Regular exercise is as important as medication in managing Parkinson’s disease (PD), but PD symptoms prevent most persons with Parkinson’s (PD warriors), from being active.

To address this, Lien Foundation in partnership with Parkinson Society Singapore (PSS), NHG Health’s Tan Tock Seng Hospital (TTSH), National Neuroscience Institute (NNI) and other SingHealth institutions, have launched a Parkinson’s Disease community rehabilitation programme called Kickstart Exercise and Empower Parkinson’s (KEEP).

The programme kicked-off in January 2026 and 2,000 PD Warriors in their early to mid-stage of disease progression are expected to benefit from the programme over the next five years.

In 2019, more than 8,000 persons in Singapore were estimated to be living with PD. Now in 2026, that figure is estimated to be more than 10,000 due to Singapore’s ageing population. The condition damages the dopamine producing neurons in the brain, causing tremors, rigidity and slowness. In addition, non-motor symptoms like fatigue, apathy and depression may also occur.

“Not knowing what exercises are safe to do, the fear of falling and lack of motivation are some of the common reasons PD Warriors give for not exercising, yet being active is known to slow down this mobility disabling condition. KEEP aims to address these challenges through bringing structured rehabilitation programmes in the community that support both PD Warriors and their caregivers,” says Clinical Associate Professor Tay Kay Yaw, Head & Senior Consultant, Regional Department of Neurology (North), National Neuroscience Institute (NNI), SingHealth.

The KEEP Framework

KEEP was co-designed by a multidisciplinary team of physiotherapists, occupational therapists, medical social workers, and PD movement disorder specialists from NNI and TTSH.

The programme is anchored on an evidence-based community care model. It introduces fitness and rehabilitation in the earlier stages of the disease, while using group sessions to address the problem of social isolation which is common as PD progresses.

The KEEP framework has three core components to provide rehabilitation and support; each tailored to the needs of PD Warriors at different stages of PD:

• KEEP Fit - Physical fitness for neuroprotection and neurorestoration
  24-sessions of 60-minutes structured group rehabilitation integrates cardiovascular exercises, strength, agility and balance training to improve fitness whilst addressing movement challenges.
   
• KEEP Active – Restore function and promote independence
  16 sessions of occupational therapy and 8 physiotherapy sessions that equip participants with practical movement, safety, and problem-solving strategies to maintain independence in daily activities, prevent falls, and stay actively engaged in their homes and communities.

• KEEP Well – Mental health and caregiver support
  3 weeks cognitive rehabilitation training following mental health screening, assessment and intervention for psychological and depressive symptoms. Caregivers will also receive 6 sessions of caregiver training to better cope with care of PD Warriors.

   

“Our aim is to support and empower PD Warriors with the knowledge, confidence and access to care needed to stay active independently and alongside fellow participants beyond the programme. To ensure participants receive timely support if their symptoms evolve, we will check in with them every six months from the date of enrolment, for up to two years to adjust their rehabilitation and mental health plans if any decline is detected,” says Dr Chloe Chung Lau Ha, Senior Principal Physiotherapist, Tan Tock Seng Hospital, NHG Health.

Psychological and practical support will also be extended to caregivers of PD Warriors. “PD symptoms can change from day to day and hour to hour, which is disruptive for both PD Warriors and their family members. Through KEEP Well, we aim to help caregivers better understand PD and how to adjust their daily routines and expectations, so they can support their loved ones, reduce the risk of burnout and improve the quality of life for both the caregiver and PD Warrior,” says Ms Phyllis Lim, Executive Director, Parkinson Society Singapore (PSS).

For 67-year-old retiree and PD Warrior William Wong (黄海昌), who joined the KEEP Fit trial, group rehabilitation provided both physical strength and vital motivation: "If you expect yourself to do exercises at home alone, chances are you lose motivation," William shared. "Parkinson's is not easy to manage by yourself - if you stay at home and stop being active, you risk falling and deteriorating. The key is getting out of the house, building muscle to keep walking, and finding something nice to do with others."

For 78-year-old PD Warrior Mr. KS Amarjit Singh Bal and his wife Mrs. Charanjit Kaur Bal (75), the combination of movement sessions and caregiver workshops transformed their daily lives: "I used to do everything for him. Now, after working on his mobility, he gets up in the morning, showers, and changes on his own,” shared Mrs. Singh. “Attending the caregiver workshops showed me I wasn't alone. Understanding what he goes through emotionally and physically made it much easier to support him."

Nationwide Community Integration

The KEEP programme is being progressively rolled out across 13 Day Rehabilitation Centres (DRCs) operated by six community providers, AWWA Ltd, Care Corner Seniors Services Singapore, NTUC Health, Parkinson Society Singapore (PSS), St Luke’s Eldercare (SLEC), and St Luke’s Hospital (SLH), providing island wide support to PD Warriors and their caregivers.

Healthcare professionals in the DRCs can consult clinicians at NNI and TTSH in the management of more complex cases. Leading the community programming is PSS. The charity, which celebrates its 30th anniversary of serving the PD community this year, will serve as the master trainer and primary training site for community partners in the enhancement of rehabilitation standards. $1.2 million from Lien Foundation’s investment of $4.48 million has been set aside to co-design and launch a progressive second PSS centre.

Mr Lee Poh Wah, CEO of the Lien Foundation, said: "With KEEP, we are building a stronger community rehabilitation ecosystem for Parkinson’s disease by bringing together our key stakeholders to provide earlier, sustained and stage-appropriate support. Our vision is that more people can access the science of rehabilitation and the strength of community to redefine what living well with Parkinson’s can look like." Parkinson’s Disease Awareness Campaign Complementing the community rehabilitation programme for PD Warriors, a public campaign is also being planned to raise awareness, spark empathy, and reduce the stigma associated with PD. Lien Foundation is curating a PD public symposium and activation, co-organised with the Singapore Institute of Technology (SIT), NNI, TTSH, and PSS, which will be launched at SIT campus in Punggol Digital District on 31 October 2026. More details will be shared closer to the date.