Lifestyle Medicine and Parkinson’s Disease in Viet Nam: Individualized Exercise, Fall Risk, and Swallowing Safety

Lifestyle Medicine and Parkinson’s Disease in Viet Nam: Individualized Exercise, Fall Risk, and Swallowing Safety

Last reviewed: October 30, 2026

A person living with Parkinson’s disease may walk comfortably in the morning but struggle to turn or initiate movement later in the day. Another may remain physically active yet experience repeated near-falls, dizziness when standing, or increasing difficulty swallowing food and medication. These changes can develop gradually and may not always be apparent during a routine medical appointment.

Exercise is an important part of Parkinson’s care, but telling every patient to walk more or stay active is not enough. The condition affects movement, balance, autonomic function, swallowing, and other aspects of daily life in ways that differ considerably between individuals. Someone who can safely participate in a supervised exercise program may benefit from improved mobility, while another person with frequent falls or swallowing difficulties may require additional assessment before making changes to their activities or diet.

Evidence-based Lifestyle Medicine can contribute through individualized physical activity, adequate nutrition, restorative sleep, psychological support, and strategies that help people maintain daily function. However, these interventions must complement neurological treatment, rehabilitation, and continuing clinical assessment.

For healthcare professionals in Viet Nam, the challenge is to help people remain active and independent while recognizing risks that require medical attention. Falls, swallowing difficulties, autonomic symptoms, and interruptions in prescribed medication deserve particular attention because their consequences can extend well beyond the patient's immediate symptoms.

Parkinson’s Disease Requires More Than General Exercise Advice

Parkinson’s disease is a progressive neurological disorder associated with degeneration of dopamine-producing neurons and changes in several interconnected neural systems. Its characteristic motor manifestations include bradykinesia, rigidity, and resting tremor. Postural instability often becomes more prominent as the disease progresses, although its timing and severity vary considerably.

Motor symptoms represent only part of the condition. People with Parkinson’s disease may also experience constipation, sleep disturbances, fatigue, depression, cognitive changes, urinary symptoms, orthostatic hypotension, and swallowing difficulties. These nonmotor manifestations can substantially affect daily functioning and influence whether particular rehabilitation activities are safe or practical.

Someone who becomes dizzy when standing may be at risk of falling even if leg strength is relatively well preserved. Another person may walk independently but struggle to swallow medication safely. A patient with cognitive impairment may have difficulty following complex exercise instructions or remembering strategies intended to reduce freezing of gait.

Parkinson’s disease is primarily a clinical diagnosis requiring appropriate neurological assessment. Other causes of parkinsonism, including medication-induced syndromes and atypical neurodegenerative conditions, may require different management approaches. Rehabilitation should therefore follow suitable clinical evaluation rather than substitute for investigating unexplained neurological symptoms.

Even among people with an established diagnosis, treatment needs change over time. Someone with mild symptoms may benefit from establishing an exercise routine that supports cardiovascular fitness, strength, and mobility. A person experiencing motor fluctuations may need activities coordinated with medication response, while another with frequent freezing episodes or substantial balance impairment may require closer supervision.

Individualized care should address current functional limitations while anticipating changes that may affect safety, participation, and independence.

The 2026 Exercise Recommendations Emphasize Individualization

On February 17, 2026, the Parkinson’s Foundation and the American College of Sports Medicine announced updated exercise recommendations for people living with Parkinson’s disease.

The update followed a review involving exercise professionals, other subject-matter experts, and members of the Parkinson’s community. Particular attention was given to practical aspects of exercise, including dose and intensity, time management, progression, and adaptation as symptoms change.

The recommendations continue to address four complementary areas: aerobic activity, strength training, flexibility, and neuromotor or functional training involving balance, agility, and multitasking.

These components address different needs. Aerobic exercise can improve cardiorespiratory fitness and endurance, while resistance training helps maintain strength for activities such as rising from a chair, climbing stairs, and walking. Flexibility exercises may help with stiffness and restricted movement. Balance and functional training focus more directly on postural control, gait, turning, and movements relevant to daily independence.

A comprehensive program may combine several of these components, but the appropriate activities, frequency, intensity, and progression depend on the individual. Someone who walks confidently outdoors may have different rehabilitation needs from a person who freezes when approaching a doorway or becomes lightheaded when standing.

