There are four primary motor symptoms of Parkinson’s disease:
- Tremor
- Rigidity
- Bradykinesia (slow movement)
- Postural Instability (balance problems)
Observing two or more symptoms listed above is the main way physicians diagnose Parkinson’s. However, it is important to know that not all of these symptoms must be present for a Parkinson’s diagnosis.
Tremor tends to occur at rest and is a slow, rhythmic movement that typically starts in one hand, foot, or leg and eventually affects both sides of the body. Alternatively, some people with Parkinson’s disease will also experience an internal tremor, which is not necessarily noticeable to others. I have had patients describe this as feeling like their phone is vibrating in their pocket even though it is not there.
Rigidity refers to stiffness or tightness of the limbs or torso not associated with arthritis or orthopedic problems. Recognizing this symptom early is important to begin completing a daily stretching routine to slow the progression and maintain a more upright posture.
Bradykinesia is a very common symptom of Parkinson’s disease, which presents as an overall slowness of movement. One of the manifestations of bradykinesia is a reduced arm swing that can occur in one or both arms while walking. Other demonstrations of bradykinesia are mask-like expression of the face, difficulty buttoning a shirt or putting on a jacket, and slow, small handwriting.
Postural Instability, or difficulty balancing, is the inability to maintain a steady, upright posture or to prevent a fall, which tends to be more pronounced in the later stages of the disease. These balance problems may lead to a greater tendency to fall backward, commonly seen when attempting to stand from a chair or step backward. Postural instability may also lead to gait difficulties. Common examples are slow, small steps or a shuffling gait, also known as festination, or the very opposite, which can be seen with a tendency to propel forward with quick, short steps. Episodes of freezing are another common gait abnormality where the feet may appear stuck or glued to the floor despite attempts to take a step.
Early speech, occupational, and physical therapy interventions are key in managing this disease progression. If you or a loved one notices these symptoms or changes in movement, it is important to participate in physical therapy and a daily exercise routine to address these motor symptoms before they start affecting daily activities. Here at WWS Physical Therapy and Vestibular Rehabilitation, we have several therapists specializing (with specific training and experience) in treating those with Parkinson’s disease and other neurological disorders.
Dr. Karli Lynch, PT, DPT,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.,
(215) 489-3234
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