Some science behind the scenes

Movement problems in Parkinson's disease

One of the symptoms of Parkinson's disease is a general problem with movement control   Movement control problems can manifest in the old and people with other diseases, but at this stage there are quite clear indications of the differences.

Do nonmotor symptoms in Parkinson's disease differ from normal aging? 
Krishnan S, Sarma G, Sarma S, Kishore A. - Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India.
Nonmotor symptoms in Parkinson's disease are frequent and affect health-related quality of life of patients. The severity and domains of nonmotor symptoms involved in Parkinson's disease and normal aging have not been compared before.  ….We performed a prospective case-control study to assess the frequency and severity of nonmotor symptoms in patients with Parkinson's disease (n = 174) and age-matched normal controls (n = 128) using the Non-Motor Symptoms Scale.
Nonmotor symptoms in Parkinson's disease were ubiquitous, more frequent, and more severe than in normal aging, particularly in women. …... Age had no effect …... In contrast, in controls, nonmotor symptoms increased with age, and sex had no effect.  Nonmotor symptoms in Parkinson's disease differ from those in aging in frequency, severity, sex predilection, and domain involvement.

The main indicators that a a person has Parkinson’s disease are: 

  • Bradykinesia (slowness of movement) associated with difficulties along the whole course of the movement process, from planning to initiation and finally execution of a movement. This can be any movement from tying shoelaces to eating, writing, or even getting dressed.  The person has severe difficulties with the sequence of movements and any simultaneous movement.  Many things can affect whether a task can be executed including emotional state – so stress can have a negative effect.  If helped and given cues, the person performs a bit better.  There is often an odd series of anomalies noticeable at the early stages, so that some patients are barely able to walk for example, yet can still ride a bicycle. 
  • Rigidity -  is stiffness and resistance to limb movement caused by increased muscle tone, an excessive and continuous contraction of muscles. In parkinsonism the rigidity can be uniform (lead-pipe rigidity) or ratchety (cogwheel rigidity). Rigidity may be associated with joint pain.   With the progression of the disease, rigidity typically affects the whole body and reduces the ability to move. 
  • Postural instability -  is typical in the late stages of the disease, leading to impaired balance and frequent falls. 

 Other recognized motor signs and symptoms include gait and posture disturbances such as ‘festination’  - rapid shuffling steps and a forward-flexed posture when walking.