In August 2026, the American Parkinson Disease Association (APDA) hosted a webinar titled “Moving with Confidence: Balance Strategies in Everyday Life,” offering practical strategies for navigating balance challenges and moving more safely and confidently at home and out in the community. The session was the third installment of a three-part balance series within the APDA’s ongoing “Let’s Keep Moving with APDA” program.
The webinar was presented by Teresa Baker, DPT, a clinical research physical therapist at Boston University’s Center for Neurorehabilitation, and was moderated by fellow physical therapist Sara Zoeller, DPT.
Key takeaways from the webinar include:
Balance challenges are deeply individual, so the first step is identifying where and when they happen for you. Difficulty may show up in specific community settings — crowded stores, parking lots, dim restaurants, uneven curbs — or at home, such as rising from a low, soft chair or turning in a narrow doorway. Naming your own trouble spots is what makes targeted strategies possible.
Every balance challenge can be broken into three parts: the environment, the task, and you. Looking at each separately — what’s around you, what you’re trying to do, and how your own energy, medication timing, vision, and confidence factor in — helps pinpoint which strategy will actually help.
Small adjustments to your surroundings and timing can make a meaningful difference. Shopping at off-peak hours, improving lighting, scheduling demanding activities during “on” medication periods, pacing errands to manage fatigue, keeping your hands free with a cross-body bag, and minimizing distractions all reduce the balance load in everyday situations.
Assistive devices widen your base of support and are most helpful when personalized with a physical therapist. A cane, walking pole, or rollator connects you to the ground and can be used situationally — kept in the car for longer walks, for example. Trying a device out with guidance from a physical therapist is the best way to find the right fit.
Simple home adaptations reduce risk. Clearing trip hazards like loose rugs, installing grab bars in the bathroom and shower, wearing supportive footwear even indoors, ensuring good lighting, and keeping frequently used items at waist height all make daily movement safer — including a clear, well-lit path for nighttime trips to the bathroom.
Specific situations have specific compensatory strategies, and repetition turns them into habits. Slowing down before turning, not fighting through a freeze, taking deliberate steps when backing up, and taking your time when standing all help — and practicing them consistently, ideally alongside a physical therapist, makes them second nature.
Resources:
A recording of this webinar is available through the APDA YouTube channel
APDA National Rehab Resource Center: The APDA National Rehabilitation Resource Center for Parkinson’s Disease, based at Boston University’s Center for Neurorehabilitation — offers an exercise helpline and can help you find a PD-informed physical therapist in your area.
Keep reading for detailed notes,
— Elizabeth
Moving with Confidence: Balance Strategies in Everyday Life
Speaker: Teresa Baker, PT, DPT, physical therapist, Center for Neurorehabilitation, Boston University (bu.edu/neurorehab)
Moderator: Sara Zoeller, PT, DPT, physical therapist, Center for Neurorehabilitation, Boston University
Webinar Host: American Parkinson Disease Association (APDA) (apdaparkinson.org)
Webinar Date: August 4, 2026
Summary by: Elizabeth Wong, Stanford Parkinson’s Community Outreach
Dr. Baker opened with the disclaimer that this webinar is for general information and should not replace individual medical advice, and participants are encouraged to work with their own physical therapist or physician. This session focused on practical strategies for the balance challenges that come up in everyday life, both out in the community and at home. Balance challenges are highly personal, and people living with Parkinson’s often know their own trouble spots best.
Understanding Where Balance Challenges Happen
Balance difficulties are individual, but certain situations come up repeatedly for people with Parkinson’s.
Out in the community, challenges often arise in crowded, visually busy, or unpredictable settings — a busy train station with escalators and people moving in every direction, a bustling sidewalk or bus stop, or a crowded hardware store or supermarket.
At home, common trouble spots include standing up from a low, soft, comfortable chair and then turning around a coffee table, moving through narrow spaces such as doorways and closets, making a turn from a hallway into a stairwell, and the transitions involved in getting in and out of a car.
Recognizing exactly where your own balance feels most challenged is the starting point for finding strategies that help.
A Framework: Environment, Task, and You
Dr. Baker suggested breaking any balance challenge into three parts: the environment you are negotiating, the task you need to do, and you personally — your own body, energy, and Parkinson’s. Looking at each separately makes it easier to see which strategy will actually address the problem, whether the challenge is out in the community or at home.
