“I have fallen at least a dozen times, and thankfully, have not broken anything,” one member of MyParkinsonsTeam wrote. Another member said, “A good day is one without falls.”

As people age, their risk of falling increases. However, people with Parkinson’s disease experience twice the risk of falling as compared to older adults without Parkinson’s. About 60 percent of people with the condition fall every year. Different motor and nonmotor symptoms of Parkinson’s disease contribute to a loss of balance and an increased risk of falling.

As Parkinson’s disease progresses, so does the possibility and fear of falling. However, not all people with Parkinson’s will experience falls. People with Parkinson’s are more likely to fall, but many steps can be taken to prevent falls and the injuries they cause.

How Parkinson’s Causes Balance Issues and Falls

There are several reasons why people with Parkinson’s disease are more prone to balance issues and falling. Parkinson’s disease affects people in two main ways: Through motor symptoms, which are changes in how you move, and nonmotor symptoms, which are changes in other aspects of your health not directly related to movement.

Motor Symptoms

Specific motor symptoms from Parkinson’s may contribute to a person’s loss of balance and risk of falling. Some of these symptoms include:

• Axial rigidity — Stiffness and loss of flexibility in the neck and trunk
• Freezing — Sudden, temporary inability to move
• Bradykinesia — Delayed reaction time and slow movements
• Changes in posture — Stooping or postural instability (trouble with balance)
• Changes in center of gravity
• Impairment of reflexes that help with balance
• Vision changes, such as blurry or double vision

Balance issues and motor symptoms that lead to balance difficulties while standing up, walking, and turning are the main sources of falls in Parkinson’s. The progression of Parkinson’s disease and its symptoms affects everyone differently. Some people might have more trouble with balance than others.

Members of MyParkinsonsTeam commonly discuss changes with balance. One member wrote, “My biggest challenge has been overall balance.” Another said, “I lose my balance very easily.”

Nonmotor Symptoms

Some nonmotor symptoms of Parkinson’s disease are also risk factors for falling. These symptoms include:

• Hypotension (low blood pressure) — This can cause dizziness, making it hard to walk without feeling lightheaded.
• Constipation — Hurried movements to use the bathroom may increase fall risk.
• Fatigue — Fatigues can slow a person’s reactions and ability to focus, raising their chances of tripping.
• Stress — Tense muscles can disrupt balance and movement.
• Problems with cognition — Trouble organizing thoughts can lead to distraction and falls.
• Dizziness or blurry vision from medications like amantadine — These symptoms also may increase a person’s fall risk.

One MyParkinsonsTeam member commented, “I’m dizzy. Sometimes it lasts a few hours, and sometimes it lasts for days.”

Another wrote, “It happens when I’m sitting or lying down — when I get up to stand, the dizzy spells happen. I have to stand still and hold on to something for a few minutes before they go away.”

How To Improve Balance and Prevent Falls With Parkinson’s

Fortunately, there are several strategies for improving balance and preventing falls when living with Parkinson’s disease.

1. Talk to Your Doctor

Talk to your doctor about your experiences. People may feel embarrassed or ashamed about falls, but it’s important to talk to your health care provider about this issue. Your medical team can find ways to prevent falls and reduce your chance of injury.

Your doctor can assess your medications, as well as their dosages and side effects. They can also refer you to a physical therapist or suggest exercise programs to improve balance. Your doctor will have your best interests in mind. Tell them the full story of your Parkinson’s symptoms so they can help you.

2. Review Your Medications

Balance issues in Parkinson’s often occur due to medications or medication dosages. Some side effects of Parkinson’s medications may affect blood pressure, dizziness, and balance. Higher doses of levodopa/carbidopa, for instance, have been associated with increased falls.

Drugs used to treat other conditions, like blood pressure, may also cause dizziness and balance issues. “I am dizzy from the meds. Does anyone else have problems with the carbidopa/levodopa?” asked one MyParkinsonsTeam member.

If you believe the side effects of your medications may be causing an issue, speak to your doctor. Never stop taking your medication without the advice of your health care provider.

People with Parkinson’s disease may also lose their balance and fall if furniture is out of place, or if their home has not been adapted to meet their mobility needs. People get used to the arrangement of household items and grow comfortable moving around those spaces. If something gets moved out of place, it may pose a fall risk to someone with Parkinson’s.

