Parkinson's disease: tips for mobility
The following is a list of tricks or strategies that have been found to assist mobility in some people with Parkinson's disease.
Tremor
- Holding the limb in a variety of positions may lessen tremor.
- Hold on to something.
- Press upper arm against body.
- Try a change in medication.
Getting up from a chair
- Tuck your feet in.
- Try swinging your shoulders left and right a few times as far as you can and then get up!
- Or slide forward to the edge of a chair. Place feet on the floor 6-8 inches (15-20 cm) apart, hands on side of chair. Lean body forwards from the hips. Rock forward and backwards and count to 3. On the third count, lean well forward with the head, press down with the arms and lead with the head to stand.
- Stand a moment to get balance before moving off heel first.
- Count to yourself.
- Rest before trying again if the first attempt fails.
Difficulties turning in bed
- Try a knotted rope laid on the bedcovers and tied to one end of the bed. Sit up by pulling on it.
- Try sheets made of shiny material such as nylon or satin.
- Take 3 deep breaths; lift head up and over, while reaching arm across the body. If stuck, slide heels up the bed, lift bottom up; move to side of bed.
Sitting from lying
- Roll over first; slowly swing feet out; lift head and push away from the pillow, up to sitting.
Freezing
- Stop trying to walk — relax.
- Correct posture, heels down.
- Try to bend, or lift one leg, or swing arms.
- Drop article on floor and step over it or pick it up.
- Walk with rhythmical music, heel first.
- Count to 3, rock from side to side.
- Look through doorways not at them.
- Lay a strip of white adhesive tape under the doorframe: the visual impact of the line should activate your non-automatic responses.
- Get a friend to rock you gently.
- Another simple aid is a walking stick; it helps you extend your reach.
- Wait before trying again if the first attempt doesn't work.
- Take a step backwards.
- Fix eyes on a position ahead.
If frozen while trying to stand or sit
- Swallow if necessary.
- Lean forwards. Tuck chin in.
- Try rocking backwards and forwards, tapping feet.
- Consider raising favourite chair if necessary.
- Turn head and shoulders to look at the chair and sit down.
Changing direction
- Consciously stop.
- Correct balance.
- Lead with head and let body follow.
- Start with slightly smaller steps.
- Turn in a wide circle.
Shuffling
- Stop and relax for several seconds, head up.
- Fix eyes on position ahead.
- Lead with knee.
- Practise walking over markers.
- Place heels firmly, widen gap between feet.
- Try counting — use metal heel caps, or swing arms, as cues.
- Say 'heel-toe' to yourself.
- Practise marching with feet apart.
Tripping
- Clear rooms.
- Have good lighting.
- Wipe up spills.
- Wear well-fitting footwear with smooth soles.
Other mobility strategies
- Break up long movement sequences into separate steps and do only one movement in the sequence at a time.
- Avoid doing 2 things at once, such as carrying a tray of drinks when walking, or talking when writing.
- Consciously think about each movement before you do it. Rehearse it in your mind's eye before you start moving.
- Carefully attend to each movement while you are doing it.
Choking
- Go behind the person in trouble; make them stand up; wrap your arms around their waist and join your arms, grabbing one wrist with the free hand. Then pull your arms towards you hard and fast.
Excessive salivation
- Trying keeping a clove in your mouth!
- Swallow often.
Dry mouth
- Avoid caffeine and tobacco.
Eat correctly
- Suggestion: eat fruit in the morning, vegetables at lunch, and leave the protein (meat, fish, eggs, cheese) for the evening meal.
- Dopamine (e.g. Madopar or Sinemet) could be taken on an empty stomach with a citrus fruit juice, and other drugs (Eldepryl etc.) after having something to eat.
Exercises
- Exercise not only the body but the face, tongue and eyes.
- Breathing, reading, writing.
Psychological tricks
- One thing at a time.
- Concentration is worse under stress or fatigue.
Ways of helping and prompting
- External cues.
- Time.
- Counting, rocking.
Walking
- If shuffling begins, stop.
- Feet apart, check posture, straighten up.
- Think about a large step.
- Place heels down first.
Dressing
- Wear loose clothes.
- Don't rush.
- Take off clothes on the stiffer side first.
- Use Velcro.
- Wear slip-on shoes and use a shoehorn.
Bathing
- Non-slip mat.
- Shower chair.
- Flexible shower hose.
- Soap-on-a-rope.
- Raised toilet seat.
- Grab rails (non-slip).
General guidelines for better speech can be applied to most parkinsonian dysarthias
- Deep breathing and daily breathing exercises.
- Relaxation techniques for the head, neck and shoulders.
- Awareness of fatigue levels and monitoring of voice demand and voice rest.
- Awareness of the communication environment, e.g. background noise.
- A deep breath before speaking.
- A swallow before speaking.
- Short sentences with frequent pauses.
- Slow, deliberate speech.
- Face-to-face contact with the listener.
- Projection of the voice using voice techniques or an aid for amplification.
Last Reviewed: 24 July 2002
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