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Understanding Parkinson’s Symptoms With a Physiotherapy Lens

Parkinson’s is a mentally and physically exhausting disease. Although it’s primarily managed with medications, physical therapy also has an important role for reducing several motor symptoms.

In this article, we’ll talk about the most common Parkinson’s symptoms and show you how physical therapy helps manage those to improve your function and quality of life.

Parkinson’s Symptoms Managed with Physiotherapy

Here are some of the motor symptoms of Parkinson’s. Motor symptoms are those that relate to muscles and movement while non-motor is related to mental, emotional, and non-physical symptoms.

1.   Tremors

Tremors can significantly affect hand stability, balance, and functional ability in Parkinson’s, making everyday tasks challenging. The reason for these tremors is dysregulation in the brain and issues with the signals generated there. But muscle control and power also have a role. While medications usually deal with the brain part of this equation, exercises help calm tremors by making your muscles stronger which makes your movements more controlled.

Our physiotherapists use targeted exercises like wrist curls with weights and hand grips to strengthen muscles and reduce tremor impact. These exercises can make tasks such as writing or eating less difficult.

For example, lifting small weights can build arm strength, helping to steady your hands. Activities that improve how well your fingers move, like picking up beads or writing, can also help.

Stress can also make tremors worse. So, doing activities like deep breathing or gentle stretches can make tremors less noticeable.

2.   Bradykinesia (Slowness of Movement)

Bradykinesia is a dominant symptom of Parkinson’s. It makes your movements feel sluggish and inefficient. Research suggests that resistance exercises and repetitive task practising can be great for reducing Bradykinesia in Parkinson’s.

This symptom is a major cause for increased fear of falling in elderly with Parkinson’s. They get scared when an unexpected obstacle appears and they have to react quickly, but they can’t.

Our physiotherapists introduce strengthening exercises that focus on speed and range of motion, such as arm and leg swings with weights and body weight resistance training while doing functional activities such as moving objects from a cupboard to the table. These exercises add fluidity to your movements.

Our patients also benefit from repetitive task practice of daily activities, like standing up from a chair or stepping over obstacles. These also increase movement efficiency and speed in daily activities.

3.   Postural Instability

This symptom is linked to the one above (bradykinesia). Having compromised balance can lead to falls, so our physiotherapy regimen focuses on exercises that improve stability. \

Activities like standing on one foot or walking heel-to-toe in a safe environment at our physiotherapy clinic in London or at your home can enhance balance. Our physiotherapists might also use techniques like the Alexander Technique to improve posture and balance.

This technique teaches you how to align your body correctly and move more easily to prevent falls. It divides your movements into small segments and describes them to you to help you be more aware of your body position in different stages of a movement, so you can correct each stage and ultimately the whole movement.

For example, we can show you how you stabilise your body weight over both your legs when you’re standing, how your buttocks, lower back, and abdominal muscles are contracting to keep you standing still, and how your arms are moving to ensure you’re balanced correctly.

Now, by focusing on one of these segments at a time, you can slowly learn to gain control over the entire movement of standing still and reduce instability in this position.

“Learning to fall” techniques are also super useful for managing postural instability in our Parkinson’s patients. It allows you to remove the fear of falling by learning how to fall safely. 

4.   Rigidity

Muscle stiffness, or rigidity, is a common issue in Parkinson’s. To combat this, our physiotherapists use stretching, strengthening, coordination and task-specific exercises.

The “task-specific” exercises are those that you need for particular tasks, which can also help you do other activities as well. For example, arm raises that you’ll need to do while putting on a T-shirt is a “task-specific” exercise. But arm raises are also helpful for other activities such as grabbing an object from the top shelf.

These exercises help loosen tight muscles, increase flexibility, and make movement easier. We also incorporate therapeutic approaches like gentle yoga or Tai Chi for their dual benefits on mind and body, promoting relaxation and flexibility.

Research suggests that improved muscle length that we can achieve through stretching and increased muscle control through coordination exercises may reduce rigidity.

5.   Gait Abnormalities

Parkinson’s patients also develop abnormal gait patterns because of the other symptoms of postural instability, bradykinesia, and tremors.

But gait can be corrected through training, where our physiotherapists analyse your walking pattern and identify specific issues. Exercises might include practising heel-to-toe walking or using treadmills while your therapist provides cues to correct specific movements of your gait pattern. This targeted approach helps improve walking patterns, making your movements safer and more efficient.

Image Alt Text	Patient testimonial for rehab at Clearcut Physiotherapy in London.

6.   Freezing of Gait:

Parkinson’s patients often literally freeze in place while walking normally. It can also happen while you’re talking.

To address freezing, our physiotherapists use research-backed cueing techniques, where we provide auditory or visual signals to help initiate movement. For example, stepping over lines on the floor or walking in time with a metronome can help overcome freezing episodes. These strategies aim to enhance your mobility and confidence, particularly when navigating challenging environments.

7.   Dystonia

Dystonia is a symptom of Parkinson’s where your muscles contract involuntarily for a long time. It’s an exaggerated cramp. As a result, the region where your muscles are contracting may twist and cause pain.

Physiotherapy helps manage dystonia using specific stretching exercises to relieve tension and prescribing exercises to promote muscle relaxation. We may also introduce heat or cold therapy to soothe sore muscles, but this is usually a short-term solution to increase engagement in the therapy regimen.

Research tells us that lower intensity exercises are generally well-managed in people struggling with dystonia. So, our physiotherapist also uses a combination of light walking, yoga, and gentle range of motion exercises.

8.   Fine Motor Skills

Improving dexterity (the skill of performing tasks that require good control of hands) is crucial for independence. Our physiotherapists use exercises like picking up small objects, buttoning a shirt on a practice board, or using utensils with modified handles to enhance your control and precision.

These activities are mostly individualised to help our patients maintain their ability to perform fine motor tasks, contributing to a better quality of life.

Non-Motor Symptoms

Pain, depression, anxiety, sleep disturbances, fatigue, and visual problems are some non-motor symptoms of Parkinson’s that we can indirectly manage with physiotherapy.

Engaging in regular physiotherapy for Parkinson’s can improve sleep quality by reducing pain and discomfort, thus enabling better rest. It can also uplift mood by releasing endorphins during exercise and alleviate fatigue through enhanced stamina and energy levels.

Overall, physiotherapy contributes to a better sense of well-being and quality of life for those living with Parkinson’s.

The Physiotherapy Approach to Managing Parkinson’s Symptoms

Our approach to physiotherapy for Parkinson’s is highly personalised. Each patient receives a tailored assessment that considers their unique set of symptoms and challenges. Based on this assessment, our physiotherapist devises a specialised treatment plan that targets your specific needs, whether it’s improving mobility, balance, or addressing tremors.

Goal setting is a critical part of this process. We collaborate with patients to set realistic, achievable goals, whether it’s enhancing daily function, increasing independence, or improving specific motor skills.

These goals provide a clear direction for the therapy sessions and a way to measure progress. Throughout the treatment, we continuously adapt the plan based on your feedback and progress. This ensures that the interventions remain relevant and focused on achieving meaningful improvements in your life.

Your Next Steps

Exploring physiotherapy as a complementary approach to managing Parkinson’s can be a game-changer for many. It offers a proactive way to address the physical challenges of the condition and can significantly enhance your quality of life.

We encourage you to consider physiotherapy not just as a treatment but as a journey towards better health and more independence. Get in touch with our physiotherapy clinics in Eltham, Battersea, Norbury, or Woolwich to learn more or start your rehab.