3. Follow an Exercise Program

Exercise and physical activity programs improve balance and gait (the pattern of moving your arms and legs while walking) in people with Parkinson’s disease. One study found that people with Parkinson’s were able to move better after a six-week treadmill regimen, as compared to people who did at-home, low-intensity balance and stretching techniques.

A meta-analysis is a study that combines findings from multiple studies to get clearer answers. One such study examined 25 randomized control trials and found overall positive effects on balance, gait, and fall rate from different exercise interventions. The best exercise programs for people with Parkinson’s combine cognitive focus and intentional movement to help improve balance and quality of life.

Some exercises that are suitable for people with Parkinson’s include:

• Dance
• Tai chi (an exercise that incorporates movement and meditation)
• Walking
• Qi gong (incorporates body postures and movements, breathing, and meditation)
• Yoga

“I have been doing tai chi for two-and-a-half years, since my diagnosis,” one MyParkinsonsTeam member wrote. “My balance is still excellent. In my opinion, tai chi is great for balance and meditative activity, and I wouldn’t give it up for anything.”

Always talk with your doctor or another health care provider before starting any new exercise regimen, including home exercises. Your medical team may also suggest exercises best suited to your abilities.

4. Try Physical Therapy

Working with a physical or occupational therapist can be a great way to improve balance and gait in a supported environment. Physical therapists can assess your risk of falls and work to improve your walking, posture, and balance through various exercises. Physical therapy can help at any stage of Parkinson’s, whether you experience regular falls or want to prevent them. Going to sessions with a caregiver is helpful because they can assist you in practicing the exercises recommended by the physical therapist at home.

One member of MyParkinsonsTeam mentioned, “My balance has been helped by physical therapy.”

This shows that physical therapy can help people with Parkinson’s feel steadier and move better, pointing out why it’s a good idea to consider treatments that can make a difference.

5. Practice Balance-Improving Techniques

Many techniques and exercises for improving balance can be done at home. Different exercises are more suitable for people with different levels of Parkinson’s. Talk to your doctor or physical therapist before trying any new balance techniques.

Some techniques recommended by a physical therapist with the Johns Hopkins Rehabilitation Network include:

• Sit-to-stand exercise — Repeatedly practice sitting down in a chair and standing up. Have a sturdy support like a countertop or table in front of you that you can reach for support.
• Balance exercise — Practice stepping side to side next to a table. Have someone with you in case you lose your balance, and also have a sturdy support in front of you that you can use to steady yourself.

You can also make small changes while you move to prevent falls. Tips to help you overcome loss of balance and freezing while walking include:

• Practice swinging both arms while walking to maintain balance.
• Walk to a regular beat, like music or a metronome, to prevent freezing.
• Consciously lift your feet and imagine stepping over a laser while walking.
• When making turns, use a “U” technique. Imagine walking in a U shape instead of pivoting sharply.
• Focus on one task at a time.
• Move slowly when standing up, sitting down, or changing positions. Try counting to 15 seconds between each movement.

6. Consider Walking Aids or Home Adaptations

There are several other ways to improve balance and avoid falls with Parkinson’s disease. Using a cane or walker can help you keep your balance and stay steady while walking.

“I just gave in to using a walker. I am so excited at the difference it has made for me. My falls have decreased, and I can walk much longer distances,” said one MyParkinsonsTeam member.

Making changes to the home may also help to prevent falls. If you live at home, your loved ones can help you with these changes. Home adaptations include:

• Removing tripping hazards like throw rugs
• Adding grab bars in the bathroom
• Ensuring bright lighting throughout the house
• Adding bright tape to the edge of steps
• Clearing clutter from walking paths

Bear in mind that people with Parkinson’s disease may also lose their balance and fall if furniture is out of place. People get used to the arrangement of household items and grow comfortable moving around those spaces. Take this into consideration when making adaptations or changing the layout of furniture.

People with Parkinson’s have a higher risk of falling as they get older because of various symptoms. Although there’s a bigger chance of falling as Parkinson’s gets worse, not everyone will fall. There are ways to help prevent falls and keep safe from injuries. To stay safer and avoid injuries, talk to your doctor about the best prevention methods.

Find Your Team

MyParkinsonsTeam is the social network for people with Parkinson’s and their loved ones. On MyParkinsonsTeam, more than 101,000 members come together to ask questions, give advice, and share their stories with others who understand life with Parkinson’s.

Do you have Parkinson’s and issues with balance and falling? Share your experience in the comments below, or start a conversation by posting on your Activities page.