By Lindsay Adler, Neurology Solutions Contributing Writer
Symptoms of Parkinson’s disease can be disruptive and extremely uncomfortable, and can affect an individual’s “Activities of Daily Living,” or ADL’s, according to the National Parkinson Foundation. Daily challenges include tasks like bathing, using the toilet, dressing, eating, sleeping, walking, and moving. However, many people with Parkinson’s can live their lives independently and perform these daily functions with the help of medication, adaptive aids, therapy, and a few daily routines they can practice at home. Following are some tips from the Neurology Solutions team for managing common Parkinson’s disease symptoms that may be helpful to both those with PD and their family or caregivers.
Walking, Moving and Poor Balance
A person affected by Parkinson’s disease may have trouble walking or with postural instability. He or she could begin leaning forward while walking, or experience uncoordinated movements such as tripping. Many PD experts say that routine exercise is an essential treatment for people with PD by helping to strengthen muscles and improve flexibility and stiffness. A few exercises recommended by Everyday Health include placing your back against the wall for support and walking briskly in place (while lifting knees high), chair exercises, and “gait training” which involves taking large steps while walking straight ahead, and walking with the use of a metronome. Activities that challenge balance are also helpful—try putting feet close together and maintaining balance, or turning head side to side. These exercises should be done with back to a corner and a chair in front of the person, for safety. Toe and heel raises, squats, and lunges can also strengthen muscles. Parkinson’s patients can make changes to their living space to create a more Parkinson’s-friendly environment, such as alternating furniture placement; using handrails on toilets, showers, and beds; or even changing the type of footwear used (velcro instead of lace-up shoes).
Freezing When Walking
A common symptom of PD is referred to as “freezing,” when muscles lock up when trying to walk or approaching an obstacle. Dr. Andrew Feigin, director of the Experimental Therapeutics Division of the Center for Neurosciences at the Feinstein Institute for Medical Research, suggests using a visual or auditory cue to concentrate on while walking. A patient can also try counting while walking with “exaggerated, marching steps.” For freezing when turning, try the “U-Turn technique” which involves visualizing a large object in your path when turning around, and then attempting to go around the object, to trigger movement.
Hand Shaking or Tremors
Hand shaking or tremors can affect a person with Parkinson’s during routine functions such as using a cellphone, opening a pill bottle, taking money of out their wallet, or opening a door. Taking medication consistently and on time is the best strategy for managing tremors. Many doctors also recommend a diet low in protein as well, as it can affect the body’s ability to absorb the prescribed medication. A healthy diet including plenty of fruits and vegetables such as the DASH Diet may also help keep symptoms under control by preserving nerve cell function.
Voice & Expression Problems
Gwyn Vernon, PD Nurse Specialist at Penn Medicine Neuroscience Center, gives a few pointers on improving communication with PD. She suggests taping yourself speaking in front of a mirror (we suggest even leaving yourself a voice mail), and taking note of any issues that you notice. Once you discover what the problems are, you can practice correcting them. Work on “speaking behavior” by straightening your posture, keeping your chin up, and focusing on “big and loud sounds and slow and short phrases.” Vernon also recommends reading one newspaper or magazine article daily out loud, and even singing to improve voice volume and clarity. For expression issues, try facial and oral exercises to loosen small facial and tongue muscles, and making faces in the mirror.
Trouble Swallowing Food
Many people with PD have problems swallowing their food, which can result in drooling and also general discomfort. One pointer is to use the chin-tuck technique, which is described as taking small sips of fluid while eating, then tucking the chin slightly when swallowing. Another tip is to use lemon juice, or lemon hard candies or lollipops to help stimulate the swallow reflex. The National Parkinson’s Foundation recommends scheduling meals during “on times” (when medication is working best), cutting food into small pieces so it’s easier to chew and swallow, and sitting up straight when eating, plus staying upright for at least 30 minutes after the meal.
Resources for Managing Parkinson’s Disease
The Parkinson’s Disease Foundation offers a variety of resources and tips for coping with symptoms and side effects of PD, and Neurology Solutions offers a list of resources for managing movement disorders including PD, essential tremor and dystonia.
Neurology Solutions’ on-site physical therapy center, Austin Renewal Therapy, provides therapeutic treatments including physical therapy, speech therapy and occupational therapy for patients with Parkinson’s disease and other neurological motor disorders.
If you are looking for a diagnosis or seeking another opinion on managing your condition, call 512-865-6310 to make an appointment with Neurology Solutions. Stay informed by frequenting Neurology Solutions’ blog, or join Neurology Solutions Movement Disorders Center’s e-mail list to stay up to date on the latest in treatments and how to manage stress, stay healthy and maintain quality of life while living with a movement disorder.