The following is an article I wrote for our support group in
Houston.
It may give you a few ideas.
nina
I'M FREEZING…AND IT'S NOT EVEN COLD!
Nina Brown
To the uninitiated, freezing might refer to the temperature,
but if you have Parkinson's, "freezing," a temporary,
involuntary inability to move, is a symptom where your feet feel
as if they are stuck to the ground. It is sometimes referred to
as "start hesitation" or "gait initiation failure" and can occur
when you begin walking, while walking, when turning, in doorways
and upon entering a confined space. This condition can last
anywhere from a few seconds to many minutes. "Freezing" is a
difficult symptom to treat but your neurologist may be able to
alter your medications (possibly add a dopaminergic agonist such
as Permax, Parlodel, Mirapex or Requip) and/or adjust your
medication scheduling to help control this problem.
Walking in general is more problematic for a person with
Parkinson's because of the slowness, the diminished arm swing
and the shuffle that comes from not raising your feet or toes
high enough off the floor. The stooped posture affects your
balance as your center of gravity shifts forward with the upper
part of your body preceding the lower part as you walk. In
order to catch up with your center of gravity and regain
balance, the tendency to take increasingly faster, shorter and
more frequent steps, known as "festination" occurs.
"Propulsion" occurs when you try to run forward to catch up to
avoid falling. "Retropulsion" takes place when you feel pulled
or forced to run backwards to recover your balance. As you
might imagine, falling becomes the biggest concern when your
body continues moving and your feet stop.
Older bones tend to break easier, so it's important to keep
them strong with weight bearing exercises and the proper diet.
Stretching and range of motion exercises can also help combat
muscular rigidity and keep your joints from becoming immobile.
Falls are not only dangerous to your physical health but
your mental health as well. Fearful of falling again, many
people stay close to home, abandoning exercise routines and
social pursuits, but withdrawal from activities is the worst way
to prevent another fall. (And anxiety also increases the
tendency to freeze.) A fall to the floor doesn't need to be a
fall into isolation or depression. If you've been hurt from a
fall, it's important to get out even if you need to use a cane
or a walker. Just pay careful attention to the threat of
"freezing" or being off balance and don't make any reckless
movements.
You need to think about every step you take. Walking is no
longer an automatic function. Actions that were once routine
become a challenge because your muscles aren't getting
instructions from your brain to move and therefore don't respond
to your need to move. It can be very frustrating when familiar
tasks must be constantly relearned and given such
disproportionate amounts of concentration; but attitude and
exercise are vital to your well-being, so approach this
challenge with spirit and determination and fight to keep as
much mobility as you possibly can. Don't become discouraged.
Some days it's just easier to move than other days. Resolve to
maintain a "can do" regarding attitude and a "will do" regarding
exercise. If you do fall down, at least it proves you were on
your feet and moving.
* * * *
EXERCISES
Abracadabra…or a few tricks for better balance and some
techniques to overcome freezing when your head won't tell your
feet to take that first step.
For better balance: practice the ancient martial art of
Tai Chi (pronounced tie-chee). Tai chi consists of more than
100 flowing, dance-like movements of "postures" or "forms" that
resemble ballet in slow motion, performed while you concentrate
single-mindedly on your movements and your breathing. The
concentration required has been likened to "meditation with
motion." Taken together, the forms are designed to work all of
your limbs and muscles. Since it's a no-impact form of
exercise, it's much better for bones and joints that can't
withstand the jarring from high-impact activities. The
continuous, smooth, gentle movements have been said to
strengthen the motor skills impacted by PD. It is also
particularly helpful in decreasing tremor because Tai Chi
reduces stress and the muscles relax.
Dr. Timothy C. Hain, a neurologist and associate professor
at Northwestern University Medical School, conducted a study
examining the potential benefits of tai chi on some patients
with Parkinson's. His results were overwhelmingly positive.
Hain said, "We think it is possible that tai chi can not only
restore balance but eventually make it better than normal." In
addition to preventing falls, other benefits included increased
strength (especially in the thighs, buttocks and calves) and
flexibility (working a full range of motion without straining
the joints or connective tissues) as well as better posture.
More suggestions for better balance:
Ø Stand with your hands on your hips, feet spread apart:
Ø Practice marching in place
Ø Practice raising your leg straight out behind you.
Ø Practice raising your leg out to the side.
Ø Practice drawing a circle with your leg.
Ø Stand with your hands at your side, feet spread apart:
Ø Lean forward and backwards.
Ø Lean to both sides.
Ø Lean in a circular motion and reverse the motion.
To help alleviate freezing:
Ø Start by maintaining an upright, tall stance, moving your
body's center of gravity backward so it runs straight up and
down through the spine, legs and ankles.
Ø Use your imagination. Dr. Dwight C. McGoon, a Mayo Clinic
surgeon, pretends he has a rocking chair leg attached to each of
his legs, and that a proper step requires that the back end of
the rocker touch the floor on the forward step and the front end
of the rocker touch the floor before the step is completed.
Ø Exaggerate your step. Imagine a point on the floor about two
feet ahead. Make that first step as long a stride as possible
because subsequent steps tend to shorten.
Ø Rock from side to side to initiate a marching in place step.
Ø March like a soldier with a stiff-legged, long-striding
military gait.
Ø Swing your arms up above your head, then bring them down
sharply to your side 2 or 3 times.
Ø Walk sideways
Ø Take a quick step backwards.
Ø Watch other people walk.
Ø If you hesitate walking through doors, focus on an object past
the doorframe.
Ø Step over an imaginary object on the ground, or use a cane or
another person's foot, tile or carpet patterns. Make a path at
night with white socks on carpet or white tape on a hard floor.
Ø Alternate the distribution of your body weight.
Ø Have someone rhythmically pull or push or raise your knee.
Ø Stamp your feet
Ø A sudden sound such as a clap may break a freeze.
Ø Walk to music to increase speed of motion and improve rhythm.
Ø Make wider turns to decrease the chance of getting your feet
entangled and falling.
Ø It helps to count each step. You're less likely to freeze if
you know how many steps it takes to get from the bedroom to the
bathroom.
Ø Avoid clutter. Keep floor areas free of shoes and other
objects to reduce the risk of a fall.
Ø If you need a walker for balance, using one with wheels (with
automatic locking mechanisms) will allow for a more normal
walking pattern than standard ones. [Hint: if tremors make the
walker unsteady, try weighting the lower bars by tying on socks
filled with pennies.]
Eddy Arden wrote:
> To the group...
> During the past few weeks my wife has experienced
> unusually severe and prolonged bouts of " Freezing",
> which in tern is causing numerous, and needless to
> say, painful cases of falling.
> If anyone out there has had any sucess in overcoming
> this problem, or diminishing it in any way, we would
> certainly appreciate your advice. Thank you.
> Edward Arden
>
> __________________________________________________
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