Occupational therapists are a crucial part of the healthcare team for those living with Parkinson's disease. They help people maintain their mobility and independence throughout the progression of the disease.
However, their expertise can be in high demand and consequently not always as easily accessible as you would hope in the community. In this guide, we have asked our very own in-house OT to guide us through the world of Parkinson’s and mobility.
What are the most common Parkinson’s symptoms
Motor symptoms of Parkinson’s disease are the most common and notable problems following a diagnosis with Parkinson’s, they include:
- Difficulty initiating movement
- Shuffling gait
- Slow movement or movement that rapidly speeds up
- Difficulty changing direction
- Reduced balance
- Involuntary movements
The basil ganglia (a group of structures in the base of the forebrain and the top of the midbrain) helps to plan, sequence and initiate our movements and dopamine plays and important role in its function. When dopamine levels are low, such as in those with Parkinson’s, any automatic motor skills such as walking become impaired.
To improve mobility strategies, focus on a few main aspects: conscious attention of a task, limiting multi-tasking and using cognitive and sensory cues. It is thought cognitive and sensory attention strategies by-pass the basal ganglia which often runs with auto-pilot tasks, increasing their effectiveness.
Coping Techniques for Parkinson’s
It is important to understand the value that experience can teach us. Occupational therapists work in this world their whole careers. Therefore, they have a wealth of knowledge to share with us that will make the world of Parkinson’s so much easier to navigate.
Taking control of your destiny and casting aside the ‘victim’ mentality will allow you to realise that many everyday activities are still achievable with a little bit more planning.
The independence and confidence to live with Parkinson’s disease cannot be underestimated, not only from a practical point of view as well as from a mental health perspective.
- As the basal ganglia has links with the area of our brain which controls our emotions setting a positive attitude is important and can have a strong influence on performance.
- Imagining a movement in as much detail before it is performed has been found to help with initiation.
- Using internal dialogue or speech to repeat the movements in words, such as ‘BIG STEP’ has been found to help begin movement. LSVT BIG conducts a programme based on this philosophy; local therapists can be found who have been trained in this treatment programme.
- Some people find visualising stepping over an object or visualising a starting line is enough to trigger movement.
- Making sure the environment responds well to the visual senses. Brightly colours or patterns rugs can cause difficulty with initiation of movement as well as having to navigate around objects. Making sure walkways are clear of tables, chairs and other objects allows the individual to clearly see the end goal and how to get it.
- Many individuals with Parkinson’s can navigate stairs, perhaps because of the fluidity of movement and the fact the lines of the end of the stairs act as markers. These markers can be replicated on flat floors by placing strips of adhesive material (which is a contrasting colour) to the floor. They will act as a guide encouraging an increase in stride length.
- Simple cue cards can be made actioning each step of the task. They can either be memorised or used a prompt.
- If you experience freezing, try shifting your weight onto one leg, this will allow the other leg to step forward, use verbal cues to assist such as: one, two, three, big step.
- Laser lights on walking frames and sticks can act as a visual cue, particularly for those who freeze.
- For those whose symptoms have progressed and internal voicing of cues is no longer working, verbal cues by family members and carers in a short and concise manner can be effective. For example: ‘one, two, three, stand’ can help when standing from a chair.
- Metronomes have been found to be effective in reducing freezing and issues with initiation by offering a consistent beat to encourage the start of a movement.
- Dancing in some people has been found to help encourage flow of movement as well as improve feelings of wellbeing. Perfect for daily activities.
- Falls can be common with Parkinson’s, having a device on hand such as a mobile phone in pocket or body belt, or having a pendant alarm can ensure help is available following a fall.
- Completing tasks when sitting will help to conserve energy, focus concentration and reduce the risk of falls when trying to multi-task through standing and task completion.
- Using a walking stick or a 4 wheeled walker can offer some much-needed stability, those with built in seats, large castors and hand brakes are best suited.
Although Parkinson's disease can present many challenges, with the correct therapy and support, people with Parkinson's can maintain their mobility and independence for many years.
If you or a loved one has been recently diagnosed with Parkinson's disease, please make sure you access an Occupational Therapist as part of your support network. There is no need to face these challenges alone.
PD Warrior is an innovative forward-thinking collective. In a world where many people live with Parkinson's, PD Warrior provides the support network and education needed to make this journey as easy as possible. They are an internationally recognized rehab program that will help you learn how move well again and gain confidence in yourself.
LSVT Global is dedicated to improving the lives of people living with neurological conditions like Parkinson’s disease (PD). They train speech, physical and occupational therapists around the world in their innovative treatments so they can provide their patients an improved long term quality-of life.
Royal College of Occupational Therapists – The RCOT provides you with everything you need to know about Occupational Therapy and Therapists. If you are struggling in your area to access resources this is a great place to look for help.
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