What is Parkinson’s Disease?

Parkinson’s Disease (PD) is a progressive neurodegenerative disorder affecting the basal ganglia, leading to impaired motor planning, slowed movement (bradykinesia), rigidity, tremor, and deficits in automaticity.

Beyond motor symptoms, PD impacts:

• Postural stability

• Gait automaticity and dual-tasking

• Visual processing

• Proprioception

• Reaction time

• Cognition and executive function

These changes contribute to freezing, falls, and difficulty adapting to environmental challenges.
Best-evidence physical therapy emphasizes external cueing, task-specific practice, and high-effort functional training to improve movement quality and reduce fall risk.

 

Which systems are affected in Parkinson’s?

1) Sensorimotor Integration (Basal Ganglia + Cortex + Proprioception)

PD reduces the brain’s ability to scale movement, shift motor programs, and adapt posture. Patients exhibit:

• Difficulty initiating movement

• Inaccurate amplitude scaling (small steps, short reach)

• Impaired joint position sense

• Difficulty adjusting to environmental unpredictability

This is why external cues (visual, auditory, cognitive) dramatically improve performance and are core to evidence-based PD treatment.

 

2) Postural Control & Balance Systems

People with PD have deficits in:

• Reactive balance

• Anticipatory postural adjustments

• Stepping strategies

• Dual-task balance

Falls often occur because patients cannot react to quick head or body shifts.
Cueing + dynamic visual feedback improves postural stability and enhances automaticity during challenging tasks.

 

3) Oculomotor and Visual Processing

PD often involves:

• Reduced saccade speed

• Impaired smooth pursuit

• Difficulty using peripheral vision

• Visual dependence

These deficits impact gait, turning, and obstacle negotiation, and contribute to freezing-of-gait episodes.
Visual feedback and structured visual–motor tasks help recalibrate movement.

 

4) Gait Automaticity & Dual-Task Function

PD impairs ability to walk and perform another task simultaneously. This leads to:

• Reduced gait speed

• Shortened step length

• Freezing during turns

• Increased fall risk

Dual-task gait training is strongly supported in PD rehab and is enhanced with interactive, reactive visual cues.

 

Why do balance, movement amplitude, and automaticity suffer in Parkinson’s?

PD disrupts internal cueing and motor output scaling.
Movement becomes:

• Smaller

• Slower

• Less adaptable

• Easily destabilized by visual changes or head turns

Adding external visual feedback, targets, and reactive tasks significantly improves:

• Step length

• Trunk and head alignment

• Balance confidence

• Reaction time

• Movement amplitude

• Engagement and motivation

This makes the Motion Guidance® system a natural fit for PD rehabilitation.

 

What are clinicians doing now? (Best-evidence overview)

1) Amplitude-Based Movement Training (LSVT-BIG style)

High-effort, large-amplitude movements improve bradykinesia, posture, gait speed, and functional mobility.

2) External Cueing (visual, auditory, tactile)

Well-supported by systematic reviews for improving:

• Step length

• Freezing-of-gait

• Gait speed

• Turning

• Functional mobility

Visual cues (targets, lines, dynamic lights) are particularly effective.

3) Dual-Task Training

Practicing gait + cognitive tasks improves automaticity and reduces freezing and fall risk.

4) Reactive Balance Training

Perturbations, unpredictable cueing, and rapid head/eye movement tasks strengthen postural responses.

5) Strengthening + Functional Conditioning

Focus areas include:

• Hip/quad strength

• Trunk stabilizers

• Step training

• Sit-to-stand

• Reach and rotation tasks

6) Visual-Motor Training

Improves turning, stepping, obstacle clearance, and orientation.

 

Treatment ideas using MotionGuidance®

 

Motion Guidance® combines laser visual feedback + MG-Interactive™ reactive pods to create engaging, externally-cued rehab tasks for people with Parkinson’s.

 

Visual Feedback for Amplitude Training

Use the head-mounted laser to:

• Increase reach height and depth

• Train overhead reach

• Improve trunk extension

• Practice large-amplitude turns

• Build confidence with external targets

Patients can see if their movement is large enough — a key deficit in PD.

 

MG-Interactive™ Pods for Reactive + Dual-Task Balance

Set pods on a wall grid for:

• Quick head-turn target acquisition

• Reactive balance exercises

• Cognitive dual-tasking (colors, numbers, sequences)

• Multi-directional reach training

• Stepping reactions

This simulates real-life challenges such as scanning the environment while walking.

 

Gait & Turning Training with External Cues

Use pods or laser targets to train:

• Step length

• Side-stepping

• Backward stepping

• Open/closed environment turning

• Obstacle negotiation

Visual cueing reduces freezing episodes and improves gait consistency.

 

Postural Recalibration & Proprioceptive Training

Laser feedback helps patients:

• Correct forward-flexed posture

• Improve trunk alignment

• Increase cervical rotation

• Develop awareness of midline

• Improve joint position sense (JPS)

Simple drills (clock targets, butterfly patterns) become engaging and self-correcting.

 

PUTTING IT ALL TOGETHER: More Advanced Training

Examples:

• Tandem stance + pod reaction tasks

• Walking paths + head laser targets

• Cognitive commands + MG-Interactive™ sequences

• Timed movement challenges with visual scoring

• Balance on foam + reactive cueing

• Turning practice with visual guides & pods

• “Look and step” drills for freezing reduction

Patients stay motivated and therapists gain real-time data about accuracy, consistency, and reaction time.