Falls are a frequent complication of Parkinson’s disease. While there are many things you can do to reduce your risk of falling, the two most important things are 1) to work with your doctor to ensure that your treatments — whether medicines or deep brain stimulation — are optimal, and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety.

How to prevent falls from common hazards

• Floors — Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
• Bathroom — Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
• Lighting — Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway. Make sure there is a light switch at the top and bottom of the staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
• Kitchen — Install non-skid rubber mats near the sink and stove. Clean spills immediately.
• Stairs — Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
• Entrances and doorways — Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.

• Keep at least one hand free at all times. Try using a backpack or fanny pack to hold things rather than carrying them in your hands. Never carry objects in both hands when walking as this interferes with keeping your balance.
• Attempt to swing both arms from front to back while walking. This might require a conscious effort if Parkinson’s disease has diminished your movement. It will, however, help you to maintain balance and posture, and reduce fatigue.
• Consciously lift your feet off of the ground when walking. Shuffling and dragging of the feet is a common culprit in losing your balance.
• When trying to navigate turns, use a "U" technique of facing forward and making a wide turn, rather than pivoting sharply.
• Try to stand with your feet shoulder-length apart. When your feet are close together for any length of time, you increase your risk of losing your balance and falling.
• Do one thing at a time. Don’t try to walk and accomplish another task, such as reading or looking around. The decrease in your automatic reflexes complicates motor function, so the less distraction, the better.
• Do not wear rubber or gripping soled shoes, they might "catch" on the floor and cause tripping.
• Move slowly when changing positions. Use deliberate, concentrated movements and, if needed, use a grab bar or walking aid. Count 15 seconds between each movement. For example, when rising from a seated position, wait 15 seconds after standing to begin walking.
• If you become "frozen," visualize stepping over an imaginary object, or have someone place his or her foot in front of yours to step over. Try not to have a caregiver or companion "pull" you, this might throw you off balance and even prolong the episode.
• If balance is a continuous problem, you might want to consider a walking aid such as a cane, walking stick, or walker. Once you’ve mastered walking with help, you might be ready to try it on your own again.

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