Acknowledgement
We would like to acknowledge the use of information taken from the Parkinson’s Disease Society fact sheet ‘Falls and Parkinson ’s’ in compiling this information.
Our thanks to Dr W Farid Abdo1for his help in reviewing this article.
Some Parkinson’s drugs may, unintentionally, lower blood pressure and this can cause dizziness and increase the likelihood of falling. If this happens you should ask your doctor or nurse to check your blood pressure both when standing and sitting. Your doctor may be able to advise on medication to help with low blood pressure and dizziness, although this can be complicated due to the possible interference with Parkinson’s medications1.
Some dizziness can be avoided. For example, when getting out of bed let your feet dangle over the side of the bed for a few minutes before standing and then rise slowly. When getting up from a chair, pause for a few moments before walking until you feel steady.
Some Parkinson’s medications can actually aggravate falls by causing dyskinesias and freezing. Again, it is important to tell your doctor if you do have falls so that they can check your medication and make adjustments if necessary.
Your doctor may recommend you visit a physiotherapist. He or she will be able to suggest exercises to help you develop a good posture and gait, carry out confident transfers and keep the muscles and joints flexible - all of which will help minimise the risk of falling.
Dancing the tango can prevent falls. Washington University researchers have conducted two studies (in 2006 and 2008) looking at the effects of tango on Parkinson's patients. Earhart, senior author of the study, believes the dance can slow progression of the disease and helps with balance. People with Parkinson's normally take very short steps and shuffle - when doing the tango, they take long, even steps which help with balance.
There are a lot of things you can do to help yourself (see How can I help myself? ) but there are also experienced professionals who can offer very useful advice. Depending on the country you live in your doctor may be your first contact and they may refer you to another expert. You may also be able to book an appointment direct, although it is likely you will have to pay for this yourself.
In some countries there are Parkinson’s Disease Nurse Specialist or nurses who specialise in neurology who have considerable experience in dealing with falls. Ask your doctor for a referral.
You may also find appointments with a physiotherapist or an occupational therapist helpful. Which therapist you are referred to will depend on the country in which you live, the resources available, and your individual needs. It is hard to generalise, but the following broadly describes the help you may receive:
A physiotherapist will address specific problems related to:
They will give you an exercise programme and strategies to address your specific problems in daily life. Exercises are very important in preventing or reducing muscle stiffness, which will in turn reduce the risks of instability and falling. Good posture is important in keeping your balance and you may be advised on exercises to help with maintaining or improving your physical fitness and posture. Physiotherapists can also train or advise your carer on your exercises and suggest appropriate ways of helping you to move, for example getting out of bed safely, and prevent or reduce your risk of falling. If you have difficulty with specific tasks they can teach you different motor control strategies so that these tasks are as easy and safe as possible.
If you experience frequent falls, a physiotherapist can teach you different ways to get yourself up and moving again, and help restore your confidence.
For more information on physiotherapists please see the Physiotherapy section of this website.
An occupational therapist will be able to help you achieve maximum independence whatever your disabilities or symptoms. They can assess your home and daily routine then suggest ways of making activities as safe and as manageable as possible. Often just very simple adjustments to the set up of your kitchen or bathroom, for example, can make a big difference to your mobility, quality of life and risk of falling. They can also advise on practical aids, equipment or adaptations that might help you, as well as suggestions to improve your ability to carry out specific tasks such as dressing or cooking.
For more information on occupational therapists see the Occupational Therapy section of this website.
If you have a foot disorder a podiatrist will be able to give you advice to help reduce any related distress or disability that may be causing you to fall. They will also be able to suggest the most suitable types of footwear to prevent falls.
Involuntary movements that tend to occur in people who have had Parkinson's disease for some years as a side effect of long-term use of Parkinson's medication.
A symptom of advanced Parkinson's disease where the person becomes ‘glued’ to the spot for a few seconds or minutes before being able to walk.
See section on Freezing.
Health profession that treats people of all ages who have physical problems that occur as a result of injury, illness or ageing. Methods they use include exercise, heat treatments, manipulation and hydrotherapy.
See section on Physiotherapy.
The way we stand or sit. Postural problems, especially a tendency to stoop forwards, are common features of Parkinson’s.
Health profession that helps people of all ages who are disabled, ill or aged to remain independent and lead fulfilling lives at home, in work and through leisure pursuits. The methods they use include specific activities and equipment.
See section on Occupational Therapy.
The care and treatment of the feet (also called chiropody).
A podiatrist (or chiropodist) deals with the assessment, diagnosis and treatment of the lower limb.
Terms used to describe people who look after or provide support, voluntarily and without payment, to relatives, partners or friends who are ill, aged or disabled.
See section on Carers.
Having to do with the movement of a part of the body.
See rigidity
