Navigating Daily Life with Parkinson's Motor Challenges - Practical Advice

Navigating Parkinson's can be challenging, but you don't have to do it alone. This podcast provides practical information and empowering strategies for people living with Parkinson's, their families, and caregivers. 

In this episode, we discuss:

• Understanding Parkinson's Motor Symptoms: We break down the common motor symptoms of Parkinson's, including tremor, bradykinesia, rigidity, postural instability, and freezing of gait.
• The Top 5 Motor Symptoms: We explore these specific symptoms in detail, explaining how they impact daily life and providing management strategies.
• The Importance of a Multidisciplinary Approach: Learn why a team of specialists, including neurologists, physical therapists, and occupational therapists, is crucial for comprehensive Parkinson's care.
• Personalized Strategies for Parkinson's: We emphasize the importance of tailoring treatment plans to individual needs and encourage proactive communication with your healthcare team.

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#ParkinsonsDisease #Parkinsons  #MotorSymptoms #Tremor #Bradykinesia #Rigidity #PosturalInstability #FreezingofGait #LiveParkinsons #MovementDisorders

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Chapters

• 0:10 Welcome and Episode Introduction
• 1:09 Understanding Core Motor Symptoms
• 3:07 Managing Tremors Effectively
• 9:09 Strategies for Easing Rigidity
• 17:22 Overcoming Slowness of Movement
• 21:52 Balance and Postural Stability
• 29:04 Freezing of Gait Solutions
• 35:44 Multidisciplinary Approach and Resources

Transcript

Speaker 1: 0:10

Hello and welcome to Live Parkinson's Live an Exceptional Life. I'm your host, chris Kustenbader, and I've been living an exceptional life with Parkinson's for the past 15 years. The mission of this podcast is to help as many people as possible living with Parkinson's to lead a great quality of life. Today's topic is navigating daily life with Parkinson's motor challenges Practical advice. Parkinson's throws a curveball at your movement, impacting everything from buttoning your shirt, enjoying a simple walk or just trying to start your day off with a hot cup of coffee. Start your day off with a hot cup of coffee. But what if I told you that? Small adjustments, smart strategies and a shift in Parkinson's it's about outsmarting its motor challenges. So in this episode, we're cutting through the medical jargon and delivering real-world advice. You need to navigate daily life with more ease and more confidence For empowerment. You're in the right place. Let's navigate this together.

Speaker 1: 1:07

Today's episode is all about one of the most defining aspects of Parkinson's motor symptoms. We're going to be discussing the movement-related symptoms most people associate with Parkinson's Tremor, slowness of movement or bradykinesia, rigidity, postural instability, freezing of gait. Here's the thing. No two people experience these motor symptoms the exact same way. I know for me. My motor symptoms started with a tremor and then dragging my left leg when I walked. I know other friends who experienced different motor symptoms that led them to see a doctor. So in this episode, we're going to break down the core motor symptoms and, more importantly, give you practical, science-backed strategies and share personal experiences that you can use to help you manage your motor symptoms and not have them have a significant impact on your daily life. As a disclaimer, please remember to always work with your healthcare team to personalize and tailor these strategies to your specific healthcare needs. The information being provided is for educational purposes only and is not for medical advice. Please review any new exercise programs with your doctor first to ensure they are appropriate for your specific needs. Now, before we dive into managing motor symptoms, if you're looking for information and strategies for non-motor symptoms, check out my previous podcast, parkinson's Hidden Battles Addressing Non-Motor Symptoms for Better Living.

Speaker 1: 2:32

All right, so if you're ready, let's jump in feet first and get started, and let's lead it off by understanding the core motor symptoms in Parkinson's. Now I'm sure if you were asked what are your top two motor symptoms that have the biggest impact on your quality of life, you would have no trouble rattling them off and explaining why they're at the top of the list. So let's start off by breaking down the five big motor symptoms so that we can use this knowledge to help us develop strategies for managing these challenging motor symptoms. Coming in at number one on our list is tremor, because it's often the first thing people notice and many of you may experience yourself. Typically, it's a resting tremor, meaning it happens when your muscles are relaxed, for example, when your hands sit resting on your lap. Some people experience action tremors, which happen when you're reaching or using that particular limb, whether it be your arm to pick up a cup of coffee.

