The vast majority of the people reading this article have had their physician examine their gait, or the way they walk. In the exam, the doctor has you walk forward about 10 meters, and then turn around and come back. Usually, you go through this routine twice. During that time your doctor is analyzing these things:
- How difficult it is to initiate your stride
- How difficult it is to reach the target 10 meters away
- How well you manage turning around
- Your posture
- Whether you experience freezing episodes
- The shape and height of your steps
- If your arms swing properly to help you balance
- How well you manage stopping and sitting down
While it may seem the doctor is concerned with aesthetics, he or she is actually using these outside clues to measure your quality of life. Among many concerns, your doctor wants to know how rapidly Parkinson's is progressing, if you are at risk of falling and hurting yourself, and if you can still walk well enough to take care of your daily needs.
Gait disorder includes symptoms such as:
- A shorter stride
- A slower walk
- Lower lift in steps
- Festinating—a shuffle with many small steps
- Struggle to balance
When these symptoms become constant, it means you have progressed to the middle stages of Parkinson's disease. It can be a discouraging time for many people, and you need to make sure that you are talking about it frankly with your neurologist.
Improving Gait
Parkinson's medications are usually the most effective treatment for keeping you on your feet and moving forward. Deep brain stimulation surgery patients frequently experience impressive results, and they usually regain some walking. Physical therapy and follow-up with daily exercise can also provide plenty of benefit. Many people try dancing, tai chi, music therapy, and other methods to stimulate their nervous system. However, because Parkinson's disease is progressive, none of these therapies provides a permanent or long-lasting benefit.
Overcoming Freezing Gait
On those occasions when you want to take that step, but your feet just will not follow the command, you may need a little help. Fortunately, your eyes can send signals to your brain that can coax your feet to get moving in the right direction. You can use visual cues. Some of these strategies include:
- Make marks on the floor where you frequently walk.
- Rather than pivoting which can be difficult, give yourself a little more space to walk in a circle.
- Use the U-step laser cane that projects a laser beam, as a type of visual cue, in front of you.
- If it is difficult to cross a doorway or threshold, draw a line on the floor there as a visual cue. You can also extend your vision to a spot beyond the doorway and make a spot within the new room your destination.
- If you freeze, trick yourself into moving by visualizing walking up steps.
- For some people, remembering a simple dance step and performing it gets them moving.
- Keep a supply of small pieces of paper, yarn, or any other inexpensive item in a shirt pocket. When you freeze, drop one on the ground in front few inches in front of yourself, and step over it.
- If you will be doing a lot of walking, take someone with you. If you freeze they can give you a visual cue or walk beside you and coach you with verbal cues. Sometimes just a touch on the arm or some coaching to "lift that left foot" can get you going.
Walking gives you access to so many of the necessities and pleasures of life. We hope that this information will help you to communicate with your doctor about keeping you walking well for as long as possible. We want you to be able to walk through the door at your family party, putter around in the garden, or walk around town at your favorite vacation spot.
