Bradykinesia, or slowed movements, is the primary motor symptom of a Parkinson’s diagnosis.

Levodopa remains the gold standard treatment for bradykinesia. It works by restoring dopamine levels in the brain, which helps improve movement speed and coordination.

What is bradykinesia?

Bradykinesia means slowness of movement, and for someone living with Parkinson’s, it can feel like moving through molasses. It affects nearly every part of the body… from walking and hand movements to blinking, facial expression, digestion, and even speech. Tasks that used to be automatic, like buttoning a shirt or smiling, may take longer and require more effort.

Bradykinesia is one of the four cardinal motor symptoms of Parkinson’s and the only symptom that must be present for a diagnosis. While tremor is often the most recognised sign, not everyone with Parkinson’s has tremor. In fact, only around 70% of people experience tremor, but 100% will experience bradykinesia at some point [1].

Bradykinesia affects how quickly and smoothly you move and can show up as:

  • Difficulty starting movements (e.g. standing up or walking)
  • Smaller, slower movements (e.g. tiny handwriting or reduced arm swing)
  • Reduced automatic movements (e.g. blinking or facial expression)
  • Freezing episodes, where movement suddenly stops

These changes can make everyday tasks, like dressing, cooking, or walking, more difficult and tiring [2].

Why does bradykinesia happen in Parkinson’s?

Bradykinesia is caused by the loss of dopamine-producing neurons in the substantia nigra, a part of the brain that helps control movement. Dopamine is a chemical messenger that allows smooth, coordinated muscle activity. When dopamine levels drop, the brain struggles to send clear signals to the muscles, leading to slower and smaller movements [3].

This is why bradykinesia is always present as a symptom in Parkinson’s… it’s directly linked to the core brain changes that define the condition.

How is bradykinesia managed?

There’s no cure for bradykinesia, but it can be managed with a combination of treatments:

1. Medication

  • Levodopa is the most effective treatment. It helps restore dopamine and improve movement.
  • Other medications include dopamine agonists, MAO-B inhibitors, and COMT inhibitors, which help boost or preserve dopamine levels [4].

2. Physical Therapy

  • A physiotherapist can help with exercises to improve walking, balance, and coordination.
  • Practising “big movements” and aerobic exercise can help reduce slowness [4].

3. Occupational Therapy

4. Deep Brain Stimulation (DBS)

  • For some people, DBS may help reduce bradykinesia when medications no longer help to control your symptoms.

Key Statistics

  • Bradykinesia is required for a Parkinson’s diagnosis, it’s the most consistent symptom across all cases.
  • Only 70% of people with Parkinson’s have tremor, but nearly 100% experience bradykinesia.
  • Bradykinesia can fluctuate throughout the day, especially during “off” periods when medication wears off.
  • Levodopa is the best treatment for bradykinesia, while exercise and movement therapies can also significantly improve overall quality of life.

What how do I manage bradykinesia?

Levodopa remains the gold standard treatment for bradykinesia. It works by restoring dopamine levels in the brain, which helps improve movement speed and coordination. Most people living with Parkinson’s experience noticeable improvement in bradykinesia when they start levodopa therapy. Even in advanced stages, levodopa continues to offer meaningful relief when managed carefully.

  1. Optimise medication timing and dosage: Work closely with your neurologist or movement disorder specialist to fine-tune your levodopa regimen. Adjusting the timing, dosage, or adding medications like dopamine agonists can help smooth out motor fluctuations and improve movement.
  2. Exercise eegularly: Physical activity, especially targeted movement therapies like accredited exercise physiology, boxing, or dance, can help retrain the brain and improve motor control. Exercise boosts dopamine release naturally and supports better mobility and balance.
  3. Use Allied Health Support: Speech pathologists, occupational therapists, and physiotherapists can help with movement, voice, and daily tasks affected by bradykinesia. They offer practical strategies to stay active and independent.

How do I access support?

It’s advisable to explore all available pathways to find the support that best suits your needs. Look to:

  • getting a GP referral to a Chronic Disease Management Plan and care team with Parkinson‘s experience
  • your state-based Parkinson’s organisation for advice on local services to access
  • private health to see what is covered in relation to consultations and expenses
  • DVA, NDIS or My Aged Care plan supports.

Infosheet under review

References

Berardelli, A, Rothwell, J. C., Thompson, P. D. and M. Hallett (2001). Pathophysiology of bradykinesia in Parkinson’s disease, Brain, Volume 124, Issue 11, November 2001, Pages 2131–2146, https://doi.org/10.1093/brain/124.11.2131

Bologna, M., Paparella, G., Fasano, A., Hallett, M., & Berardelli, A. (2020). Evolving concepts on bradykinesia. Brain : a journal of neurology, 143(3), 727–750. https://doi.org/10.1093/brain/awz344

Herz, D. M., & Brown, P. (2023). Moving, fast and slow: behavioural insights into bradykinesia in Parkinson’s disease. Brain : a journal of neurology, 146(9), 3576–3586. https://doi.org/10.1093/brain/awad069

Langeskov-Christensen, M., Franzén, E., Hvid, L. G., & Dalgas, U. (2023). Exercise as medicine in Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 95(11), 1077–1085. https://doi.org/10.1136/jnnp-2023-332974

Riederer, P., Strobel, S., Nagatsu, T., Watanabe, H., Chen, X., Löschmann, P.-A., Sian-Hulsmann, J., Jost, W. H., Müller, T., Dijkstra, J. M., & Monoranu, C.-M. (2025). Levodopa treatment: Impacts and mechanisms throughout Parkinson’s disease progression. Journal of Neural Transmission, 132(4), 743–779. https://doi.org/10.1007/s00702-025-02893-4

Sarasso, E., Gardoni, A., Zenere, L. et al. Neural correlates of bradykinesia in Parkinson’s disease: a kinematic and functional MRI study. npj Parkinsons Dis. 10, 167 (2024). https://doi.org/10.1038/s41531-024-00783-2

Sturkenboom, I. H. W. M., Talebi, A. H., Maas, B. R., de Vries, N. M., Darweesh, S. K. L., & Kalfa, J. G. (2024). Specialized allied health care for Parkinson’s disease: State of the art and future directions. Journal of Parkinson’s Disease, 14(3), 567–582. https://doi.org/10.3233/JPD-230307

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