Speaker 1: 3:27

Now, we all know that tremors can be unpredictable. For some people, tremors are minor, while other people it can have a significant impact on their daily life by interfering with everyday tasks like writing, eating or even buttoning your shirt. So what causes tremors? In Parkinson's? Tremors are primarily caused by the loss of dopamine-producing neurons in the brain in the area called the substantia nigra. Dopamine is a neurotransmitter that plays a key role in controlling our movement, but it's also involved in the reward and recognition centers, so that when you get excited about something, you have a release of dopamine that makes you want to do it again. So when dopamine levels drop, it disrupts the communication between the nerve cells, leading to tremors, also known as rhythmic shaking. Parkinson's tremors tend to be resting tremors and often start on one side of the body, such as the hands, fingers and jaws, and may spread over time, particularly to the other side of the body, such as the hands, fingers and jaws, and may spread over time, particularly to the other side of your body. Now I'm personally affected with tremors in my left hand, which fortunately doesn't affect my handwriting Well, in terms of shaking it doesn't, but my handwriting has definitely gotten smaller and more difficult to read.

Speaker 1: 4:40

Number two on our list is rigidity. Rigidity refers to the stiffness of your muscles, which tend to get stiffer as the disease progresses. It can make it difficult to move and can even cause pain. The tightness and stiffness often affect the arms, legs and neck muscles and can make it harder to swing your arms naturally when you're walking. I know I have this problem myself. My left arm doesn't swing when I walk, which affects the natural motion when I'm walking and causes me to have a slight twist in my body because my arm isn't swinging when the other one's not, and that can cause a little bit of tightness and lower back pain In terms of stiffness. For me, more than two hours in the car without a break is rough. I get out of the car and I'm so stiff it's hard to walk and I really need to stretch before I can really get moving. All right.

Speaker 1: 5:32

Number three is bradykinesia, which is a fancy term for slowness of movement. It can feel like your body just isn't cooperating. Everything from brushing your teeth to getting out of the chair becomes slower and more effortful. Bradykinesia can also reduce your range of motion, which is known as hypokinesia and that's a good trivia question to stump people with if you're playing trivia. And when you go to see your neurologist or movement disorder specialist, they usually have you tap your fingers and your thumb together as fast as you can to test for bradykinesia. Another test is the one where you have your hand on your thigh, with your hand facing up, and they have you flip it back and forth on your thigh. They're looking at how fast you do that, so they're testing to see if you have bradykinesia. So essentially, you don't need fancy medical equipment to test for bradykinesia. So essentially, you don't need fancy medical equipment to test for bradykinesia. All right.

Speaker 1: 6:27

Number four is postural instability as Parkinson's progresses. You often see people with rounded shoulders, with a slumped look, often looking at their feet, and this may cause balance problems, and this is due to the loss of reflexes that help keep you upright. This increases the risk of falls, which is a major concern and can have a devastating effect on a person's quality of life, because they can get injured and end up in a rehabilitation center, and then the time it takes to recover can have a substantial impact on the person's quality of life and their social interactions. So that's why it's important to do balance exercises every day to help improve and maintain your balance. Now, for me personally, I spend about 10 to 15 minutes every morning and I've noticed significant improvements in my balance over the years. Now, to learn more, visit my website, libparkinsonscom, and you can download a free copy of Nine Balance Exercises to Improve Balance with Parkinson's and use this as a guide for helping to improve your balance.

