Physical Activity for Advanced Parkinson’s: Safe Exercises and Benefits
Neurological DisordersParkinson's Disease

Physical Activity for Advanced Parkinson’s: Why and How to Stay Active

Physical Activity for Advanced Parkinson’s: Why and How to Stay Active
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Published on March 18, 2026
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Advanced Parkinson’s disease can make it harder to get around, and you may need help to get ready for the day, prepare meals, and go to doctor's appointments. But experts have found that if you exercise consistently over years, you can slow down symptoms that steal your independence.

“Research shows that exercise can significantly improve mobility and quality of life, and even delay the disease process,” says Sarah Hawks, a physical therapist and specialist in neurologic physical therapy at Cleveland Clinic in Ohio.

Learn the benefits of physical activity for people with advanced Parkinson’s, as well as exercises you can try to stay active and mobile.

Benefits of Exercise for Advanced Parkinson’s

Far from an add-on therapy, exercise has a vital role in the treatment of advanced Parkinson’s.

 Physical activity can improve balance, strength, and even pain, says Hawks.
Benefits of exercising regularly with advanced Parkinson’s include improvements in these areas:

  • Mood Less depression and anxiety

  • Sleep Better sleep quality and increased slow-wave sleep

  • Movement Better balance, flexibility, stamina, and coordination
  • Breathing Stronger and less rigid chest muscles, allowing easier breaths and protection against pneumonia

Consistent physical activity can also mean fewer falls and freezing episodes, plus less brain cell damage.

 And exercise strengthens your bones, so if you do fall, you may have a smaller chance of fractures.

Adapting Activity for Safety and Success

To stay as safe and independent as possible, you can make some changes to how you get around and do daily tasks. “It is essential to have a multidisciplinary healthcare team to support you along your journey, including a neurologist and rehab specialists like physical, occupational, and speech therapists,” says Hawks.

Hawks recommends doing exercises next to a countertop or sturdy chair for extra support. You can also ask your physical therapist how to create a fall-proof exercise zone at home, which can include grab bars and nonslip surfaces.

“If someone's balance and strength are significantly impaired, chair exercise can be an excellent option,” says Hawks. You could also check out existing exercise or dance programs for people with Parkinson’s in your area or online.

No matter what, focus on what you can do instead of what you can’t. Your physical therapist can assess your safety, recommend specific exercises based on your physical challenges, and even train caregivers to assist as needed, says Hawks.

For example, caregivers can help you stay safe with movement using these methods:

  • Staying close during exercise
  • Keeping you focused on the task
  • Reminding you to take large steps
  • Monitoring for tripping hazards, like pets underfoot

Types of Exercise for Advanced Parkinson’s

If you want to lessen your Parkinson’s symptoms through physical activity, include aerobic exercise, strengthening, balance training, and stretching for flexibility.

Aerobic Activity

Aerobic exercise gets your heart pumping. You can use stationary equipment to get this activity, too, says Julie Lyne, a physical therapist and clinical specialist in neurologic physical therapy with SSM Health Therapy Services in Madison, Wisconsin. Lyne recommends these options:

  • Recumbent bikes
  • Seated steppers
  • Treadmills
  • Arm bikes
  • Seated weight machines
  • Recreational equipment
You could also ask your physical therapist about dancing for exercise or using a special treadmill that supports your body weight to build balance and speed.

Functional Exercises

Functional exercises help you stay strong enough for the activities of daily living, like getting dressed and brushing your teeth.

 Lyne often suggests these functional exercises for specific skills:
  • Sit-to-Stand Practicing getting in and out of a chair

  • Stepping in Formation Using box steps, figure 8s, or simple dance sequences
  • Seated Movement Patterns Adding in handling an object with your hands
  • Poles and Rolling Walkers Moving to the beat of a metronome or music
  • Walking as a Character Marching like a soldier or a king, for example
  • Managing Obstacles Walking into a corner or closet, or turning around, stepping over thresholds, and climbing stairs
  • Voice, Music, and Hand Gestures Accentuating whole-body movements

Resistance Training

Resistance training (also called strength training) includes anything that builds your muscles, like push-ups, squats, and lifting weights.

 This type of strengthening exercise works even better for Parkinson’s when you add a level of instability, like standing on a balance pad or sitting on an exercise ball.

Seated or Lying Movement

For people with advanced Parkinson’s, exercising while seated (like chair yoga) or lying down can help you get stronger, says Hawks. Seated or lying activities could include the following:

  • Shoulder Blade Squeeze Sit on the edge of a chair, stretch your arms to each side, then pull your arms backward, squeezing your shoulder blades together.
  • Bridge Lying on your back with your knees bent and feet flat on the floor, squeeze your buttock muscles and raise your hips.
  • Back Extension Lying on your stomach, lift your upper body and support your weight on your forearms.

Aquatic Therapy

When you exercise in water, you don’t feel the pull of gravity as much, which can lessen joint strain, balance problems, and the fear of falling. Water activities offer both resistance and aerobic benefits — just walking around in water takes some effort.

You can try water aerobics, dance, or simple swimming or pool running. Almost every exercise can be done in water, with fewer risks of injury and maybe a little more fun.

Action Observation

Some research shows that people with Parkinson’s can benefit from simply watching others exercise — a therapy called action observation, says Lyne. Experts think that this works because your brain has mirror neurons: brain cells that like to copy what you see.

By watching other people do a movement first, you may be able to do it better when you try.

 “In kind, people with Parkinson’s may respond to virtual reality programs for daily life events such as walking, interacting with others, or looking for objects,” says Lyne.

