Motor symptoms are used to clinically diagnose Parkinson’s.
Motor symptoms are a hallmark of Parkinson’s, significantly impacting movement and daily activities. The hallmark motor symptoms of Parkinson’s include tremors, bradykinesia (slowness of movement), muscle rigidity (stiffness), postural instability, and episodes of freezing.
Understanding and managing these symptoms through medications, physical and occupational therapy, and sometimes surgical interventions can greatly enhance your quality of life.
Bradykinesia, or slow movement, is a core motor symptom of Parkinson’s. It gradually reduces spontaneous movement, making everyday tasks like buttoning a shirt, washing dishes or walking more challenging. This symptom can significantly impact your quality of life, often leading to difficulties starting and completing movements. Managing bradykinesia involves a combination of dopaminergic medications, which help replenish dopamine levels to get messages from your brain to your body, and physical therapy to maintain mobility and function.
Dyskinesia refers to involuntary, erratic, and often excessive movements that can occur in individuals with Parkinson’s, typically as a side effect of long-term use of dopaminergic medications like levodopa. These movements can range from mild to severe and may affect various body parts, including the arms, legs, and face. While dyskinesia can be disruptive and uncomfortable, adjusting medication regimens and incorporating other treatments can help manage these symptoms.
Dystonia is characterised by involuntary muscle contractions that cause repetitive or twisting movements. The condition can affect one part of the body (focal dystonia), two or more adjacent parts (segmental dystonia), or all parts of the body (general dystonia). The muscle spasms can range from mild to severe and may be painful, interfering with daily tasks.
Falls can be associated with Parkinson’s due to a range of symptoms. Taking small or varying steps can lead to instability. When arms don’t swing during walking, balance is affected. Side effects of some Parkinson’s medications can cause dyskinesia, impacting balance. As Parkinson’s progresses, stooped posture and rigid muscles increase fall risk. Reduced activity weakens muscles and raises the risk of falling. Some Parkinson’s medications affect blood pressure, leading to dizziness and falls. Managing falls involves addressing muscle stiffness, mobility, and balance issues. It’s always best to discuss any concerns with your care team.
Festination, or shuffling gait, is a common motor symptom in Parkinson’s. You may experience short, rapid steps that propel you forward, often resulting in a stooped posture. This gait pattern occurs because your centre of gravity is too far forward, causing you to take quick, shuffling steps to avoid falling. Festination can make walking difficult and increase the risk of falls. Management strategies include physical therapy, gait training, and optimising your medications to improve mobility and safety.
Freezing of gait (FOG), where you temporarily lose the ability to move your feet, feeling as if they are glued to the ground, can be a challenging and common symptom of Parkinson’s. This phenomenon often occurs during walking, particularly when starting to move, turning, or navigating through narrow spaces. Episodes can last from a few seconds to several minutes and significantly increase the risk of falls. Management strategies include optimising medication regimens, using visual or auditory cues to start movement, and physical therapy to improve gait and balance.
Gait disturbances are common in Parkinson’s. Small, shuffling steps characterised by reduced stride length and walking speed is known as Parkinsonian gait. You may also experience festination, where steps become quicker and shorter, and freezing of gait, a sudden inability to move the feet forward. The good news is, there is a wide range of treatments that can help with gait disturbances, offering hope and reassurance.
People with Parkinson’s often exhibit masked facial features, a condition known as hypomimia. Without sufficient dopamine, the muscles, including those in the face, become rigid and slow to respond. It may result in loss of facial expression and impact your non-verbal communication cues. It can help to regularly perform facial exercises to maintain muscle tone and improve responsiveness. Work with a speech pathologist and optimise your Parkinson’s medications to improve dopamine levels and muscle control. Be mindful of your emotions and consciously express them through your facial movements or communicate this verbally with those you are interacting with.
Postural instability in Parkinson’s refers to difficulty maintaining balance and stability, making you more prone to falls. This symptom often appears in the later stages of the disease and is characterised by unsteadiness when standing, walking, or making sudden movements. You may exhibit a stooped posture, small shuffling steps, and a tendency to lean forward while walking. The risk of falls increases significantly, which can lead to injuries. However, there is hope. Managing postural instability involves effective physical therapy, exercise, and home safety modifications to reduce fall risks, empowering you to take control of your condition.
Rigidity in Parkinson’s disease is a primary motor symptom characterised by muscle stiffness and resistance to movement. Rigidity can affect your arms, legs, and trunk. This stiffness goes beyond what would be expected from normal aging or arthritis and can lead to a decreased range of motion. There are two main types of rigidity: lead-pipe rigidity, where the resistance is constant throughout the movement, and cogwheel rigidity, where the resistance is intermittent, creating a ratchet-like effect. Rigidity can cause discomfort, pain, and difficulties with everyday activities, such as walking, dressing, and writing.
It’s important to note that a reduced frequency of blinking is common with Parkinson’s. The normal blink rate is about 15 to 20 times per minute, but people with Parkinson’s may blink significantly less, sometimes only 3 to 4 times per minute. This reduced blink rate can lead to dry eyes, discomfort, and vision problems. Blinking helps spread tears across your eye’s surface, keeping it moist and clear. Managing this symptom involves using artificial tears and consciously blinking more frequently.
Tremor, a primary symptom of Parkinson’s, manifests as an uncontrollable movement that affects a part of the body. It occurs in up to 80% of people with Parkinson’s. Parkinson’s tremor often starts on one side of the body and can appear at rest (like a ‘pill-rolling’ motion in your hand) or during action (such as when holding a book). Some people may also experience internal tremors. Medication may help control it, and assistive technology can help minimise the impacts on daily life.