Speaker 1: 7:31

And then, finally, rounding out, our top five is freezing of gait. Do you ever feel like your feet are suddenly glued to the floor? That's called freezing, or freezing of gait. It often happens when you're turning, you're going through a doorway or you're starting to initiate walking, and it can be incredibly frustrating, but it's also manageable. Now, one of the things I do to help me when my feet feel like they're glued to the floor is and to help prevent this is I like to listen to music, because the constant beat helps me to make sure that I keep my feet moving, or if they do feel like they're stuck to the floor, I count one, two, three and then often begin to move my feet, and it really does help.

Speaker 1: 8:15

Okay, that was an overview of the core motor symptoms of Parkinson's. Now let's look at each motor symptom in more detail and provide some practical tips and strategies for managing each one to help lessen their impact on our daily lives. Now, these strategies I will be sharing are evidence-based, meaning they have research supporting their benefits, and also include personal success stories from individuals living with Parkinson's. And let's lead it off with one of the symptoms that affects most people living with Parkinson's. And that's lead it off with one of the symptoms that affects most people living with Parkinson's, and that's tremors. As we discussed, most people will experience a resting tremor when the muscle is relaxed. Now, one of the things I've noticed when I have tremors is they seem to have a mind of their own meaning. No matter how hard I try, I just can't will them to stop. They keep right on going. Now I also notice that when I'm stressed, the tremors seem to be worse, but thankfully, there are a number of strategies that you can use to help manage your tremors. The first one is mindfulness and relaxation techniques, or, as I like to say, calming the internal storm. Now, evidence suggests that stress and anxiety can exacerbate Parkinson's tremors. Just as I mentioned, that happens to me. Mindfulness and relaxation techniques offer a way for you to manage your body's stress response and potentially reduce tremor intensity.

Speaker 1: 9:35

Mindfulness meditation is a practice that involves focusing your attention on the present moment with an attitude of acceptance. Present moment with an attitude of acceptance. It can include several techniques, involving deep breathing exercises, body scans, where you slowly go over how you feel in each area of your body as you move from your feet to your head, and observing thoughts and body sensations without judgment. For example, if you notice your heart rate and breathing are increasing, instead of letting your mind race and saying what's wrong with me, why is my heart rate beating faster, just simply acknowledge it and accept it and focus on the present moment. Studies have shown that, using fMRI, the mindfulness-based interventions can lead to increased gray matter density in the brain regions associated with emotional regulation in Parkinson's. According to the study, mindfulness-based intervention in Parkinson's disease leads to structural brain changes in MRI published in Clinical Neurology and Neurosurgery. When you focus on the present moment, without judgment, you become more aware of your tremor and develop a sense of acceptance, potentially reducing the anxiety it causes.

Speaker 1: 10:48

Simple practices like focusing on your breath, body sensations or sounds can be done anywhere at any time. As a practical tip, start with 5-10 minute sessions daily, gradually increasing the duration. Now there are a number of guided meditations available, either through apps or online resources specifically designed for Parkinson's. Now for more information and a sample meditation, listen to my podcast, the Parkinson's Anxiety Toolkit Mindfulness Strategies at Work. Next up is deep breathing exercises. Slow, deep breaths can activate the parasympathetic nervous system, promoting relaxation and reducing overall tension, which may help to reduce your tremor. As a practical tip, use the 4-7-8 breathing technique. So what you want to do is inhale for four counts, hold for a count of seven and then exhale for a count of eight. This can be a quick and effective way to help calm down when your tremor is really bothering you. Then we have progressive muscle relaxation, which is a technique that involves tensing and then releasing different muscle groups in the body to help you identify and release areas of tension that might be contributing to your tremors. For example, starting with your feet, tense the muscles in your feet, then relax, then move to your calves, then your thighs, your abs, repeating the process. As a practical tip, find a quiet place and work through each muscle group, from your toes to your face, tensing and relaxing each muscle group. Another relaxation technique is yoga and tai chi. These movement practices combine physical postures or stances, which you typically use in tai chi, with controlled breathing and mindfulness, helping to improve your flexibility, your balance and potentially, reducing stress and tremor. As a practical tip, look for classes that are specifically tailored for individuals with Parkinson's, or ask the instructor for modifications to help you with your specific needs, and then focus on these gentle movements to help you reduce stress, and that will lead to help you becoming more calm.

