A Balancing Act: The Struggle to Maintain Balance With PD
Now and then, especially as I’ve gotten older, my gait can be a bit unsteady. I’ve been known to drift a little to the left while walking.
As we age, our balance, steadiness, strength, and agility decrease, and our chances of falling increase. For people with Parkinson’s disease (PD), balance, walking, and gait are often major issues due to both motor and nonmotor symptoms, making them even more susceptible to falls and other injuries.
As Parkinson’s News Today points out, “One of the most debilitating effects of Parkinson’s disease is the loss of coordination and control in body movements, which in many cases leads to severe walking disabilities.”
The Davis Phinney Foundation for Parkinson’s notes that PD causes a loss of dopamine and the impairment of the basal ganglia, the part of the brain responsible for motor control. Therefore, individuals with PD may struggle with balance, delayed reaction time, speed of movements, and postural “righting reflexes,” which help someone regain balance when their body sways off its base of support. All of these issues increase the risk of falling.
Because other factors can cause balance issues, folks with PD need to be evaluated so that medical professionals can address their balance and gait problems in the way that works best for them.
My sister, Bev, who is currently diagnosed with stage 3 Parkinson’s, has obvious problems with walking and balance, though she does not have freezing or stiffness episodes. Unfortunately, her unsteady gait and balance problems have led to a number of falling episodes. Fortunately, she’s had no major injuries as a result.
To decrease the possibility of falling, and to increase her strength and abilities, Bev regularly attends a PD balance and exercise class in her community. She has also attended a fall prevention program sponsored by the National Council on Aging. The program is open to older adults and others considered at high risk for falls. Her neurologist also ordered physical therapy to improve her balance and strength.
The Cleveland Clinic has shared tips for preventing falls and maintaining balance that involve making changes in the home environment and employing certain habits while walking or standing. Some helpful tips include:
- Remove or anchor area rugs and other potential obstacles in your home.
- Use aids and assistive devices, such as grab bars and nonslip mats, in the bathroom.
- Choose the right shoes for you. Certain types of soles can make it easier to trip.
- Keep night lights in your bedroom, bathroom, and hallways.
- Ensure stairwells have railings that are easy to hold.
- Wear a medical alert bracelet or pendant in case a fall does occur.
- Make an effort to deliberately pick up your foot with each step, and get up slowly from chairs.
- Focus on one thing at a time. This helps with both thinking and walking because it limits distractions.
Bev is fortunate to have a medical alert device that was provided by her community at a low cost. She also uses a rollator, or a walker with swivel wheels on all four legs and hand brakes. It has a seat and a basket for carrying items.
Managing balance issues caused by PD can be challenging. However, Bev presses on despite PD’s effects. She says, “I will keep on doing what I can when I can to the best of my ability, and I will continue to follow suggestions that help me to improve my coordination.”
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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.
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barbara glass
What kind of soles make it easier to trip?
Barbara Ernesy
I purchased alarm buttons for my wife to alert me if I am in the house or outside.
Unfortunately, even though it was around her neck she rarely
used it. Not because she was incapacitated, but she simply
must have forgotten she had it on. I searched the Internet unsuccessfully for a
accelerometer type tilt alarm that could transmit a signal like the
push button to an audible/visual alarm in the event of a fall.
I don’t know whether this was a general issue with PD afflicted
people or specific to her. Anyone care to weigh in on this.
William Palmer
My main motor problem is walking and balance--it started two years before I was diagnosed with PD (last year). Lightheadedness compounded it, but that seems better now, perhaps since taking Sinemet. I use a cane; I'm grateful it helps. Yet I can no longer drink a full beer or glass of wine because it makes my balance/walking much worse. This used to depress me, but I'm getting used to it. Also, I have trouble mowing my lawn. After a half hour, fatigue hits my legs. I need to mow in 2 or 3 sections, with long breaks in between. Marsha, a friend in my local PD support group, says we can "learn to work around Parkinson's." This has become a mantra for me.
