In most patients, PD starts asymmetrically: on one side before the other. The asymmetry can appear as a lack of arm swing on one side, a turning-in or out of one foot, or a shuffling or scuffing of one foot. Our feet normally work as a team, so that if one foot slows down, as it does in PD, in time it forces the other foot to slow down as well.
The exercises we emphasize at the Muhammad Ali Parkinson Clinic are ones that force both sides of your body to work together as a team in order to re-establish symmetry. We teach the following:
Walk with your spouse in front of you. She holds the front end of a walking stick in each of her hands, while you hold the back end of the walking sticks in each of yours. The walking sticks link you together like a bicycle built for two. She starts walking, swinging her arms and the walking sticks. This forces you to swing both your arms and to keep pace with her. Your arms and your legs are now working as a team.
Get on your hands and knees. Don’t try this if you’ve had a knee and/or a hip replacement. Lower yourself to the floor on both hands and knees, then “walk” on your hands and knees. “Walking” this way forces you to move both your hands and feet symmetrically.
A variant of this is to “walk” backwards on your hands and feet—this “re-programs” the sensors in your feet, as they’re programmed to walk forward, not backward. This especially helps if you’re having difficulty with balance or if you’re “freezing.” If you’re walking on your hands and feet you can’t fall and injure yourself.
Another variant is to crawl, “commando-style,” using your arms and legs to propel you forward. This also forces you to move both your hands and feet symmetrically. Ride a stationary bicycle. Place a television set on a shelf in front of you, slightly above eye level. This forces you to look up at the television. This, in turn, forces your shoulder blades up and straightens out your spine. Now pedal—you’re moving your arms and legs—symmetrically and in tandem.
Dance with your spouse. When you dance, you hold your partner, one arm around her waist, forcing your pelvis upward, and straightening your spine. The other arm is around her neck, forcing your shoulder blades upward, and also straightening your spine. The music, the rhythm, “takes over,” and you move your arms and legs, rhythmically, symmetrically. Almost every PD patient will tell you they can dance much better than they can walk.
Swim. Some PD patients have difficulty swimming, they don’t move an arm or a leg, and they “tip” to the side if they’re not moving. When you swim, make sure some-one is in the pool with you. Swim the breast stroke—it forces you to keep your eye on each arm, forcing you to move both arms, it forces your shoulder blades up, straightening your spine, and it tones and stretches your intercostal muscles, helping you breathe better.