Speaker 1: 13:05

Now the next type of strategies to help us manage our tremors is compensatory strategies, or working smarter, not harder. So what are compensatory strategies, chris? Well, glad, yes. These are strategies that focus on modifying how you perform tasks to minimize the impact of tremors on function and independence. So let's look at some of these compensatory strategies, starting with proximal stabilization, which is just a fancy way of saying. They provide support of your arm with a tremor close to the core of your body. So the further your arm is away from your body, the harder it is to control your tremor. So I used to either put my thumb in my pocket and hold my hand near my waist when I had a tremor, or just put my hand in my pocket. But you can also just hold it close to your body. So, as a practical tip, keep your elbows close to your body when performing tasks, and then you can also rest your forearms or elbows on the table or countertop for stability when eating, writing or performing fine motor tasks. Next, use both hands so you can use the non-tremor hand to assist your tremor hand, which can help provide stability and control. So, as a practical tip, use your unaffected hand to guide or study the tremoring hand during tasks. Like you know, maybe you're pouring a drink, you're opening a container or when you're using utensils.

Speaker 1: 14:36

Next, slow down your movements. Rapid movements can make your tremors worse. So when doing daily tasks, deliberately slow movements to allow for greater control of your hands as a practical tip, consciously focusing on the speed of your movements. So make sure you give yourself ample time to complete tasks so you don't feel like you're rushed. And then next up is my personal favorite and a lesson I learned from learning songs and playing guitar, and that's to break down tasks. Sometimes our daily activities can involve some complex steps, but breaking them down into smaller, more manageable steps can make them easier.

Speaker 1: 15:17

Now some practical tips for you. When getting dressed is focus on one piece of clothing at a time. Maybe lay them out on the bed so you're ready when it's time to get dressed. But only focus on one thing at a time when you're getting dressed. So, when you're cooking, prepare the ingredients in stages so that you can add them when they're needed in your recipe, so that you're not racing around trying to get the ingredients as you're cooking your meal. And then, finally, weighting Adding weight to your utensils or wearing weighted gloves can help reduce the tremors in some people.

Speaker 1: 15:53

So make sure you get some guidance and approach from an occupational therapist and they can help you select the one that's most appropriate for you. And you want to be a little bit worried because some people may get fatigued from using weighted utensils or a weighted glove. Now, as a practical tip, experiment with weighted pens, utensils or weighted gloves and or wrist weights under the supervision of an occupational therapist, to see if they provide a benefit. Now I'll put some of my recommended products in the product description. Now the next strategy for tremors is adaptive equipment, which I like to call tools for enhanced independence. Now a variety of adaptive equipment is available to help you manage your tremors and maintain independence in your daily activities Weighted utensils and cups. The added weight provides more stability during eating and drinking and that helps to reduce spills. So, as a practical tip, experiment with different weights and handle sizes to find what works best for you.

Speaker 1: 17:00

Now another key tip is to use non-slip mats and surfaces. These can prevent items from sliding during tasks, giving you more stability. So some practical tips is use non-slip mats under plates, bowls and cutting boards. Next is buttonholes and zipper pulls. These can help when you are getting dressed and can help reduce the need for fine motor control. An occupational therapist can give some instruction on how to use these. Next is electric toothbrushes and razors. Now, the larger handles and power to action can make grooming tasks easier. Now I'm a little bit biased, because I used to sell and promote one of the power brushes and it was an Oral-B and I highly recommend them. Finally, writing aids like weighted grips or even voice-to-text software can help in your work and oral communication. As a practical tip, experiment with different types of pens and grips and consider using a slant board for writing. So, as we conclude these strategies for managing tremors, try using a multifaceted approach that includes mindfulness and relaxation, compensatory strategies and assistive technology. These can help to significantly improve your daily life and help you maintain your independence.

