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Parkinson’s disease (or Parkinson’s disorders) makes movement for several people difficult, due to which they can fall. While most of the falls might result in minor scrapes, a few might have a life-altering impact on their mobility. Recently, Colum MacKinnon, a renowned name in Parkinson’s research, conducted a webinar where he described why trouble moving can contribute to falls and how to lessen the risk. In this blog, we will share key points from the webinar.

Fear Of Fall

As Parkinson’s disease progresses, it creates several problems, including gait difficulties and postural instability. When combined with the gradual decrease in muscle strength due to aging, they can develop a life-altering illness. These complications can lead to falls when the individual is trying to take a turn, bend, initiate walking, and avoid obstacles.

If these falls occur frequently, the individual will begin to develop a fear of falling. And these falls occur in two-thirds of the cases of Parkinsonian disorders. Once the fear of falling sets in, they choose to decrease their movement. As individuals decrease their physical activity, it leads to muscle atrophy, cognitive decline, and decreased cardiovascular fitness.

All these factors have an impact on the overall health and well-being of an individual. It makes the extensors, which help straighten joints, and the flexors, responsible for bending them, weaker. It has been reported that people with Parkinsonian disorders usually have much weaker extensors and flexors. All these factors make individuals with Parkinsonian disorders more susceptible to falling. It is a problem that can be scary and have serious consequences.

But another way to look at this is that these individuals are making their day-to-day lives difficult by not exercising. But if they exercise with a large range of motion, it will strengthen their muscles. In addition, they force the brain to build new synapses and build up their daily-use muscles to a great extent, which can help them do simple tasks like walking and getting out of bed with more stability.

Advancells Patient Stories

Tips To Master Fall Prevention In Parkinson’s Disease

Margrethe Stege had been living with Parkinson's disorder since 2007, and she saw many ups and downs. As she advanced in the latter half of her life, she started to find it challenging to carry out everyday tasks. In her attempt to fight back, she learned about Parkinson's stem cell treatment. Although they are in clinical trials, she wanted to undergo the treatment to better manage her conditionControl The Upper Body

Too often, when we think about how to keep people from falling, we focus on their legs and feet. For people with Parkinson’s, handling their upper body is harder.

The two-thirds-two-thirds problem is something that all people have to deal with. It means that two-thirds of your body mass is two-thirds of your body height above the ground. There is a natural instability here. We do not think about getting past this every time we take a step. When you are standing, your center of mass is inside your base of support. When you move, however, it moves outside of your base of support. Controlling this big mass up high is what makes it hard to keep your balance and walk. With Parkinsonian disorders, this problem is made worse.

 

Strength Training And Movement

Progressive resistance strength training means adding more weight properly over time. Do this at least twice or three times a week for 20 to 60 minutes. As needed, keep adding weight and work out all of your major muscle groups, from your head to your toes.

  • Work out all of your major muscle groups, but pay special attention to:Strength Training and Movement
  • Those that stretch (ankle, knee, hip, and back)
  • Flexors and extensors of the hip
  • Abductors and adductors of the hip

It may be best for you to do progressive strength training along with:

  • When you use an uneven surface to build muscle groups, like a wobble board or a stability ball, this is called instability training.
  • Activities that help you be more flexible, like yoga and stretching, involve moving your body in a lot of different ways.

Recognize Falls Risks

Falls in Parkinson’s disease can cause significant disability and loss of independence. While aging may put us all at an increased risk for falling, the risk of hip fracture is four times higher in people with Parkinsonian disorders. The severity and frequency of falls can increase as Parkinson’s progresses.

The consequences can include fear of future falls, injury, reduced quality of life, and high levels of stress for care partners and loved ones.

About 80% of the falls in Parkinsonian disorders are due to postural instability (difficulty maintaining balance while standing or walking) and episodes of “freezing” of gait, which is the temporary, involuntary inability to move.

Freezing initially responds well to levodopa dopamine replacement therapy but can become medication-resistant over time. Deep brain stimulation (DBS), which involves surgically implanting small electrodes into specific brain regions, can also reduce or eliminate freezing, but for many, freezing eventually returns. Establishing early exercise habits is critical.

