Steps, turns and freezing
Observe gait and practise starts, stops and changes of direction. Where freezing is present, trial an individual visual, verbal or rhythmic cue and check whether it helps in the person’s usual setting.
Parkinson’s and parkinsonism · Western Sydney and The Hills
Practical movement strategies for Parkinson’s disease and parkinsonism
When starting a step, turning or getting out of a chair takes more thought, physiotherapy can help work through the task. Tandem provides home and community visits for adults with Parkinson’s disease and other parkinsonian presentations.
Understanding the presentation
Similar movement difficulties, different needs
Parkinsonism describes a group of movement features; it is not another name for Parkinson’s disease. Different underlying conditions can produce these features, with different patterns of change and responses to treatment.
Slowness of movement (bradykinesia), smaller steps, stiffness or difficulty combining movements may affect daily life. Assessment starts with the person’s actual difficulties and priorities, rather than assuming that one exercise or cue will suit everyone.
Read About Chris and Tandem’s broader Clinical Focus for the service’s background and approach.
Practice with a purpose
Working on movement that carries into the day
Size and sequence of movement
Practise a purposeful movement amplitude, such as reaching further or taking a larger step when appropriate. Break tasks such as turning in bed or rising from a chair into manageable parts.
Balance, strength and attention
Choose strength and balance exercises matched to ability and falls risk. Assess what happens when walking and talking or carrying an item; dual-task practice is introduced only when suitable, with simpler strategies where needed.
Aids and support strategies
Trial mobility aids in context, considering turning, attention and freezing rather than assuming an aid will help. With consent, involve family or support workers in consistent cues, appropriate assistance and practice between visits.
Why the doorway or usual chair matters
Narrow doorways, crowded rooms or a low lounge may reveal difficulties not seen on a clear clinic walkway. Home assessment tests strategies using the person’s furniture and available support.
Community goals might include negotiating a path, approaching a seat or managing a familiar outing. The task, distance and assistance are selected together, without assuming that clinic performance will transfer automatically.
Adapting over time
Function may vary across the day, including around prescribed medication timing. This helps inform appointment timing and practice; medication changes remain with the prescriber. Review can shift the emphasis between physical capacity, movement strategies, maintenance and additional assistance as needs change.
Referrals and service area
Discuss the movement problem you are seeing
Anyone can enquire. Include movement difficulties, falls or freezing, current assistance, diagnosis and symptom pattern. Referring for someone else requires consent or appropriate authority.
Visits cover Western Sydney and The Hills District, including Penrith and surrounds, subject to location, clinical fit and availability. See Service Areas.
Private enquiries welcome. NDIS funding: self-managed and plan-managed only; Tandem is not NDIS-registered. Funding and required approvals are confirmed before services start.
Related functional support
When steadiness is the main concern, read about falls risk assessment and reduction. For persistent pain that also limits movement or participation, see complex chronic pain physiotherapy.