Speaker 1: 18:24

All right, now let's move on to our next motor symptom on the top five list, and coming in at number two, is rigidity. Rigidity refers to the stiffness and resistance to movement caused by increased muscle tone. It's considered one of the core motor symptoms of Parkinson's and it can affect any part of the body, and it can also lead to pain, restricted range of motion and difficulty with your daily activities. While medication is important, several other strategies can help. So let's look at easing rigidity using these strategies and leading it off with gentle stretching and range of motion exercises. These exercises are going to be crucial for maintaining muscle length and joint flexibility, which is going to help you counteract the increased muscle tone in Parkinson's. And then these exercises can help prevent contractures or shortening and tightening of the muscles, and so it helps with your overall movement, as evidenced. Physical therapy guidelines and expert consensus strongly recommend regular stretching and range of motion exercises for Parkinson's. Studies have shown that these exercises can improve your flexibility, reduce your stiffness, and so they're going to be beneficial, and I recommend doing these every day, trying to do at least five to ten minutes of stretching. I know that it really helps me and it's really helped me in terms of my flexibility and movement.

Speaker 1: 19:55

Now let's look at some practical tips and examples. We'll start with neck stretches, and what you can do is slowly tilt your head to each side, holding for 15 to 30 seconds, and then gently rotate your head in a circular motion. That'll help stretch out your neck muscles. Shoulder rolls Roll your shoulders forward and backward in smooth circular motions. Then we have arm circles you can extend your arms and make small, then larger, arm circular motions. Wrist and hand exercises Flex and extend your wrists and then make a fist and then open your hand as wide as you can, gently stretching each finger individually. Leg swings Standing with support, you can swing each leg forward and backward and then, side to side Ankle circles Holding onto something of course rotate your ankles in a circular motion, and you could do that while you're sitting as well.

Speaker 1: 20:58

Now some important things to consider. You want to perform stretches slowly and gently and avoiding any forceful movement that can cause pain. You want to focus on smooth, controlled movements and repeat each stretch several times, holding for 15 to 30 seconds. And you want to perform these exercises daily, and you can even do them several times a day, as recommended by a physical therapist. And then a physical therapist can provide a personalized exercise program tailored to your specific needs and limitations.

Speaker 1: 21:30

Now the next strategy is warm baths or showers. Heat can help relax muscles, increase blood flow and reduce pain and stiffness. Now some evidence. While not specific to Parkinson's, the general principle of thermotherapy or heat therapy are well established in rehabilitation and pain management. Heat application is known to decrease muscle tone and improve tissue extensibility. Heat application is known to decrease muscle tone and improve tissue extensibility. Now let's look at some practical tips. Take a warm, not hot bath or shower for 15 or 20 minutes. Ensure the water temperature is safe, because you want to avoid burns. And then you can also add Epsom salts to the bath, which some people find soothing for muscle relaxation. You can apply warm compresses to specific areas of rigidity such as your shoulders or your neck. Those are going to help a little bit to help loosen up the muscles.

Speaker 1: 22:30

Now the next strategy to help with rigidity is massage therapy. A massage can help loosen tight muscles, improve your circulation and reduce pain. It may also have a calming effect which can indirectly reduce muscle strain. Well, research on massage therapy specifically for Parkinson's is ongoing. Studies suggest that massage can be beneficial for reducing muscle stiffness and pain in other musculoskeletal conditions. Now I personally get a massage once a month and I can honestly say I feel looser and more flexible, as well as more relaxed. So I would highly recommend getting a massage. I mean, it's a great way to stay loose and help you reduce stress and get rid of some of the tightness in your muscles. So here are some practical tips Seek a massage therapist who is experienced in working with people with neurological conditions, if possible, and then gentle and slow massage techniques are often preferred. Let your massage therapist know about your comfort level or any areas of particular tightness, and that's usually one of the first things they ask me when I go in for a massage is do you have any areas that are tight or that are bothering you? And then, finally, the last strategy to help with tightness is maintaining activity.

