Parkinson’s disease is a progressive nervous system disorder that affects the movement of arms, legs, and other parts of the body.
Rigidity refers to abnormal stiffness in the limbs or other body parts, which prevents muscles from stretching and relaxing. It can occur on one or both sides of the body.
Rigidity is one of the four main motor symptoms of Parkinson’s disease. The other three are bradykinesia (slowness of movement), tremors (involuntary and uncontrollable movement of arms, legs, hands, or other body parts when at rest), and postural instability (impaired balance, or difficulty standing or walking).
How rigidity affects patients
Characteristics of rigidity in Parkinson’s disease patients include:
- Stiffness or inflexibility in muscles
- Pain and muscle cramps
- Fixed, mask-like facial expression because of rigidity in facial muscles
- Inability to swing arms while walking because of tight and stiff muscles
- Problems turning around, getting out of chairs, and turning over in bed
- Difficulties in writing, cutting food, or doing up buttons
- Difficulty in sleeping at night due to stiffness and reduced mobility in bed
- Aches or pain in the affected muscles or joints
- Stooped posture commonly associated with Parkinson’s disease
Clinical diagnosis of rigidity
A doctor will test for rigidity by flexing and extending the patient’s relaxed wrist and elbow joint, and look for sustained rigidity or intermittent (cogwheel) rigidity if tremors are associated with it.
Clinically, Parkinson’s rigidity is characterized by increased muscle tone during examination using passive movement of the affected body parts. Parkinson’s rigidity is more marked in flexor muscles (which contracts to bend hands, arms, legs, or other parts of the body) than extensor muscles (a muscle that, when relaxed, extends or straightens hands, arms, legs, or other parts of the body). Rigidity may be enhanced by voluntary movement of other body parts and is more pronounced during slow stretching rather than fast stretching. These features help to differentiate Parkinson’s rigidity from spasticity, which becomes worse during fast movements.
Treatment and management options
There are several treatment options available to alleviate the motor symptoms associated with Parkinson’s disease. Most of them also help Parkinson’s patients overcome issues related to rigidity. These include:
- Medications such as levodopa (administered with carbidopa), dopamine agonists, anticholinergics, catechol-O-methyl transferase (COMT) inhibitors, and monoamine oxidase-B (MAO-B) inhibitors. One treatment or a combination of treatments is commonly prescribed to Parkinson’s disease patients to improve motor problems, including rigidity, that occur due to dysfunction in dopaminergic neurons.
- Physiotherapy to improve mobility and the range of movement in muscles and joints, and to alleviate the muscle cramps common in Parkinson’s disease patients. An occupational therapist or physiotherapist can advise on daily routines, exercises, and the use of assistive devices, such as walkers or canes, to help the patient stay as mobile and independent as possible. Occupational therapy is generally needed for patients to perform daily activities more effectively, such as rolling in bed or getting up from a chair, for example. Regular exercise and stretching can strengthen muscles and maintain flexibility.
- Speech therapy that teaches facial exercises to help with speech and communication.
- Deep brain stimulation for Parkinson’s disease patients whose symptoms are not adequately controlled with medications and/or exercise.
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