Medication response also matters. Physical performance can vary between periods when Parkinson’s medication is working well and periods when symptoms become more pronounced. Fatigue, cognitive difficulties, other medical conditions, and previous exercise experience may further influence the program.

For some people, supervised exercise is especially valuable during initial assessment and training. Others may be suitable for structured home-based activities after appropriate instruction, with periodic review of symptoms, functional progress, and safety.

The updated recommendations should therefore be understood as a framework for exercise planning rather than a fixed prescription for everyone with Parkinson’s disease.

Exercise Can Improve Function, but Disease Modification Remains Uncertain

Exercise is an evidence-supported component of comprehensive Parkinson’s care because of its potential to improve motor symptoms, physical performance, and quality of life.

A Cochrane systematic review and network meta-analysis published in April 2024 evaluated 154 randomized controlled trials involving 7,837 participants with Parkinson’s disease. Several forms of exercise demonstrated benefits compared with no exercise.

Dance and gait, balance, or functional training probably provided moderate improvements in motor symptoms. Programs combining several exercise domains also showed benefits, while endurance training, resistance training, aquatic exercise, and mind–body activities produced potentially favorable effects on selected outcomes.

However, the review found relatively little reliable evidence that one exercise modality was consistently superior to all others. Clinical suitability is not determined by exercise type alone.

Someone who enjoys dancing may participate more consistently in a suitable dance-based program. Another person may prefer stationary cycling, supervised walking, or activities involving balance and strengthening. The choice should reflect clinical needs and safety, but preferences, accessibility, and the likelihood of sustained participation also matter.

The evidence has limitations. Most participants in the Cochrane review had mild-to-moderate Parkinson’s disease, and many studies excluded people with advanced disability or substantial cognitive impairment. Findings cannot therefore be generalized automatically to those with severe disease.

Adverse events were also reported inconsistently. Falls, pain, and other problems occurred in some studies, but the available evidence was insufficient to establish reliably which exercise approaches carried the lowest risk across different patient groups.

Another important distinction concerns disease progression. Improvements in walking, motor performance, or quality of life do not demonstrate that exercise prevents neuronal degeneration or stops Parkinson’s disease from progressing.

Whether particular exercise interventions have disease-modifying effects remains an important research question. Until stronger evidence is available, exercise should be promoted for its established functional benefits without presenting it as a means of reversing the underlying neurological disorder.

Fall Prevention Requires Attention to Everyday Movement

Falls can have serious consequences for people with Parkinson’s disease, particularly when they cause fractures, hospitalization, fear of movement, or loss of independence.

Fall risk involves more than muscle weakness. Freezing of gait, impaired postural reflexes, difficulty turning, reduced attention, visual problems, orthostatic hypotension, and medication-related motor fluctuations can all contribute.

Freezing of gait is particularly challenging because it may occur unexpectedly. A person may walk relatively comfortably along an open corridor but suddenly become unable to initiate or continue stepping when approaching a doorway, turning, or moving through a crowded space.

A conventional walking program may not adequately address this difficulty. Parkinson-specific rehabilitation can include gait training, turning strategies, external cueing, and exercises targeting postural control.

Rhythmic auditory cues or visual references may help selected patients manage freezing episodes. However, these techniques are not uniformly effective and should be introduced according to the person's clinical presentation and ability to use them safely.

Dual-task training, in which a movement is performed while completing another task, can also be relevant to everyday functioning. It may help some patients manage situations requiring divided attention, but for others it can increase instability. The appropriateness of this approach depends on cognitive function, balance, and supervision.

Assessment should extend beyond what happens during a rehabilitation session. Someone may perform reasonably well during a supervised walking test but repeatedly lose balance while turning in a small bathroom, getting out of bed, or rushing to answer the telephone.

Asking about near-falls, fear of falling, activities that patients have begun avoiding, and the circumstances surrounding previous falls may reveal risks that are not apparent during a brief examination. Footwear, walking aids, lighting, floor surfaces, and home layout may also influence safety.

An umbrella review published in Frontiers in Psychology on October 13, 2026, examined systematic reviews and meta-analyses of exercise interventions for balance in Parkinson’s disease.

The authors found improvements in several clinical balance measures, but evidence relating to actual falls was inconsistent. Some analyses suggested reductions in fall rates, while others did not demonstrate a reduction in the proportion of people who experienced falls. The certainty of the underlying evidence also varied.

