Parkinson’s disease fundamentally alters how the brain controls movement, but emerging research and specialized therapies are revealing that the body can learn new ways to move””even as the disease progresses. The key insight driving current treatment approaches is that movement retraining, combined with targeted therapies addressing dopamine signaling at baseline levels rather than during active movement, can help patients maintain function longer than previously thought possible. Programs like LSVT BIG are demonstrating that people with Parkinson’s can recalibrate their perception of movement, essentially relearning motor patterns that the disease has disrupted.
Consider Ruth Riley, one of many patients whose story appears on the Parkinson’s Foundation website, learning to navigate daily tasks that once required no conscious thought. Her experience reflects a broader truth: Parkinson’s affects approximately one million Americans, yet each person’s journey involves unique adaptations and discoveries about what their body can still accomplish. Peter Dunlap-Shohl captured this reality in his graphic novel “My Degeneration,” examining how PD impairs movement, speech, writing, and balance””while also documenting resilience and adaptation. This article explores the science behind movement changes in Parkinson’s, current therapeutic approaches that help patients relearn motor skills, breakthrough research from 2025 and 2026 that may reshape treatment, and practical considerations for those facing this diagnosis or caring for someone who is.
Table of Contents
- How Does Parkinson’s Disease Change the Way People Move?
- The Science of Dopamine and Movement: What Recent Research Reveals
- Movement Retraining Programs: LSVT BIG and the Art of Recalibration
- Emerging Therapies in the Treatment Pipeline
- Clinical Trials Targeting Disease Modification
- Storytelling and Community in Parkinson’s Care
- Looking Ahead: The Future of Parkinson’s Movement Therapy
- Conclusion
How Does Parkinson’s Disease Change the Way People Move?
parkinson‘s disease disrupts the brain’s dopamine-producing neurons in the substantia nigra, a region critical for coordinating smooth, purposeful movement. without adequate dopamine signaling, patients experience the hallmark symptoms: tremor, rigidity, bradykinesia (slowness of movement), and postural instability. But the effects run deeper than these visible signs. The brain’s internal sense of movement amplitude becomes distorted, causing patients to perceive their movements as larger than they actually are. This perceptual mismatch creates a frustrating paradox.
A person with Parkinson’s may feel they are taking normal steps while actually shuffling, or believe they are speaking at normal volume when their voice has become a whisper. The striatum, a brain region involved in motor learning and habit formation, begins encoding aberrant patterns. Research published in January 2026 by Northwestern Medicine scientists, appearing in *Science Advances*, identified how targeting neuronal signaling that controls this aberrant learning may improve treatment outcomes and reduce therapy-related side effects like dyskinesia. Understanding this mechanism matters because it reveals that Parkinson’s is not simply about lost movement capacity””it involves the brain learning the wrong movement patterns. This distinction opens doors for therapies that focus on retraining rather than just compensating.
The Science of Dopamine and Movement: What Recent Research Reveals
A December 2025 study from McGill University challenged longstanding assumptions about dopamine’s role in Parkinson’s treatment. Researchers discovered that manipulating dopamine levels during active movement had no effect on motor performance. What mattered instead was restoring baseline dopamine levels””the background dopamine present when a person is not actively moving. This finding could fundamentally reshape treatment approaches.
The implication is significant: current therapies largely focus on providing dopamine to support active movement, but the McGill research suggests the real therapeutic target may be different. Restoring the brain’s baseline dopamine environment might be more important than boosting dopamine during the moments when a patient is walking, reaching, or performing other motor tasks. However, translating laboratory findings into clinical practice takes time, and not all patients will respond identically to new treatment paradigms. Individual variation in disease progression, genetics, and overall health means that what works for one patient may not work for another. The McGill research provides direction, but personalized treatment plans remain essential.
Movement Retraining Programs: LSVT BIG and the Art of Recalibration
LSVT BIG represents one of the most validated approaches to movement retraining in Parkinson’s disease. Developed as a physical therapy protocol, the program trains patients to use their bodies more normally by addressing the perceptual distortion that makes movements feel larger than they are. Patients practice exaggerated, high-amplitude movements until these bigger motions feel normal””essentially recalibrating their internal movement sense. The program improves both fine and gross motor tasks. Patients report better ability to button shirts, write legibly, and handle utensils (small motor tasks), as well as improved performance getting up from chairs, walking with better balance, and turning safely (large motor tasks).
