Postural instability in Parkinson’s

Martin Pryor and the tales of his dog, Bungee
15th March 2023
Hallucinations in Parkinson’s
9th April 2023

Postural instability in Parkinson’s

Postural instability in Parkinson’s

Parkinson’s is a complex neurological condition that affects more than 220,000 people in Australia. One of the most common symptoms of Parkinson’s is postural instability, which can cause balance problems and unsteadiness while standing or walking.

Postural instability occurs due to changes in the brain and nervous system that affect the body’s ability to maintain balance. This symptom can significantly impact the daily lives of people living with Parkinson’s, increasing the risk of falls and decreasing quality of life.

It’s crucial for people with Parkinson’s to understand the causes and management strategies for postural instability. There are various treatment options available, including medication, physiotherapy, and exercise programs designed to improve balance and prevent falls.

It’s also essential to take steps to reduce the risk of falls by making modifications to the environment, such as removing trip hazards and improving lighting. Wearing appropriate footwear and using walking aids can also help prevent falls and improve balance.

Signs that may indicate postural instability include

  • stooped posture,
  • small shuffling steps, and
  • a tendency to lean forward when walking.

Postural instability often occurs when a person is first diagnosed with Parkinson’s, but it may become more common and worsens as the disease progresses. People with Parkinson’s are more prone to falls if they cannot re-stabilise from changes in motion, leading to hospital stays or serious injury.

Many doctors and allied health practitioners will tell you that exercise is the best approach to treating postural instability and balance issues. Exercise has been proven to improve balance and your walking (gait).  Which can help reduce your risk of falling.

Balance exercise done three times per week can help reduce the risk of falls and improve your balance.  Practising daily is best.

When practising your balance exercise you want to be safe.  Here are some tips to help you exercise safely.

  • Choose a time when you are at your best.
  • Be rested and ensure symptoms are at their best with your medications
  • Exercise at your own pace

There are many symptoms that contribute to poor balance in Parkinson’s. Postural instability is when poor posture causes the inability to correct your balance after being thrown off balance.

Freezing of gait is the abnormal walking pattern where you can’t take the next step forward.

Festinating gait which is when you pick up speed walking and can’t stop.

Visuospatial changes which make manoeuvring around obstacles difficult and tripping easy.  These are all common symptoms with Parkinson’s

Prevention is a vital step to help someone keep their balance and prevent falls.  Here are some suggestions:

  • Remove rugs and potential obstacles.
  • Install grab bars in key areas in which falls are more likely, such as the bathroom.
  • Choose the right supporting shoes for you.
  • Wear a medical alert bracelet in case of a fall.
  • Always have a firm support close by to hold onto if needed, such as a chair or table that won’t move.
  • If you experience pain or great difficulty with any exercise, STOP and consult your physiotherapist or doctor.

Balance Exercises

Single Leg Stand

Standing tall, pull your stomach in and lift one leg up off the ground and hold for 10 seconds.  Breathe.

If unsteady you can keep your toe of the raised foot in contact with the floor.

Swap and do the other leg.

If you are steady hold each position for a longer time.



Weight shifts

Stand with your feet hip-width apart.

Shift your weight onto your right foot.

Raise your left foot.

Hold this position for up to 30 seconds.


Then do the opposite side.

Do each side three times.


If you or someone you know is living with Parkinson’s, it’s important to seek advice from healthcare professionals and support services to manage postural instability and other symptoms effectively. Parkinson’s NSW is here to provide information, support and resources to assist those impacted by Parkinson’s.

In this video, we explore the common symptom of postural instability in Parkinson’s.


Understanding postural instability & balance in Parkinson's