Balance in the Community
In community settings, several features of the environment can undermine balance: crowds (parking lots, stores, doctors’ offices, pharmacies), the unpredictability of stopping and starting (pulling open a door, stopping at a crosswalk, moving quickly when elevator doors open), uneven or changing surfaces (ramps, curbs, bumpy curb cutouts), and lighting that shifts from dim to bright (a darkened theater or restaurant, or stepping from an office into a bright parking lot).
Some possible strategies:
- Optimize conditions when you can — shop at off-peak hours, and either park close to the entrance or, if you prefer, park farther away where the area around your car is less crowded (keeping in mind the trade-off of a longer walk).
- Consider an assistive device for added support, especially over longer distances.
- Plan for lighting — for example, keep a flashlight or use your phone’s light to reach a seat in a dark theater.
The task itself also carries balance demands. Shopping, for instance, means managing items — lifting, carrying, and turning to load them into the car — and holding a conversation while walking can become its own distraction. Some approaches:
- Minimize distractions and attentional demands; sometimes it helps to focus only on walking safely from the car into the store.
- Use a cross-body bag (or a backpack, depending on what works for you) so your hands stay free for support, a cart, or a device.
Finally, your own body plays a role. Common personal factors include:
- Fatigue — if several errands in a row are difficult, use a pacing plan with planned breaks, or reduce how many errands you take on at once.
- Medication cycle — when possible, schedule the more balance-demanding parts of your day during your “on” time.
- Vision — make sure you have the right glasses for the task, whether distance glasses for getting around or a different pair for reading items in a store.
- Confidence — a previous stumble or fall can lower confidence, and recognizing that is part of understanding how you move.
Assistive Devices
An assistive device connects you to the ground, which widens your base of support and makes balance easier to maintain. There are many options, and recommendations should be personalized: it is best to try a device out and to work with a physical therapist to find what suits you. Use can be very context-specific — some people keep a rollator in the trunk for longer walks, or bring a hiking pole, walking stick, or cane into certain situations and not others. A visible device can also signal to others that you may need a little extra time and space.
Balance While Walking
With walking, it helps to identify the goal. For some people, simply getting around feels challenging and requires close attention to balance; for others, walking is an exercise tool where the aim is more speed or challenge; and for travel, the goal is to enjoy unfamiliar, sometimes unpredictable terrain, where a lightweight assistive device may help.
Environmental factors — indoor versus outdoor, or uphill surfaces — shape the challenge, as does your own walking pattern: a forward or stooped posture that makes losing balance forward more likely, shuffling, or freezing of gait.
A physical therapist can help work through balance challenges specific to walking.
Navigating an Unfamiliar Place
Using the example of dinner at an unfamiliar restaurant — a scenario that could equally be a wedding reception, a new specialist’s office, or a new gym. Strategies to consider:
- Call ahead to learn how close the parking is and how busy it will be at your reservation time.
- Bring a cane if it sometimes helps, since you cannot predict what support you will want.
- Wear comfortable, sturdy, confidence-inspiring shoes rather than less-supportive footwear.
- Think about seating — whether a chair or the support of a booth suits you better.
- If you will be sitting a while, warm up before standing (for example, ankle pumps under the table), and let your companions help — holding your chair as you stand, or leading the way through traffic to the restroom.
Balance at Home
Home brings many of the same considerations — environment, task, and self — with some differences. Your home is familiar and usually less crowded, which is an advantage, but some elements are fixed and harder to change. For example, if you trip over a threshold between rooms, options include painting it a distinct color to draw your attention or adding a grab bar for reliable support during the transition.
Unpredictability can come from pets or grandchildren, and while lighting is something you often have more control over at home, sounds such as a ringing doorbell can prompt rushing — so it helps to recognize that and move at your own pace.
Tasks at home vary widely — lifting, carrying, changing sheets, taking something to the basement — and each task can challenge balance differently.
Some practical strategies:
- Minimize distractions and focus on one thing at a time.
- Plan ahead, and keep frequently used kitchen items at waist height rather than in low cabinets.
- For difficult sit-to-stand transitions, incorporate functional balance-training exercises, set your legs the way you need them, and use good arm support.
