Research has unveiled some important associations between bad posture and health issues. Age related degenerative changes in the spine can contribute to a stooped posture, and a tendency to bend or flex forward is also the most common change in posture seen with Parkinson’s disease.
With normal posture our weight is well centered over the middle of our feet making it much easier to balance. When our spine is bent forward, the head also comes forward and our center of mass shifts ahead of the feet. This leads to difficulty in taking big steps and requires more energy to walk. Falls are more likely to happen due to reduced foot clearance or shuffling that occurs while walking with knees bent. Also, forward slouching limits arm swing, can cause shoulder and neck problems, and reduces lung volume which can lead to poor breath support affecting both speech and swallowing.
Good posture starts with a strong core, which includes the diaphragm and abdominal muscles. Strong core muscles are resistant to pain and injuries, help to hold your body upright, and help improve balance. Specific exercises targeting the diaphragm may help strengthen the core and improve breathing patterns, including the timing and coordination required for efficient breathing and swallowing. A few pilot studies indicate that for the elderly, who are more at risk for falling, instruction in diaphragmatic breathing would reduce the occurrence of injury and/or fatality.
Diaphragmatic breathing can be easily taught and strengthening of this muscle can include the use of respiratory muscle training (RMT). RMT is typically done by breathing through a handheld device with varying levels of resistance similar to using free weights for skeletal muscle strengthening. In addition to improvement in posture, strengthening of the diaphragm can promote a deeper inspiration, helping to expand the distal airways and improve expiratory muscle function necessary for adequate speech production and cough.
Breathing muscles are also a vital component of the systems that enable a person to maintain upright posture and to stabilize the body’s core. But competition between the non-respiratory functions and respiratory functions of the trunk musculature can lead to overload (an example of this is when someone holds their breath while trying to balance on one leg). Researchers recently showed that 8 weeks of unsupervised, home-based inspiratory muscle training (IMT) is both feasible and effective in improving balance ability, and reported that it improves dynamic and reactive balance, as well as gait speed and inspiratory muscle function for healthy older adults.
[1] Ferraro FV, Gavin JP, Wainwright TW, McConnell AK (2020) Comparison of balance changes after inspiratory muscle or Otago exercise training. https://doi.org/10.1371/journal.pone.0227379 January 24, 2020
Breathing Exercises Can Help People with Parkinson’s related symptoms

Patient with Parkinson’s related swallowing problems uses the Breather with manometer for feedback and targeted training.
Rigidity of the trunk muscles is common in Parkinson’s disease, and may contribute to reduced balance and falls. In addition, restricted breathing patterns may also impact speech production and co-ordination of breathing and swallowing. The Breather® is a combined, inspiratory-expiratory respiratory (cRMT) muscle training device that can easily be incorporated into your daily schedule. Use it once or twice a day for core strengthening and additional potential benefits including improved breath support for speech and swallowing.
Dr. Andrew Weil, pioneer of the holistic health movement and author says: “If I had to limit my advice on healthier living to just one tip, it would be simply to learn how to breathe correctly.”
Voice Aerobics® Breath Work
Breathwork is Part 1 of the Voice Aerobics® DVD and the 15 minute video provides guided practice with focus on diaphragmatic breathing and upper body posture and stretching. It was developed for persons with Parkinson’s disease and related diagnosis, and it can be purchased for as little as $7.99. Visit our website to order or to learn more about our products. https://voiceaerobicsdvd.com/product/breathwork-video/
We often have heard it said all we have is the present but this year has truly been a lesson for all of us about living and being in the present. As this unusual year comes to an end, I hope that we can all stay in a place of gratefullness and optimism towards what 2021 might bring, and perhaps borrow a few words from the serenity prayer.
God grant me the Serenity to accept the things I cannot change,
Courage to change the things I can, and
Wisdom to know the difference.
My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice
Voice Aerobics the heART and Science of Voice Practice
The diaphragm is the primary muscle of inspiration and also a part of the core muscles which provide support and stability to the spine. Rib cage expansion is indeed important, and can be reduced post operatively due to pain, when muscles are weak, or when muscles are stiff a symptom associated with a disease process as is the case in Parkinson’s.
All breathing is done with the diaphram whether your chest expands or you belly. All breathing is diaphramatic. If your chest does not exand you can only get half of a breath. I think it’s ridiculous to try and breathe without expanding your chest.
Thank you, Vijee for your comment and feedback. Now more than ever we can all benefit from some “mindful” breathing, and I’m glad to hear you have found the Breather a helpful tool.
Great post. Thanks for sharing. Posture, core strength, and, breathing correctly are all so important to one’s well-being. I have noticed an improvement in my overall health after I started practicing mindful breathing with The Breather.