Speaker 1: 23:52

Regular physical activity, aka exercise, is essential for managing Parkinson's symptoms, including rigidity. Movement helps keep muscles active. It's going to improve your circulation and maintain your joint mobility. Evidence to support these comes from Parkinson's Outcome Project and other large scale studies have demonstrated that regular exercise yes, I said it, exercise can slow the progression of motor symptoms and improve your quality of life. So, as a practical tip, engage in a variety of activities you enjoy, such as walking, swimming, cycling, dancing and even gardening. Aim for at least 150 minutes of moderate intensity aerobic activity. Include activities that focus on flexibility, such as stretching, yoga or tai chi. Consider Parkinson's specific exercise programs like the LSVT Big program, which emphasizes large amplitude movements to counteract bradykinesia and rigidity, and then consult with a physical therapist to develop safe and effective exercise programs tailored to your individual needs and abilities. Now, remember, even small amounts of movement throughout the day can be helpful, so you can break up periods of sitting with short walks or a little stretching session.

Speaker 1: 25:22

All right, moving on to strategies for developing the types of motor symptoms we experience, which is bradykinesia or slowness of movement. Bradykinesia is a core motor symptom of Parkinson's disease and it's characterized by slowness of movement. And it's not just about moving slowly. It also includes difficulty initiating movement, hesitation before starting an action, like getting out of a chair. Reduced amplitude of movement, where you're making smaller movements, so decreased arm swing while walking, smaller handwriting. Slowness of execution, where you take a long time to complete a movement. And then fatigue, where you're feeling tired because the simple movements required to move require so much effort from being slow that it causes some fatigue. Now, the slowness stems from a lack of dopamine in the brain, and again, dopamine's the neurotransmitter that's crucial for our movement.

Speaker 1: 26:21

Now let's look at some of the strategies for dealing with bradykinesia. The first is exercise and physical therapy. Yes, it comes up again, but regular exercise is crucial for maintaining your mobility and your function in doing daily activities. Next up is LSVT Big. It's a program, a specialized physical therapy program that uses large, amplified movements to combat bradykinesia. Now, I participated in the LSVT Big program the first time I went to physical therapy and I did find it beneficial. And they actually give you handouts with each of the exercises that you can do at home, which I still have and I will do today, and I still use it as a reference because when I'm feeling slow or tight, I pull those out and do a lot of those exercises. Now, walking, focusing on heel to toe exercises. Now, walking, focusing on heel to toe, meaning landing on your heel and rolling on your toes while swinging your arms can help. Stretching helps to prevent stiffness and improves your range of motion. And then occupational therapy An occupational therapist can help you adapt your environment and your daily tasks to help you with bradykinesia.

Speaker 1: 27:40

Next up are movement strategies and leading off with again breaking down tasks, you want to divide complex activities into smaller, more manageable steps, because that's going to help you focus on one thing at a time and prevent you from being overwhelmed and being tired. Focus on one thing at a time and prevent you from being overwhelmed and being tired. And then you can use rhythm and counting Count aloud as you use muscles to help you initiate your movement when you're slow and then also visualize your movement. Imagine your movement before you're doing it. So, if you're getting out of a chair, visualize yourself getting out of the chair in a nice, slow, smooth movement. Allow extra time, don't rush yourself, and give yourself plenty of time to complete the tasks. Another thing you can do is rocking. If you have trouble getting out of the chair, you can rock back and forth to help initiate standing. Or you can also use that to get out of bed as well. If you're sitting on the edge of the bed, maybe you can rock back and forth a little bit, but don't go too far forward and lose your balance and fall forward. And then finally, speech therapy. Bradykinesia can affect our speech, making it softer and more monotone, so speech therapy can help. Now I've done speech therapy twice and I highly recommend it because I had people telling me that they were having trouble understanding me. So and I highly recommend it because I had people telling me that they were having trouble understanding me, so speech therapy is a great option.

