Bradykinesia

Parkinson’s disease is a neurological disorder in which nerve cells progressively die, resulting in the loss of dopamine, a chemical messenger that relays information between nerve cells, and from the brain to the rest of the body. Reduced levels of dopamine affect the body’s motor function, causing movement disorders such as bradykinesia — a classic symptom of Parkinson’s disease.

What is bradykinesia?

Bradykinesia is slowness or difficulty in body movement and is one of the early signs of Parkinson’s disease. It is reported by approximately 98 percent of patients.

A reduced ability to move is seldom constant, especially in the early stages of Parkinson’s disease. Periods of normal movement can be followed by poor quality of movement, making it increasingly challenging for patients to carry out normal activities. It can affect the whole body, just one side of the body, or only one limb. The unpredictability of its onset negatively impacts a patient’s quality of life.

Small or cramped handwriting (micrographia), movement hesitation, reduced arm swing while walking, and reduced blinking may be subtle signs of bradykinesia. Patients may sometimes experience reduced movement (hypokinesia) or a complete loss of movement (akinesia).

Diagnosis of bradykinesia

A neurologist or physician trained in movement disorders can help diagnose bradykinesia.

The patient’s medical history can help the doctor rule out any medications that could cause reduced movement. A detailed review of the patient’s family history is also crucial to make an accurate diagnosis.

People experiencing bradykinesia have the most difficulty with quick repetitive movements. Doctors may order a motor exam, which assesses the patient’s movement abilities. The test may ask the patient to either clap, form a grip and release, rapidly tap the thumb and index finger in a pinching motion, or tap the foot fast to determine movement quality.

An MRI may be recommended to eliminate other likely causes of bradykinesia, such as a tumor or a stroke.

Managing bradykinesia

Physical therapy plays a vital role in managing bradykinesia. Exercise is essential to maintain movement and slow down the progression of bradykinesia. An exercise regimen that can improve muscle tone and quality of movements should be planned in consultation with a trained physiotherapist.

Occupational therapy can help adjust the patient’s daily activities so that they can continue to remain independent and mobile despite poor movement quality. Occupational therapists can also recommend gadgets and technical aids.

Parkinson’s disease medications that help increase the levels of dopamine — such as levodopa, dopamine agonists, and MAO-B (monoamine oxidase-B) inhibitors — can also help alleviate bradykinesia.

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