April 18, 2025 • 39 mins
Navigating Parkinson's can be challenging, but you don't have to do it alone. This podcast provides practical information and empowering strategies for people living with Parkinson's, their families, and caregivers.
In this episode, we discuss:
- Understanding Parkinson's Motor Symptoms: We break down the common motor symptoms of Parkinson's, including tremor, bradykinesia, rigidity, postural instability, and freezing of gait.
- The Top 5 Motor Symptoms: We explore these specific symptoms in detail, explaining how they impact daily life and providing management strategies.
- The Importance of a Multidisciplinary Approach: Learn why a team of specialists, including neurologists, physical therapists, and occupational therapists, is crucial for comprehensive Parkinson's care.
- Personalized Strategies for Parkinson's: We emphasize the importance of tailoring treatment plans to individual needs and encourage proactive communication with your healthcare team.
Ready to take control of your Parkinson's journey?
- Visit liveparkinsons.com to subscribe to our Free Monthly Newsletter for the latest Parkinson's information, tips, and resources.
- Get your copy of the Building Your Parkinson's Care Team Resource Guide and Workbook for just $10! This invaluable tool will help you build and coordinate your optimal care team. Purchase it atko-fi.com/liveparkinsons.
- If you find our content valuable and want to support our mission to empower the Parkinson's community, please consider contributing to our Ko-fi page: ko-fi.com/liveparkinsons. Your support helps us create more vital resources.
#ParkinsonsDisease #Parkinsons #MotorSymptoms #Tremor #Bradykinesia #Rigidity #PosturalInstability #FreezingofGait #LiveParkinsons #MovementDisorders
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Disclaimer: This podcast is for educational purposes only is not intended to treat or diagnose Parkinson's Disease. Please ensure that you are following the treatment plan developed by your doctor. Please ensure before starting anything new you get approval from your doctor. The information being provided is based on my own personal experiences and does not guarantee that it will benefit everyone.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Hello and welcome to Live Parkinson's Live an
Exceptional Life.
I'm your host, chrisKustenbader, and I've been
living an exceptional life withParkinson's for the past 15
years.
The mission of this podcast isto help as many people as
possible living with Parkinson'sto lead a great quality of life
.
Today's topic is navigatingdaily life with Parkinson's
motor challenges Practicaladvice.
(00:32):
Parkinson's throws a curveballat your movement, impacting
everything from buttoning yourshirt, enjoying a simple walk or
just trying to start your dayoff with a hot cup of coffee.
Start your day off with a hotcup of coffee.
But what if I told you that?
Small adjustments, smartstrategies and a shift in
Parkinson's it's aboutoutsmarting its motor challenges
.
So in this episode, we'recutting through the medical
(00:57):
jargon and delivering real-worldadvice.
You need to navigate daily lifewith more ease and more
confidence For empowerment.
You're in the right place.
Let's navigate this together.
Today's episode is all about oneof the most defining aspects of
Parkinson's motor symptoms.
We're going to be discussingthe movement-related symptoms
most people associate withParkinson's Tremor, slowness of
(01:20):
movement or bradykinesia,rigidity, postural instability,
freezing of gait.
Here's the thing.
No two people experience thesemotor symptoms the exact same
way.
I know for me.
My motor symptoms started witha tremor and then dragging my
left leg when I walked.
I know other friends whoexperienced different motor
(01:40):
symptoms that led them to see adoctor.
So in this episode, we're goingto break down the core motor
symptoms and, more importantly,give you practical,
science-backed strategies andshare personal experiences that
you can use to help you manageyour motor symptoms and not have
them have a significant impacton your daily life.
As a disclaimer, pleaseremember to always work with
your healthcare team topersonalize and tailor these
(02:03):
strategies to your specifichealthcare needs.
The information being providedis for educational purposes only
and is not for medical advice.
Please review any new exerciseprograms with your doctor first
to ensure they are appropriatefor your specific needs.
Now, before we dive intomanaging motor symptoms, if
you're looking for informationand strategies for non-motor
(02:25):
symptoms, check out my previouspodcast, parkinson's Hidden
Battles Addressing Non-MotorSymptoms for Better Living.
All right, so if you're ready,let's jump in feet first and get
started, and let's lead it offby understanding the core motor
symptoms in Parkinson's.
Now I'm sure if you were askedwhat are your top two motor
symptoms that have the biggestimpact on your quality of life,
(02:47):
you would have no troublerattling them off and explaining
why they're at the top of thelist.
So let's start off by breakingdown the five big motor symptoms
so that we can use thisknowledge to help us develop
strategies for managing thesechallenging motor symptoms.
Coming in at number one on ourlist is tremor, because it's
often the first thing peoplenotice and many of you may
(03:09):
experience yourself.
Typically, it's a restingtremor, meaning it happens when
your muscles are relaxed, forexample, when your hands sit
resting on your lap.
Some people experience actiontremors, which happen when
you're reaching or using thatparticular limb, whether it be
your arm to pick up a cup ofcoffee.
Now, we all know that tremorscan be unpredictable.
For some people, tremors areminor, while other people it can
(03:32):
have a significant impact ontheir daily life by interfering
with everyday tasks like writing, eating or even buttoning your
shirt.
So what causes tremors?
In Parkinson's?
Tremors are primarily caused bythe loss of dopamine-producing
neurons in the brain in the areacalled the substantia nigra.
Dopamine is a neurotransmitterthat plays a key role in
(03:54):
controlling our movement, butit's also involved in the reward
and recognition centers, sothat when you get excited about
something, you have a release ofdopamine that makes you want to
do it again.
So when dopamine levels drop,it disrupts the communication
between the nerve cells, leadingto tremors, also known as
(04:15):
rhythmic shaking.
Parkinson's tremors tend to beresting tremors and often start
on one side of the body, such asthe hands, fingers and jaws,
and may spread over time,particularly to the other side
of the body, such as the hands,fingers and jaws, and may spread
over time, particularly to theother side of your body.
Now I'm personally affectedwith tremors in my left hand,
which fortunately doesn't affectmy handwriting Well, in terms
of shaking it doesn't, but myhandwriting has definitely
(04:36):
gotten smaller and moredifficult to read.
Number two on our list isrigidity.
Rigidity refers to thestiffness of your muscles, which
tend to get stiffer as thedisease progresses.
It can make it difficult tomove and can even cause pain.
The tightness and stiffnessoften affect the arms, legs and
(04:58):
neck muscles and can make itharder to swing your arms
naturally when you're walking.
I know I have this problemmyself.
My left arm doesn't swing whenI walk, which affects the
natural motion when I'm walkingand causes me to have a slight
twist in my body because my armisn't swinging when the other
one's not, and that can cause alittle bit of tightness and
(05:20):
lower back pain In terms ofstiffness.
For me, more than two hours inthe car without a break is rough
.
I get out of the car and I'm sostiff it's hard to walk and I
really need to stretch before Ican really get moving.
All right.
Number three is bradykinesia,which is a fancy term for
slowness of movement.
It can feel like your body justisn't cooperating.
Everything from brushing yourteeth to getting out of the
(05:43):
chair becomes slower and moreeffortful.
Bradykinesia can also reduceyour range of motion, which is
known as hypokinesia and that'sa good trivia question to stump
people with if you're playingtrivia.
And when you go to see yourneurologist or movement disorder
specialist, they usually haveyou tap your fingers and your
thumb together as fast as youcan to test for bradykinesia.
(06:06):
Another test is the one whereyou have your hand on your thigh
, with your hand facing up, andthey have you flip it back and
forth on your thigh.
They're looking at how fast youdo that, so they're testing to
see if you have bradykinesia.
So essentially, you don't needfancy medical equipment to test
for bradykinesia.
So essentially, you don't needfancy medical equipment to test
for bradykinesia.
(06:26):
All right.
Number four is posturalinstability as Parkinson's
progresses.
You often see people withrounded shoulders, with a
slumped look, often looking attheir feet, and this may cause
balance problems, and this isdue to the loss of reflexes that
help keep you upright.
This increases the risk offalls, which is a major concern
(06:47):
and can have a devastatingeffect on a person's quality of
life, because they can getinjured and end up in a
rehabilitation center, and thenthe time it takes to recover can
have a substantial impact onthe person's quality of life and
their social interactions.
So that's why it's important todo balance exercises every day
to help improve and maintainyour balance.
(07:08):
Now, for me personally, I spendabout 10 to 15 minutes every
morning and I've noticedsignificant improvements in my
balance over the years.
