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Out-Thinking Parkinson's

Progressive Symptom Reduction Strategies for Parkinson's Disease
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Learning How to Walk Again with Parkinson's Disease

May 3, 2016

People with Parkinson's tend to shuffle when we "walk". We take very small steps, hardly lifting our feet off the floor at all. We often trip over things and lose our balance. It is part and parcel of that terrible posture, the stooped over "Parkinson's Stance", which many of us develop when we do nothing to correct it. The resulting "Parkinson's Shuffle" is an extremely inefficient way to move around and is so very tiring.

Back nearer the start of the Out-Thinking Parkinson's project, we turned our attention to this serious problem and, over the course of weekend, found I could actually, with concentration and mindfulness, still find ways to walk properly, even when my Parkinson's symptoms are in full force. Moreover,  I found a large degree of symptomatic relief when I did manage to take big, confident striding steps. In this article, I seek to explain as fully as possible the process of how I did it. It is my hope that this give other People with Parkinson's a springboard to help them to start moving forwards again.

Deb Helfrich, the Wellness Coach who helped me to start "out-thinking" my Parkinson's Disease, was instrumental in this regard. Deb is a proponent of good posture and how we sit, stand and walk. She often talked to me about the kinetic chain of our bodies: how the head, shoulders, hips and feet all affect each other when we move. Deb had been trying to persuade me for some time try a brand of shoes called "FitFlops". She suggested these could help me correct my posture and balance and possibly even help me to walk better again. This, she explained, is because FitFlop shoes have a special technology embedded in them, called the "microwobbleboard", which results in their footwear providing a much more even pressure distribution for the feet.

Deb actually discovered this brand of shoe five years earlier, when she was researching posture, and has been wearing them exclusively herself ever since. I finally got round to buying a pair as part of one of my Amazon shopping sprees for new toys and ideas which might help me relearn movement. The point of mentioning the shoes is simply to emphasize that the choice of footwear is something that people with PD should perhaps give all due to consideration to: the right or wrong shoes can make or break moving around with the condition. The same is true of clothing more generally:

CLOTHING AND THE FREEZE PHENOMENA IN PARKINSON'S DISEASE

Here's what happened when I put my new shoes on in a video demonstration. Below, I also describe in words what I an showing here.

Standing up, things felt very odd indeed. When I tried walking in them, the same old Parkinson's shuffle. No miraculous difference yet. But what these shoes allowed me to do was very quickly fathom out exactly what was wrong. As soon as I stood up in them, the pressure distribution of me feet told me immediately that my kinetic chain is way off. The shoes helped me understand that I was leaning forward - the pressure was all on my toes, not on my heels. I was leaning heavily sideways too, so that the weight was mainly on the right leg. My balance was very wrong indeed!

I started to shuffle about again. With these shoes on, what became clear was that this Parkinson's shuffling isn't really about walking at all. Actually I was just continually falling over forwards and each shuffling "step" was a correction to stop myself from over-balancing. I stopped again and stood still. I shifted my weight slowly, incrementally backwards and to the left, adjusting the pressures I felt in my feet, until the heels came into play more while also seeking a better left-right balance. I then tried walking forward once more and was unbalanced again, resulting in another series of uncontrolled shuffling steps. Stop. Re-balance. Shuffle. By doing this over and over again, I really began to understand what was happening and from there I was able to begin unlocking walking again.

Next I started being mindful that, according to Deb, when we walk properly and naturally, the motion actually begins in the glutes, not in the feet. Concentrating on this helped me to begin to take the first staccato steps where I could lift a foot much higher off the ground and then place it slightly forward. I tried to do this walking backwards too. These exercises again helped me tune into to what I was doing wrong.

Then I put the music on, those songs which have been motivating to be able to move my arms and upper body again. Now as I moved forward again, I tried to put a small bounce into each step in tune to the music, a sort of dancing shuffle. Then I concentrated not on lifting my feet of the ground and moving them forward, but instead on pushing off - launching myself forwards - with the opposite foot. By now, the shoes had allowed me to begin to understand about "heel-toe" walking again. Like a Frankenstein's Monster, I was now taking one slow step after another, but at least now I was walking in a proper sense and no longer just falling forwards.

Then I took the shoes off and the difference I felt was incredible, but this massive contrast in itself gave me yet more powerful clues about my imbalances and more understandings of how to progress.

I kept at these experiments for a long time and continually varied the exercises, while remaining very mindful of what was happening through the soles of my feet. It wasn't easy and as soon as I stopped concentrating I would lapse back to the shuffle. I tried different music, I alternated with the shoes on and then barefoot. Now each time I began to shuffle, I would seek to correct it by rising up higher onto my tip toes with each miss-step, either using this to start a jogging motion or as a brake to come to a full stop and then lower myself back onto my heels properly.

Eventually, with a crescendo of a motivational song in my ears, I did it. I simply walked confidently, quickly and normally without effort, from one side of the house to the other. And while I was doing this, all my Parkinson's symptoms temporarily disappeared.

I have been practising a lot ever since over the past year. When my symptoms are bad, it is still not natural and I always revert to shuffling as soon as I stop being mindful. But entering that mindset in which I can just start walking normally is becoming easier. I have found a couple of ways to help achieve this too. The first is to use a visual stimulus - I look at an object at the other end of the room and keep looking at it as I start to walk towards it with intent. The second is vocal. I say out loud "I trust myself" and other vocalizations borrowed from the Alexander Technique. I've also found that using "visual cues" such as walking on paving slabs extremely helpful, as shown in the video below.

In Exercise, Assistive Technology, Video, Re-thinking Movement, Therapies Tags shoes, posture, Walking, Shuffling, Gait
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