Make a simple adaptation to your walker and walk better!
Welcome to Part 2 of my series on exercise and well-being strategies for Parkinson’s: How to Trick the Disease. This week I’ll be showing you how to make a simple adaptation to a walker to improve your gait. Before you attempt this, be sure to check with your doctor to make sure it’s an appropriate strategy for you.
Early on in my pursuit to find exercise strategies and methods to address the symptoms that can occur for people living with Parkinson’s disease, I discovered that by adding visual cues was an extremely effective way in getting my clients to move in larger, smoother and in more consistently coordinated movement patterns. I did some research and found out very quickly that there are numerous studies that validate the phenomena I noticed.
Research has shown that by intruding auditory and visual cues, larger amplitude of movement can be immediately achieved. From the International Encyclopedia of Rehabilitation:
“External visual and auditory rhythmic cues are important features in the treatment of PD, although not widely used in clinical practice. Studies have shown improvement in electromyographic and spatio-temporal parameters of gait in Parkinson’s patients undergoing gait training with auditory, visual and tactile cues.”
Fátima Rodrigues-de-Paula, PT, Ph.D.
Department of Physical Therapy, Universidade Federal de Minas Gerais
Many trainers and physical therapists that are acquainted with current Parkinson’s exercise strategies employ these techniques to make the sessions more effective. If you’re currently working with a physical therapist or a trainer who understands PD, you will have likely performed drills that include auditory and visual cues.
Working with individuals on a regular basis who use walkers and many of whom are fall risks, I’ve always searched for ways that safely and effectively improve movement, stride length and reduce freezing. Training to avoid falls is always first on the list when working with this population.
I discovered the technique I’m about to demonstrate over 10 years ago with my first Parkinson’s client, Joe. Joe had an atypical form of Parkinson’s called vascular Parkinson’s and he was an extremely tough customer. He also suffered from Lewy body disease and to top it off, was an extremely stubborn and head strong individual.
During our sessions together, we would spend quite a bit of time trying to get Joe to walk. Although it was extremely important for him, he hated doing it. Walking is a great way to get the entire skeletal and muscle system weight bearing and involved. Joe disliked doing it. For me, it was like trying to push a boulder up a hill.
Whether we were performing upper body, or lower body exercises, I soon discovered that by swinging a ball to Joe or giving him a target to reach for, the success we had at getting him to participate and getting him to move as instructed was greatly enhanced. It also added a component of fun or play to the session which engaged Joe and allowed me sneak in some meaningful exercises.
One day I decided to experiment with applying visual cues to his walker. I attached a piece of brightly colored exercise tubing to the back legs of the walker about shin high, and instructed Joe to attempt to touch the tubing with his shin as we walked. Joe’s gait changed immediately.