This distinction matters because improved performance on a balance test does not guarantee that someone will fall less frequently at home.

For healthcare professionals, the goal is to support safer mobility while monitoring actual falls, near-falls, injuries, and changes in the person's confidence and independence.

Orthostatic Hypotension Can Affect Rehabilitation Safety

A person with Parkinson’s disease may experience dizziness, weakness, visual dimming, or instability when moving from sitting to standing.

These symptoms may reflect orthostatic hypotension, which can result from autonomic dysfunction and may also be influenced by medication, hydration status, or other medical conditions.

Orthostatic hypotension can increase fall risk and make rehabilitation more difficult. Someone may perform seated exercises comfortably but become unstable when standing or walking. Another may experience symptoms after meals, during hot weather, or when getting out of bed.

Clinical evaluation may include blood pressure measurements while lying down and standing, medication review, and consideration of other possible causes. Treatment should reflect the underlying problem and the patient's overall medical condition.

The relevance to Viet Nam is practical. Hot weather, prolonged outdoor activities, and difficulty maintaining adequate hydration can complicate symptoms for some patients. However, recommendations to increase fluid or salt intake require individual assessment, especially when hypertension, heart failure, kidney disease, or other relevant conditions are present.

A prospective observational study published in the Cantho Journal of Medicine and Pharmacy on April 25, 2026, evaluated 54 patients with Parkinson’s disease and autonomic dysfunction receiving treatment at Can Tho Central General Hospital.

Over three months, the investigators reported improvements in autonomic symptom scores and quality of life. The median score on the eight-item Parkinson’s Disease Questionnaire decreased from nine to five, while measures of autonomic dysfunction and orthostatic hypotension-related symptoms also improved.

These findings provide useful insight into the clinical importance of autonomic symptoms among Vietnamese patients. However, the study did not include a randomized comparison group, and the improvements cannot be attributed exclusively to a particular medication, lifestyle intervention, or treatment component.

The results should therefore be interpreted as observational evidence rather than proof of the effectiveness of a specific approach.

For exercise planning, the practical implication is that autonomic symptoms need to be assessed alongside gait, balance, strength, and medication response.

Medication Timing Is an Important Part of Safe Care

Exercise and neurological medication should be considered together rather than managed as unrelated aspects of Parkinson’s care.

Levodopa remains a central treatment for motor symptoms. Some people experience predictable periods of good symptom control followed by periods when medication becomes less effective, while others develop more complex motor fluctuations.

These changes can influence walking, balance, coordination, and the ability to participate safely in physical activity. A person who exercises comfortably during a period of good medication response may struggle with the same activity when rigidity or freezing becomes more pronounced.

Rehabilitation professionals should therefore understand the medication schedule and how physical performance changes throughout the day. Exercise timing may be adjusted according to symptom control, fatigue, functional goals, and practical circumstances.

However, medication adjustment is not part of general lifestyle counseling. Patients should not independently change levodopa doses, extend dosing intervals, or discontinue treatment because they are participating in an exercise program.

Medication continuity becomes particularly important during hospitalization.

Delayed or missed doses can cause substantial deterioration in motor function and, in some circumstances, serious complications. Abrupt withdrawal or major interruption of dopaminergic treatment may precipitate a potentially life-threatening withdrawal syndrome.

An international expert consensus on dysphagia management during hospitalization, published in January 2026, emphasizes timely medication reconciliation and administration. Neurological input is recommended when treatment changes become necessary.

Swallowing difficulties can make medication administration more complicated. Some formulations cannot safely be crushed, divided, or administered through feeding tubes without professional review.

When a patient cannot swallow medication safely, the appropriate response is to establish an alternative plan with the treating team and relevant pharmacy professionals rather than withholding doses or changing the formulation independently.

Care is also needed when patients undergo procedures requiring temporary restrictions on oral intake. The medication schedule should be considered during planning, with alternative administration arrangements established when necessary.

Maintaining prescribed neurological treatment is therefore essential to rehabilitation safety, particularly during admission, procedures, discharge, and transfers between healthcare facilities.

Swallowing Difficulties Need Early Recognition

Swallowing difficulties are an important and sometimes underrecognized complication of Parkinson’s disease.

Patients may experience coughing or choking during meals, prolonged eating time, difficulty swallowing tablets, drooling, changes in voice quality after swallowing, or unintentional weight loss.

