Examining Muscle Weakness and Rigidity in Parkinson’s Disease
The sun peeks over the horizon, and before long Dad is up and at it. It’s a boxing day, and he wants to time his medications to optimize control over his Parkinson’s symptoms.
The other part of his routine revolves around his morning stretches. Muscle rigidity is the first obstacle that he faces when he wakes, and he chooses to confront it with a stretching practice.
Parkinson’s disease claims multiple functions as it progresses. Understanding how the disease affects the patient may help to inform treatment decisions. I’m a curious person, and Dad’s stretching routine makes me wonder if Parkinson’s disease directly affects the way muscles work. I think about how muscle rigidity and weakness are linked and how others handle these symptoms.
Muscle weakness and rigidity
As his Parkinson’s progresses, Dad complains that his stiffness is slowing him down. The frequency and intensity with which it occurs seem to be increasing. To better understand the disease and how it relates to the body, I decided to explore the research.
In an abstract of a literature review published by the American Journal of Physical Medicine & Rehabilitation, the authors stated that “isokinetic muscle strength was decreased in patients with Parkinson’s disease and that muscle weakness was not specifically related to tremor or rigidity.”
Brain-related muscle weakness
In the early 1800s, surgeon James Parkinson first described Parkinson’s disease as the “Shaking Palsy.” Back then, doctors observed muscle weakness as a key component of the disease.
According to the American Parkinson Disease Association, “Although patients feel the weakness in their limbs, the problem is in the brain.” Parkinson’s disease is a neurological disease, which affects the entire body, including muscular strength.
How exercise can help
Research shows that regular exercise has significant benefits for Parkinson’s patients. Since the disease affects flexibility, strength, and balance, patients are encouraged to use targeted exercise routines to manage the disease.
A study review published in the Clinical Journal of Sport Medicine found that exercise improves overall physical performance in Parkinson’s patients. The authors concluded that future research should examine the long-term effects of exercise programs.
As a rock climber, I spend a lot of time pulling on jagged edges. I’ve learned that it’s important to balance muscle growth with the opposite action. I’ve integrated pushing (yoga) into my routine to balance the pulling that I do on a rock wall. Focusing on both pushing and pulling helps my body to stay balanced and prevents injuries.
While I haven’t yet encountered a rock climber with Parkinson’s, the same premise could apply. If Parkinson’s causes constant muscle contractions, how can we encourage those muscles to extend and relax? Yoga emphasizes both strength and flexibility. And it’s possible to practice a routine at home. Starting a yoga practice might offer a solution to managing muscular changes.
Managing muscular changes
As Parkinson’s progresses, we must make adaptations. We need to be creative to find solutions to challenges relating to tremors or stiffness. Dad incorporates regular stretches and boxing sessions into his life — and he notices a difference when he’s unable to make it to a boxing class.
While we’re unable to eliminate muscular weakness and rigidity, we can take an active approach to ease these symptoms. As well as establishing a regular exercise routine, other treatment options include physiotherapy and occupational therapy.
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Alan Tobey
It may help to think about at least some of the motor-tremor behavior as involving PAIRS of muscles in opposition that are out of balance rather than just single muscles in isolation. For example, the familiar “flapping” of the hand when at rest does not involve your brain initiating equal effort in both directions (called flexing and extending) but an imbalance between the two. Often the extensor movements in the direction of making a fist are stronger than the opposing extensor movements, so that the whole motion is made up of what feels like an effort followed by a reaction.
So I like your insight that you need to exercise pairs of muscles to address tremor behavior. So for example using 2-5 pound hand weights will generally produce progress if you put more effort on the flexors. And taking that idea more generally may give you a whole new way of building an exercise regimen that fits your personal situation.
Dilip Kulkarni
I am a PD Patient? Six months back I got DBS done. Since then I loose balance quite often.
I feel like my left leg, the bottom of left foot is always swollen.
Is there any medicine?