Preventing Falls in Parkinson’s Disease
Why You Must Read On...
- Understand why people with PD are at a significant risk of falling.
- The consequences of a fall and how to prevent it.
- The meaning of “Freezing of Gait” and how to deal with it.
1. Why do people with Parkinson’s at a significant risk of falling?
People living with PD have slowness of movement, rigidity and poor balance. The risk of falls is higher in people with Parkinson’s due to various factors. They may experience a phenomenon called freezing and may develop a stooped posture which makes them more likely to have a fall. Being less active than before leads to poor muscle strength, thus increasing their chances of a fall. Sometimes, medications can cause low blood pressure leading to dizziness and falls.
2. What are the consequences of a fall?
Falls in older adults can cause injuries and fractures, which may lead to hospitalisation. This may set off a series of events such as developing fear of further falls, getting dependent on carers for basic daily activities and sometimes institutionalisation. Apart from causing physical decline, falls can also lead to depression and social isolation. This ultimately affects the quality of life for the older person. Falls have huge economic and social implications as treatment of fall related injuries is a costly affair and impacts the lives of caregivers and families of the patient.
3. Can falls be prevented?
Staying active and exercising can help improve muscle strength and balance, thereby preventing falls. Physiotherapists can help with exercise programs specifically designed for Parkinson’s patients.
Exercises such as walking, or swimming are beneficial for cardiovascular health, reduces risk of osteoporosis and improves emotional well-being.
Having a discussion with the doctor about the medication list is worthwhile as Parkinson’s patients develop motor fluctuations over time (usually years) which need adjustment of medications.
4. Can you explain in simpler terms on the definition of “Freezing of Gait”(FOG)?
Freezing of gait is a symptom experienced by Parkinson’s patients. It is a feeling of feet being stuck to the ground or glued to the ground. Patients tend to freeze when they start walking or try to get up from a chair, and while turning. It tends to happen while navigating narrow spaces like doorways or lifts, and in crowded places like supermarkets and social gatherings.
5. Can you share the tips and tricks to deal with FOG?
Some techniques suggested by Physiotherapists and Occupational therapists to deal with FOG:
- Taking medications on time.
- Walking to a rhythm (by counting, marching, singing to yourself or listening to a beat or music).
- Using visual cues like stepping over an imaginary line or patterns.
- Shifting weight from one foot to the other to start walking.
- Concentrating on one thing at a time (avoiding distractions).
- At home, keeping the environment clutter-free by removing rugs etc..
Dr Deepa Alex joined as lecturer (fractional) in Geriatrics in May 2018. She completed her MBBS in 2010 and MD in Geriatric medicine in 2014 from The Tamil Dr MGR Medical University, India. She subsequently obtained her MRCP (UK) in 2017, during which time she was attached to the Department of Geriatrics, University Malaya. She is a member of Indian Medical Council and Indian Association of Geriatrics.
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