However, the absence of obvious choking does not exclude swallowing impairment.

Some people experience silent aspiration, in which food, liquid, or saliva enters the airway without producing an effective cough response. This can make swallowing problems difficult to recognize through ordinary observation.

Recurrent respiratory infections, unexplained nutritional decline, changes in eating habits, or increasing difficulty taking medication may therefore warrant further assessment.

An international expert consensus published online on January 5, 2026, in the Journal of Parkinson’s Disease addressed dysphagia management during hospitalization.

The consensus recommends standardized screening for oropharyngeal dysphagia in hospitalized patients with Parkinson’s disease unless there is a compelling reason screening cannot be performed.

Patients who fail screening or have a relevant history of swallowing difficulties may require assessment by an appropriately qualified swallowing specialist. When clinically indicated, instrumental evaluation may include videofluoroscopic swallowing studies or flexible endoscopic evaluation of swallowing.

These investigations can provide information about swallowing physiology and aspiration risk that may not be apparent through bedside observation alone.

The consensus also emphasizes nutritional risk assessment and coordination among neurologists, swallowing specialists, rehabilitation professionals, dietitians, nurses, and pharmacists.

This is important because dysphagia may affect several aspects of care simultaneously. A patient may struggle to maintain adequate food intake, become dehydrated, lose weight, or experience difficulty receiving prescribed medication on time.

Changes to food texture, liquid thickness, swallowing posture, or feeding methods should be selected according to the person's swallowing function and clinical circumstances.

They should not be applied as universal solutions.

For example, thickened liquids may reduce certain swallowing-related risks in selected patients but can also affect acceptability, hydration, and quality of life. Modified-texture diets may contribute to inadequate nutritional intake if they are poorly planned or tolerated.

In patients with severe or persistent dysphagia, alternative routes for nutrition or medication may sometimes be considered following appropriate multidisciplinary assessment and shared decision-making. However, feeding tube placement does not eliminate aspiration risk and should not be presented as a guaranteed way to prevent aspiration pneumonia.

The appropriate goal is to balance swallowing safety, adequate nutrition, hydration, medication administration, and patient preferences.

When swallowing problems interfere with essential treatment or nutritional intake, timely clinical assessment and specialist coordination become particularly important.

What the 2026 Cochrane Review Tells Us About Swallowing Rehabilitation

A Cochrane systematic review published on January 21, 2026, examined rehabilitation interventions for oropharyngeal dysphagia in people with Parkinson’s disease.

The review included 18 randomized studies involving 1,216 participants.

Investigated approaches included behavioral swallowing rehabilitation, expiratory muscle strength training, tongue-strengthening exercises, and several types of electrical or noninvasive brain stimulation.

Some behavioral interventions, particularly expiratory muscle strength training, showed potentially favorable effects on selected measures of swallowing safety. However, the certainty of the evidence was very low.

Most studies were relatively small and differed in intervention methods, treatment duration, participant characteristics, and outcome measurement. These limitations made it difficult to draw reliable conclusions about the effectiveness of specific techniques.

The authors concluded that larger, well-designed trials are needed to establish which rehabilitation interventions are effective and for which patients.

This uncertainty should not be interpreted as a reason to neglect dysphagia management.

Patients with swallowing difficulties still require appropriate assessment and care to address immediate risks to nutrition, hydration, medication delivery, and respiratory health.

However, individual rehabilitation techniques should not be promoted as proven to eliminate swallowing difficulties, prevent aspiration pneumonia, or reduce mortality in every person with Parkinson’s disease.

Clinical management may involve individualized swallowing strategies, compensatory techniques, appropriate exercises, or changes to food and medication administration when indicated.

The intervention selected should reflect the patient's swallowing assessment, clinical risk, treatment goals, and response to care.

The available evidence supports the importance of addressing dysphagia while requiring transparency about what remains uncertain regarding individual rehabilitation methods.

What Research From Viet Nam Shows About Swallowing Rehabilitation

A study published in the Vietnam Journal of Community Medicine on January 15, 2026, evaluated swallowing function among patients with Parkinson’s disease receiving rehabilitation at the National Geriatric Hospital.

The study included 35 patients treated between September 2024 and September 2025.

Participants received a three-week rehabilitation program involving oropharyngeal exercises, safe swallowing techniques, and training in appropriate posture during meals, delivered under professional supervision.