General home strategies include:
- Clear surfaces of loose rugs or anything you could trip over, even a rug that has been there for years.
- Install grab bars, especially in the bathroom and shower where turning and transitions are frequent.
- Choose supportive footwear even indoors if house slippers do not give you enough stability.
Staying Safe at Night
A nighttime trip to the bathroom can be especially risky — you may be tired, groggy, and at the point in your medication cycle with the least medication in your system.
Helpful steps include keeping the path from bed to bathroom clear and straight, considering an assistive device such as a walker just for that trip, ensuring critical lighting with a nightlight or a well-lit path rather than dim lighting, and having grab bars or another stable surface for support.
Key Take-Home Points
Identify specifically where your balance challenges happen, at home and in the community.
Optimize what you can, eliminate distractions, and add the supports that work for you.
Work with a physical therapist on your individual challenges — a recommendation the presenters returned to throughout.
Questions and Answers
Q: I have trouble with my balance when I turn or navigate corners. What are the top strategies for that?
A: Turning is a common balance challenge because it involves a change in direction and often a head turn that some people find destabilizing. The main suggestion is to slow down before turning, rather than turning at full walking pace, since moving straight into a turn at cruising speed is often where balance becomes unstable.
Dr. Baker recommended looking where you are going as you turn — the head and eyes lead the body — while staying aware of the surface around your feet without staring straight down. For those who tend to turn quickly, almost pivoting, she suggested a wider turn using more, steadier steps, and noted that a railing or an assistive device can add support through the turn.
Q: Freezing of gait affects my balance. What strategies can help me stay steady when it happens?
A: Dr. Baker noted that freezing is especially challenging because the freeze reduces stability and often heightens anxiety, which further affects balance. Her first recommendation is to stop forward movement rather than fighting through the freeze, then initiate movement deliberately — self-coaching the first step, imagining stepping over something, taking a single side step before going forward, or marching in place and turning that into a step. She added that some people use visual cues, such as the lines of a crosswalk, to get smoother steps, that assistive devices help some people who freeze, and that it helps to recognize personal triggers and take the pressure off by letting others go first. Dr. Zoeller added that modifying the environment can help as well — widening spaces, removing clutter, and reducing surface changes in the spots where freezing tends to happen.
Q: Backing up or stepping backward is a real challenge for me. Any strategies for when I have to back up?
A: Dr. Baker pointed out that backing up comes up constantly in daily life — stepping back from a grocery shelf to your cart, or moving around the kitchen — so the first step is recognizing it as a challenge. When possible, she recommended having hand support on a genuinely stable, fixed surface — a counter, wall, or door frame rather than something that can move, like a chair — and keeping your focus on the task rather than on conversation.
Because backing up usually happens in just a step or two, she suggested a slightly longer, deliberate backward step, landing it, then landing the next, as an intentional “one, two.”
Dr. Zoeller added that some people succeed with that same “one, two” while adding a bit of lateral movement — almost a diagonal, dance-like step — so they are not moving straight back.
Q: For someone with visual impairment or vision difficulties related to Parkinson’s, what options are there?
A: Dr. Baker emphasized that vision is a major contributor to balance, so it is worth the effort to optimize it. She gave the example of bifocals, which can make a curb step or a staircase especially difficult because of the visual mismatch.
For a curb, she suggested full focus on the task, deliberately looking down and taking an intentional step so the foot clears and lands on the curb; for stairs, staying on the railing side and, when not confident about seeing each step, switching to a slower “step-together, step-together” pattern.
She also recommended staying in regular contact with your ophthalmologist or vision provider, since adjusting your glasses may give sharper, clearer input.
Q: I often lose my balance when I first stand up, especially if I stand up quickly. What can help?
A: Both PTs agreed the first step is to take your time — giving yourself a few seconds to transition and check in with how you feel before moving.
Dr. Baker added that if blood pressure changes are noticeable on standing, they can sometimes be addressed with compression garments, and that a little ankle or lower-leg activity beforehand can help with blood flow when you know you are about to stand. Once up, she advised against rushing — keep holding onto something a moment longer than feels necessary to be sure of your balance, and let the people you are with know you may need an extra moment.
Dr. Zoeller closed with a reminder that choosing one or two strategies and repeating them — widening your feet before standing, pausing before you walk — turns them from something you have to think about into a habit.