Anyone can fall over but falls are more common as we age. If you fall over we need to know why. If you go down without warning and have no memory of tripping you need to see your GP, to rule out treatable causes such as medication side effects, low blood pressure, irregular heart beat or mini-stroke. Several falls over a short period of time may indicate an infection. Often people who are admitted to hospital with a fall are found to have a chest or urine infection.
Most falls occurring to people with Parkinson’s relate to poor balance, muscle weakness, freezing and poor risk assessment.
In part one of this article I will cover balance and muscle weakness in more detail. In part two, in the next newspost, I will discuss freezing and risk assessment.
Having Parkinson’s means that your righting reflexes no longer kick in automatically to tell your brain where your centre of gravity is. Without this vital information the brain has to rely on your senses (vision, hearing and touch) to tell you if you need to adjust your posture to maintain your balance. Over time, your posture changes with Parkinson’s and you tend to lean forward, putting your weight on the balls of the feet, flexing at the waist and knees. In this stance your centre of gravity is too far forward so the merest bump or jolt can make you feel unbalanced or even fall. Any activity that makes you reach up or down can compromise your balance and lead to falls.
Improving your posture is the key to maintaining your balance, standing up straight with your shoulders back, head up, swinging your arms while taking bigger steps with heels down first will improve your posture and balance while walking. Vision is also important in maintaining balance and also in spatial awareness. Wearing bifocals when walking may not be such a good idea because they can distort your vision especially when looking down.
People who are less active or are recovering from illness can suffer from muscle weakness. When engaging in any activity, the muscles feel weak and the person feels unsteady when walking. In these circumstances falls are more likely, leading to a loss of confidence, so there is a tendency to walk less. This unfortunately compounds the problem as the less you walk, the weaker your muscles get. A course of physiotherapy can really help in this situation to bolster confidence and strengthen muscles. Walking daily is vital in maintaining muscle strength and has many other benefits.
If you are concerned about your balance and falls please see this fact sheet from Parkinson’s UK: Falls and Parkinson’s
Part two: in next newsletter
Read the entire collection of articles from Liz since she started writing for us in 2010.