Mukta T Killedar, Suraj B Kanase
Parkinson's disease is a progressive neurodegenerative disorder that commonly results in gait dysfunction, balance impairment, postural instability, and reduced functional independence. Freezing gait (FOG) is among the most disabling motor manifestations of the disease and is associated with an increased risk of falls, impaired mobility, and reduced quality of life. Although exercise-based rehabilitation has demonstrated beneficial effects in individuals with Parkinson's disease, detailed reports describing the response of patients with long-standing disease and significant freezing gait remain limited. This case report describes the effects of a structured physiotherapy rehabilitation program in a 74-year-old male with a 15-year history of Stage III Parkinson's disease who presented with freezing gait, shuffling gait, impaired balance, rigidity, tremor, postural abnormalities, and reduced functional mobility. The patient underwent a six-week rehabilitation program consisting of gait training, balance retraining, cueing strategies, strengthening exercises, flexibility exercises, postural correction exercises, aerobic conditioning, coordination training, and functional task practice for 45 minutes per session, five days per week. Outcomes were assessed using the Timed Up and Go (TUG) test, Berg Balance Scale (BBS), and Modified Hoehn and Yahr staging system. Following the intervention, functional mobility improved, with TUG time decreasing from 21 seconds to 14 seconds. Balance performance improved, with the BBS score increasing from 28/56 to 41/56. The Modified Hoehn and Yahr stage changed from Stage III to Stage II following rehabilitation. Clinical observations also suggested reductions in freezing episodes, shuffling gait, rigidity, tremor, micrographia, hypophonia, and postural abnormalities. The patient additionally reported improved walking ability, greater confidence during ambulation, reduced fear of falling, and enhanced endurance during daily activities. This case report highlights the potential benefits of a structured, multi-component physiotherapy rehabilitation program for improving freezing gait, functional mobility, balance, and overall functional performance in an individual with long-standing Parkinson's disease. These findings support the role of individualized physiotherapy as an important adjunct to pharmacological management in chronic Parkinson's disease. However, these findings should be interpreted cautiously and should not be interpreted as evidence of reversal of the underlying neurodegenerative disease.