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Dear listmembers This is an excptional amount of confusement and communication disturbance about falling. It awakens the psychotherapist in me. First I have a question, which, I suppose, can be answered without increasing the disagreement. There it is;"wat is festination ?" and the next question might be a bit risky, is it possible that a word,that isn't in any of the dictionary's that are mine not even in that big one that contains all existing English words and imho also many non-existing, is an existing English word.? I doubt this seriously. I'll start with the first mail of Tom Riess QUOTE 1 In Parkinsonian terms I would define "falling" as festination which does not catch up to a displaced center of gravity. While ambulating anyone's center of gravity is displaced forward. What prevents us from falling ambulating anyone's center of gravity is despite this forward imbalance is the continual advancement of our feet each step serving to catch us and prevent the imbalance from accelerating making us fall. If we allow the imbalance to increase then we have to advance our feet more rapidly and this is running. If we can't advance our feet a far enough distance then the cadence of our steps increases as we attempt to catch up to the imbalance. When the strides get too short we can't decelerate fast enough to catch up and neutralize this acceleratingf force of .displaced center of gravity and then the result is a fall. End Quote In the past I had the same reaction on a part of the mails of Tom as Dennis Green expressed in his reaction that is quoted (QUOTE 2) My experience of falling as a direct consequence of having PD bears such little resemblance to the examples you provide as to make me wonder if we are talking about the same thing. End Quote Reading earlier mails from Tom like this I didn't get the feeling that the German call an" AHA Erlebniss" an Aha experience which comes when suddenly an amount of not coherent facts change in an amount of facts which have clear relations to each other. I don't say now that the mails of Tom Riess did not clarify something, but that they had not an increasing effect on my understanding of my own problems with walking falling and freezing. But when now I was reading the quoted 1 mail, I did have a kind of an Aha experience.Before my eyes a movie about PD came back, which was showed many years ago in the neurology lectures. The man we saw was old, had a forward stooped posture and walked and fell exactly the way that is described by Tom.That man was The Typical PWP and lived somwhere in pre- levadopa times and he appeared in my mind again when I was told my symptoms indicated that I suffered from PD. But I could hardly believe the disease I suffered from was the same as his. I did not have the tendency to stoop forward but to tighten my back and bending it backward and this was not the only difference. So that might be the clue to understand my lack of Aha. Tom wrote about that other patient and not about me, having quite different symptoms. and, as I learned from the quote 2, also not about Dennis Greene. And to add more complexity the falls of Dennis seem to be different from mine as I learned from quote 3 QUOTE3 "We drag our feet and trip over things that wouldn't normally trip a 2y old toddler. Things like ball point pens etc." end of Quote Dennis you could not write something that would clarify more for me that at least part of my falls are not the same as yours, I assume this is not interpreted by you as criticism, because you did not claim to understand all falling of all PWP’s The fact is I may also trip over things but that never makes me fall not when "on" and not when "off." People around me have many times been astonished about me recovering my equilibrium after a trip.so easily and prevent a fall when that seems for the ones who watch just inevitable. This is so amazing because I had phases in my disease in which falling was a serious problem. The next short quote:from Dennis: QUOTE4 " our feet can't move fast enough to keep themselves under our heads" ( Dennis this is a beautifull one and will certainly stick in my memory. Do you have copyrights ?) seems to me a more than perfect recapitulation of that same PWP that figures in the mails of Tom. Than comes a mail from Rita Weeks QUOTE5 My movement is not like Tom's.....the non-educated would not recognize both of us as having the same neurological diagnosis.........but I can say without hesitation that I have no doubt that vision has an impact on movement for Tom Reiss and other Parkinson's patients. Dennis, try to have an open mind and discard your view of "if it doesn't happen to me, then it doesn't happen". We have enough to deal with without having to justify our movement/lack of movement to other Parkinson's patients. end of quote Rita, I don't understand what it is that you're reproaching Dennis for. The only thing I see in your mail is that you are saying that you have to justify your synptoms to other PWP,s because Dennis thinks his falls are different from Tom's. May be you intended to say something else and wish to clarify The next quote is from Tom again and reading it after I had made the foregoing analysis, confused me again QUOTE6 Falling almost always occurs while "on" because while "off" gait initiation problems prevent one from walking with any volitional displacement of center of gravity. The environment can, however induce displacement for example steep inclines or if someone gives the subject a shove (push/pull test). End of quote I fear that the confusion about "on" and "off" in this thread reminds me of the same old dicussion as it does Dennis and that all I say about it can only increase the confusion . My self-control is not strong enough to keep silence, but I put myself on the brake (Dennis, I remember you once wrote a beautifull sentence about short willpower and long opinions, I don’t remember it exactly any more). So I have only one question for Tom:" was that man in the movie from the pre-levadopa times, according to the way you use thoses concepts , "on" or "off"? It would be a great loss if we could not write anymore the facts about our symptoms to the list, because we fear, they are not supporting an interpretation or a theory of other listmembers. I have learned during that former discussion how persons, who claim to know what are possible reactions of PWP’s inhibit other people to write about what they observe in themselves. Interpretation and theorizing are productive if they stimulate people to look for facts that support it or that reject it. It is counterproductive if it makes his adherents blind for all facts that don’t support it. So I think Tom Riess had better listen to Dennis and try to understand why this theories didn’t appeal to him. I see a parallel of the reaction in the behavior of some doctors which can not say:"I don’t know" and deny the possibility that something is wrong but they don’t understand what it is. If they can’t assess any diagnosis, they say :the symptoms are not real, it is only psychic etc. So people, who have a theory about something might not be capable to go through the phase of integrating new facts , which causes always a period of uncertainty. So they have to learn that a person who is capable of saying "I don’t know; I see that the observations are sound , but I don’t understand them", might prove not his ignorance, but his wisdom. ida -------------------------------------------------------------- Vriendelijke Groeten / Kind regards, Ida Kamphuis mailto: [log in to unmask]