Functional Fitness for Parkinson’s: Improving Daily Function

By Ziya “Z” Altug, PT, DPT, MS, DipACLM, OCS

and

Patrick LoSasso, President of Parkinson’s Community Los Angeles

Introduction

There are many forms of exercise available for persons with Parkinson’s (PWP) that range from tai chi, yoga, dancing, and water aerobics to the more athletic and intense modalities, such as non-contact boxing, power walking, table tennis, pickleball, biking, running, or weightlifting. “Exercise is Medicine!” according to the American College of Sports Medicine (ACSM 2026). This adage certainly applies to PWP. From managing symptoms, to improving function, and avoiding other comorbidities, exercise is a must. 

One of the most common questions is: “What is the best form of exercise for Parkinson’s?” And the answer is: one that you enjoy, that challenges you, and that you'll stick with. Many aspects of exercise have benefits that cross over into activities of daily living (ADLs) because they require functional movement patterns that resemble actions we perform in our daily lives.

What is Functional Fitness

Functional exercise involves multi-joint body movements that replicate the demands of ADLs rather than training muscle groups in a more isolated manner. In other words, functional fitness involves the incorporation of exercises that help you improve movements that you use throughout the day for ADLs. 

Here are some scenarios you might have encountered where incorporating functional fitness could be helpful:

• Needing to retrieve your keys from the floor after dropping them.
• Carrying the laundry basket from the laundry room to the folding table
• Pushing through a revolving door to enter the shopping mall
• Placing cans of soup and other items on an upper shelf in your pantry
• Rising to a standing position from a variety of chairs and couches
• Playing a game with your children or grandchildren that requires you to get down to the floor and back up again

What do all these daily movements have in common? It’s often referred to as “functional independence.” By practicing these types of movements on a regular basis, you maintain the ability to stay independent in your activities of daily living and improve your quality of life. 

In order to engage in functional exercise, it is recommended that a person start with a physical therapist and/or occupational therapist specializing in Parkinson’s, then transition to a personal fitness trainer specializing in Parkinson’s. 

The following functional movements, with accompanying real-life actions, may be incorporated into your home fitness program (where you perform each activity for 3 to 5 repetitions):

• Squat: Pick up your keys from the floor‍
• Lift: Reach down and lift the laundry basket using your legs and arms.‍
• Carry: Carry a grocery bag that has a handle for 10 steps, switch sides, and return.‍
• Push: Sitting in the car, push the door open and exit to a standing position. 
• Pull: Open the car door and get in.‍
• Overhead Reach: Reach up and place a package in an overhead cabinet. ‍
• Sit to Stand: Transition from a sitting position to standing from a dining room chair or couch. ‍
• Floor sit to stand: Transition from standing to sitting on the floor, then stand back up (if necessary, use a chair or stabilizing object for assistance).

What Does the Research Say?

The science behind functional fitness for Parkinson’s is growing. Researchers are finding that movement programs designed around real-world tasks produce meaningful gains in the everyday abilities that matter most to individuals.

For example, turning is a challenging and fall-prone movement for some people with Parkinson’s. A randomized controlled trial by Khobkhun and colleagues (2022) found that a task-specific movement program led to meaningful improvements in turning ability, offering evidence that practicing the exact movements individuals struggle with may translate to safer and more confident mobility in daily life.

Strength training also plays a critical role. A 2021 study by Strand and colleagues makes the case for a structured and progressive resistance program to help counter both the natural effects of aging and the specific challenges that Parkinson’s introduces.

Functional training exercises, including squats and lunges, along with the use of agility ladders, balls, dumbbells, mats, mini bands, cones, and steps may also be used to improve non-motor symptoms in PWP. A 2025 randomized controlled trial by Moratelli and colleagues, published in the Aging & Mental Health, found that functional training may help individuals with Parkinson’s improve depressive symptoms, anxiety, cognition, and happiness.

Finally, high intensity functional training is another exercise option. A study published in 2024 by Handlery and colleagues in the American Journal of Health Promotion showed that high intensity functional training for PWP may lead to health benefits. Exercise professionals interested in the detailed exercise protocols can refer to this study.

Getting Started

To begin safely:

• Wear loose, comfortable clothing.
• Choose properly fitting athletic shoes that have a wide and stable base, roomy toe box, nonslip soles, and that are easy to get on/off.
• Keep water nearby to maintain hydration. Take sips of water at regular intervals to maintain hydration. 
• Learn proper techniques from a qualified therapist or instructor, ideally in person during initial sessions.

Safety Precautions for Parkinson’s

Before beginning any type of exercise program, particularly for individuals with balance concerns, safety is essential:

• Obtain medical clearance for exercise before starting a program.
• Perform your training sessions near a stable surface or wall for support.
• Begin with shorter sessions to prevent excessive fatigue.
• Progress gradually under professional supervision.

Final Thoughts

Functional fitness is more than a workout routine. It is an investment in your ability to live well with Parkinson’s. By training the movements that matter most in daily life, you can help reduce your risk of falling, preserve your independence, and support both your physical and mental well-being. Every rep, every step, and every practice session brings you closer to having the confidence to pick up your keys from the floor, climb the stairs, and move through your day on your own terms. 

Helpful Resources

• American Parkinson Disease Association‍
• Davis Phinney Foundation for Parkinson’s‍
• Parkinson’s Foundation‍
• SmartXPD

References

• American College of Sports Medicine (ACSM). Exercise is Medicine. Accessed from https://www.exerciseismedicine.org, 2026.
• Handlery R, Handlery K, Kahl D, Koon L, Cabe SL, Regan EW. High intensity functional training for people with Parkinson’s & their care partners: a feasibility study. Am J Health Promot. 2024;38(5):648-660. https://pubmed.ncbi.nlm.nih.gov/38311368/‍
• Khobkhun F, Hollands M, Tretriluxana J, Srivanitchapoom P, Richards J, Ajjimaporn A. Benefits of task-specific movement program on en bloc turning in Parkinson's disease: A randomized controlled trial. Physiother Res Int. 2022;27(4):e1963. https://pubmed.ncbi.nlm.nih.gov/35717662/‍
• Moratelli JA, Corrêa CL, Andrade A, Lyra VB, Guimarães ACA. Functional training and Mat Pilates have a positive effect on non-motor symptoms improving cognition, depressive symptoms, anxiety, and happiness in people with Parkinson's disease: a randomized controlled clinical trial with follow-up. Aging Ment Health. 2025;29(10):1892-1901. https://pubmed.ncbi.nlm.nih.gov/40289666/‍
• Strand KL, Cherup NP, Totillo MC, Castillo DC, Gabor NJ, Signorile JF. Periodized resistance training with and without functional training improves functional capacity, balance, and strength in Parkinson's Disease. J Strength Cond Res. 2021;35(6):1611-1619. https://pubmed.ncbi.nlm.nih.gov/33927114/

Written by and Ziya “Z” Altug, PT, DPT, MS, DipACLM, OCS and Patrick LoSasso, President of Parkinson’s Community Los Angeles and founder of SmartXPD (https://www.smartxpd.com/).