Swallowing function was assessed using the Gugging Swallowing Screen.

The mean score increased from 12.97 before treatment to 14.31 afterward, representing an average improvement of 1.34 points. The difference was statistically significant.

These findings provide useful preliminary information about the outcomes of swallowing rehabilitation delivered in a Vietnamese hospital.

However, the study did not include a control group. Consequently, changes observed after treatment cannot be attributed exclusively to the rehabilitation program.

Changes in medication, clinical condition, learning effects during assessment, or other factors may have contributed.

The sample was relatively small, and the intervention lasted only three weeks. The findings do not establish that the program prevented aspiration pneumonia, reduced hospitalizations, or improved survival.

They also do not demonstrate that the intervention was superior to other rehabilitation approaches.

A statistically significant change in an assessment score should not automatically be interpreted as a clinically important improvement for every patient.

The study's value lies in documenting outcomes from a locally delivered intervention and highlighting the need for further research.

Future studies in Viet Nam could examine different rehabilitation approaches, longer follow-up periods, nutritional outcomes, respiratory complications, and patient-reported experiences of eating and swallowing.

Together with the international evidence, these findings reinforce the importance of distinguishing improvement in a clinical assessment score from proven reductions in serious complications.

Nutrition Must Support Swallowing and Medication Treatment

People with Parkinson’s disease may experience nutritional difficulties for several reasons.

Reduced appetite, swallowing impairment, constipation, slow eating, involuntary movements, fatigue, and difficulty shopping for or preparing food can all contribute to inadequate intake.

Over time, these problems may increase the risk of unintentional weight loss, malnutrition, and reduced muscle mass.

Nutritional assessment is therefore an important component of comprehensive care, particularly when symptoms are advanced or physical function is declining.

However, dietary counseling should not be reduced to recommending particular foods or supplements.

One issue requiring careful assessment is the interaction between dietary protein and levodopa.

In some patients, amino acids derived from dietary protein can compete with levodopa for transport mechanisms involved in intestinal absorption and entry into the central nervous system. This may contribute to fluctuations in medication response.

The effect is not equally important for everyone.

Most people with Parkinson’s disease do not need to reduce their total protein intake. For selected patients who experience clinically significant motor fluctuations associated with meals, the treating neurological team and an appropriately qualified dietitian may consider changing how protein is distributed throughout the day.

A protein redistribution diet generally involves consuming a greater proportion of daily protein later in the day while maintaining adequate total intake.

This is different from recommending a low-protein diet.

Inappropriate protein restriction can contribute to weight loss, loss of muscle mass, and nutritional deficiencies, particularly among older adults and those already experiencing weakness or malnutrition.

The updated Parkinson’s UK professional guidance for dietitians, reviewed in February and announced in March 2026, adopts a symptom-led approach to nutritional care.

It considers malnutrition, constipation, swallowing difficulties, involuntary movements, and medication–nutrient interactions rather than assuming that dietary needs depend only on the stage of disease.

This approach is relevant in Viet Nam, where daily meals commonly include rice, noodles, vegetables, fish, meat, tofu, and other familiar foods.

A practical nutrition plan should consider meal timing, food preferences, swallowing ability, nutritional requirements, and the relationship between meals and medication response.

A person with dysphagia may require changes to food texture or eating methods. Someone with reduced appetite may need support to maintain adequate energy intake. Another patient experiencing motor fluctuations may benefit from careful review of meal patterns and levodopa administration.

These are different clinical problems and should not be managed through the same dietary recommendation.

No particular diet, nutritional supplement, or commercial wellness program has been established as a cure for Parkinson’s disease.

Nutrition care should aim to maintain adequate intake, support physical function, and complement effective neurological treatment while reducing avoidable complications.

Measuring Outcomes That Matter to Patients

A Parkinson’s rehabilitation program should be evaluated according to changes in function, safety, symptoms, and quality of life.

Attendance at exercise sessions or completion of prescribed activities provides information about participation, but it does not establish clinical benefit.

For motor function, appropriate measures may include the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale, gait speed, the Timed Up and Go test, and standardized balance assessments.

The measures selected should reflect the patient's functional abilities and treatment goals.

Medication state also needs consideration because performance may differ between periods of good symptom control and periods when motor symptoms are more pronounced.

Fall-related outcomes deserve attention beyond balance scores.

Recording actual falls, near-falls, and the circumstances in which they occur can identify risks that may not be apparent during supervised testing.

