Neurologic/Geriatric>>Parkinson Disease: Movement Tips - 1/5/2007
Parkinson Disease: Movement Strategies & Exercise Tips
Kevin Lockette PT
NO MORE FREEZING When freezing occurs, your feet can feel like they are glued to the floor. You are basically stuck there standing. Attempts to move are useless or you may lose your balance trying.
DO THIS: When a freezing episode occurs the 1st thing to do is just stop. Then slowly shift your weight from side to side. I call it the "poor man's hula". The "hula" will prepare you to re-initiate moving. With freezing, you will typically have weight on both feet not freeing up any of your two legs. Now deliberately shift weight to one leg (hula) and purposefully pick up the opposite foot to re-initiate stepping. It may take a little practice, but this technique can be in your bag of tricks if freezing occurs.
When turning corners or turning to sit down, plan out your steps so that you are conscious of what each foot is doing. Try not to pivot on one leg but rather take smaller steps utilizing the "hula technique".
DARN THAT GRAVITY/ FORWARD POSTURING: You know the drill. You stand up and gradually or fairly immediately gravity gets the best of you and you find yourself bending forward as if you are looking for change. Also when your center of gravity is in front of your base of support (your feet), you are constantly trying to catch up with it (center of gravity) to keep from falling.
DO THIS: When you are slumped, your skeleton is no longer mechanically stack which actually puts your muscles at a mechanical disadvantage- in other words they have to work harder to pull you up. Some simple ways to cue your body is to squeeze your shoulder blades together. This will force your body to realign itself since you can't do this (squeeze the shoulder blades) in a slump posture. Do this throughout the day. Your "automatic pilot" is not working so you have to consciously think to do this.
Try to break your habit of reaching for a wall, your chair, etc. All that does is place your center of gravity even more further away from your feet making you even more unbalanced.
THE CURLY SHUFFLE: Okay, you can hear each and every step you take and the front under soles of your shoes are worn thin. Often times you just get going (see FORWARD POSTURING) and you can't stop. The gait looks like this: shuffling feet, knees maintain bent, slumped posture, and no arm swing.
DO THIS: This goes back to the earlier statement about the "automatic pilot". Parkinson Disease makes it ineffective. In other words, prior to Parkinson Disease, you did not have to think to move, but now, well, you do. What may be helpful is talking to your body. Actually tell the legs when and how to move. One effective training tool is to use to broom sticks or two canes. Now you will perform a 4 point walking pattern, 1 stick, 2 opposite leg, 3 opposite stick, 4 opposite leg. It helps to talk to you body: "Arm, Leg, Arm, Leg". With each step attempt to get your heel down first while your knee is fully extended.
If you are using a walker, keep your walker close to you. Do not let it get too far in front of you or it may actually get away from you causing a fall.
EXERCISE: The focus of an exercise program is to combat the symptoms such as difficulty with initiating movement, difficulty with changing directions when moving, weight shifting, and that darn stooping, forward posture. The focus of a good exercise plan is one that emphasizes posture (i.e., extension (hip extensors, scapular muscles). The following are samples of exercises that you may find helpful. Exercise programs should be individualized, so if you have any doubts, please consult your physician or physical therapist. The following exercises include both a standing and sitting regime as well as other gait (walking) strategies. The best exercise program is one that is short that can be done in 15-20 minutes. It is more important to do exercises consistently/daily than to try to make it up by doing longer exercise sessions. Good luck, stand tall and enjoy!