Thor Eriksen
i only tend to fall when i am gettig up from a chair...I had the worst fall i have ever had the other day when my brother took me out for lunch. We were seated when I decided to get up and pull my chair in a bit closer. .Disaster struck...I could feel myself falling backwards and there was nothing I COULD DO...I hit the floor and the next table and lay on the floor. I felt so embarrassed and tried to get up. My brothrr rushed around as did the manager and they helped me up on my feet. i said I was ok but I HURT MY ARM SLIGTLY...My brotherr told the manager I had PD and I tried to apokogise for creating a scene. He said don't be silly and all he was concerned about was that I was ok. I assured him I WAS and resumed my seat and ordered lunch... ..Later on I chrcked out my arm and it was ok except for a bruise.my brother told me I MISSED THE NEXT TABLE BY INCHES WITH MY HEAD WHEN I FELL...That is the only time I HAVE FALLEN IN PUBLIC..but I live in a old peoples vilage and when I GET UP FROM MY COMPUTER i always fall backwrds ONTO MY BED...So no harm is done. I HAVE NOT TOLD ANNYBODY ABOUT THIS .If I DO i THINK THAT THEY TTAKE AWAY SOME OF MY INDEPENDENCE....So there is my story about balance be careful..
Louis "Skip" Sander
Yes. What kind?
Roger Jenkins
AMEN and THANK YOU!
Necessity requires creativity!!! MORE LATER ???
Les Canning
I have had parkinsons for 13yrs and have had dbs 2yrs ago. Helped me with my walking and completely stopped the tremors..However my walking has got worse now again ie the stop start happening again and my balance..However I have since discovered an app called metronome which has helped me considerably. Well.worth it as I can now walk with only my waking stick
Curt M Peterson
Unfortunately, falling backwards seems to one of the common directions for falls. I garden and do yard work, which I enjoy, but this year I have fallen backwards three times, twice I was crouching down weeding a flower bed and fell backwards unto the lawn, so no injuries, but just the surprise that it happened. The third time I was working in a raised garden bed and fell backwards off the frame of the raised bed back into some azalea bushes. I pretty much decimated one bush and had a hard time getting up because my upper torso was lower than my legs. Falling backwards also can occur while ascending stairs, which can occur in older individuals without the added disadvantage of having PD, so I reaffirm what others have said here, that always being cognizant of your surroundings and attentive to what you are doing is a must.
Shannan Lloyd
I'm 40, diagnosed with early onset Parkinson's almost 7 years ago. Wow that's hard to believe that I've been living with Parkinson's for 7+ years! I've had DBS surgery twice, 1st in October 2019, bilateral and the 2nd in October 2020,a revision of the left side to move the wire to a different target area, and they fried my battery during surgery and I had to have that replaced. I started really struggling with my balance after the 1st surgery buy it's gotten worse since the 2nd surgery. I can be standing still and all of a sudden start going back on my heels and fall straight back. I find myself drifting to one side usually the right and start side stepping faster and faster trying to find my balance and I fall. Then not to mention that I'm more thrown off when I'm Dyskinetic or Dystonia in my right foot and ankle. I'm using a rollator now to help with keeping my balance and when my Dystonia is really bad. I've had some pretty nasty falls but luckily I've not had anything more than some pretty ugly bruises, no major injuries and by the grace of God, I've not hit my head! I can hardly do anything without falling and it's definitely affected my confidence socially. I have better moments but a lot of bad and I just see myself declining quickly and losing my independence.
Doug Haines
Hi to have fallen many of times I’ve had Parkinson’s for over 25 years.
Thanks for a good Walker that I use all the time . I have minimized my falling.
Thanks Doug
Lynne H Smith
I have taken a couple of spectacular falls moving or getting up from my chair. I have been doing physical therapy, yoga and walking, but certain movements seem to spin me out, too.
I'm so so glad you weren't more seriously injured!
Sandy Harnagel
I've had PD 3 or 4 years, or maybe more. I've had some falls that my husband and sisters thought I died on the spot. After all this I learned to slow down. I've always been a "fast" person. Changing my gait was hard. But I finally got the message and have slowed down. Many less falls and trips.
Terry Roskovich
Doug Haines in your reply "Balance Issues" you mentioned a good "WA;LKER" what brand/style Walker are you referring to.
Looking forward hearing from you.
K Eugene Thurston
I have had PD since 1994. I am 77 years old and, fortunately no falls. I still work at least 6 hours a day and I exercise at least 4 days a week, including weight lifting and cardio. I find it important to keep active for my mind's sake and exercise to maintain a strong inter core. PD is a 24/7 battle and I refuse to lose!
catherine prow
my husband has stage five and falling is a big problem he has a rollator for many years but now it is too dangerous as turning is a big problem I am thinking of a gutter frame for him and an electric wheelchair I can operate with brakes he is beyond helping himself much now and am interested in the walker you have to see if it may be suitable.
Thanks Catherine