Now, to learn more, visit mywebsite, libparkinsonscom, and
you can download a free copy ofNine Balance Exercises to
Improve Balance with Parkinson'sand use this as a guide for
(07:29):
helping to improve your balance.
And then, finally, rounding out,our top five is freezing of
gait.
Do you ever feel like your feetare suddenly glued to the floor
?
That's called freezing, orfreezing of gait.
It often happens when you'returning, you're going through a
doorway or you're starting toinitiate walking, and it can be
(07:49):
incredibly frustrating, but it'salso manageable.
Now, one of the things I do tohelp me when my feet feel like
they're glued to the floor isand to help prevent this is I
like to listen to music, becausethe constant beat helps me to
make sure that I keep my feetmoving, or if they do feel like
(08:11):
they're stuck to the floor, Icount one, two, three and then
often begin to move my feet, andit really does help.
Okay, that was an overview ofthe core motor symptoms of
Parkinson's.
Now let's look at each motorsymptom in more detail and
provide some practical tips andstrategies for managing each one
to help lessen their impact onour daily lives.
Now, these strategies I will besharing are evidence-based,
(08:32):
meaning they have researchsupporting their benefits, and
also include personal successstories from individuals living
with Parkinson's.
And let's lead it off with oneof the symptoms that affects
most people living withParkinson's.
And that's lead it off with oneof the symptoms that affects
most people living withParkinson's, and that's tremors.
As we discussed, most peoplewill experience a resting tremor
when the muscle is relaxed.
Now, one of the things I'venoticed when I have tremors is
(08:54):
they seem to have a mind oftheir own meaning.
No matter how hard I try, Ijust can't will them to stop.
They keep right on going.
Now I also notice that when I'mstressed, the tremors seem to
be worse, but thankfully, thereare a number of strategies that
you can use to help manage yourtremors.
The first one is mindfulnessand relaxation techniques, or,
(09:15):
as I like to say, calming theinternal storm.
Now, evidence suggests thatstress and anxiety can
exacerbate Parkinson's tremors.
Just as I mentioned, thathappens to me.
Mindfulness and relaxationtechniques offer a way for you
to manage your body's stressresponse and potentially reduce
tremor intensity.
Mindfulness meditation is apractice that involves focusing
(09:38):
your attention on the presentmoment with an attitude of
acceptance.
Present moment with an attitudeof acceptance.
It can include severaltechniques, involving deep
breathing exercises, body scans,where you slowly go over how
you feel in each area of yourbody as you move from your feet
to your head, and observingthoughts and body sensations
(09:59):
without judgment.
For example, if you notice yourheart rate and breathing are
increasing, instead of lettingyour mind race and saying what's
wrong with me, why is my heartrate beating faster, just simply
acknowledge it and accept itand focus on the present moment.
Studies have shown that, usingfMRI, the mindfulness-based
(10:19):
interventions can lead toincreased gray matter density in
the brain regions associatedwith emotional regulation in
Parkinson's.
According to the study,mindfulness-based intervention
in Parkinson's disease leads tostructural brain changes in MRI
published in Clinical Neurologyand Neurosurgery.
When you focus on the presentmoment, without judgment, you
(10:40):
become more aware of your tremorand develop a sense of
acceptance, potentially reducingthe anxiety it causes.
Simple practices like focusingon your breath, body sensations
or sounds can be done anywhereat any time.
As a practical tip, start with5-10 minute sessions daily,
(11:00):
gradually increasing theduration.
Now there are a number ofguided meditations available,
either through apps or onlineresources specifically designed
for Parkinson's.
Now for more information and asample meditation, listen to my
podcast, the Parkinson's AnxietyToolkit Mindfulness Strategies
at Work.
Next up is deep breathingexercises.
(11:23):
Slow, deep breaths can activatethe parasympathetic nervous
system, promoting relaxation andreducing overall tension, which
may help to reduce your tremor.
As a practical tip, use the4-7-8 breathing technique.
So what you want to do isinhale for four counts, hold for
a count of seven and thenexhale for a count of eight.
(11:45):
This can be a quick andeffective way to help calm down
when your tremor is reallybothering you.
Then we have progressive musclerelaxation, which is a
technique that involves tensingand then releasing different
muscle groups in the body tohelp you identify and release
areas of tension that might becontributing to your tremors.
For example, starting with yourfeet, tense the muscles in your
(12:13):
feet, then relax, then move toyour calves, then your thighs,
your abs, repeating the process.
As a practical tip, find aquiet place and work through
each muscle group, from yourtoes to your face, tensing and
relaxing each muscle group.
Another relaxation technique isyoga and tai chi.
These movement practicescombine physical postures or
(12:35):
stances, which you typically usein tai chi, with controlled
breathing and mindfulness,helping to improve your
flexibility, your balance andpotentially, reducing stress and
tremor.
As a practical tip, look forclasses that are specifically
tailored for individuals withParkinson's, or ask the
instructor for modifications tohelp you with your specific
(12:56):
needs, and then focus on thesegentle movements to help you
reduce stress, and that willlead to help you becoming more
calm.
Now the next type of strategiesto help us manage our tremors is
compensatory strategies, orworking smarter, not harder.
(13:18):
So what are compensatorystrategies, chris?
Well, glad, yes.
These are strategies that focuson modifying how you perform
tasks to minimize the impact oftremors on function and
independence.
So let's look at some of thesecompensatory strategies,
starting with proximalstabilization, which is just a
fancy way of saying.
They provide support of yourarm with a tremor close to the
(13:39):
core of your body.
So the further your arm is awayfrom your body, the harder it
is to control your tremor.
So I used to either put mythumb in my pocket and hold my
hand near my waist when I had atremor, or just put my hand in
my pocket.
But you can also just hold itclose to your body.
So, as a practical tip, keepyour elbows close to your body
(14:00):
when performing tasks, and thenyou can also rest your forearms
or elbows on the table orcountertop for stability when
eating, writing or performingfine motor tasks.
Next, use both hands so you canuse the non-tremor hand to
assist your tremor hand, whichcan help provide stability and
(14:20):
control.
So, as a practical tip, useyour unaffected hand to guide or
study the tremoring hand duringtasks.
Like you know, maybe you'repouring a drink, you're opening
a container or when you're usingutensils.
Next, slow down your movements.
Rapid movements can make yourtremors worse.
(14:40):
So when doing daily tasks,deliberately slow movements to
allow for greater control ofyour hands as a practical tip,
consciously focusing on thespeed of your movements.
So make sure you give yourselfample time to complete tasks so
you don't feel like you'rerushed.
And then next up is my personalfavorite and a lesson I learned
(15:02):
from learning songs and playingguitar, and that's to break
down tasks.
Sometimes our daily activitiescan involve some complex steps,
but breaking them down intosmaller, more manageable steps
can make them easier.
Now some practical tips for you.
When getting dressed is focuson one piece of clothing at a
time.
Maybe lay them out on the bedso you're ready when it's time
(15:27):
to get dressed.
But only focus on one thing ata time when you're getting
dressed.
So, when you're cooking,prepare the ingredients in
stages so that you can add themwhen they're needed in your
recipe, so that you're notracing around trying to get the
ingredients as you're cookingyour meal.
And then, finally, weightingAdding weight to your utensils
(15:51):
or wearing weighted gloves canhelp reduce the tremors in some
people.
So make sure you get someguidance and approach from an
occupational therapist and theycan help you select the one
that's most appropriate for you.
And you want to be a little bitworried because some people may
get fatigued from usingweighted utensils or a weighted
glove.
Now, as a practical tip,experiment with weighted pens,
(16:15):
utensils or weighted gloves andor wrist weights under the
supervision of an occupationaltherapist, to see if they
provide a benefit.
Now I'll put some of myrecommended products in the
product description.
Now the next strategy fortremors is adaptive equipment,
which I like to call tools forenhanced independence.
Now a variety of adaptiveequipment is available to help
(16:38):
you manage your tremors andmaintain independence in your
daily activities Weightedutensils and cups.
The added weight provides morestability during eating and
drinking and that helps toreduce spills.
So, as a practical tip,experiment with different
weights and handle sizes to findwhat works best for you.
(17:00):
Now another key tip is to usenon-slip mats and surfaces.
These can prevent items fromsliding during tasks, giving you
more stability.
So some practical tips is usenon-slip mats under plates,
bowls and cutting boards.
Next is buttonholes and zipperpulls.
These can help when you aregetting dressed and can help
(17:22):
reduce the need for fine motorcontrol.
