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Suggestions to Remember 1.Consciously lift feet to avoid shuffling and falls due to the slight foot drag common to Parkinson's disease. 2.Avoid prolonged standing with feet too close together, which increase the risk for falls. 3.For better balance executing turns, avoid the instinctive "pivot" maneuver; practice reversing direction by using a forward facing wide U-turn pattern. 4.If balance is a problem, the patient can learn to use a single point cane with a large rubber tip. It takes practice to use a cane with ease: once mastered, the classic "walking stick" is portable, affordable, and invaluable. 5.If feet feel frozen or "glued to the floor" when initiating movement, several physical strategies can break the pattern: One can step over an actual or imaginary obstacle in the path to continue forward motion. Rocking from side- to-side can also break the sensation of being "stuck in place". It is not helpful for a companion to pull the patient forward or urge the patient verbally to "hurry up", this will often prolong the freezing episode. 6.Never carry objects in both hands while walking, as this severely compromises balance. 7.Swing both arms freely when walking; this may require a deliberate effort, since the automatic nature of many movements is diminished in PD. Gently swinging the arms helps maintain balance and lessens fatigue. 8.A decrease in automatic reflexes complicates trying to do two things at once. Automatic Reflexes work less efficiently if competing sensory stimuli take the patient's attention away from a motor function. For instance, it may be difficult to walk and look away at something or attend to a conversation at the same time. One learns to minimize distractions for maximal gait and balance control. 9.If getting out of a chair is difficult, place feet directly under the knees and stand up firmly to overcome the pull of gravity. Rather than bearing excessive weight on the hands and arms to stand erect, use the large thigh muscles to propel the body upward. Practicing this maneuver strengthens the quadriceps muscle and helps maintain independent ambulation. 10.Rubber or crepe-soled shoes arc not recommended, since they grip the floor and may cause tripping. 11.Patients who experience a tendency to fall backward or sensations of lightheadedness should move slowly when changing positions. Sit on the side of the bed when arising from lying down for 15 seconds before standing, and stand in place with support for an additional 15 seconds before starting to walk. This is a learned discipline, but it can prevent dangerous falls. |
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Treatment
Methods / Parkinson's Index /
Diet / Patient Should Know / Things To Remember
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