Which of the following is commonly included in Parkinson's disease physical therapy?

• A. Spinal orthoses
• B. Aquatic therapy
• C. Massage therapy
• D. Respiratory training

Answer: (D)

Breathing and airway clearance are often addressed in Parkinson’s disease physical therapy because the disease can weaken the muscles you rely on to breathe deeply, cough effectively, and keep airways clear. Bradykinesia and rigidity don’t just affect limb movement; they can dull chest wall expansion and shorten the breath, leading to shallower breathing, reduced vital capacity, and a less forceful cough. Over time, this raises the risk of fatigue, shortness of breath with activity, speech changes, and respiratory infections.

A typical respiratory training plan aims to strengthen the respiratory muscles and retrain breathing patterns, so patients can ventilate better during daily activities and clear secretions more effectively. This includes diaphragmatic or deep-breathing exercises to improve chest expansion, pursed-lip breathing to regulate airflow and prevent dyspnea, and sometimes inspiratory muscle training with devices to build strength. It also covers techniques to support safe swallowing and effective coughing during exertion or illness.

Other options, while they may be used in some cases (for example, aquatic therapy or adjunct massage), are not as routinely emphasized across standard PD physical therapy programs as respiratory training, which directly targets a common, disabling impairment in this population.