People often remark that one minute they were walking along and the next they were on the floor. In the last newsletter, I discussed falls occurring to people with Parkinson’s as a result of poor balance or muscle weakness. This time I will focus on falls associated with freezing and poor risk assessment.
Parkinson’s affects sequencing and planning of movements. This affects walking and at its most severe is seen in freezing. This is when the fluidity of movement completely breaks down and it is difficult to take the next step, as though glued to the floor. This commonly happens when turning, moving through doorways or when the floor covering changes. Freezing does not respond to higher doses of medication but it can be helped by developing strategies to get moving again once stuck. Many falls occur because the legs freeze but the upper body momentum continues. A course of physiotherapy may help to develop cues to employ when freezing occurs.
Tasks that require more concentration and co-ordination are associated with falls. Carrying something on a tray upstairs or to another room is more difficult. People with memory problems or dementia often forget to take their walking aid with them when getting up to do something. Assessing risk is sometimes difficult for people with Parkinson’s. If you have balance problems, standing on a step ladder or stool to reach up or do DIY work is not a good idea. Falling from a height increases the risk of bone fractures which can have devastating effects for individuals and their families.
We cannot stop people from falling over, but there are some things that we can all do to reduce the number of falls:
- Maintaining a good posture improves balance
- Regular exercising strengthens muscles and improves fitness levels
- Working out strategies to overcome freezing reduces falling
- Developing an insight into how Parkinson’s affects daily life may help in risk assessing what tasks are safe to do around the home
If you are concerned about your balance and falls please see the Parkinson’s UK fact sheet Falls and Parkinson’s.
If you have not been offered a course of physiotherapy and you would like to be assessed, please let me know.
Read the entire collection of articles from Liz since she started writing for us in 2010.