Speaker 1: 29:02

All right, moving on to the fourth motor symptom on our top five list is postural instability, which, in layman's terms for people like me who like to keep it simple, means the inability to maintain your balance. In Parkinson's, now in Parkinson's. In Parkinson's, now in Parkinson's it's caused by a loss of reflexes that help us stay upright and often leads to an increased fall risk. Postural instability can have a significant impact on our daily lives because if you're constantly worried about falling, that can really limit the things that you do. So postural instability is going to increase our fall risk. So posture instability is going to increase our fall risk. It can cause difficulty with our mobility, so for simple activities like walking, turning or standing, that can become very challenging. It can also restrict our activities because a fear of falling can cause us to avoid, you know, participating in our social activities and it can limit our exercise and can keep us from doing the hobbies we enjoy. And then loss of independence, because balance and posture problems can make it harder to perform everyday tasks like dressing, bathing and cooking without assistance. And it can have a big psychological impact because if you have a constant fear of falling, that can lead to anxiety and depression, which we want to make sure that we can try to combat.

Speaker 1: 30:24

All right, now let's look at some of the strategies to help manage postural instability, and leading off with balance training. Specific exercises can help improve your balance and your coordination and again, you can go to liveparkinsonscom and get the free copy of the nine balance exercises to improve your balance. Now these activities can include standing on one leg with support, and then you can also do shifting weight exercises or tai chi. There's some other examples of balance exercises that you can use. Another thing you can do is gait training sizes that you can use. Another thing you can do is gait training where you can practice techniques to improve your walking, like proactively taking larger steps, focusing on heel-toe walking and using visual cues like lines on the floor to help improve your stride length. And then strength training is another good strategy, because when you strengthen your leg and your core muscles, that can help provide better support and stability.

Speaker 1: 31:25

Now the next group of strategies helps with fall prevention. Now, these would include home modifications like removing tripping hazards, like throw rugs, and then using non-slip mats in the bathroom and kitchen. I remember we had a mat in our kitchen that was non-slip and I about killed myself because it slipped out underneath. So since then, it's all non-slip. And then you can also have adequate lighting in the hallway and other areas to help give you a better visual cues. And then, finally, assistive devices like canes and walkers can help provide extra support, and a physical therapist can help select the most appropriate choice.

Speaker 1: 32:06

All right, now it's time to address number five on our top five motor symptom list and that's freezing of gait, which can be a distressing symptom, and it's characterized by sudden, temporary inability to move your feet despite wanting to walk, and it often feels like your feet are glued to the floor. Typically they're brief and only last a few seconds, but they can be unpredictable and may occur when initiating your walking, turning or passing through narrow spaces or doorways, and when you're approaching your destination spaces or doorways. And when you're approaching your destination, I know that when I've had problems it's your mind saying to your feet move, but your feet don't want to cooperate. And freezing a gait can have significant impact on your quality of life because it can increase your potential for fall risk and reduce your mobility and independence and a lot of people it can cause fear and anxiety. That may occur when you're walking, because if you're going out you may start to worry about oh gosh, I hope I don't have freezing, because that's going to be not only embarrassing, but I don't want to fall in front of everybody.

Speaker 1: 33:12

So let's look at some strategies for managing it, and the first are cueing techniques, and these involve visual cues so you can practice stepping over a line, which can be real or imagined. You can use a laser pointer line or an object like a small cone to step over. Auditory cues like marching to a beat or counting one, two, three or even using a metronome can also help. And then, finally, using mental cues, visualizing yourself walking smoothly. So those are different types of cues that you can use. And then there are movement strategies, which can include weight shifting when you shift your weight from one leg to the other to initiate movement. There are stepping strategies to the other to initiate movement. There are stepping strategies taking small steps you can march in place before moving forward, or taking a step to the side can also help. You can also use a technique called stop, stand still, sigh breath and then take a big step.