An occupational therapist cangive some instruction on how to
use these.
Next is electric toothbrushesand razors.
Now, the larger handles andpower to action can make
grooming tasks easier.
Now I'm a little bit biased,because I used to sell and
promote one of the power brushesand it was an Oral-B and I
(17:46):
highly recommend them.
Finally, writing aids likeweighted grips or even
voice-to-text software can helpin your work and oral
communication.
As a practical tip, experimentwith different types of pens and
grips and consider using aslant board for writing.
So, as we conclude thesestrategies for managing tremors,
(18:09):
try using a multifacetedapproach that includes
mindfulness and relaxation,compensatory strategies and
assistive technology.
These can help to significantlyimprove your daily life and
help you maintain yourindependence.
All right, now let's move on toour next motor symptom on the
top five list, and coming in atnumber two, is rigidity.
(18:30):
Rigidity refers to thestiffness and resistance to
movement caused by increasedmuscle tone.
It's considered one of the coremotor symptoms of Parkinson's
and it can affect any part ofthe body, and it can also lead
to pain, restricted range ofmotion and difficulty with your
daily activities.
(18:51):
While medication is important,several other strategies can
help.
So let's look at easingrigidity using these strategies
and leading it off with gentlestretching and range of motion
exercises.
These exercises are going to becrucial for maintaining muscle
length and joint flexibility,which is going to help you
(19:13):
counteract the increased muscletone in Parkinson's.
And then these exercises canhelp prevent contractures or
shortening and tightening of themuscles, and so it helps with
your overall movement, asevidenced.
Physical therapy guidelines andexpert consensus strongly
recommend regular stretching andrange of motion exercises for
(19:35):
Parkinson's.
Studies have shown that theseexercises can improve your
flexibility, reduce yourstiffness, and so they're going
to be beneficial, and Irecommend doing these every day,
trying to do at least five toten minutes of stretching.
I know that it really helps meand it's really helped me in
terms of my flexibility andmovement.
(19:55):
Now let's look at some practicaltips and examples.
We'll start with neck stretches, and what you can do is slowly
tilt your head to each side,holding for 15 to 30 seconds,
and then gently rotate your headin a circular motion.
That'll help stretch out yourneck muscles.
Shoulder rolls Roll yourshoulders forward and backward
(20:16):
in smooth circular motions.
Then we have arm circles youcan extend your arms and make
small, then larger, arm circularmotions.
Wrist and hand exercises Flexand extend your wrists and then
make a fist and then open yourhand as wide as you can, gently
(20:37):
stretching each fingerindividually.
Leg swings Standing withsupport, you can swing each leg
forward and backward and then,side to side Ankle circles
Holding onto something of courserotate your ankles in a
circular motion, and you coulddo that while you're sitting as
well.
(20:58):
Now some important things toconsider.
You want to perform stretchesslowly and gently and avoiding
any forceful movement that cancause pain.
You want to focus on smooth,controlled movements and repeat
each stretch several times,holding for 15 to 30 seconds.
And you want to perform theseexercises daily, and you can
(21:19):
even do them several times a day, as recommended by a physical
therapist.
And then a physical therapistcan provide a personalized
exercise program tailored toyour specific needs and
limitations.
Now the next strategy is warmbaths or showers.
Heat can help relax muscles,increase blood flow and reduce
pain and stiffness.
(21:39):
Now some evidence.
While not specific toParkinson's, the general
principle of thermotherapy orheat therapy are well
established in rehabilitationand pain management.
Heat application is known todecrease muscle tone and improve
tissue extensibility.
Heat application is known todecrease muscle tone and improve
(22:00):
tissue extensibility.
Now let's look at somepractical tips.
Take a warm, not hot bath orshower for 15 or 20 minutes.
Ensure the water temperature issafe, because you want to avoid
burns.
And then you can also add Epsomsalts to the bath, which some
people find soothing for musclerelaxation.
You can apply warm compressesto specific areas of rigidity
(22:23):
such as your shoulders or yourneck.
Those are going to help alittle bit to help loosen up the
muscles.
Now the next strategy to helpwith rigidity is massage therapy
.
A massage can help loosen tightmuscles, improve your
circulation and reduce pain.
It may also have a calmingeffect which can indirectly
reduce muscle strain.
(22:44):
Well, research on massagetherapy specifically for
Parkinson's is ongoing.
Studies suggest that massagecan be beneficial for reducing
muscle stiffness and pain inother musculoskeletal conditions
.
Now I personally get a massageonce a month and I can honestly
say I feel looser and moreflexible, as well as more
(23:06):
relaxed.
So I would highly recommendgetting a massage.
I mean, it's a great way tostay loose and help you reduce
stress and get rid of some ofthe tightness in your muscles.
So here are some practical tipsSeek a massage therapist who is
experienced in working withpeople with neurological
conditions, if possible, andthen gentle and slow massage
(23:30):
techniques are often preferred.
Let your massage therapist knowabout your comfort level or any
areas of particular tightness,and that's usually one of the
first things they ask me when Igo in for a massage is do you
have any areas that are tight orthat are bothering you?
And then, finally, the laststrategy to help with tightness
is maintaining activity.
(23:52):
Regular physical activity, akaexercise, is essential for
managing Parkinson's symptoms,including rigidity.
Movement helps keep musclesactive.
It's going to improve yourcirculation and maintain your
joint mobility.
Evidence to support these comesfrom Parkinson's Outcome
Project and other large scalestudies have demonstrated that
(24:15):
regular exercise yes, I said it,exercise can slow the
progression of motor symptomsand improve your quality of life
.
So, as a practical tip, engagein a variety of activities you
enjoy, such as walking, swimming, cycling, dancing and even
gardening.
Aim for at least 150 minutes ofmoderate intensity aerobic
(24:39):
activity.
Include activities that focuson flexibility, such as
stretching, yoga or tai chi.
Consider Parkinson's specificexercise programs like the LSVT
Big program, which emphasizeslarge amplitude movements to
counteract bradykinesia andrigidity, and then consult with
(25:01):
a physical therapist to developsafe and effective exercise
programs tailored to yourindividual needs and abilities.
Now, remember, even smallamounts of movement throughout
the day can be helpful, so youcan break up periods of sitting
with short walks or a littlestretching session.
(25:22):
All right, moving on tostrategies for developing the
types of motor symptoms weexperience, which is
bradykinesia or slowness ofmovement.
Bradykinesia is a core motorsymptom of Parkinson's disease
and it's characterized byslowness of movement.
And it's not just about movingslowly.
It also includes difficultyinitiating movement, hesitation
(25:43):
before starting an action, likegetting out of a chair.
Reduced amplitude of movement,where you're making smaller
movements, so decreased armswing while walking, smaller
handwriting.
Slowness of execution, whereyou take a long time to complete
a movement.
And then fatigue, where you'refeeling tired because the simple
(26:05):
movements required to moverequire so much effort from
being slow that it causes somefatigue.
Now, the slowness stems from alack of dopamine in the brain,
and again, dopamine's theneurotransmitter that's crucial
for our movement.
Now let's look at some of thestrategies for dealing with
bradykinesia.
The first is exercise andphysical therapy.
(26:28):
Yes, it comes up again, butregular exercise is crucial for
maintaining your mobility andyour function in doing daily
activities.
Next up is LSVT Big.
It's a program, a specializedphysical therapy program that
uses large, amplified movementsto combat bradykinesia.
(26:48):
Now, I participated in the LSVTBig program the first time I
went to physical therapy and Idid find it beneficial.
And they actually give youhandouts with each of the
exercises that you can do athome, which I still have and I
will do today, and I still useit as a reference because when
I'm feeling slow or tight, Ipull those out and do a lot of
(27:13):
those exercises.
Now, walking, focusing on heelto toe exercises.
Now, walking, focusing on heelto toe, meaning landing on your
heel and rolling on your toeswhile swinging your arms can
help.
Stretching helps to preventstiffness and improves your
range of motion.
And then occupational therapyAn occupational therapist can
help you adapt your environmentand your daily tasks to help you
(27:37):
with bradykinesia.
Next up are movement strategiesand leading off with again
breaking down tasks, you want todivide complex activities into
smaller, more manageable steps,because that's going to help you
focus on one thing at a timeand prevent you from being
overwhelmed and being tired.
Focus on one thing at a timeand prevent you from being
overwhelmed and being tired.
(27:58):
And then you can use rhythm andcounting Count aloud as you use
muscles to help you initiateyour movement when you're slow
and then also visualize yourmovement.
