“Every day you may make progress. Every step may be fruitful. Yet there will stretch out before you an ever-lengthening, ever-ascending, ever-improving path. You know you will never get to the end of the journey. But this, so far from discouraging, only adds to the joy and glory of the climb.” Winston Churchill
The So-Called ‘Cardinal’ Symptoms of Parkinson’s: There are 4 major symptoms typically expressed by those of us with Parkinson’s, outwardly visible and noticed by you and others. Since Parkinson’s is a neurodegenerative disorder, the disruption in motor functions becomes apparent.
The motor symptoms of Parkinson’s include:
Rigidity, which is unusual stiffness in a limb or some body part;
Slowness of movement (also called bradykinesis), which is slowing down with the loss of voluntary movement;
Resting tremor, which is uncontrolled motion of a resting limb, but it stops during a voluntary movement (a previous post described tremor, please see: https://journeywithparkinsons.com/2015/04/28/tremor-tutorial/ );
Postural instability and gait problems, which are difficulties with standing, walking, and/or problems with balance and coordination.
For further information about the motor and non-motor symptoms of Parkinson’s, please see the following sites: http://nihseniorhealth.gov/parkinsonsdisease/whatisparkinsonsdisease/01.html
Parkinson’s Postural Instability And Gait Problems: Why are we concerned with balance, orientation, and postural control in Parkinson’s? How to define these terms? “Balance is the ability to automatically and accurately maintain your center of mass over your base of support. Postural orientation is the ability to control the segments of your body in relation to one another and to gravity, taking into account the environment and whatever task is being performed. Postural control involves both balance and postural orientation.” (from https://www.atrainceu.com/course/parkinsons-disease-moving-forward-143 )
Why do we even care about these postural instability and gait problems when everybody as they age can become less stable, stumble and fall. Postural instability and gait problems in Parkinson’s increase the risk of falls. It really matters.
Stumble. Fall. Stand. Adapt. Re-Learn: Personally, Parkinson’s feels as if the ‘gyroscope gizmo’ we were born with, and used successfully for 50-something years for balance and walking and posture, is now out-of-whack and much less trustworthy. My balance and gait are still relatively good (I have not fallen, I have not experienced any ‘frozen gait’, and I have stumbled only a few times while immediately regaining my balance). However, today, I told my Physical Therapist (PT) that “it sucks royally I’m re-teaching myself how to walk all over again!”. She totally agreed.
What Is LSVT* BIG? As described on their website (http://www.lsvtglobal.com/patient-resources/what-is-lsvt-big ): Recently principles of LSVT LOUD® were applied to limb movement in people with Parkinson disease (LSVT BIG®) and have been documented to be effective in the short term. Specifically, training increased amplitude of limb and body movement (Bigness) in people with Parkinson disease has documented improvements in amplitude (trunk rotation/gait) that generalized to improved speed (upper/lower limbs), balance, and quality of life. In addition, people were able to maintain these improvements when challenged with a dual task.
LSVT BIG can be delivered by a physical or occupational therapist. Treatment is administered in 16 sessions over a single month (four individual 60 minute sessions per week). This protocol was developed specifically to address the unique movement impairments for people with Parkinson disease. The protocol is both intensive and complex, with many repetitions of core movements that are used in daily living. This type of practice is necessary to optimize learning and carryover of your better movement into everyday life!
For additional information about LSVT BIG, I much prefer this site in New Zealand: http://www.onthegophysio.co.nz/lsvt-big.html
*LSVT = Lee Silverman Voice Treatment
My Opinion Of LSVT BIG: Wow! Although this is only week 1 of 4, the process is wonderful. Directed by a PT, one-on-one, the exercises flow from start to finish. You will sweat. You will have homework every night. The repetitive nature, the intensity, and the homework are all aimed at re-programming your neural network to accentuate bigger movement. Bigger movement from a Parkinson’s patient will translate into more normal movements. To get a head start on the exercises and to have a ready referral for post LSVT BIG training, I also have the DVD: “LSVT BIG Homework Helper!” (http://www.amazon.com/LSVT-BIG-Homework-Helper-DVD/dp/B00HNEQZ46/ref=sr_1_1?ie=UTF8&qid=1431574073&sr=8-1&keywords=lsvt+big+homework+helper+-+dvd )
Parkinson’s, Keep Moving Forward: I didn’t choose to have Parkinson’s, but now that I do have it, I am trying every reasonable means to enable a fuller life with better more natural motion/movements. As you probably already know, exercise has been a huge part of my life, and now with Parkinson’s, exercise is crucial for achieving a liveable life. To date, I have dedicates 2 posts to the importance of exercise for dealing with Parkinson’s (please see: https://journeywithparkinsons.com/2015/04/16/meditation-yoga-and-exercise-in-parkinsons/ and https://journeywithparkinsons.com/2015/03/14/exercise-and-parkinsons/ ).
Hopeful that LSVT BIG improves my posture, gait, and mobility. Hopeful that daily exercise lends a helping-hand to living better with Parkinson’s. Determined to not let Parkinson’s diminish me. Hope and determination, mixed with a lot of sweat, simply means it’s going to be a great month, a really great month. Stumble. Fall. Stand. Adapt. Re-Learn. Keep Going. Stay Strong!
“You can have anything you want if you want it badly enough. You can be anything you want to be, do anything you set out to accomplish if you hold to that desire with singleness of purpose.” Abraham Lincoln
*Cover photo credit: http://www.thewallpapers.org/photo/35317/lake-and-fog.jpg