Speaker 1: 34:22

The next is assistive devices Walking aids like canes, especially those with built-in cues, like some of them have a little bit of a laser pointer that you can improve stability and reduce freezing because you're looking at the laser line. And then physical therapy and exercise, which you notice has been a common theme across all these. So physical therapy can really be beneficial. And then gait training when you work with a physical therapist to improve your walking patterns and you can get strategies for overcoming freezing. And then again, we talked about strength and balance exercises, so improving your lower body, strength and balance can help reduce the risk of falls. And then, finally, you can have environmental modifications, like clearing pathways in your living area, where you remove clutter and obstacles so that you don't have the potential to trip over those, and then make sure you have adequate lighting to improve your visibility, and that's going to help reduce hesitation while walking. Now I personally experience freezing and it can be very frustrating, but these strategies and techniques have really helped me manage it, so give them a try. Okay, those are the top five symptoms and strategies to manage our motor symptoms.

Speaker 1: 35:44

Now I briefly want to discuss the importance of using a multidisciplinary approach and personalized strategies in managing your Parkinson's motor symptoms. Now, here's why it's important, because Parkinson's affects people in diverse ways and symptoms can change over time, and a team of specialists working together can help you manage these motor symptoms more effectively. Now, the team typically includes a neurologist or movement disorder specialist they're going to help you diagnose the Parkinson's, they're going to manage your medications and they're going to provide overall care during the course of the disease and then a physical therapist, who can help improve your mobility, balance and gait by giving you targeted exercises and therapies. Then you're going to want to have an occupational therapist who can assist with adapting your daily activities to the environment and to help you maintain your independence. Then you want to have a speech pathologist or speech therapist, because they can help you address speech and swallowing issues. So, to learn more and get a detailed plan for a multidisciplinary approach, get a copy of the Building your Parkinson's Care Team resource and workbook at Live Parkinson's or on my COFI page at coficom slash liveparkinsons.

Speaker 1: 37:05

Remember, personalized strategies are essential because Parkinson's affects everyone differently, so what works for one person may not work for another. Disease stage, symptom severity and overall health and personal preferences influence how a person responds to treatment. So it's important that treatment plans are tailored to your specific needs and your goals. And one thing I did want to stress is proactive communication is key. So you want to be sure to be proactive in sharing your symptoms and challenges with your healthcare team, because they can help you develop targeted treatment plans and address your symptoms. Now you can go to the liveparkinsonscom and get a Parkinson's symptom tracker and medication tracker to help you and your physician know when your symptoms are more severe and when they impact your daily life more so, as we close out this podcast, it's important to remember that effectively managing Parkinson's, especially the motor symptoms we discussed, requires dedicated and personalized approach. Remember, you're not alone in this journey. By working closely with a multidisciplinary team of specialists and tailoring strategies to your unique needs can help you manage these motor symptoms and the challenges they cause, so that you can continue to live your best life.

Speaker 1: 38:29

Now we encourage you to take action in your role in care and arm yourself with knowledge and resources. So visit liveparkinsonscom today and subscribe to the free monthly newsletter. It's packed with the latest information and tips, while there be sure to check out the Building your Parkinson's Care Team Resource Guide and Workbook For just $10,. It's an incredible tool to help you build and coordinate your optimal care team. If you find the information we provide valuable and want to support our mission of empowering the Parkinson's community to live a great quality of life, please consider contributing to our Ko-fi page at ko-ficom slash liveparkinsons. Your support will help to continue to create and share vital resources. And again, thank you very much for joining me today. I'm committed to being your partner in navigating Parkinson's every step of the way. So until next time, stay healthy, stay strong and remember to live your best life with Parkinson's. Thanks again, and I really appreciate all of you for listening. Thank you.