Imagine your movement beforeyou're doing it.
So, if you're getting out of achair, visualize yourself
getting out of the chair in anice, slow, smooth movement.
Allow extra time, don't rushyourself, and give yourself
(28:25):
plenty of time to complete thetasks.
Another thing you can do isrocking.
If you have trouble getting outof the chair, you can rock back
and forth to help initiatestanding.
Or you can also use that to getout of bed as well.
If you're sitting on the edgeof the bed, maybe you can rock
back and forth a little bit, butdon't go too far forward and
lose your balance and fallforward.
And then finally, speechtherapy.
Bradykinesia can affect ourspeech, making it softer and
(28:48):
more monotone, so speech therapycan help.
Now I've done speech therapytwice and I highly recommend it
because I had people telling methat they were having trouble
understanding me.
So and I highly recommend itbecause I had people telling me
that they were having troubleunderstanding me, so speech
therapy is a great option.
All right, moving on to thefourth motor symptom on our top
five list is posturalinstability, which, in layman's
terms for people like me wholike to keep it simple, means
(29:11):
the inability to maintain yourbalance.
In Parkinson's, now inParkinson's.
In Parkinson's, now inParkinson's it's caused by a
loss of reflexes that help usstay upright and often leads to
an increased fall risk.
Postural instability can have asignificant impact on our daily
lives because if you'reconstantly worried about falling
, that can really limit thethings that you do.
(29:33):
So postural instability isgoing to increase our fall risk.
So posture instability is goingto increase our fall risk.
It can cause difficulty withour mobility, so for simple
activities like walking, turningor standing, that can become
very challenging.
It can also restrict ouractivities because a fear of
falling can cause us to avoid,you know, participating in our
(29:53):
social activities and it canlimit our exercise and can keep
us from doing the hobbies weenjoy.
And then loss of independence,because balance and posture
problems can make it harder toperform everyday tasks like
dressing, bathing and cookingwithout assistance.
And it can have a bigpsychological impact because if
(30:15):
you have a constant fear offalling, that can lead to
anxiety and depression, which wewant to make sure that we can
try to combat.
All right, now let's look atsome of the strategies to help
manage postural instability, andleading off with balance
training.
Specific exercises can helpimprove your balance and your
(30:35):
coordination and again, you cango to liveparkinsonscom and get
the free copy of the ninebalance exercises to improve
your balance.
Now these activities caninclude standing on one leg with
support, and then you can alsodo shifting weight exercises or
tai chi.
There's some other examples ofbalance exercises that you can
(30:55):
use.
Another thing you can do isgait training sizes that you can
use.
Another thing you can do isgait training where you can
practice techniques to improveyour walking, like proactively
taking larger steps, focusing onheel-toe walking and using
visual cues like lines on thefloor to help improve your
stride length.
And then strength training isanother good strategy, because
(31:17):
when you strengthen your leg andyour core muscles, that can
help provide better support andstability.
Now the next group of strategieshelps with fall prevention.
Now, these would include homemodifications like removing
tripping hazards, like throwrugs, and then using non-slip
mats in the bathroom and kitchen.
I remember we had a mat in ourkitchen that was non-slip and I
(31:41):
about killed myself because itslipped out underneath.
So since then, it's allnon-slip.
And then you can also haveadequate lighting in the hallway
and other areas to help giveyou a better visual cues.
And then, finally, assistivedevices like canes and walkers
can help provide extra support,and a physical therapist can
(32:04):
help select the most appropriatechoice.
All right, now it's time toaddress number five on our top
five motor symptom list andthat's freezing of gait, which
can be a distressing symptom,and it's characterized by sudden
, temporary inability to moveyour feet despite wanting to
walk, and it often feels likeyour feet are glued to the floor
.
Typically they're brief andonly last a few seconds, but
(32:28):
they can be unpredictable andmay occur when initiating your
walking, turning or passingthrough narrow spaces or
doorways, and when you'reapproaching your destination
spaces or doorways.
And when you're approachingyour destination, I know that
when I've had problems it's yourmind saying to your feet move,
but your feet don't want tocooperate.
And freezing a gait can havesignificant impact on your
(32:49):
quality of life because it canincrease your potential for fall
risk and reduce your mobilityand independence and a lot of
people it can cause fear andanxiety.
That may occur when you'rewalking, because if you're going
out you may start to worryabout oh gosh, I hope I don't
have freezing, because that'sgoing to be not only
embarrassing, but I don't wantto fall in front of everybody.
(33:12):
So let's look at some strategiesfor managing it, and the first
are cueing techniques, and theseinvolve visual cues so you can
practice stepping over a line,which can be real or imagined.
You can use a laser pointerline or an object like a small
cone to step over.
Auditory cues like marching toa beat or counting one, two,
(33:36):
three or even using a metronomecan also help.
And then, finally, using mentalcues, visualizing yourself
walking smoothly.
So those are different types ofcues that you can use.
And then there are movementstrategies, which can include
weight shifting when you shiftyour weight from one leg to the
(33:57):
other to initiate movement.
There are stepping strategiesto the other to initiate
movement.
There are stepping strategiestaking small steps you can march
in place before moving forward,or taking a step to the side
can also help.
You can also use a techniquecalled stop, stand still, sigh
breath and then take a big step.
(34:22):
The next is assistive devicesWalking aids like canes,
especially those with built-incues, like some of them have a
little bit of a laser pointerthat you can improve stability
and reduce freezing becauseyou're looking at the laser line
.
And then physical therapy andexercise, which you notice has
been a common theme across allthese.
(34:43):
So physical therapy can reallybe beneficial.
And then gait training when youwork with a physical therapist
to improve your walking patternsand you can get strategies for
overcoming freezing.
And then again, we talked aboutstrength and balance exercises,
so improving your lower body,strength and balance can help
reduce the risk of falls.
(35:04):
And then, finally, you can haveenvironmental modifications,
like clearing pathways in yourliving area, where you remove
clutter and obstacles so thatyou don't have the potential to
trip over those, and then makesure you have adequate lighting
to improve your visibility, andthat's going to help reduce
(35:26):
hesitation while walking.
Now I personally experiencefreezing and it can be very
frustrating, but thesestrategies and techniques have
really helped me manage it, sogive them a try.
Okay, those are the top fivesymptoms and strategies to
manage our motor symptoms.
Now I briefly want to discussthe importance of using a
(35:47):
multidisciplinary approach andpersonalized strategies in
managing your Parkinson's motorsymptoms.
Now, here's why it's important,because Parkinson's affects
people in diverse ways andsymptoms can change over time,
and a team of specialistsworking together can help you
manage these motor symptoms moreeffectively.
(36:08):
Now, the team typicallyincludes a neurologist or
movement disorder specialistthey're going to help you
diagnose the Parkinson's,they're going to manage your
medications and they're going toprovide overall care during the
course of the disease and thena physical therapist, who can
help improve your mobility,balance and gait by giving you
(36:29):
targeted exercises and therapies.
Then you're going to want tohave an occupational therapist
who can assist with adaptingyour daily activities to the
environment and to help youmaintain your independence.
Then you want to have a speechpathologist or speech therapist,
because they can help youaddress speech and swallowing
issues.
So, to learn more and get adetailed plan for a
(36:52):
multidisciplinary approach, geta copy of the Building your
Parkinson's Care Team resourceand workbook at Live Parkinson's
or on my COFI page at coficomslash liveparkinsons.
Remember, personalizedstrategies are essential because
Parkinson's affects everyonedifferently, so what works for
one person may not work foranother.
(37:14):
Disease stage, symptom severityand overall health and personal
preferences influence how aperson responds to treatment.
So it's important thattreatment plans are tailored to
your specific needs and yourgoals.
And one thing I did want tostress is proactive
communication is key.
So you want to be sure to beproactive in sharing your
(37:35):
symptoms and challenges withyour healthcare team, because
they can help you developtargeted treatment plans and
address your symptoms.
Now you can go to theliveparkinsonscom and get a
Parkinson's symptom tracker andmedication tracker to help you
and your physician know whenyour symptoms are more severe
and when they impact your dailylife more so, as we close out
(37:59):
this podcast, it's important toremember that effectively
managing Parkinson's, especiallythe motor symptoms we discussed
, requires dedicated andpersonalized approach.
Remember, you're not alone inthis journey.
By working closely with amultidisciplinary team of
specialists and tailoringstrategies to your unique needs
(38:20):
can help you manage these motorsymptoms and the challenges they
cause, so that you can continueto live your best life.
