Ken,
Dr. Duvoisin talks about walking difficulty in his book _Parkinson's
Disease: A Guide for Patient and Family_ (required reading, btw).
pp.45-46 in his 3rd edition describe parkinsonian gait. The person
doesn't raise the feet off the floor as high as normal and subsequently
shuffles, resulting in tiny steps. Meanwhile the upper body may move
forward at a more normal rate (leaning forward) until a fall results.
ANother problem is that the person may not have the natural armswing that
accompanies normal walking (right arm/left leg forward, left arm/right
leg forward, alternating).
In separate reading, I have come across the suggestion that carrying a
cane or umbrella or similar object can help with freezing. When a person
freezes, she drops her cane or umbrella and then steps over it. The
process of consciously stepping over the object helps with lifting the feet.
I have seen an ad for a product which is a series of alternating colored
mats for use in the home. Each change in color acts as a stimulus for
the person to step over. The same result could be achieved with tape or
even a rug that has an appropriate pattern. This type of stimulus is
particularly important in doorways and tight hallways, especially for turns.
(I'm sorry I can't offer citations for that last bit. It's one of those
things I came across in my reading and can't locate.)
_The Parkinson Handbook_ put out by the National Parkinson Foundation
(800) 327-4545
offers exercise suggestions (paraphrased without permission):
FOR BALANCE
1. Stand with hands on hips and feet spread. Hold onto a support if
necessary.
a) march in place
b) raise each leg to the rear with the knee straight
do not touch the foot to the floor
2. Stand with hands at your sides and feet spread
a) lean forward and backward
b) lean to the left and the right
c) lean in all four directions in a circular motion
FOR WALKING:
(this part I just flat copied)
When walking, take as large a step as possible, raising your toes as you
step forward and hitting the ground on your heel. Keep your legs apart
and your posture straight. Let your legs do the walking, swing your arms
and look straight ahead.
To practice proper swinging of the arms, walk holding folded magazines in
both hands and keep your elbows straight. Your right arm should swing
with your left leg; your left arm should swing with your right leg.
Practice walking sideways, backwards and in circles.
FOR TURNING:
When practicing turning, use small steps, raising your feet from the
floor. Keep feet spread apart and high. Rock from side to side.
If you feel glued to the floor [i.e., FROZEN]:
1. Relax back on your heels and raise your toes.
2. Raise your head and shoulders and try again.
3. Tap the hip of the leg you want to move
4. Rock from side to side or bend your knees and straighten up.
5. Raise your arms in a sudden short motion.
SUGGESTIONS: (still plagiarizing _The Parkinson Handbook_)
1. Bring your toes up with every step you take.
2. Spread your legs 12 to 15 inches apart when walking or turning to
provide a wide base and better stance and prevent falling. It may not
look beautiful, but neither does falling.
3. For greater safety in turning, use small steps with feet widely
separated. Never cross one leg over the other or pivot when turning.
Practice walking a few yards and turning.
4. Practice walking into tight corners of a room, to overcome any fear
of closed places [where freezing frequently occurs].
5. To ensure good body balance, practice rapid movements of the body,
backward, forward and to the right and left, five minutes at a time,
several times a day. Do not look for a wall when you think you are
falling. It may not be there. Your body will protect you if you
practice balance daily.
6. If your legs feel frozen or glued to the floor, a lift of the toes
eliminates muscle spasm and the fear of falling. You are free to walk
again. In addition, shift your weight from side to side in order to
start moving again.
7. Swing your arms freely when walking. It helps to maintain balance,
lessen fatigue, and loosen your arms and shoulders.
8. If getting out of a chair is difficult, try rising as quickly as
possible to overcome the pull of gravity. Sitting down should be done
slowly, with your body bent sharply forward until you touch the seat.
Practice this at least a dozen times a day.
9. If you need assistance while walking, your helper should walk by
your side, never pull from the front.
10. Any task that is difficult, such as buttoning a shirt or getting
out of bed, should be practiced daily.
11. Rubber or crepe-soled shoes are not recommended since they grip
the floor and may cause forward falling.
I definitely recommend this book. It contains exercises and tips for all
kinds of problems associated with Parkinson's.
BIG DISCLAIMER: I am posting this personally as an interested party,
quoting sources for which I cannot vouch and certainly not representing
an opinion of the NeuroScience Center that might get me in deep legal doo
doo. I AM NOT A DOCTOR. As with any exercise, it doesn't hurt to
consult a person with M.D. after his name before engaging in these
exercises. Know yourself, know your limits and if you feel the slightest
bit uncomfortable, have someone standing by to help you with your balance
if you do try these exercises. Also note, if you have a balance disorder
above and beyond the trouble associated with shuffling feet and walking,
you may need to see a balance disorder specialist.
Sorry for the length of this message. I hope it proves useful.
Chris @8)
(representing himself and not his employer, but poor and penniless in his
own right, so don't bother suing him anyway. Void where prohibited.)
The NeuroScience Center [log in to unmask]
at Tallahassee Memorial (904) 681-5037
On Wed, 19 Oct 1994, Kenneth Aidekman wrote:
> Lately I've encountered a number of folks who are having severe problems with
> freezing and falling. I know that these problems have been discussed in the
> past but I thought it might be helpful to make up a list of methods that you
> have found to be effective in dealing with such difficult situations. I'm
> looking for low-tech answers that do not include surgery.
> Any suggestions?
> Ken Aidekman
>