The improvements persist beyond the training period when patients continue practicing the techniques at home. One limitation of LSVT BIG is its intensity: the standard protocol requires sixteen sessions over four weeks with a certified therapist, plus daily homework. Access can be challenging in rural areas or for patients with mobility limitations that make frequent clinic visits difficult. Some patients find the exaggerated movements awkward or tiring, particularly in early sessions. The program works best when patients are motivated and have support systems to encourage continued practice.
Emerging Therapies in the Treatment Pipeline
The Parkinson’s treatment landscape is evolving rapidly, with several promising therapies in development that could reach patients within the next few years. Tavapadon, developed by AbbVie, had its new drug application submitted to the FDA in September 2025. With FDA review typically taking about ten months, a decision could come in mid-2026. If approved, tavapadon may help smooth motor symptoms and reduce the need for frequent levodopa dosing””a meaningful improvement for patients who currently experience “wearing off” effects between doses. Bemdaneprocel, under development by Bayer, takes a radically different approach: stem cell therapy.
This treatment implants dopamine-producing neurons derived from stem cells directly into affected brain regions. While promising, stem cell therapies carry inherent uncertainties about long-term outcomes and may not be appropriate for all patients. Comparing these approaches reveals important tradeoffs. Tavapadon offers a more conventional medication option with a clearer regulatory path but addresses symptoms rather than underlying disease progression. Bemdaneprocel theoretically could restore lost neurons but involves a more invasive procedure and longer development timeline. Patients and physicians will need to weigh these factors as new options become available.
Clinical Trials Targeting Disease Modification
Beyond symptom management, several trials are investigating whether Parkinson’s progression itself can be slowed. The BIIB122 compound, currently in Phase 2 trials (the Luma study), tests whether LRRK2 inhibition can slow worsening in early-stage Parkinson’s. LRRK2 mutations are among the most common genetic causes of Parkinson’s, making this a particularly relevant target for certain patient populations. The ACTIVATE study is evaluating BIA 28-6156, a therapy targeting the GCase enzyme in patients with GBA1 gene variants.
Results are expected by mid-2026. This approach exemplifies the trend toward precision medicine in Parkinson’s treatment””identifying patients with specific genetic profiles who may benefit from targeted therapies. A critical limitation: these disease-modifying approaches may only help subsets of patients with particular genetic backgrounds. The majority of Parkinson’s cases are idiopathic (no identified genetic cause), and it remains unclear whether therapies designed for genetic variants will benefit the broader patient population. Patients should discuss genetic testing with their neurologists to understand whether emerging precision therapies might be relevant to their situation.
Storytelling and Community in Parkinson’s Care
Columbia University’s PD Movers Storybook, developed in 2021 with Black and African American individuals with Parkinson’s and their care partners, illustrates how narrative can serve therapeutic and educational purposes. The project recognized that Parkinson’s affects diverse communities differently and that representation matters in healthcare education.
Personal stories help newly diagnosed patients understand what lies ahead while seeing examples of successful adaptation. The Parkinson’s Foundation maintains an extensive collection of patient narratives that serve this purpose, offering both practical insights and emotional support for those navigating the disease.
Looking Ahead: The Future of Parkinson’s Movement Therapy
The convergence of new scientific understanding, targeted drug development, and refined rehabilitation approaches suggests a more hopeful trajectory for Parkinson’s patients than existed even five years ago. The Northwestern findings about aberrant learning in the striatum, combined with the McGill insights about baseline dopamine, point toward treatment strategies that address root mechanisms rather than just downstream symptoms.
Research continues into combining pharmacological and physical therapy approaches, recognizing that medications alone cannot address the complex motor learning deficits that characterize Parkinson’s. The future likely involves integrated treatment protocols where movement retraining programs like LSVT BIG work alongside next-generation medications to provide comprehensive care.
Conclusion
Parkinson’s disease fundamentally changes how the brain plans and executes movement, but this is not a story of inevitable decline. Current research reveals that the disease involves aberrant motor learning that can be addressed through targeted therapies and intensive movement retraining. Programs like LSVT BIG demonstrate that patients can recalibrate their movement perception, while emerging medications like tavapadon and stem cell therapies like bemdaneprocel offer additional tools for the treatment toolkit.
For patients and caregivers, the practical takeaway is to pursue comprehensive care that includes both neurological management and specialized physical therapy. Understanding that movement difficulties involve perception as much as physical capability can reduce frustration and inform better strategies for daily living. As research from institutions like Northwestern and McGill continues to illuminate the underlying mechanisms of Parkinson’s, treatment approaches will become increasingly precise and effective.