Now we encourage you to takeaction in your role in care and
arm yourself with knowledge andresources.
So visit liveparkinsonscomtoday and subscribe to the free
monthly newsletter.
It's packed with the latestinformation and tips, while
(38:44):
there be sure to check out theBuilding your Parkinson's Care
Team Resource Guide and WorkbookFor just $10,.
It's an incredible tool to helpyou build and coordinate your
optimal care team.
If you find the information weprovide valuable and want to
support our mission ofempowering the Parkinson's
community to live a greatquality of life, please consider
contributing to our Ko-fi pageat ko-ficom slash liveparkinsons
(39:07):
.
Your support will help tocontinue to create and share
vital resources.
And again, thank you very muchfor joining me today.
I'm committed to being yourpartner in navigating
Parkinson's every step of theway.
So until next time, stayhealthy, stay strong and
remember to live your best lifewith Parkinson's.
(39:28):
Thanks again, and I reallyappreciate all of you for
listening.
Thank you.
Hello and welcome to Live Parkinson's Live an
Exceptional Life.
I'm your host, chrisKustenbader, and I've been
living an exceptional life withParkinson's for the past 15
years.
The mission of this podcast isto help as many people as
possible living with Parkinson'sto lead a great quality of life
.
Today's topic is navigatingdaily life with Parkinson's
motor challenges Practicaladvice.
(00:32):
Parkinson's throws a curveballat your movement, impacting
everything from buttoning yourshirt, enjoying a simple walk or
just trying to start your dayoff with a hot cup of coffee.
Start your day off with a hotcup of coffee.
But what if I told you that?
Small adjustments, smartstrategies and a shift in
Parkinson's it's aboutoutsmarting its motor challenges
.
So in this episode, we'recutting through the medical
(00:57):
jargon and delivering real-worldadvice.
You need to navigate daily lifewith more ease and more
confidence For empowerment.
You're in the right place.
Let's navigate this together.
Today's episode is all about oneof the most defining aspects of
Parkinson's motor symptoms.
We're going to be discussingthe movement-related symptoms
most people associate withParkinson's Tremor, slowness of
(01:20):
movement or bradykinesia,rigidity, postural instability,
freezing of gait.
Here's the thing.
No two people experience thesemotor symptoms the exact same
way.
I know for me.
My motor symptoms started witha tremor and then dragging my
left leg when I walked.
I know other friends whoexperienced different motor
(01:40):
symptoms that led them to see adoctor.
So in this episode, we're goingto break down the core motor
symptoms and, more importantly,give you practical,
science-backed strategies andshare personal experiences that
you can use to help you manageyour motor symptoms and not have
them have a significant impacton your daily life.
As a disclaimer, pleaseremember to always work with
your healthcare team topersonalize and tailor these
(02:03):
strategies to your specifichealthcare needs.
The information being providedis for educational purposes only
and is not for medical advice.
Please review any new exerciseprograms with your doctor first
to ensure they are appropriatefor your specific needs.
Now, before we dive intomanaging motor symptoms, if
you're looking for informationand strategies for non-motor
(02:25):
symptoms, check out my previouspodcast, parkinson's Hidden
Battles Addressing Non-MotorSymptoms for Better Living.
All right, so if you're ready,let's jump in feet first and get
started, and let's lead it offby understanding the core motor
symptoms in Parkinson's.
Now I'm sure if you were askedwhat are your top two motor
symptoms that have the biggestimpact on your quality of life,
(02:47):
you would have no troublerattling them off and explaining
why they're at the top of thelist.
So let's start off by breakingdown the five big motor symptoms
so that we can use thisknowledge to help us develop
strategies for managing thesechallenging motor symptoms.
Coming in at number one on ourlist is tremor, because it's
often the first thing peoplenotice and many of you may
(03:09):
experience yourself.
Typically, it's a restingtremor, meaning it happens when
your muscles are relaxed, forexample, when your hands sit
resting on your lap.
Some people experience actiontremors, which happen when
you're reaching or using thatparticular limb, whether it be
your arm to pick up a cup ofcoffee.
Now, we all know that tremorscan be unpredictable.
For some people, tremors areminor, while other people it can
(03:32):
have a significant impact ontheir daily life by interfering
with everyday tasks like writing, eating or even buttoning your
shirt.
So what causes tremors?
In Parkinson's?
Tremors are primarily caused bythe loss of dopamine-producing
neurons in the brain in the areacalled the substantia nigra.
Dopamine is a neurotransmitterthat plays a key role in
(03:54):
controlling our movement, butit's also involved in the reward
and recognition centers, sothat when you get excited about
something, you have a release ofdopamine that makes you want to
do it again.
So when dopamine levels drop,it disrupts the communication
between the nerve cells, leadingto tremors, also known as
(04:15):
rhythmic shaking.
Parkinson's tremors tend to beresting tremors and often start
on one side of the body, such asthe hands, fingers and jaws,
and may spread over time,particularly to the other side
of the body, such as the hands,fingers and jaws, and may spread
over time, particularly to theother side of your body.
Now I'm personally affectedwith tremors in my left hand,
which fortunately doesn't affectmy handwriting Well, in terms
of shaking it doesn't, but myhandwriting has definitely
(04:36):
gotten smaller and moredifficult to read.
Number two on our list isrigidity.
Rigidity refers to thestiffness of your muscles, which
tend to get stiffer as thedisease progresses.
It can make it difficult tomove and can even cause pain.
The tightness and stiffnessoften affect the arms, legs and
(04:58):
neck muscles and can make itharder to swing your arms
naturally when you're walking.
I know I have this problemmyself.
My left arm doesn't swing whenI walk, which affects the
natural motion when I'm walkingand causes me to have a slight
twist in my body because my armisn't swinging when the other
one's not, and that can cause alittle bit of tightness and
(05:20):
lower back pain In terms ofstiffness.
For me, more than two hours inthe car without a break is rough
.
I get out of the car and I'm sostiff it's hard to walk and I
really need to stretch before Ican really get moving.
All right.
Number three is bradykinesia,which is a fancy term for
slowness of movement.
It can feel like your body justisn't cooperating.
Everything from brushing yourteeth to getting out of the
(05:43):
chair becomes slower and moreeffortful.
Bradykinesia can also reduceyour range of motion, which is
known as hypokinesia and that'sa good trivia question to stump
people with if you're playingtrivia.
And when you go to see yourneurologist or movement disorder
specialist, they usually haveyou tap your fingers and your
thumb together as fast as youcan to test for bradykinesia.
(06:06):
Another test is the one whereyou have your hand on your thigh
, with your hand facing up, andthey have you flip it back and
forth on your thigh.
They're looking at how fast youdo that, so they're testing to
see if you have bradykinesia.
So essentially, you don't needfancy medical equipment to test
for bradykinesia.
So essentially, you don't needfancy medical equipment to test
for bradykinesia.
(06:26):
All right.
Number four is posturalinstability as Parkinson's
progresses.
You often see people withrounded shoulders, with a
slumped look, often looking attheir feet, and this may cause
balance problems, and this isdue to the loss of reflexes that
help keep you upright.
This increases the risk offalls, which is a major concern
(06:47):
and can have a devastatingeffect on a person's quality of
life, because they can getinjured and end up in a
rehabilitation center, and thenthe time it takes to recover can
have a substantial impact onthe person's quality of life and
their social interactions.
So that's why it's important todo balance exercises every day
to help improve and maintainyour balance.
(07:08):
Now, for me personally, I spendabout 10 to 15 minutes every
morning and I've noticedsignificant improvements in my
balance over the years.
Now, to learn more, visit mywebsite, libparkinsonscom, and
you can download a free copy ofNine Balance Exercises to
Improve Balance with Parkinson'sand use this as a guide for
(07:29):
helping to improve your balance.
And then, finally, rounding out,our top five is freezing of
gait.
Do you ever feel like your feetare suddenly glued to the floor
?
That's called freezing, orfreezing of gait.
It often happens when you'returning, you're going through a
doorway or you're starting toinitiate walking, and it can be
(07:49):
incredibly frustrating, but it'salso manageable.
Now, one of the things I do tohelp me when my feet feel like
they're glued to the floor isand to help prevent this is I
like to listen to music, becausethe constant beat helps me to
make sure that I keep my feetmoving, or if they do feel like
(08:11):
they're stuck to the floor, Icount one, two, three and then
often begin to move my feet, andit really does help.
Okay, that was an overview ofthe core motor symptoms of
Parkinson's.
