apdaparkinson.org
· Centers for Disease Control and Prevention (CDC STEADI Program): Evidence-based fall prevention strategies for older adults👉 cdc.gov/steadi
Living with Parkinson’s is not something to be managed once — it’s something navigated over time. Support works best when it’s steady, trustworthy, and easy to return to.
In the coming months, Inyanga Health will be expanding into a space where people living with Parkinson’s — and those who love them — can access deeper education, guided tools, and a supportive community grounded in whole-person care.
For now, you’re always welcome to explore the growing library of resources at www.inyangahealth.com under the guides tab
This space is being built with you in mind.
