How to Improve Walking in People with Parkinson’s Disease

Oct. 18, 2021 -- Problems with walking are communal and bothersome to radical with Parkinson’s disease, but a caller survey of implicit 4,000 radical with Parkinson’s and mobility problems recovered 7 “workarounds” that tin help.

“Compensation strategies are ‘tricks’ that persons with [Parkinson’s] usage to flooded their walking difficulties,” accidental investigators Anouk Tosserams, MD, and Jorik Nonnekes, MD, some of Radboud University Medical Centre successful the Netherlands.

Parkinson’s often causes issues with movement, specified arsenic imbalance, shuffling, falling, staggering, and freezing.

“We recovered that these strategies are commonly used, but that the patients’ consciousness of the afloat spectrum of disposable strategies is alternatively limited,” they say.

A personalized attack to rehab and diligent acquisition is important, the authors say.

Rebecca Gilbert, MD, vice president and main technological serviceman of the American Parkinson Disease Association, says the survey should assistance doctors and patients.

While galore of the suggestions are already successful use, the study, which goes into greater detail, should marque the practices much “systematic,” says Gilbert, an subordinate prof of neurology astatine Bellevue Hospital Center successful New York City.

Creative Solutions

Tosserams and Nonnekes explicate that their probe was “inspired by the creativity of persons with [Parkinson’s] who person travel up with a wide assortment of strategies to flooded their walking difficulties.”

Improving the quality to locomotion done these kinds of non-invasive strategies is essential, they say, arsenic drugs and country often aren’t palmy enough.

In their regular practice, the authors accidental they “noticed that antithetic strategies look to person antithetic effects connected walking, depending connected the idiosyncratic who uses the strategy and the discourse successful which the strategy is used.”

An online survey was sent to implicit 8,000 participants (age 18 years oregon above) with Parkinson’s who person a hard clip walking. Of these, 4,324 responded and were included successful the analysis.

Participants were drawn from the Fox Insight cohort, a survey led by the Michael J Fox foundation, and from ParkinsonNEXT.

The survey was divided into 3 parts: The archetypal included accusation astir gender, age, clip since diagnosis, walking ability, and past of falls during the past year.

The 2nd portion of the survey asked participants however acquainted they are with 7 strategies:

• External cueing (for example, walking to the bushed of a metronome, wearing vibrating socks, oregon stepping implicit lines)
• Internal cueing (for example, utilizing self-prompting oregon intelligence math)
• Changing the equilibrium requirements (for example, shifting value successful spot earlier stepping, making wider turns, oregon utilizing walking aids)
• Altering the intelligence authorities (for example, breathing exercises oregon different approaches to bounds anxiety oregon fearfulness of falling)
• Action reflection and centrifugal imagery (mimicking idiosyncratic other walking oregon visualizing the desired movement)
• Adapting a caller walking signifier (for example, scissoring, genu lifting, jumping, running, oregon walking backward)
• Other forms of utilizing the legs to determination guardant (for example, bicycling, skateboarding, oregon crawling)

The 3rd portion of the survey focused connected participants’ involvement successful learning much astir these strategies.

Context Matters

A 5th of respondents had ne'er tried immoderate signifier of compensation strategies, but astir had tried astatine slightest one. The astir commonly tried strategy was adapting to a caller walking pattern.

Overall, adjacent to 65% of respondents continued to usage astatine slightest 1 strategy successful regular beingness -- astir often erstwhile walking outdoors oregon successful time-pressure situations. The astir wide utilized class was changing the equilibrium requirement, followed by interior cueing and altering the intelligence state. Interestingly, outer cueing was utilized the slightest (only 55%).