Now let's look at each motorsymptom in more detail and
provide some practical tips andstrategies for managing each one
to help lessen their impact onour daily lives.
Now, these strategies I will besharing are evidence-based,
(08:32):
meaning they have researchsupporting their benefits, and
also include personal successstories from individuals living
with Parkinson's.
And let's lead it off with oneof the symptoms that affects
most people living withParkinson's.
And that's lead it off with oneof the symptoms that affects
most people living withParkinson's, and that's tremors.
As we discussed, most peoplewill experience a resting tremor
when the muscle is relaxed.
Now, one of the things I'venoticed when I have tremors is
(08:54):
they seem to have a mind oftheir own meaning.
No matter how hard I try, Ijust can't will them to stop.
They keep right on going.
Now I also notice that when I'mstressed, the tremors seem to
be worse, but thankfully, thereare a number of strategies that
you can use to help manage yourtremors.
The first one is mindfulnessand relaxation techniques, or,
(09:15):
as I like to say, calming theinternal storm.
Now, evidence suggests thatstress and anxiety can
exacerbate Parkinson's tremors.
Just as I mentioned, thathappens to me.
Mindfulness and relaxationtechniques offer a way for you
to manage your body's stressresponse and potentially reduce
tremor intensity.
Mindfulness meditation is apractice that involves focusing
(09:38):
your attention on the presentmoment with an attitude of
acceptance.
Present moment with an attitudeof acceptance.
It can include severaltechniques, involving deep
breathing exercises, body scans,where you slowly go over how
you feel in each area of yourbody as you move from your feet
to your head, and observingthoughts and body sensations
(09:59):
without judgment.
For example, if you notice yourheart rate and breathing are
increasing, instead of lettingyour mind race and saying what's
wrong with me, why is my heartrate beating faster, just simply
acknowledge it and accept itand focus on the present moment.
Studies have shown that, usingfMRI, the mindfulness-based
(10:19):
interventions can lead toincreased gray matter density in
the brain regions associatedwith emotional regulation in
Parkinson's.
According to the study,mindfulness-based intervention
in Parkinson's disease leads tostructural brain changes in MRI
published in Clinical Neurologyand Neurosurgery.
When you focus on the presentmoment, without judgment, you
(10:40):
become more aware of your tremorand develop a sense of
acceptance, potentially reducingthe anxiety it causes.
Simple practices like focusingon your breath, body sensations
or sounds can be done anywhereat any time.
As a practical tip, start with5-10 minute sessions daily,
(11:00):
gradually increasing theduration.
Now there are a number ofguided meditations available,
either through apps or onlineresources specifically designed
for Parkinson's.
Now for more information and asample meditation, listen to my
podcast, the Parkinson's AnxietyToolkit Mindfulness Strategies
at Work.
Next up is deep breathingexercises.
(11:23):
Slow, deep breaths can activatethe parasympathetic nervous
system, promoting relaxation andreducing overall tension, which
may help to reduce your tremor.
As a practical tip, use the4-7-8 breathing technique.
So what you want to do isinhale for four counts, hold for
a count of seven and thenexhale for a count of eight.
(11:45):
This can be a quick andeffective way to help calm down
when your tremor is reallybothering you.
Then we have progressive musclerelaxation, which is a
technique that involves tensingand then releasing different
muscle groups in the body tohelp you identify and release
areas of tension that might becontributing to your tremors.
For example, starting with yourfeet, tense the muscles in your
(12:13):
feet, then relax, then move toyour calves, then your thighs,
your abs, repeating the process.
As a practical tip, find aquiet place and work through
each muscle group, from yourtoes to your face, tensing and
relaxing each muscle group.
Another relaxation technique isyoga and tai chi.
These movement practicescombine physical postures or
(12:35):
stances, which you typically usein tai chi, with controlled
breathing and mindfulness,helping to improve your
flexibility, your balance andpotentially, reducing stress and
tremor.
As a practical tip, look forclasses that are specifically
tailored for individuals withParkinson's, or ask the
instructor for modifications tohelp you with your specific
(12:56):
needs, and then focus on thesegentle movements to help you
reduce stress, and that willlead to help you becoming more
calm.
Now the next type of strategiesto help us manage our tremors is
compensatory strategies, orworking smarter, not harder.
(13:18):
So what are compensatorystrategies, chris?
Well, glad, yes.
These are strategies that focuson modifying how you perform
tasks to minimize the impact oftremors on function and
independence.
So let's look at some of thesecompensatory strategies,
starting with proximalstabilization, which is just a
fancy way of saying.
They provide support of yourarm with a tremor close to the
(13:39):
core of your body.
So the further your arm is awayfrom your body, the harder it
is to control your tremor.
So I used to either put mythumb in my pocket and hold my
hand near my waist when I had atremor, or just put my hand in
my pocket.
But you can also just hold itclose to your body.
So, as a practical tip, keepyour elbows close to your body
(14:00):
when performing tasks, and thenyou can also rest your forearms
or elbows on the table orcountertop for stability when
eating, writing or performingfine motor tasks.
Next, use both hands so you canuse the non-tremor hand to
assist your tremor hand, whichcan help provide stability and
(14:20):
control.
So, as a practical tip, useyour unaffected hand to guide or
study the tremoring hand duringtasks.
Like you know, maybe you'repouring a drink, you're opening
a container or when you're usingutensils.
Next, slow down your movements.
Rapid movements can make yourtremors worse.
(14:40):
So when doing daily tasks,deliberately slow movements to
allow for greater control ofyour hands as a practical tip,
consciously focusing on thespeed of your movements.
So make sure you give yourselfample time to complete tasks so
you don't feel like you'rerushed.
And then next up is my personalfavorite and a lesson I learned
(15:02):
from learning songs and playingguitar, and that's to break
down tasks.
Sometimes our daily activitiescan involve some complex steps,
but breaking them down intosmaller, more manageable steps
can make them easier.
Now some practical tips for you.
When getting dressed is focuson one piece of clothing at a
time.
Maybe lay them out on the bedso you're ready when it's time
(15:27):
to get dressed.
But only focus on one thing ata time when you're getting
dressed.
So, when you're cooking,prepare the ingredients in
stages so that you can add themwhen they're needed in your
recipe, so that you're notracing around trying to get the
ingredients as you're cookingyour meal.
And then, finally, weightingAdding weight to your utensils
(15:51):
or wearing weighted gloves canhelp reduce the tremors in some
people.
So make sure you get someguidance and approach from an
occupational therapist and theycan help you select the one
that's most appropriate for you.
And you want to be a little bitworried because some people may
get fatigued from usingweighted utensils or a weighted
glove.
Now, as a practical tip,experiment with weighted pens,
(16:15):
utensils or weighted gloves andor wrist weights under the
supervision of an occupationaltherapist, to see if they
provide a benefit.
Now I'll put some of myrecommended products in the
product description.
Now the next strategy fortremors is adaptive equipment,
which I like to call tools forenhanced independence.
Now a variety of adaptiveequipment is available to help
(16:38):
you manage your tremors andmaintain independence in your
daily activities Weightedutensils and cups.
The added weight provides morestability during eating and
drinking and that helps toreduce spills.
So, as a practical tip,experiment with different
weights and handle sizes to findwhat works best for you.
(17:00):
Now another key tip is to usenon-slip mats and surfaces.
These can prevent items fromsliding during tasks, giving you
more stability.
So some practical tips is usenon-slip mats under plates,
bowls and cutting boards.
Next is buttonholes and zipperpulls.
These can help when you aregetting dressed and can help
(17:22):
reduce the need for fine motorcontrol.
An occupational therapist cangive some instruction on how to
use these.
Next is electric toothbrushesand razors.
Now, the larger handles andpower to action can make
grooming tasks easier.
Now I'm a little bit biased,because I used to sell and
promote one of the power brushesand it was an Oral-B and I
(17:46):
highly recommend them.
Finally, writing aids likeweighted grips or even
voice-to-text software can helpin your work and oral
communication.
As a practical tip, experimentwith different types of pens and
grips and consider using aslant board for writing.
So, as we conclude thesestrategies for managing tremors,
(18:09):
try using a multifacetedapproach that includes
mindfulness and relaxation,compensatory strategies and
assistive technology.
These can help to significantlyimprove your daily life and
help you maintain yourindependence.
All right, now let's move on toour next motor symptom on the
top five list, and coming in atnumber two, is rigidity.
(18:30):
Rigidity refers to thestiffness and resistance to
movement caused by increasedmuscle tone.