People with Parkinsonian disorders fall most frequently during:Recognize Falls Risks

  • Turns
  • Bending forward
  • Standing up
  • Initiating walking or trying to avoid an obstacle

Self-induced movements of the center mass are the dominant cause of PD-related falls. The first step of people with Parkinson’s is often too short and even shorter for those experiencing freezing. This combination shrinks the base of support for your body’s trunk. When your trunk gets ahead of your feet and your step is too small to balance it all, the likelihood of a fall is higher.

Physical and occupational therapy can improve balance, posture and sense of position to minimize freezing and falls. LSVT BIG is a PD-specific treatment that focuses on making big movements with vigor and intensity and practicing awareness of your legs, trunk and feet.

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What About A Treatment Option?

Currently, there is no cure for Parkinsonian disorders, but several management and treatment options are in different stages of clinical trials. The researchers are exploring medicines like Buntanetap tartrate, which is in Phase III trials, and cell therapy utilizing adult mesenchymal stem cells, which is also showing promise in Phase I trials. In their initial testing, they have shown that they are quite plausible. These treatment advancement options give a glimmer of hope for treatment in the near future.

But what are some ways an individual can manage Parkinsonian disorders? There are several options, including physiotherapy, exercise, and enrolling in clinical trials, including stem cell therapy. If you have a Parkinsonian disorder above the age of 60, you may be able to join a clinical trial. If you wonder if there are cases where Parkinson’s stem cell treatment has shown improvements, then let’s discuss how Margrethe Stege (82) continued her fight against Parkinson’s.

Margrethe Stege’s Fight Against Parkinson’s Disease

Margrethe Stege had been living with Parkinson's disorder since 2007, and she saw many ups and downs. As she advanced in the latter half of her life, she started to find it challenging to carry out everyday tasks. In her attempt to fight back, she learned about Parkinson's stem cell treatment. Although they are in clinical trials, she wanted to undergo the treatment to better manage her conditionMargrethe Stege had been living with Parkinson’s disorder since 2007, and she saw many ups and downs. As she advanced in the latter half of her life, she started to find it challenging to carry out everyday tasks. In her attempt to fight back, she learned about Parkinson’s stem cell treatment. Although they are in clinical trials, she wanted to undergo the treatment to better manage her condition.

Her symptoms, such as tremors, difficulty changing positions, and difficulty walking, are common symptoms linked to Parkinsonian disorders. In her own words:

“As most other Parkinson’s patients, I began to feel that walking became difficult; I felt restless, had gastrointestinal problems, had tremors, and had problems with balance; for instance, I could not walk backward.”

In her treatment, stem cells were extracted from her adipose tissue and bone marrow. Then, these stem cells were provided to her intravenously, and she returned home on the same day. At home, she followed a routine of exercise for recovery. Three months after Parkinson’s stem cell treatment, she had the following to say:

“….I am very happy with the results and improvements after my stem cell treatment….”

Overall, she saw improvement in her symptoms, and she is able to live a better lifestyle. You can read her complete story here.

Last Words

While Parkinsonian disorders make movement and balance challenging, they don’t have to dictate your life. By prioritizing upper-body control, strength training, and exercise regimens, individuals can significantly reduce their risk of falling and maintain independence. Managing Parkinson’s is a multifaceted approach, and you can achieve this by combining physical therapy, exercise, and staying updated on the treatment options. Remember, you are not alone in this fight. 

Disclaimer: This article is based on A Balancing Act: Freezing and Fall Prevention in Parkinson’s, presented by Colum MacKinnon, PhD, Professor, Department of Neurology, Institute of Translational Neuroscience, University of Minnesota. The Story of Margrethe Stege is shared to showcase the effect of stem cell therapy in the management of Parkinson’s disease. This information is for educational purposes only and is not a substitute for professional medical advice. Please consult your healthcare provider for diagnosis and treatment decisions. You can connect with our experts for a free online consultation by sharing your contact details with us.

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