Hi doctor,
My wife has been suffering from Parkinson's disease for the past seven years. She lives in a nursing home. She needs assistance with walking. They do not make her walk at the nursing home. Is walking necessary to prevent further worsening of gait in Parkinson's disease? What are the mechanisms by which daily walking might preserve further worsening of gait? Will walking helps to strengthen other muscles of the body? She is currently taking Carbidopa, Levodopa, Azilect, Donepezil, Diltiazem, and Levothyroxine. Kindly advise.
Hello,
Welcome to icliniq.com.
Thanks for writing in, and I understand your concern.
It is quite difficult to make the patient walk without support or less support in the case of Parkinson's disease. Due to intake of medicine regularly and as the disease is progressive in nature, the walking ability worsens. Training for walking is important because it helps maintain the mobility of the joints and reduces the atrophy of muscles. It makes the patient become self-independent; atleast the patient will be able to reach out to his or her medicines placed near them.
Bedside mobility exercises should be encouraged with active-free or with support movements of hands, trunk, and legs. You can let the patient be seated on a chair or her bed with back support and perform leg straightening and bending exercises, cycling movements, ankle-toe exercises as well. Standing with the support for balance, walking near the bed and inside the room should be encouraged. Standing with support helps to maintain posture and strengthens paraspinal muscles. Activities like active leg movements, cycling, ankle moves, Thera band exercises, kicking a ball, and balance activities on wobble board can be done. Ambiance modifications can be done to suit the patient.
Gait analysis of the patient should be done on a regular basis. Walking improves circulation, strengthens leg muscles, reduces fatigue, and makes the patient self-independent. Positioning and leg elevation can be done to avoid bed sores and muscle wasting.
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