All About Walking

05/01/2010

Changes in walking that occur over time include shorter shuffling steps, fast or runaway steps (festination), slow and cautious steps and gait freezing. Parkinson’s movement problems begin on one side of the body. Symptoms of tremor, rigidity and slowness are worse on that side. This is also true for walking. You may notice decreased arm swing, shuffling of one foot, heaviness or shorter stride length in one leg. You may find that you scuff your shores or stub your toes while walking.

Posture

Our posture can change as we age. Weak back and shoulder muscles, osteoporosis or bone changes and spine arthritis can hasten these changes. Changes in posture include slouched shoulders, forward flexing neck and upper back. Camptocormia is a relatively rare form of posture change in which there is a significant bending at the waste with difficulty standing up erect. Posture exercises that increase back muscle strength and reinforce our proprioceptive feedback or body awareness of postural changes can improve posture.

Balance

Postural instability is a problem with keeping and correcting your center of balance so it is upright and over your toes. Postural flexion or bending forward at the neck, back, hips, and knees also leans the body and your center of mass ahead of your toes - compromising your base of support. These problems can lead to unpredictable falls. The instability can come on suddenly causing a person to call for the ground before they can break their fall. Some people notice the tendency to fall backward called retropulsion.

Postural instability typically ocurrs later in disease after many years. It is important to work on your balance with balance exercises immediately even if you have no balance problems. Starting with the best possible balance today will help you as you get older and Parkinson’s changes. When imbalance is significant a walker may be needed. Not every walker will do and some can even increase the risk of falls. A stable 4 wheel walker, usually outfitted with a seat is best. Your physical therapy will help you choose the best fit for you.

Walking problems do not always improve with medication making physical therapy and exercise even more important at this stage. That is why you are encouraged to see a physical therapist and begin exercises for balance from the very beginning rather than wait until it is a problem.

[See tips to manage freezing.]

[See related article on posture.]

[See related articles on exercise for balance.]

[See related articles on bone health, fall safety.]

Author: Monique Giroux, MD

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