Muscle Rigidity in Parkinson’s

Rigidity, or the stiffness and inflexibility of the limbs, neck or trunk, is one of the primary motor symptoms of Parkinson’s Disease (PD), although not all patients with PD experience rigidity. In Parkinson’s, rigidity can prevent you from moving easily, and this lack of easy movement can lead to more stiffness in a downward cycle, this symptom can cause discomfort or pain in your muscles.

The other main primary motor symptoms are tremor, particularly when the limb is at rest, postural instability, impaired balance or difficulty standing or walking, and bradykinesia, gradual loss and slowing down of spontaneous movement.

Muscles usually stretch when they move and relax when they are at rest, and rigidity causes the muscles to remain stiff and unable to rest. When your muscles are rigid and you’re having trouble moving them, it leads to several problems.

Along with bradykinesia, rigidity may cause the following problems for someone with Parkinson’s:

The inability to move your arms or legs very far, which means you’ll take shorter steps and may not swing your arms as you walk. This can lead to problems with balance, even if it doesn’t affect the “balance centers” in the brain. You might find it difficult to do things that require small, careful movements, like button a shirt.

When your doctor tries to move your arm or leg around, it may move in a jerky “cogwheel” manner rather than having your movements feel “fluid-like” it seems like they occur in several, jerky steps.

You may have trouble with normal facial expressions, leading to a masked or blank expression. Rigidity can interfere with normal communication both by the masked face appearance leaving others uncertain of your emotional reaction to the conversation and by changing the appearance of your written words as well. This expression can, in turn, affect your relationships, as your facial expression may suggest that you feel differently about a situation based on body language.

If your face is rigid and mask-like, a speech therapist may be able to help you exercise those muscles and keep them more flexible. It’s best to start this type of therapy soon after your diagnosis to have the most success with it.

Rigidity is worsened by voluntary movements on the other side of the body. For example:

  • Stiffness in your left arm and shoulder may be enhanced when you use your right arm.
  • Pain and muscle cramps may occur on top of an already present feeling of tightness.
  • The constant tenseness of the muscles can lead to aching.
  • Axial rigidity may cause your spine to be curved, and you may stoop. Unfortunately, this stooped posture can cause more stiffness and rigidity and also increases the risk of falls.

Stress, anxiety and depression can all worsen motor-symptoms and make rigidity worse. If you suffer from any of these, treating this can ultimately improve rigidity and even tremor.

The muscle rigidity in Parkinson’s Disease can impact every area of your life. Going through a normal day, rigidity affects mobility by making it difficult walking, turning, with the stopped posture disrupting the normal way in which landmarks are used to navigate safely. Eating can be affected, and even getting out of a chair or turning in bed can be difficult.

Treatment

Thankfully, treatment can improve the quality of life for most people. Thinking about an ordinary day, however, is a good reminder that treatment goes beyond using medications to help with the symptoms and methods to help adapt to the symptoms that cannot be controlled. It includes educating family and friends about Parkinson’s Disease along the spectrum from the difficulty in interpreting facial expressions to the importance of fall prevention.

Exercise

Regular exercise can keep your muscles more flexible and will keep you moving generally. Although it can be difficult to get motivated to exercise, especially if your muscles don’t want to cooperateIncreasing everyday movement can help improve motor symptoms, which in turn helps prevent stiff muscles. Exercises such as Yoga, Tai Chi and Qigong are really important to practice. As problems with mobility directly links to risk of falls in PD, practicing Yoga, Tai  Chi and Qigong can improve functional mobility and how a person with PD walks. Standing yoga poses target the hip extensor, knee extensor and ankle plantar flexor, which support centre-of-mass during walking and may improve overall stability.

Balance training is an important component of any PD therapy. Research shows Tai Chi-related improvements in balance and an associated reduction in fear of falling; this can also help keep people with PD active in their community for longer.

While any level of physical activity can be beneficial for Parkinson’s Disease, recent research suggests that high-intensity interval training, or HIIT, is also more effective at improving a range of Parkinson’s symptoms. One study in Poland showed that HIIT could alleviate the rigidity and excessive muscle tone that makes it difficult for Parkinson’s disease patients to move their arms and legs. The researchers, from the University School of Physical Education in Krakow, Poland, showed in 11 patients with mild to moderate Parkinson’s symptoms that eight weeks of HIIT, three times a week, on a stationary bike had a global benefit, improving both lower and upper body function.

A HIIT session generally involves 30 to 60 seconds of hard exercise near the top of a person’s limit, followed by an easy recovery exercise for the same amount of time. Then the process is repeated for about 20 minutes. One convenient feature of HIIT is that it can be adapted to exercises many already do, such as walking, jogging and cycling.

We have recently launched a new Beat Box INTENSE exercise, which provides a high intensity boxing workout to music. Find out on our FREE exercise classes on: https://parkinsonscare.org.uk/exercise/

Physio

Working with a physical therapist can be very helpful in designing a routine, as well as to learn more about how to improve your balance and reduce your risk of falls.  Physical therapists can help you optimize your exercise routine, re-learn challenging tasks or stay safe and independent in the home. Some of the most common movement goals for people with Parkinson’s include:

  • Learning about exercises
  • Improving walking, balance or posture
  • Addressing fall risk
  • Treating pain

Some drugs prescribed for Parkinson’s Disease can help to reduce rigidity with the consequences of side effects.

All prescribed medications can have potential side effects, including those used to treat Parkinson’s. It is often that side effects of medication are often confused to be symptoms of Parkinson’s. Some people’s side effects will have a big impact on their lives and have to be kept under control along with the symptoms.

Tips

The following suggestions may help:

  • Continue your normal routine and daily activities as long as you are able.
  • Follow a simple exercise programme to keep your muscles flexible and strong.
  • Adjust your routine so that you do things that might tire your muscles when you feel least stiff.
  • Remove or firmly secure loose rugs that you can trip over, and rearrange furniture to make it easier to move around at home.
  • Maintain a positive attitude – this can help with all sorts of difficulties.

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