LSVT BIG

Your physical therapist may suggest a therapy called LSVT BIG, which helps you walk faster and take bigger steps. This exercise program takes about four weeks (four one-hour sessions each week) and includes homework exercises to cement what you’ve learned.

Fine Motor Training

Besides walking and balance, it’s also important to strengthen smaller muscles, like the ones you use to button up a shirt or use a knife and fork. Exercises for fine motor skills can include the following:

  • Touching your thumb to each fingertip on the same hand
  • Squeezing a stress ball or putty
  • Turning over coins on a table with your thumb and pointer finger
  • Buttoning and unbuttoning a shirt several times
  • Writing, doodling, and drawing

Overcoming Barriers to Exercise

Parkinson’s changes how you move, and you can modify exercises by sitting, using hand supports (like a rail or assistive device), or getting help from a loved one, says Hawks.

But Parkinson’s can also cause other symptoms that make it harder to exercise. Here are some activity barriers and what you can do to manage them:

  • “Off” Times Between medication doses, you may have “off” times when you experience more symptoms, so try to schedule activity when your meds work their best.
  • Fatigue Respect your limits, take breaks, and stop before you reach exhaustion.
  • Fear of Falling If you are afraid of falls, you may hesitate to get active, but by asking your physical therapist to create safety solutions tailored to your needs, you can exercise with confidence.

  • Depression Apathy and depression can make you feel too discouraged to exercise, so Lyne and Hawks often recommend a variety of activities, like joining a community exercise class, walking with friends, and playing with grandchildren.
  • Treat Pain Parkinson’s can cause back pain, which may lower your motivation to move, says Hawks. You can ask your provider to help you treat your pain so you can stay active and strong.

How you overcome these barriers depends on your symptoms and motivators, says Lyne. “I examine each person’s individual health profile, cognitive and physical abilities, characteristics, support system, and safe access to equipment,” she says.

Your physical therapist can offer specific exercises and individualized advice on how to change an activity to address your barriers and keep you moving, says Hawks, adding, “For many people, movement is medicine!”

The Takeaway

  • Advanced Parkinson’s can make movement more difficult, but regular exercise can keep you stronger, more independent, and even improve your mood and sleep.
  • With the help of a physical therapist, you can adapt most exercises to keep you physically active while staying safe.
  • Physical activity for people with advanced Parkinson’s can include seated movements, aquatic therapy, aerobic exercise, resistance training, and fine motor workouts.
  • If you need help designing an exercise program suitable for a person with Parkinson’s, you can ask a healthcare provider to recommend a physical therapist who specializes in this movement disorder.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. McGinley JL et al. Exercise for People with Parkinson’s Disease: Updates and Future Considerations. Physical Therapy Research. July 19, 2024.
  2. Osborne JA et al. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association. Physical Therapy. December 28, 2021.
  3. Exercise. Parkinson's Foundation.
  4. Shafiq MA et al. Effect of Exercise on Sleep Quality in Parkinson’s Disease: A Mini Review. BMC Neurology. January 30, 2024.
  5. Cristini J et al. The Effects of Exercise on Sleep Quality in Persons With Parkinson’s Disease: A Systematic Review With Meta-Analysis. Sleep Medicine Reviews. February 2021.
  6. Lung health and Parkinson's. Parkinson's UK.
  7. Bouça‐Machado R et al. Physical Activity, Exercise, and Physiotherapy in Parkinson's Disease: Defining the Concepts. Movement Disorders Clinical Practice. November 11, 2019.
  8. Preventing Falls at Home: Room by Room. National Institute on Aging. September 12, 2022.
  9. Activities of Daily Living. Parkinson's Foundation.
  10. Cholewa J et al. Functional Physical Rehabilitation and Self-Assessment of Physical Activity in Parkinson’s Disease. Medical Science Monitor. November 27, 2025.
  11. Ciani H et al. Fitness Counts: A Body Guide to Parkinson’s Disease. Parkinson's Foundation. 2025.
  12. Cave K. Resistance Training Exercises and Concepts You Should Use. National Academy of Sports Medicine.
  13. Water Exercises Good for People With Parkinson’s Disease. UCLA Health. September 4, 2023.
  14. Giannakopoulos I et al. The Effects of Action Observation Therapy as a Rehabilitation Tool in Parkinson’s Disease Patients: A Systematic Review. International Journal of Environmental Research and Public Health. March 11, 2022.
  15. LSVT BIG for Parkinson's Disease Program. Cooper University Health Care.
  16. Hand Dexterity and Parkinson’s: Simple Exercises to Maintain Fine Motor Skills. Center for Movement Challenges.
  17. Vickers-Green L. Exercise and Parkinson’s: How to Overcome Barriers to Physical Activity. Parkinson's Europe. May 14, 2024.
  18. Jonasson SB et al. Experiences of Fear of Falling in Persons With Parkinson’s Disease – A Qualitative Study. BMC Geriatrics. February 6, 2018.
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Jason Paul Chua, MD, PhD

Medical Reviewer
Castle Connolly Top Doctor

Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.

Dr. Chua’s primary research interests are in neurodegenerative disease, with a special focus on the cellular housekeeping pathway of autophagy and its impact on disease development in diseases such as Parkinson disease. His work has been supported by multiple research training and career development grants from the National Institute of Neurological Disorders and Stroke and the American Academy of Neurology. He is the primary or coauthor of 14 peer-reviewed scientific publications and two peer-reviewed online learning modules from the American Academy of Neurology. He is also a contributing author to The Little Black Book of Neurology by Osama Zaldat, MD and Alan Lerner, MD, and has peer reviewed for the scientific journals Autophagy, eLife, and Neurobiology of Disease.

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Abby McCoy, RN

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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