Parkinson’s disease (PD) is a chronic, progressive disorder that causes slowness of movement or lack of movement in the body. Resting tremor, seen as an uncontrolled, repetitive shaking of the hand or hands, may also be present. The changes in motor control can affect many areas of the body. If you have PD, you may have one or many areas of the body that are affected.
While there is no known cure for PD, you doctor may prescribe medication to help limit symptoms. He or she may also prescribe physical therapy to help regulate the motor control changes that occur with the disease.
Parkinson’s disease causes changes in many different body parts, so your physical therapist may be part of a multidisciplinary team of healthcare professionals who can help you. Aside from your doctor and physical therapist, you may also need to be evaluated and treated by a speech therapist, occupational therapist, respiratory therapist and social worker.
Changes Seen in Motor Control
Movement Planning. If you have PD, you may notice difficulty with initiating movement. Your reaction time may be slowed. This can cause you to lose your balance while walking, or you may not be able to reach for something quickly to grab it.
There may also be changes in movements that occur in sequence. This means that activities that occur in a step-by-step fashion may be slowed. For example, rising from a chair requires that you scoot to the end of the chair, put your feet securely on the floor in just the right place and then lean your body forward to stand up. This sort of mobility may be difficult if you have PD.
Simultaneous movement may also be affected if you have PD. For example, you may be walking and need to reach into your pocket or purse. The simultaneous movement of walking and reaching may be slowed. You may need to stop walking, reach into your pocket and then start walking again if you have PD.
Gait. Gait refers to the way you walk. If you have PD, you may notice changes in your gait. You may have a festinating gait pattern. This means that as you are walking, you start to take small, rapid steps. Festinating gait patterns increase your likelihood of losing your balance.
You may also have a difficult time initiating walking. Since PD affects the area of the brain responsible for motor planning, you may have trouble taking first steps while standing. You may also experience the freezing phenomenon. This occurs when you are walking and then suddenly and temporarily cannot take another step and your feet appear frozen to the floor. This phenomenon typically lasts for a few seconds and then normal walking can resume.
Posture. Your posture may become affected if you have PD. Often posture becomes more and more flexed forward, and the arms tend to flex inward as well. A flexed posture can alter your center of gravity and increase your chances of falling.
Hand motion. As motor planning becomes affected in PD, you may notice that the control of your hands may change. You may reach for items and miss them completely, or you may try to reach for something but have a difficult time initiating movement. Resting tremor is also common in PD, and you may notice that your hand or hands shake when at rest.
Respiratory function. Changes in lung function are another motor control issue with PD. If your posture is flexed forward, you may have difficulty fully expanding the lungs during breathing. Changes in the muscles of inspiration and expiration, namely the diaphragm and the intercostal muscles, may also limit breathing.
Swallowing and speech. Muscular control changes may occur in the muscles of the face and neck, making speech and swallowing difficult. You should consult your doctor, who may refer you to a speech/swallowing therapist to address these changes.
If you have PD, you may benefit from physical therapy to help with improved coordination and movement. Your physical therapist will evaluate many different systems to help you gain or maintain control of your movement. While physical therapy does not cure the disease, it may help to improve safe mobility and quality of life.
Carr, J. H. (2000). Neurological rehabilitation: optimizing motor performance. Oxford: Butterworth Heinemann
