Parkinson’s Disease is a progressive and degenerative disease of the neurological system and, specifically, of the brain. There is a region inside the brain called the substantia nigra that produces a chemical called dopamine. Dopamine helps with many functions of the human body, including movement, memory, emotions, sleep and motivation. Individuals with Parkinson’s Disease have at least a 50-80% loss of the cells that produce Dopamine. While we do not know exactly why this happens, we do understand the profound consequences of not having enough Dopamine in our brain. People with Parkinson’s Disease live with a large number of movement and cognitive related challenges, such as dizziness and balance impairments.
Difficulties with balance typically begin midway through the stages of progression of Parkinson’s Disease (PD). Muscle rigidity, tremors, and difficulty initiating movement all contribute to the balance problems we see in people with PD. These symptoms impact how a person with PD walks, which is often with a slow, shuffling gait pattern. Tripping can become a common problem because they do not sufficiently pick their feet up off of the floor. Their inability to initiate movement fast enough to correct their posture during a loss of balance can result in falling. Another complication can be freezing of movement. Sometimes people with PD will get “stuck” in doorways, narrower spaces, or even when crossing changes in flooring. This phenomenon can also result in more frequent losses of balance as the individual tries to navigate through this challenge.
To complicate things more, people with PD often have complaints of dizziness. This may be directly or indirectly related to the disease. People with PD can have secondary health issues, such as vestibular (inner ear) disorders, orthostatic hypotension (a drop in blood pressure when moving to an upright position), or cardiac problems. These secondary health issues need to evaluated by the most appropriate medical professional and treated accordingly. Treatments intended to help people with PD can also produce dizziness. Medication and Deep Brain Stimulator side-effects can produce symptoms of dizziness, which would need to be addressed by the neurologist and neurosurgeon. Rigidity of the neck can also cause feelings of dizziness.
While these symptoms are common complications of this disease, people with PD should not just accept having to live with balance impairments and dizziness. Physical therapy, such as the services offered at the Smith Balance + Concussion Center, can be very beneficial in helping people with PD move better with better balance.
Physical therapy can also be helpful in reducing dizziness symptoms that come from problems in the vestibular system and the neck. Specific intensive therapy programs such as LSVT-BIG focus on teaching people with PD to move with larger movements. Moving with larger amplitude can feel quite odd for someone at first, but it soon becomes more normal and allows for better steps and postural reactions to help reduce tripping and freezing. It also facilitates better postural reactions to allow the person to catch and correct their balance to prevent falls.
So while PD is a progressive disease, interventions such as physical therapy and the LSVT-BIG program can actually improve an individual's level of function and independence. At Smith Balance + Concussion Center, both Dana and Lauren are certified LSVT-BIG practitioners. Please contact us at any time to see if skilled physical therapy can be beneficial for you or someone you know who is living with PD.
The month of April is Parkinson’s Awareness Month. If you would like to learn more about PD, we recommend the following resources:
