PARKINSON’S CARE AND SUPPORT UK SYMPTOM TRACKER

Personal Details

*
*
*
*

By using the Parkinson’s Care and Support UK Symptoms Tracker you will be able to consistently track important PD symptoms and how they relate to your exercise regime. This tracker will allow you to identify any changes in symptoms during and after your exercise programmes, which can in turn help you to understand and better manage your Parkinson’s.

How to Use This Tracker

You should complete this form every 8 weeks. Keep a copy and send a copy back to exercise@parkinsonscare.org.uk

In this form, you will be asked to rate how you feel in several specific areas

The areas of focus are:

Motor Symptoms:
  • Tremor
  • Rigidity
  • Slowness of movement
  • Falls and dizziness
  • Balance/Walking difficulties
  • Motor fluctuations/dyskinesia
Non-Motor Symptoms:
  • Fatigue/Sleep disturbances
  • Pain
  • Anxiety/Depression/Memory
  • Swallowing
  • Gastrointestinal Issues/Constipation
*
*

Section 1:

Please rate how the following symptoms affect your daily function before an exercise on a scale from 0 to 5. * 0 Never 1 Rarely 2 Occasionally 3 Sometimes 4 Frequently 5 Always

*
*
*
*
*
*
*
*
*
*
*
*
*
*
*

Section 2:

Please rate what effect an individual class has on your symptoms after an exercise class, on a scale from 0 to 5. *
0.None 1.Barely 2.Small 3.Medium 4.Strong 5.Very strong

Neuro-Physio

*
*
*
*
*
*
*
*
*
*
*

Exercise to Music

*
*
*
*
*
*
*
*
*
*
*

Beat Box Intense

*
*
*
*
*
*
*
*
*
*
*

Zhineng Qigong

*
*
*
*
*
*
*
*
*
*
*

Beat Box

*
*
*
*
*
*
*
*
*
*
*

Mindfulness Yoga

*
*
*
*
*
*
*
*
*
*
*

Gentle Fitness Class

*
*
*
*
*
*
*
*
*
*
*
*
*