A patient may demonstrate improved balance in a clinic but continue to fall at home when turning, getting out of bed, or moving through a crowded space.

Patient-reported measures, including the Parkinson’s Disease Questionnaire, can provide additional information about mobility, emotional well-being, daily activities, and quality of life.

For swallowing rehabilitation, standardized tools may help monitor change, but assessment should also consider nutritional status, respiratory complications, the ability to take medication safely, and the person's experience of eating.

The interpretation of clinical instruments should reflect professional training, language, and the availability of appropriately validated versions.

A score change should not automatically be described as clinically meaningful simply because it is statistically significant.

Patients may also have different priorities.

One person may want to walk safely to a nearby shop. Another may hope to continue sharing meals with family members without distress. Someone with advanced disease may prioritize safe transfers, comfortable eating, communication, or maintaining familiar routines with assistance.

These goals should inform care planning while remaining realistic about the progressive nature of the condition.

When expected improvements do not occur, the care team should reconsider symptoms, medication response, rehabilitation activities, and possible medical complications rather than simply extending the same intervention.

Making Coordinated Parkinson’s Care Practical in Viet Nam

Evidence-based Parkinson’s care requires coordination among neurological treatment, rehabilitation, nutrition, swallowing assessment, and support for everyday functioning.

This can be difficult when patients receive care through different healthcare facilities or have limited access to specialized services.

In Viet Nam, someone may attend a neurological clinic at a major hospital while receiving rehabilitation or continuing support closer to home.

Travel distance, cost, local service availability, and family caregiving responsibilities can influence whether treatment remains consistent.

These circumstances should be considered when developing rehabilitation plans.

For clinically suitable patients, home-based exercise may offer an accessible option after appropriate assessment, instruction, and follow-up.

Family members and other care partners can help support participation, recognize changes in symptoms, and communicate concerns to healthcare professionals.

However, their involvement does not replace professional evaluation.

A person with frequent falls, severe freezing of gait, significant cognitive impairment, or swallowing difficulties may require further assessment before undertaking independent activities.

Similarly, someone with suspected aspiration may need formal swallowing evaluation before substantial changes are made to food texture, liquid consistency, or feeding methods.

Telehealth and digital tools may support education, medication reminders, follow-up, and communication for selected patients.

However, they cannot reliably replace physical examination, individualized gait assessment, or instrumental swallowing evaluation when these are clinically necessary.

An international consensus on multidisciplinary rehabilitation in Parkinson’s disease published in 2024 emphasizes coordinated services across disease stages, including physical therapy, occupational therapy, speech-language therapy, and other relevant disciplines.

For Vietnamese healthcare organizations, improvements may begin with clearer referral criteria, better documentation of medication schedules, appropriate assessment of fall risk, and earlier identification of swallowing difficulties.

Communication during hospital admission, discharge, and transfer between facilities is especially important.

Patients and care partners should understand which activities are suitable, what symptoms require reassessment, and how prescribed medications should be maintained safely.

Healthcare professionals also need access to relevant information about rehabilitation progress, swallowing restrictions, medication changes, and important clinical risks.

The purpose is not to reproduce a complex international rehabilitation model without considering local resources.

It is to apply the underlying evidence and safety principles through coordinated services that are feasible, professionally appropriate, and responsive to the patient's needs.

Professional Responsibilities and Legal Boundaries in Viet Nam

Lifestyle Medicine can contribute to Parkinson’s disease care through evidence-based education, appropriate physical activity, nutritional support, sleep-related health education, behavior-change support, and attention to the circumstances affecting daily functioning.

However, diagnosing Parkinson’s disease, prescribing or adjusting neurological medication, determining rehabilitation safety, and evaluating or treating swallowing disorders are clinical activities requiring appropriate professional qualifications and authorization.

In Viet Nam, the Law on Medical Examination and Treatment No. 15/2023/QH15, together with applicable amendments and implementing regulations, provides the relevant legal framework.

Consolidated Document No. 26/VBHN-VPQH, issued by the Office of the National Assembly on February 26, 2026, reflects the consolidated provisions of the Law.

Healthcare professionals must act within their qualifications, competence, legally authorized professional scope, and applicable institutional responsibilities.

