The motor symptoms of Parkinson’s refer to those signs of the disease that affect the body’s movement. There are four hallmark symptoms that are characteristic of Parkinson’s, and are important for diagnosing the neurodegenerative disorder: resting tremor, bradykinesia, rigidity, and postural instability.
People with Parkinson’s also may experience other motor symptoms, such as freezing, impaired coordination, and difficulty speaking. There also are non-motor symptoms associated with the disease.
Because Parkinson’s is a progressive disease, most symptoms will start slowly, and then get worse as time progresses.
In the early stages of the disease, about 70% of patients experience a slight tremor in the fingers, hand, or foot on one side of the body, or occasionally in the jaw or face.
The tremor consists of a shaking or oscillating movement, and usually appears when a person’s muscles are at rest or relaxed, hence the term “resting tremor.” Sometimes a hand tremor can be stopped by keeping the hand in motion or in a flexed grip. The tremor may get worse with stress or excitement and often spreads to the other side of the body as the disease progresses, but usually remains most apparent on the initially affected side.
Bradykinesia, or slowness of movement, is a defining feature of Parkinson’s disease that involves a general reduction of spontaneous movement. This can give the appearance of abnormal stillness and a decrease in facial expressiveness.
Due to bradykinesia, patients with Parkinson’s disease may have difficulties executing repetitive movements and performing everyday tasks, such as buttoning a shirt or brushing their teeth. People who experience bradykinesia may walk with short, shuffling steps. The reduction in movement caused by bradykinesia can affect a person’s speech as the disease progresses.
Stiffness or inflexibility of the muscles of the neck, shoulders, trunk, and limbs is common in Parkinson’s and known as rigidity. It causes the affected muscles to remain stiff and not relaxed, decreasing their range of motion. Rigidity can be uncomfortable or even painful. A person with rigidity and bradykinesia cannot swing their arms while walking.
Postural instability, or impaired balance, is caused by the loss of reflexes that keep people in an upright position. Some patients develop a dangerous tendency to sway backward when rising from a chair, standing, or turning. This problem is called retropulsion and may result in a backward fall. Symptoms of postural instability usually develop later on in the course of the disease.
Other motor symptoms
In addition to the cardinal signs of Parkinson’s disease, there are many other motor symptoms associated with the disease.
People with Parkinson’s may experience freezing, also called akinesia — a lack of movement in everyday tasks. A common manifestation is freezing of gait, when a person temporarily feels as if his or her feet are glued to the floor and hesitate before stepping forward. Freezing may occur in specific situations, such as when a patient is starting to walk, crossing a doorway, or approaching a chair, and it may increase a person’s risk of falling.
Micrographia refers to the shrinkage in Parkinson’s patients’ handwriting. This happens as a result of bradykinesia, which causes difficulty with repetitive actions.
Abnormal muscle tone, or dystonia, manifests as repetitive muscle twisting, spasms, or painful muscle cramps that can occur at different stages of the disease. It usually starts when a person tries to initiate movement with the involved body part, although it can occur at rest. Dystonia usually is an early symptom of young-onset Parkinson’s. Although some people with Parkinson’s experience this motor symptom, dystonia is its own movement disorder and people can experience it without having the disease.
Some people with Parkinson’s disease experience unwanted rapid movements. These involuntary accelerations are troublesome, particularly during speech and movement. People with excessively fast speech, known as tachyphemia, produce a rapid stammering that is hard to understand. Those who experience an uncontrollable acceleration in gait (or festination) are at an increased risk for falls.
Other motor symptoms that also may be experienced by those with Parkinson’s include stooped posture, or a tendency to lean forward, impaired fine motor dexterity and motor coordination, impaired gross motor coordination, and reduced movement, often manifesting as a decreased arm swing.
Akathisia, or a tendency to keep moving, speech problems — including a soft voice or slurred speech — cramping, sexual dysfunction, and difficulty swallowing also are common motor symptoms, along with reduced swallowing movements, which can cause drooling and excess saliva.
Dyskinesia, or uncontrolled, involuntary movements, is not a symptom of Parkinson’s itself, but can be a complication resulting from some medications taken to treat the disease.
Last updated: Aug 18, 2021
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