Stiffness, loss of balance, “frostbite” are some of the stumbling blocks that people suffering from Parkinson’s disease face every day to do an activity that is absolutely taken for granted for many: walking.
However, there are several gait compensation strategies, expedients that can help patients move while maintaining their independence. Too bad that according to a study conducted by Radboud University Medical Centre, in Nijmegen, in the Netherlands, few people know and have experienced them. The research, published in the journal Neurology, also highlighted that there would not be a formula that is effective for all patients and valid in all contexts.
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Seven strategies
Seven strategies could be adopted to compensate for the walking problems experienced by people with Parkinson’s: the use of an external signal (for example, going to the rhythm of a metronome); the use of an internal signal (counting steps); work on your balance by making wider curves or shifting your weight appropriately before taking a step; work on one’s mental state through relaxation techniques; imitating the action by visualizing the movement in one’s own mind or by observing another person’s gait; adopt new walking patterns (jumping or walking backwards); move your legs in a different way, imitating pedaling on a bicycle, for example.
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The survey
To find out how well these strategies were known and used, the Dutch researchers surveyed more than 4,300 patients with walking problems. They found that although many used compensatory strategies, only 4% of the participants were aware of all seven techniques.
On average, respondents only knew 3 of them, but 17% had never heard of them and 23% had never even tried one. The most popular strategies among respondents are the use of an external signal (47%) and an internal signal (45%). Only 14% of people, on the other hand, had heard of the strategy by imitation.
There is no single effective formula
Those who have tried one or more compensatory strategies have reported that they found them useful. From patient responses, some appear to be less effective than others, but there are no ad hoc designed studies to confirm this. The researchers also deduced that the use of one strategy rather than another may be related to the patient’s context.
For example, in public a person may prefer a certain strategy because it is less conspicuous, thus avoiding embarrassment and stigmatization. Furthermore, one technique may be more suitable than another in a given situation or for a specific purpose. The survey found, for example, that using an internal signal is more useful to start walking, while it is less useful to stop.
Still, motion visualization works best in open places. “Our results suggest that a ‘one size fits all’ approach doesn’t work because different contexts may require different strategies or because people simply respond better to one strategy than another,” commented Anouk Tosserams, one of the study’s authors.
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An online platform dedicated to strategies
As he told Medical News Today Michael S. Okun, a medical consultant of the Parkinson Foundation who was not involved in the study, it is currently difficult to identify a reliable source of information on all possible strategies to compensate for walking problems.
For this reason, the researchers propose to create a dedicated online platform, including multimedia content, to inform patients about alternatives they can experiment, to help each person with Parkinson’s to find the strategy that works for them, they say.
“The instructions on how to use each strategy safely – said Okun – should come directly from well-trained doctors, physiotherapists and health professionals with adequate experience with Parkinson’s disease”.
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