Education or certification in Lifestyle Medicine does not independently authorize someone to diagnose Parkinson’s disease, prescribe neurological medication, deliver specialized clinical rehabilitation, or determine an individualized swallowing treatment plan beyond their permitted professional responsibilities.

Exercise and nutrition interventions delivered as part of medical treatment must also comply with applicable professional and institutional requirements.

International recommendations from the Parkinson’s Foundation, American College of Sports Medicine, National Institute for Health and Care Excellence, Cochrane, and other professional organizations may inform clinical education, evidence appraisal, and quality improvement.

However, they do not automatically become Vietnamese regulatory requirements or establish the approval, availability, reimbursement, or suitability of particular medicines, rehabilitation services, or diagnostic technologies.

Personal health information also requires appropriate protection.

Neurological diagnoses, medication schedules, rehabilitation assessments, swallowing records, photographs, video recordings, and other identifiable patient information must be handled according to applicable confidentiality and personal data protection requirements.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/NĐ-CP, both effective January 1, 2026, are relevant to organizations processing identifiable personal health information.

Healthcare organizations and other parties processing such information must establish appropriate lawful processing arrangements, security safeguards, and clearly defined responsibilities.

For the Vietnam Lifestyle Medicine Alliance, the appropriate contribution is professional education, scientific knowledge sharing, critical appraisal of evidence, and responsible communication about the application of research in healthcare.

Educational articles and activities should not be presented as official Vietnamese clinical practice guidelines, individualized medical advice, or authorization to provide regulated medical treatment.

Supporting Movement, Safety, and Independence Together

Parkinson’s disease illustrates why Lifestyle Medicine must be individualized and integrated with established neurological care.

Exercise can improve motor function, physical capacity, and quality of life for many people. However, the most appropriate program depends on disease stage, medication response, balance, cognition, and other medical conditions.

Fall prevention requires attention to gait, freezing episodes, autonomic symptoms, and the environments in which people move. Improved balance during a supervised assessment does not necessarily establish that falls will decrease in everyday life.

Swallowing difficulties require equally careful consideration. Rehabilitation may help selected patients, but current evidence remains uncertain about the effectiveness of individual techniques for preventing serious complications.

Safe care also depends on adequate nutrition, reliable medication administration, and timely specialist assessment.

Research from Vietnamese hospitals provides useful early evidence about swallowing rehabilitation and autonomic symptom management. However, the findings must be interpreted according to their study designs rather than treated as proof that particular interventions are universally effective.

For healthcare professionals in Viet Nam, the opportunity is to strengthen the connection between neurological treatment, individualized exercise, fall-risk management, nutrition, swallowing safety, and coordinated follow-up.

Lifestyle Medicine can contribute by supporting activities that help people maintain function and participate in daily life while recognizing when additional medical treatment, rehabilitation, or specialist care is necessary.

The goal is not simply to encourage people with Parkinson’s disease to exercise more. It is to help them move, eat, and participate in everyday activities as safely and independently as their condition allows, supported by evidence-based, coordinated, and person-centered care.

Selected References

1. Parkinson’s Foundation and American College of Sports Medicine. Updated Parkinson’s Disease Exercise Recommendations. February 17, 2026.

2. Ernst M, Folkerts AK, Gollan R, et al. Physical Exercise for People With Parkinson’s Disease: A Systematic Review and Network Meta-analysis. Cochrane Database of Systematic Reviews. 2024;4. doi:10.1002/14651858.CD013856.pub3.

3. Yuan Y, Ran H, Song Y, Xu S, Chen K. Effects of Exercise on Balance in People With Parkinson’s Disease: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Controlled Trials. Frontiers in Psychology. 2026;17:1939213. Published October 13, 2026. doi:10.3389/fpsyg.2026.1939213.

4. National Institute for Health and Care Excellence. Parkinson’s Disease in Adults: Diagnosis and Management. NICE Guideline NG71. 2017. Consulted October 2026.

5. Goldman JG, Volpe D, Ellis TD, et al. Delivering Multidisciplinary Rehabilitation Care in Parkinson’s Disease: An International Consensus Statement. Journal of Parkinson’s Disease. 2024;14(1):135–166. doi:10.3233/JPD-230117.

6. Safarpour D, Brooks A, Smiley A, et al. Consensus Expert Recommendations for Management of Dysphagia During Hospital Admission in Parkinson’s Disease. Journal of Parkinson’s Disease. 2026;16(1):16–35. Published online January 5, 2026. doi:10.1177/1877718X251410503.

