Managing Gait, Balance, and Posture in Parkinson’s Disease

  • Bettina Debû
  • Clecio De Oliveira Godeiro
  • Jarbas Correa Lino
  • Elena Moro
Movement Disorders (S Fox, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Movement Disorders


Purpose of Review

Postural instability and gait difficulties inexorably worsen with Parkinson’s disease (PD) progression and become treatment resistant, with a severe impact on autonomy and quality of life. We review the main characteristics of balance instability, gait disabilities, and static postural alterations in advanced PD, and the available treatment strategies.

Recent Findings

It remains very difficult to satisfactorily alleviate gait and postural disturbances in advanced PD. Medical and surgical interventions often fail to provide satisfactory or durable alleviation of these axial symptoms, that may actually call for differential treatments. Exercise and adapted physical activity programs can contribute to improving the patients’ condition.


Gait, balance, and postural disabilities are often lumped together under the Postural Instability and Gait Difficulties umbrella term. This may lead to sub-optimal patients’ management as data suggest that postural, balance, and gait problems might depend on distinct underlying mechanisms. We advocate for a multidisciplinary approach from the day of diagnosis.


Advanced Parkinson’s disease Medical management Balance Gait Posture Physical activity 


Compliance with Ethical Standards

Conflict of Interest

Bettina Debû, Clecio De Oliveira Godeiro, and Jarbas Correa Lino declare no conflict of interest.

Elena Moro has received personal fees from Medtronic and Bial, and grants from Merz and Amadys.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Bettina Debû
    • 1
    • 2
  • Clecio De Oliveira Godeiro
    • 2
    • 3
    • 4
  • Jarbas Correa Lino
    • 2
    • 3
    • 5
  • Elena Moro
    • 1
    • 2
    • 3
  1. 1.University Grenoble AlpesGrenobleFrance
  2. 2.INSERM U1216GrenobleFrance
  3. 3.Movement Disorders Unit, Division of NeurologyCHU Grenoble AlpesGrenobleFrance
  4. 4.Division of NeurologyFederal University of Rio Grande do NorteNatalBrazil
  5. 5.Division of NeurologyCHU AmiensAmiensFrance

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