BLOG - PARKINSON's & PODIATRY 

Parkinson’s mainly affects people over 50 years old although 2-10 in every 100 people living with Parkinson’s is under 50. 
 
It is a progressive disease meaning that it moves through a series of well documented stages. 
 
These stages comprise of motor and non-motor symptoms. Motor symptoms refer to movement such as losing balance when walking, symptoms usually progress slowly. 
There are many medical conditions that affect a person’s gait, and, in this blog, I am going to chat about Parkinson’s, how it affects a person’s gait and what I can do to help. 
 
Podiatrists are experts in Gait. No this is not the squeaky hinged, wooden affair at the entrance to your estate but the walking sort. 
 
Gait: noun a person’s manner of walking 
 
Motor Symptoms Affecting Gait: 
• Bradykinesia, this means slowness of movements that normally come automatically for example standing up from sitting, walking, and swinging your arms when walking. 
• Dystonia which describes abnormal muscle tone causing spasms and postural changes, this responds well to medication. 
• Postural Instability. Many people with Parkinson’s suffer from poor balance and frequent falls. This element of the condition it the hardest symptom to treat. 
• Rigidity, stiffness or tightness in the arms and legs. This can cause pain and a reduction in range of motion of the affected limbs. 
 
Parkinson’s is not a terminal disease, but these problems can lead to the person living with Parkinson’s feeling fearful, insecure, in pain and consequently avoiding the exercise which can help them so much. Recent studies have shown the positive influence of dance and rhythm on managing the progress of the motor degeneration. Exercise is important to maintain flexibility and strength and can slow down the progress of the disease. 
 
As a podiatrist my priority is keeping you on your feet and keeping you active. 
 
Gait anomalies we see during a biomechanical assessment include shorter strides, shuffling, freezing - where the patient feels like their feet are ‘stuck’ to the floor and dual stance - where both feet are on the floor for much of the gait cycle rather than one foot then the other as in ‘normal’ gait. 
 
Have a look at this video showing gait during the various stages of Parkinson’s Disease https://youtu.be/pFLC9C-xH8E 
 
During the assessment I will examine the patient’s feet and legs and their range of movement, the patient’s centre of gravity and their gait. However, a verbal report from the patient or their partner will give me the larger picture of day to day problems. 
 
The priority here is to treat any lesions on the feet that are causing pain. This can be corns, cracks and pressure points caused by the freezing and dual stance. Freezing and dual stance cause you to have your feet on the ground for prolonged periods which increased the pressure and forces going through them and this in turn can cause problematic and painful lesions. 
 
Next, I want to improve the gait by increasing momentum or enhancing proprioception and stability. This can be done with the use of orthoses; these are specialist insoles that are prescribed to treat a specific individual. Orthoses can also reduce areas of pressure to prevent the recurrence of the lesions previously mentioned. 
Medication and lifestyle choices can help slow down the progress of the disease. Stretching exercises in conjunction with the above methods of treatment can help manage the muscular spasms, maintain good mobility and in turn improve quality of life. 
 
Often when a patient presents with a gait issue the disease has progressed through the first of five stages, it may even be in the third stage where loss of balance, slowness of movement and increased falls are common. Like most conditions the earlier these issues are dealt with, the more successful the treatment. 
 
So, don’t waste time!!! 
 
For further information please go to https://www.parkinson.org/ 
Tagged as: Parkinson's
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