7. Battel I, Arienti C, Del Furia MJ, Lazzarini SG, Warnecke T, Walshe M. Rehabilitation Interventions for Oropharyngeal Dysphagia in People With Parkinson’s Disease. Cochrane Database of Systematic Reviews. 2026;1. doi:10.1002/14651858.CD015816.pub2.

8. Nguyễn Thị Tân Uyên, Nguyễn Hoài Nam, Kim Anh Tùng. Cải thiện khả năng nuốt theo thang điểm GUSS và các yếu tố liên quan ở người bệnh Parkinson sau phục hồi chức năng tại Bệnh viện Lão khoa Trung ương. Tạp chí Y học Cộng đồng. 2026;67(1):210–215. doi:10.52163/yhc.v67i1.4172.

9. Le VM, Lam TU, Thach MK, Le DMA. Effectiveness of Treatment for Autonomic Dysfunction and Quality of Life Changes in Parkinson’s Disease Patients. Cantho Journal of Medicine and Pharmacy. 2026;97:43–48. Published April 25, 2026. doi:10.58490/ctjump.2026i97.4818.

10. Parkinson’s UK. Best Practice Guidelines for Dietitians on the Management of Parkinson’s. Professional guidance reviewed February 2, 2026; updated edition announced March 31, 2026.

11. Rea BL, Cheema S, Lanza S, et al. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2026;20(3):443–451. First published online October 28, 2025. doi:10.1177/15598276251379821.

12. National Assembly of Viet Nam. Law No. 15/2023/QH15, dated January 9, 2023. Law on Medical Examination and Treatment.

13. Office of the National Assembly of Viet Nam. Consolidated Document No. 26/VBHN-VPQH, dated February 26, 2026. Law on Medical Examination and Treatment.

14. National Assembly of Viet Nam. Law No. 91/2025/QH15, dated June 26, 2025. Law on Personal Data Protection. Effective January 1, 2026.

15. Government of Viet Nam. Decree No. 356/2025/NĐ-CP, dated December 31, 2025. Detailing Certain Articles and Measures for the Implementation of the Law on Personal Data Protection. Effective January 1, 2026.

Editorial, Clinical and Legal Disclaimer

This article is published by Vietnam Lifestyle Medicine Alliance (VLMA), a physician-led professional education and knowledge-sharing initiative operated by Vietnam Lifestyle Medicine Alliance Company Limited, for general information and professional education. It provides an evidence-informed discussion of Lifestyle Medicine in Parkinson’s disease care and does not constitute an official clinical practice guideline, individualized medical advice, a neurological diagnosis, an exercise prescription, a swallowing rehabilitation protocol, a medication recommendation, or a treatment plan.

Exercise, nutrition, and other lifestyle-related interventions may contribute to Parkinson’s disease management but must not replace necessary neurological treatment, rehabilitation, medical monitoring, or specialist assessment.

The information must not be used to independently diagnose Parkinson’s disease, initiate or discontinue medication, adjust levodopa doses, determine individualized exercise safety, prescribe swallowing exercises, modify food or liquid consistency, or change medication administration methods without appropriate professional evaluation.

Patients experiencing sudden neurological deterioration, serious injuries following a fall, suspected aspiration with respiratory distress, inability to swallow safely, marked deterioration associated with missed medication, or other acute concerning symptoms require urgent medical assessment.

The exercise and rehabilitation recommendations discussed in this article are not universally appropriate. Their application depends on disease stage, clinical stability, medication response, balance, cognition, swallowing function, and other medical conditions.

International recommendations do not automatically constitute Vietnamese clinical standards or establish the regulatory approval, availability, reimbursement, or suitability of particular medicines, diagnostic techniques, rehabilitation methods, or medical technologies in Viet Nam.

All regulated clinical activities must be undertaken by appropriately qualified healthcare professionals acting within their legally authorized scope of practice and applicable requirements governing healthcare facilities in Viet Nam.

This article does not endorse any commercial exercise program, dietary product, supplement, medical device, rehabilitation provider, or healthcare organization. Identifiable patient information must be handled in accordance with applicable confidentiality and personal data protection requirements.

The content reflects the scientific evidence, professional recommendations, and legal sources reviewed as of October 30, 2026, and may require updating as further research, clinical guidance, and Vietnamese regulatory requirements evolve.