[ms-protect-content id=”372,292″]In almost two hundred years, as observed by James Parkinson’s in 1817, people with Parkinson’s fall.  It is inevitably that if you have Parkinson’s you are probably going to fall. The major concern with Parkinson’s is falling will impact the quality of life. These falls affect mobility causing minor cuts and bruises to fractures, head trauma or even death.  This is the major fear of my clients and those with Parkinson’s-falling.

Many people blame the cause of PD falls to the motor symptoms as the major factor, which is a contributor to falls.  The main thing for someone with PD is to recognize this which is a first step in preventing falls.  Rigidity (stiffness) bradykinesia (slowness of movement) stooping posture all are contributors to falls.  As the disease progresses the posture deteriorates with a pronounced forward lean and shuffling gate that projects the center of gravity (located just below the navel) outside the base of support (the feet parallel apart standing straight and the shoulders square).  Simple movements like standing, walking, bending now can cause a balance issue with the probability of falling increased.  Therefore it is imperative that an exercise program be developed to strengthen muscles and work on balance for fall prevention.

Every day before I begin with my clients I ask two questions:  How many glasses of water have you drunk and how much sleep did you get?  These two factors are the major issues with having a productive day as fatigue and exhaustion are most common in PD.  Then I’ll ask is there any things I need to know that would cause you stress or out of your normal routine?  These emotional swings and reactions to life are factors that a major impact of the physical abilities of one with PD affecting their balance.

This is an on-going monitoring I do with my clients is their medications.   Be aware of the number of medications taken and the dosage especially after the prescriptions are changed, dosage increased or new medications ones added.  This can cause drug interactions and increase the probably of falls.  The PD recipient may actually be drugged and at a very high risk of falling.  I’ve had this happen on more than one occasion with my clients.  Your Doctor is trying to find the right combination to give maximum mobility and stability. When these medications  provide the base foundation for mobility/stability then an exercise program on balance to reduce the risk of falls is maximize. It is very important to give the Doctor specific feedback on the reaction to medications and the exercise programs you are participating in.

Remember the PD current medication regimen is an on-going process of assessment and adjustment.  The general rule of thumb for medications when it comes to falls is less is best. The best plan would be a program where small adjustments in medication dosages/timing that optimize the PD recipients functionality with consideration of decreasing medication to minimize adverse reactions.

Vision is a factor which can be a risk factor and a cause of PD falls.  It is not un-common for those with PD to have vision problems.  This could be double or blurred vision as well as depth perception.  If you have problems with vision most likely there is a difficulty with balance increasing the probability of falls.

Another factor to consider that we tend to overlook as a risk factor to falls is infections.  Blood stream, urinary and respiratory infections are the most common culprits of infection related falls. These are all common occurrences in PD.  We don’t recognize these as risk factors for falls but an infection can cause low blood pressure making someone dizzy or confusion. So be aware.

It is essential to keep a person with PD as healthy so they can participate in life and daily activities.  Exercise is paramount that it is now part of the PD recipients’ daily routine.

The exercise program should have four parts: strength, flexibility/stretching, balance and forced aerobics (walking, biking, and swimming) these will reduce the risk of falls..

Exercise research on PD is showing that a robust exercise program could be beneficial to neuroprotective or slowing down, stopping or reverse the progression of PD.[/ms-protect-content]