Bradykinesia in Parkinson's Disease

Slowness of movement tends to occur in later-stage disease

Doctor walking with an elderly woman at garden

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Bradykinesia is a medical term used to describe the abnormal slowness of movement. It's one of the three characteristic symptoms of Parkinson's disease alongside tremors and rigidity that occurs in everyone who has Parkinson's.

This slowness of movement is most obvious when a person with Parkinson's is starting or performing activities that require several successive steps. These can include all kinds of activities of daily life, like getting dressed, making a sandwich, or opening a padlock.

Tasks requiring fine motor control (such as buttoning a shirt or using utensils) are particularly slow for someone with Parkinson-induced bradykinesia; reaction times are also slower.

Bradykinesia also can cause someone with Parkinson's to take slow, short steps and shuffle more than walk. The slowing of verbal skills can lead to soft speech, making it difficult for others to comprehend what is being said.

Bradykinesia tends to occur in the later stages of Parkinson's disease. According to a 2016 review published in Parkinson's Disease, tremors are more likely to define the disease in one's 20s to 40s, while bradykinesia and rigidity are largely seen after the age of 60.

Symptoms

When you have Parkinson-induced bradykinesia, you may feel as if your body isn't obeying your brain's commands, at least in the way that they used to. You may feel as if your arms and legs are weaker or that your limbs ache as you try to perform tasks that involve repetitive motion, such as walking.

In some people with advanced Parkinson's disease, bradykinesia leads to a sensation that their feet are stuck to the floor simply because they are unable to get them moving.

You may also have trouble writing or notice that your handwriting is getting smaller and slanting upward to the right. This is a symptom called micrographia which tends to co-occur with bradykinesia. Around 50% to 60% of people with Parkinson's disease will experience some level of micrographia.

Bradykinesia may cause the loss of facial expression (hypomimia), the decreased frequency of blinking, monotonic speech, and drooling due to decreased spontaneous swallowing

Your emotional state can also influence bradykinesia but often in a beneficial way. For example, even if your movements are impaired by Parkinson's disease, there is a phenomenon called kinesia paradoxica in which fear or panic allows you to respond quickly. Fortunately, Parkinson's disease does not destroy the neurologic pathways that facilitates the "fight-or-flight" response.

Diagnosis

When doctors test or bradykinesia, they will ask the affected person to perform rapid, repetitive, or alternating movements of the hand (such as moving the palm up and down, doing finger taps, and gripping objects). People with bradykinesia generally can't perform these actions quickly. The slowness of movement can manifest in awkward gestures or speech and may even affect how often or quickly you can blink your eyes.

Sometimes, bradykinesia is subtle, especially in the early stages of the disease. To detect it, doctors will look for hesitation before the person starts to move as well as reduced arm movements while walking. These are some of the early tell-tale signs.

Treatment

It may be possible to overcome some of the symptoms of bradykinesia through physical and occupational therapy. The programs may involve repetitive exercises such as marching in place or stepping back and forth over imaginary lines. You may also be provided tools (such a voice-controlled rather than manual remote) to aid in your everyday life.

Although Parkinson's disease cannot be cured, medications and other therapies can help manage the symptoms, including bradykinesia. If you're having trouble accomplishing tasks in daily life because of your Parkinson's disease, talk to your doctor about treatments that might help stabilize or even improve your symptoms.

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