It's considered one of the coremotor symptoms of Parkinson's
and it can affect any part ofthe body, and it can also lead
to pain, restricted range ofmotion and difficulty with your
daily activities.
(18:51):
While medication is important,several other strategies can
help.
So let's look at easingrigidity using these strategies
and leading it off with gentlestretching and range of motion
exercises.
These exercises are going to becrucial for maintaining muscle
length and joint flexibility,which is going to help you
(19:13):
counteract the increased muscletone in Parkinson's.
And then these exercises canhelp prevent contractures or
shortening and tightening of themuscles, and so it helps with
your overall movement, asevidenced.
Physical therapy guidelines andexpert consensus strongly
recommend regular stretching andrange of motion exercises for
(19:35):
Parkinson's.
Studies have shown that theseexercises can improve your
flexibility, reduce yourstiffness, and so they're going
to be beneficial, and Irecommend doing these every day,
trying to do at least five toten minutes of stretching.
I know that it really helps meand it's really helped me in
terms of my flexibility andmovement.
(19:55):
Now let's look at some practicaltips and examples.
We'll start with neck stretches, and what you can do is slowly
tilt your head to each side,holding for 15 to 30 seconds,
and then gently rotate your headin a circular motion.
That'll help stretch out yourneck muscles.
Shoulder rolls Roll yourshoulders forward and backward
(20:16):
in smooth circular motions.
Then we have arm circles youcan extend your arms and make
small, then larger, arm circularmotions.
Wrist and hand exercises Flexand extend your wrists and then
make a fist and then open yourhand as wide as you can, gently
(20:37):
stretching each fingerindividually.
Leg swings Standing withsupport, you can swing each leg
forward and backward and then,side to side Ankle circles
Holding onto something of courserotate your ankles in a
circular motion, and you coulddo that while you're sitting as
well.
(20:58):
Now some important things toconsider.
You want to perform stretchesslowly and gently and avoiding
any forceful movement that cancause pain.
You want to focus on smooth,controlled movements and repeat
each stretch several times,holding for 15 to 30 seconds.
And you want to perform theseexercises daily, and you can
(21:19):
even do them several times a day, as recommended by a physical
therapist.
And then a physical therapistcan provide a personalized
exercise program tailored toyour specific needs and
limitations.
Now the next strategy is warmbaths or showers.
Heat can help relax muscles,increase blood flow and reduce
pain and stiffness.
(21:39):
Now some evidence.
While not specific toParkinson's, the general
principle of thermotherapy orheat therapy are well
established in rehabilitationand pain management.
Heat application is known todecrease muscle tone and improve
tissue extensibility.
Heat application is known todecrease muscle tone and improve
(22:00):
tissue extensibility.
Now let's look at somepractical tips.
Take a warm, not hot bath orshower for 15 or 20 minutes.
Ensure the water temperature issafe, because you want to avoid
burns.
And then you can also add Epsomsalts to the bath, which some
people find soothing for musclerelaxation.
You can apply warm compressesto specific areas of rigidity
(22:23):
such as your shoulders or yourneck.
Those are going to help alittle bit to help loosen up the
muscles.
Now the next strategy to helpwith rigidity is massage therapy
.
A massage can help loosen tightmuscles, improve your
circulation and reduce pain.
It may also have a calmingeffect which can indirectly
reduce muscle strain.
(22:44):
Well, research on massagetherapy specifically for
Parkinson's is ongoing.
Studies suggest that massagecan be beneficial for reducing
muscle stiffness and pain inother musculoskeletal conditions
.
Now I personally get a massageonce a month and I can honestly
say I feel looser and moreflexible, as well as more
(23:06):
relaxed.
So I would highly recommendgetting a massage.
I mean, it's a great way tostay loose and help you reduce
stress and get rid of some ofthe tightness in your muscles.
So here are some practical tipsSeek a massage therapist who is
experienced in working withpeople with neurological
conditions, if possible, andthen gentle and slow massage
(23:30):
techniques are often preferred.
Let your massage therapist knowabout your comfort level or any
areas of particular tightness,and that's usually one of the
first things they ask me when Igo in for a massage is do you
have any areas that are tight orthat are bothering you?
And then, finally, the laststrategy to help with tightness
is maintaining activity.
(23:52):
Regular physical activity, akaexercise, is essential for
managing Parkinson's symptoms,including rigidity.
Movement helps keep musclesactive.
It's going to improve yourcirculation and maintain your
joint mobility.
Evidence to support these comesfrom Parkinson's Outcome
Project and other large scalestudies have demonstrated that
(24:15):
regular exercise yes, I said it,exercise can slow the
progression of motor symptomsand improve your quality of life
.
So, as a practical tip, engagein a variety of activities you
enjoy, such as walking, swimming, cycling, dancing and even
gardening.
Aim for at least 150 minutes ofmoderate intensity aerobic
(24:39):
activity.
Include activities that focuson flexibility, such as
stretching, yoga or tai chi.
Consider Parkinson's specificexercise programs like the LSVT
Big program, which emphasizeslarge amplitude movements to
counteract bradykinesia andrigidity, and then consult with
(25:01):
a physical therapist to developsafe and effective exercise
programs tailored to yourindividual needs and abilities.
Now, remember, even smallamounts of movement throughout
the day can be helpful, so youcan break up periods of sitting
with short walks or a littlestretching session.
(25:22):
All right, moving on tostrategies for developing the
types of motor symptoms weexperience, which is
bradykinesia or slowness ofmovement.
Bradykinesia is a core motorsymptom of Parkinson's disease
and it's characterized byslowness of movement.
And it's not just about movingslowly.
It also includes difficultyinitiating movement, hesitation
(25:43):
before starting an action, likegetting out of a chair.
Reduced amplitude of movement,where you're making smaller
movements, so decreased armswing while walking, smaller
handwriting.
Slowness of execution, whereyou take a long time to complete
a movement.
And then fatigue, where you'refeeling tired because the simple
(26:05):
movements required to moverequire so much effort from
being slow that it causes somefatigue.
Now, the slowness stems from alack of dopamine in the brain,
and again, dopamine's theneurotransmitter that's crucial
for our movement.
Now let's look at some of thestrategies for dealing with
bradykinesia.
The first is exercise andphysical therapy.
(26:28):
Yes, it comes up again, butregular exercise is crucial for
maintaining your mobility andyour function in doing daily
activities.
Next up is LSVT Big.
It's a program, a specializedphysical therapy program that
uses large, amplified movementsto combat bradykinesia.
(26:48):
Now, I participated in the LSVTBig program the first time I
went to physical therapy and Idid find it beneficial.
And they actually give youhandouts with each of the
exercises that you can do athome, which I still have and I
will do today, and I still useit as a reference because when
I'm feeling slow or tight, Ipull those out and do a lot of
(27:13):
those exercises.
Now, walking, focusing on heelto toe exercises.
Now, walking, focusing on heelto toe, meaning landing on your
heel and rolling on your toeswhile swinging your arms can
help.
Stretching helps to preventstiffness and improves your
range of motion.
And then occupational therapyAn occupational therapist can
help you adapt your environmentand your daily tasks to help you
(27:37):
with bradykinesia.
Next up are movement strategiesand leading off with again
breaking down tasks, you want todivide complex activities into
smaller, more manageable steps,because that's going to help you
focus on one thing at a timeand prevent you from being
overwhelmed and being tired.
Focus on one thing at a timeand prevent you from being
overwhelmed and being tired.
(27:58):
And then you can use rhythm andcounting Count aloud as you use
muscles to help you initiateyour movement when you're slow
and then also visualize yourmovement.
Imagine your movement beforeyou're doing it.
So, if you're getting out of achair, visualize yourself
getting out of the chair in anice, slow, smooth movement.
Allow extra time, don't rushyourself, and give yourself
(28:25):
plenty of time to complete thetasks.
Another thing you can do isrocking.
If you have trouble getting outof the chair, you can rock back
and forth to help initiatestanding.
Or you can also use that to getout of bed as well.
If you're sitting on the edgeof the bed, maybe you can rock
back and forth a little bit, butdon't go too far forward and
lose your balance and fallforward.
And then finally, speechtherapy.
Bradykinesia can affect ourspeech, making it softer and
(28:48):
more monotone, so speech therapycan help.
Now I've done speech therapytwice and I highly recommend it
because I had people telling methat they were having trouble
understanding me.
So and I highly recommend itbecause I had people telling me
that they were having troubleunderstanding me, so speech
therapy is a great option.
