Living with Parkinson’s
MAKING
STRIDES
FOR WALKING
AND BALANCE
PROBLEMS
by RACHEL DOLHUN, MD
WE DON’T TYPICALLY THINK MUCH ABOUT
walking or keeping balance unless we have
trouble with these activities. That’s because
we don’t have to think about them. Our brains
automatically coordinate our bodies to move
steadily. Parkinson’s can interrupt these
automatic connections and cause walking and
balance problems, especially in people who live
with the disease for many years. People often
walk more slowly and shuffle (unintentionally
drag their feet) and sometimes stoop forward
a bit. Freezing, the temporary inability to
move, also may occur with progressing disease.
Walking changes and freezing can lead to falls,
limit the desire to be out in public with friends
or make it unsafe to live at home alone.
These symptoms are, unfortunately, challenging
to treat. Current Parkinson’s medications may
help somewhat, but surgical therapies such as
deep brain stimulation don’t typically offer
much relief and may even worsen balance.
Effective treatment usually involves regular
exercise as well as physical or occupational
therapy. While any exercise is good, walking,
yoga and tai chi are especially helpful. Physical
and occupational therapists can recommend
an appropriate exercise regimen and design
programs to improve walking and balance,
lessen or prevent falls, and allow you to do daily
activities more easily and safely. Therapists also
can suggest ways to avoid freezing and cues to
get unstuck. Cues can be visual (a laser beam to
step over); auditory (a metronome or hummed
tune); touch (a tap from another person);
or physical movement (marching or shifting
weight between the feet).
Building on these treatment strategies, MJFF is
funding unconventional therapies to reduce or
prevent freezing and falls. These include gadgets
that could detect freezing and prompt movement
— socks and an in-shoe device that vibrate;
a wearable system that makes a sound; and a
headset that gives visual cues (such as stripes
on the ground) when needed. Rehabilitation
programs also are targeting walking, balance and
freezing — one combines cues with daily exercise
to lessen symptoms and another teaches specific
footsteps to regain balance and avoid falls.
Innovative contraptions are helping people live
better lives with these symptoms — a wearable
airbag inflates with falls to prevent injury
and a lightweight robotic device encourages
bigger steps for easier walking. While they may
sound like science fiction, these out-of-the-box
therapies are practical solutions for symptoms
that can make daily life impractical.
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The Fox Focus