What is Parkinson’s Walk?
Parkinson’s disease is a chronic and progressive neurodegenerative disorder that affects movement. It causes loss of the dopamine-producing cells of the brain and is characterized by tremors, rigidity, bradykinesia, and postural instability.(1) Why it occurs is not fully understood, but is believed to have genetic and environmental factors play a role. The symptoms start showing up by the age of 60 years and in rare cases can affect younger people as well. It can result due to the loss of cells in the substantia nigra, a part of the brain that is responsible for movement.(2) Currently, there is no cure for Parkinson’s disease but medication and therapies can be helpful in managing the symptoms and improving the quality of life of a person with this condition.
Parkinson’s walk is an abnormal gait associated with Parkinson’s disease. It is characterized by shuffling, stooped posture, quick steps, and reduced arm swing. The person finds it difficult to initiate movement leading to hesitation and freezing of gait.
Characteristics of Parkinson’s Walk
The loss of cells in substancia nigra leads to a lack of dopamine, which is a messenger controlling movement. This may lead to tremors and slowed movements.
Parkinson’s gait is characterized by the following.
- Shuffling Gait: The person with Parkinson’s disease is seen taking small shuffling steps. Their feet barely leave the ground making it difficult to move and walk long distances.
- Stooped Shoulder: The posture of the person is stooped forward and the shoulder hunched over. This may make balancing difficult and lead to a feeling of unsteadiness.(3)
- Reduced Arm Swing: The arms may not swing properly as they should while walking making the gait appear stiff and awkward.
- Freezing Episodes: There may be sudden hesitation or freezing of gait in which the person is unable to initiate the first movement. This may be noticeable on starting to walk, turning, or approaching obstacles. According to the International Parkinson’s Movement Disorder Society up to 50% of people with Parkinson’s disease experience freezing.(4)
Causes of Parkinson’s Walk
Parkinson’s walk occurs as the brain has difficulty processing automatic movements involving swinging of arms and lifting of feet. There are a few factors that may be responsible for contributing to Parkinson’s walk.
- Dopamine Depletion: Dopamine is a neurotransmitter that plays a role in regulating movements. In Parkinson’s disease, the cells producing dopamine die. This leads to a shortage of this neurotransmitter and leads to a range of motor symptoms including tremors, bradykinesia, and postural instability.
- Damage to the Basal Ganglia: A group of structures present in the brain is called the basal ganglia. These are responsible for controlling movements. In Parkinson’s disease, there is a loss of dopamine-producing neurons in the basal ganglia. This can affect the function of the basal ganglia and interferes with the control of movement.
Also, basal ganglia in Parkinson’s disease is overactive which can result in increased inhibition of the thalamus, a structure that is responsible for the relay of signals from the cortex to the motor areas of the brain. This can lead to difficulty in controlling movements as well as lead to tremors, rigidity, and bradykinesia.
Diagnosis of Parkinson’s Walk
Currently, there is no single test that can diagnose Parkinson’s disease. A combination of clinical evaluation and imaging tests can help make it up to the diagnosis.
Parkinson’s walk can be diagnosed by a neurologist or a movement disorder specialist who evaluates the symptoms of the patient, takes a medical history, and performs a physical exam.
During a physical examination, the doctor examines the gait and looks for the characteristic features of Parkinson’s walk including the arm swing, shuffling gait, postural instability, and freezing of gait. Additional tests are performed to evaluate the motor symptoms associated with Parkinson’s disease.
Imaging tests are ordered including CT scan and MRI to rule out other conditions that may be causing similar symptoms. A dopamine transporter imaging study is also performed in which a special radioactive tracer is used to evaluate the integrity of dopamine-producing cells in the brain.
Treatment of Parkinson’s Walk
The treatment of Parkinson’s walk involves a combination of medication and physical therapy. This helps in managing motor symptoms associated with the condition.
- Medications: Medications are given to increase the dopamine levels in the brain.(1) These include Levodopa and dopamine agonist. These improve motor symptoms including gait. This can also bring an improvement in stiffness, rigidity and improve coordination and reduce the frequency and severity of tremors. All these can help in improving gait.
- Deep Brain Stimulation: This involves implanting small electrodes in the brain that delivers electrical impulses to the targeted areas of the brain and reduce symptoms including gait changes.
- Physical Therapy and Exercises: A physical therapist design the exercise program focusing on improving balance, strength, and coordination.
Exercising regularly can lead to an improvement in quality of life and movement.(5) Exercises that can incorporate rhythmic movement including boxing and dancing can be beneficial for improving gait and reducing symptoms.
Assistive Devices: These can be helpful in managing Parkinson’s walk and help in improving mobility. These include canes and walkers, orthotics, and gait belts.
A neurologist or a movement disorder specialist can help in developing a comprehensive treatment plan depending on the person’s condition and improve Parkinson’s walk.
Coping Strategies for Parkinson’s Walk
There are various strategies that can help a person cope with Parkinson’s gait. These include:
- Regular Exercise: Exercise can help in improving strength, flexibility, and balance which can be helpful in reducing the symptoms of Parkinson’s gait and improving walking ability.
- Using Assistance Devices: These provide support and bring stability during walking.
- Taking Breaks: Taking rest in between walking can reduce fatigue and improve the overall walking ability.
- Focus on Posture: Focusing on maintaining a good posture and balance while walking can help improve walking ability and reduce the risk of falls.
- Seek Physical Therapy: A physical therapist can develop a customized exercise plan and teach specific techniques to improve walking abilities.
- Join Support Groups: Joining support groups can help by providing emotional support and coping with disease including walking difficulties.
FAQs on Parkinson’s Walk
What is Parkinson’s gait or walking problem?
Parkinson’s gait or walking problem is a common symptom of Parkinson’s disease that affects a person’s ability to walk normally. It can include symptoms such as shuffling feet, difficulty initiating movement, freezing of gait, and loss of balance.
How does Parkinson’s gait or walking problem develop?
Parkinson’s gait or walking problem develops as a result of damage to the part of the brain that controls movement, particularly the basal ganglia. This damage causes a reduction in dopamine levels, leading to problems with movement, including gait abnormalities.
What are the symptoms of Parkinson’s gait or walking problem?
The symptoms of Parkinson’s gait or walking problem may include shuffling gait, difficulty initiating movement, freezing of gait, reduced arm swing, and loss of balance.
Can Parkinson’s gait or walking problem be treated?
Yes, Parkinson’s gait or walking problem can be treated with medication, physical therapy, and exercise. In some cases, surgery may be recommended. The treatment plan may vary depending on the severity of the symptoms and the individual needs of the patient.
Can exercise help improve Parkinson’s gait or walking problem?
Yes, exercise can be an effective way to improve Parkinson’s gait or walking problem. Physical therapy and exercise programs designed specifically for Parkinson’s patients can help improve strength, balance, and coordination, reducing the risk of falls and improving overall mobility.
What other lifestyle changes can help improve Parkinson’s gait or walking problem?
Other lifestyle changes that can help improve Parkinson’s gait or walking problem include maintaining a healthy diet, getting enough sleep, and avoiding stress. Making adjustments to the living environment, such as removing trip hazards, can also help reduce the risk of falls.
In Parkinson’s disease, an individual’s walking ability is affected leading to challenges in mobility and balance.
A person can cope with these by including medications, regular exercises, using assistive devices, taking breaks, and joining support groups. All these can help improve walking with Parkinson’s disease, reduce the risk of falls, and overall quality of life. Speaking with a healthcare professional and support groups can help develop a comprehensive plan and bring in an improvement in walking ability.
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