All right, moving on to thefourth motor symptom on our top
five list is posturalinstability, which, in layman's
terms for people like me wholike to keep it simple, means
(29:11):
the inability to maintain yourbalance.
In Parkinson's, now inParkinson's.
In Parkinson's, now inParkinson's it's caused by a
loss of reflexes that help usstay upright and often leads to
an increased fall risk.
Postural instability can have asignificant impact on our daily
lives because if you'reconstantly worried about falling
, that can really limit thethings that you do.
(29:33):
So postural instability isgoing to increase our fall risk.
So posture instability is goingto increase our fall risk.
It can cause difficulty withour mobility, so for simple
activities like walking, turningor standing, that can become
very challenging.
It can also restrict ouractivities because a fear of
falling can cause us to avoid,you know, participating in our
(29:53):
social activities and it canlimit our exercise and can keep
us from doing the hobbies weenjoy.
And then loss of independence,because balance and posture
problems can make it harder toperform everyday tasks like
dressing, bathing and cookingwithout assistance.
And it can have a bigpsychological impact because if
(30:15):
you have a constant fear offalling, that can lead to
anxiety and depression, which wewant to make sure that we can
try to combat.
All right, now let's look atsome of the strategies to help
manage postural instability, andleading off with balance
training.
Specific exercises can helpimprove your balance and your
(30:35):
coordination and again, you cango to liveparkinsonscom and get
the free copy of the ninebalance exercises to improve
your balance.
Now these activities caninclude standing on one leg with
support, and then you can alsodo shifting weight exercises or
tai chi.
There's some other examples ofbalance exercises that you can
(30:55):
use.
Another thing you can do isgait training sizes that you can
use.
Another thing you can do isgait training where you can
practice techniques to improveyour walking, like proactively
taking larger steps, focusing onheel-toe walking and using
visual cues like lines on thefloor to help improve your
stride length.
And then strength training isanother good strategy, because
(31:17):
when you strengthen your leg andyour core muscles, that can
help provide better support andstability.
Now the next group of strategieshelps with fall prevention.
Now, these would include homemodifications like removing
tripping hazards, like throwrugs, and then using non-slip
mats in the bathroom and kitchen.
I remember we had a mat in ourkitchen that was non-slip and I
(31:41):
about killed myself because itslipped out underneath.
So since then, it's allnon-slip.
And then you can also haveadequate lighting in the hallway
and other areas to help giveyou a better visual cues.
And then, finally, assistivedevices like canes and walkers
can help provide extra support,and a physical therapist can
(32:04):
help select the most appropriatechoice.
All right, now it's time toaddress number five on our top
five motor symptom list andthat's freezing of gait, which
can be a distressing symptom,and it's characterized by sudden
, temporary inability to moveyour feet despite wanting to
walk, and it often feels likeyour feet are glued to the floor
.
Typically they're brief andonly last a few seconds, but
(32:28):
they can be unpredictable andmay occur when initiating your
walking, turning or passingthrough narrow spaces or
doorways, and when you'reapproaching your destination
spaces or doorways.
And when you're approachingyour destination, I know that
when I've had problems it's yourmind saying to your feet move,
but your feet don't want tocooperate.
And freezing a gait can havesignificant impact on your
(32:49):
quality of life because it canincrease your potential for fall
risk and reduce your mobilityand independence and a lot of
people it can cause fear andanxiety.
That may occur when you'rewalking, because if you're going
out you may start to worryabout oh gosh, I hope I don't
have freezing, because that'sgoing to be not only
embarrassing, but I don't wantto fall in front of everybody.
(33:12):
So let's look at some strategiesfor managing it, and the first
are cueing techniques, and theseinvolve visual cues so you can
practice stepping over a line,which can be real or imagined.
You can use a laser pointerline or an object like a small
cone to step over.
Auditory cues like marching toa beat or counting one, two,
(33:36):
three or even using a metronomecan also help.
And then, finally, using mentalcues, visualizing yourself
walking smoothly.
So those are different types ofcues that you can use.
And then there are movementstrategies, which can include
weight shifting when you shiftyour weight from one leg to the
(33:57):
other to initiate movement.
There are stepping strategiesto the other to initiate
movement.
There are stepping strategiestaking small steps you can march
in place before moving forward,or taking a step to the side
can also help.
You can also use a techniquecalled stop, stand still, sigh
breath and then take a big step.
(34:22):
The next is assistive devicesWalking aids like canes,
especially those with built-incues, like some of them have a
little bit of a laser pointerthat you can improve stability
and reduce freezing becauseyou're looking at the laser line
.
And then physical therapy andexercise, which you notice has
been a common theme across allthese.
(34:43):
So physical therapy can reallybe beneficial.
And then gait training when youwork with a physical therapist
to improve your walking patternsand you can get strategies for
overcoming freezing.
And then again, we talked aboutstrength and balance exercises,
so improving your lower body,strength and balance can help
reduce the risk of falls.
(35:04):
And then, finally, you can haveenvironmental modifications,
like clearing pathways in yourliving area, where you remove
clutter and obstacles so thatyou don't have the potential to
trip over those, and then makesure you have adequate lighting
to improve your visibility, andthat's going to help reduce
(35:26):
hesitation while walking.
Now I personally experiencefreezing and it can be very
frustrating, but thesestrategies and techniques have
really helped me manage it, sogive them a try.
Okay, those are the top fivesymptoms and strategies to
manage our motor symptoms.
Now I briefly want to discussthe importance of using a
(35:47):
multidisciplinary approach andpersonalized strategies in
managing your Parkinson's motorsymptoms.
Now, here's why it's important,because Parkinson's affects
people in diverse ways andsymptoms can change over time,
and a team of specialistsworking together can help you
manage these motor symptoms moreeffectively.
(36:08):
Now, the team typicallyincludes a neurologist or
movement disorder specialistthey're going to help you
diagnose the Parkinson's,they're going to manage your
medications and they're going toprovide overall care during the
course of the disease and thena physical therapist, who can
help improve your mobility,balance and gait by giving you
(36:29):
targeted exercises and therapies.
Then you're going to want tohave an occupational therapist
who can assist with adaptingyour daily activities to the
environment and to help youmaintain your independence.
Then you want to have a speechpathologist or speech therapist,
because they can help youaddress speech and swallowing
issues.
So, to learn more and get adetailed plan for a
(36:52):
multidisciplinary approach, geta copy of the Building your
Parkinson's Care Team resourceand workbook at Live Parkinson's
or on my COFI page at coficomslash liveparkinsons.
Remember, personalizedstrategies are essential because
Parkinson's affects everyonedifferently, so what works for
one person may not work foranother.
(37:14):
Disease stage, symptom severityand overall health and personal
preferences influence how aperson responds to treatment.
So it's important thattreatment plans are tailored to
your specific needs and yourgoals.
And one thing I did want tostress is proactive
communication is key.
So you want to be sure to beproactive in sharing your
(37:35):
symptoms and challenges withyour healthcare team, because
they can help you developtargeted treatment plans and
address your symptoms.
Now you can go to theliveparkinsonscom and get a
Parkinson's symptom tracker andmedication tracker to help you
and your physician know whenyour symptoms are more severe
and when they impact your dailylife more so, as we close out
(37:59):
this podcast, it's important toremember that effectively
managing Parkinson's, especiallythe motor symptoms we discussed
, requires dedicated andpersonalized approach.
Remember, you're not alone inthis journey.
By working closely with amultidisciplinary team of
specialists and tailoringstrategies to your unique needs
(38:20):
can help you manage these motorsymptoms and the challenges they
cause, so that you can continueto live your best life.
Now we encourage you to takeaction in your role in care and
arm yourself with knowledge andresources.
So visit liveparkinsonscomtoday and subscribe to the free
monthly newsletter.
It's packed with the latestinformation and tips, while
(38:44):
there be sure to check out theBuilding your Parkinson's Care
Team Resource Guide and WorkbookFor just $10,.
It's an incredible tool to helpyou build and coordinate your
optimal care team.
If you find the information weprovide valuable and want to
support our mission ofempowering the Parkinson's
community to live a greatquality of life, please consider
contributing to our Ko-fi pageat ko-ficom slash liveparkinsons
(39:07):
.
Your support will help tocontinue to create and share
vital resources.
And again, thank you very muchfor joining me today.
I'm committed to being yourpartner in navigating
Parkinson's every step of theway.
So until next time, stayhealthy, stay strong and
remember to live your best lifewith Parkinson's.
(39:28):
Thanks again, and I reallyappreciate all of you for
listening.
Thank you.
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