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PD Take Three: Tips & Tools from the PD Team
How can I lessen my risk of falls with Parkinson's disease?
The Movement Disorder Specialist
On one hand, falls are very dangerous. On the other hand, they are completely preventable.
- Understand when falls happen. Common scenarios include: freezing while trying to pivot, resulting in a toppling to one side; freezing when starting to walk, stepping through a doorway, or approaching a chair, leading to a forward fall; a fall caused by a tendency to lean backwards; toppling while squatting; tripping over an uneven surface; falling on stairs while carrying something in both hands; falling when moving without your walker.
- Assess why falls happen for you. Ask your neurologist to assess your risk by conducting an exam. Review the history and pattern of your falls, perhaps by keeping a diary: What happened right before you fell? Were you rushing?
- Find ways to lessen your risk. Work with your neurologist to adjust medications in order to reduce freezing. He or she may suggest physical therapy, balance exercises or improvement of fitness. Consider using "cues" for freezing, a cane or a walker or — if you cannot stand unsupported — a wheelchair.
Blair Ford, M.D., Professor of Clinical Neurology, Columbia University Medical Center, PDF Scientific Editor, New York, NY
The Occupational Therapist
- Make your floors safe. Remove all throw rugs in the home. If floors are a dark color, wear white shoes to promote contrast. If floors are light, wear black! Use electrical tape on steps to improve depth perception. It is preferable to use a color tape that contrasts with carpet /floor. If you have hardwood flooring, place non-skid strips in front of chairs and toilets to prevent feet from sliding.
- Use adaptive equipment in riskier rooms. Install railings on stairwells. Keep a walker/cane on each level of the home so you don't have to maneuver it on stairs. Place vertical grab bars beside the shower. Replace sliding glass doors in your bathtub with a shower curtain to create more space when you step over the tub.
- Dress for success. Wear shoes that fit your feet. Avoid flip flops or slide-ons. Instead of sitting on the edge of the bed for dressing, sit in a chair with bilateral arm rests. When putting on socks, utilize a sock aid, reacher or a dressing stick. Use a walker tray or basket to carry items around the home.
Stacy Hodges, O.T., Director, Rehab Services, Virginia Gay Hospital, Vinton, IA
The Physical Therapist
- Pursue a serious exercise regimen — one that gets you doing some type of exercise every day. Include a form of exercise that gets your heart rate up — dancing, water aerobics or walking at a good pace with BIG steps. Do balance exercises like tai chi, standing on one leg or shifting weight from one leg to the other. Perform strengthening exercises, especially for your legs and posture.
- Unclutter your home, your office ... and your mind! Clear your floor of objects that are likely to trip you. Rearrange furniture to give you more space to walk. Do not try to do — or to think about too many things at once. Multitasking makes walking more challenging.
- Learn how to walk and move properly — that means seeing a physical or occupational therapist. Stand TALL and look where you are going — NOT at your feet. Take BIG steps and land on your heels. DO NOT PIVOT when you turn — take a BIG step in the direction you want to go. To turn right, step with the right foot first.
Heather J. Cianci, P.T., M.S., G.C.S., founding therapist, Dan Aaron Parkinson's Rehabilitation Center, Good Shepherd Penn Partners, Philadelphia, PA