What is Parkinson’s and What does it effect?
Parkinson’s Disease (PD) is a disease resulting from the death of the group of neurons in the brain that produce dopamine. Dopamine is a chemical that helps transmit information between nerves. Dopamine is associated with pleasurable sensations, learning, memory, motivation, sleep, mood, and most importantly for our topic today the speed, quality, fluency, and ease of movement.
The “typical” motor symptoms of PD including slow, small movements, and difficulty with automatic tasks are related to the factors we’re discussing today, while the non-motor symptoms of PD are often related to the other roles of dopamine as well as the medications needed to manage motor symptoms.
Brain Anatomy
The neurons that create Dopamine are in a part of the brain known as substantia nigra, which is a part of the Basal Ganglia.
The Basal Ganglia play a major role in motor control, motor learning as well as emotions, and executive function. This means, they are very important for learning new movement skills and performing “automatic” movement skills.
Research and experience have shown that both the learning of the motor skill, as well as the execution of automatic skills become difficult with PD. Research comparing brain MRIs of people with and without PD as they learn and perform an automatic task show that although those with PD may take longer to learn a new movement pattern, they can achieve similar results using different nerve pathways in the brain. This ability for the brain to make new pathways is called neuroplasticity.
This Neuroplasticity means we can use these new pathways (detours) to achieve better movement!
If you get stuck or freeze while walking or turning around, have a hard time getting out of tight spaces, chairs, or the bed, or just feel like you are moving more slowly or smaller. It’s time to use the alternate neural pathways (the detours) to make moving more effective.
The main detours we will use are purposeful movement and auditory cuing. Learn more about these "detours" below, and then check out this article on ways you can use them!
Purposeful Movement or focusing on the big picture task at hand like crossing the street while the crosswalk sign is still white, uses attention to “bypass” the damaged automatic pathway and allow for improved movement quality.
Auditory Cuing, or more specifically, Rhythmic Auditory Cuing, utilizes a rhythmic beat/cadence/etc to cue the body to move at a specific rate over a longer period of time. Many people with Parkinson’s often start walking with large, controlled steps, but after a while, the steps become smaller, quicker, and more “shuffly”. The rhythmic cues help maintain even steps.
How can I use this information?
Some of my most frequently offered recommendations for people with Parkinson's use these techniques.
Both types of "detours" are found in the major exercise programs for people with Parkinson’s such as ‘LSVT”, “PWR”, and “Rock Steady”. These programs are evidenced based, and they produce excellent results. However, if you’re having difficulty with everyday movements, it is smart to reach out to a PT who focuses on those with neurological conditions to get started.
Move Free Physical Therapy at Home is experienced with treating neurological conditions such as Parkinson's Disease and we would love to help you move better. You can schedule a FREE phone consultation, or an PT evaluation to get started here. We are located in the Triangle of NC, however we provide consulting and telehealth services more widely.
References and Resources:
DAVIS PHINNEY FOUNDATION: I highly recommend their webinars and their “Every Victory Counts” Guide full of useful information shared in an accessible format (Live Well with Parkinson's TODAY - Davis Phinney Foundation)
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