While the risk for falling typically increases with age, an individual’s risk is highly personal, affected by their activity level, medical conditions and other factors. For those diagnosed with Parkinson's disease, the incidence of falls is typically higher than other adults of the same age. Parkinson's disease is a progressive neurodegenerative disorder that affects movement control, balance, and coordination, making individuals more susceptible to falls, no matter their age. In this article, we'll delve into the causes and risks of falling for people with Parkinson's disease and explore why measuring balance is crucial in managing the condition and reducing fall risk. We'll also discuss evidence-based methods for improving balance and mitigating the likelihood of falls.

Understanding the Causes and Risks

Parkinson's disease primarily affects the brain's ability to produce dopamine, a neurotransmitter crucial for coordinating movement. As dopamine levels decline, people experience symptoms such as tremors, stiffness, bradykinesia (slowness of movement), and postural instability. The latter, postural instability, significantly contributes to the risk of falls among Parkinson's patients.

Several factors contribute to postural instability and increased fall risk in Parkinson's disease:

1. Muscle Rigidity: Stiffness in muscles can impair flexibility and hinder the body's ability to make necessary adjustments to maintain balance.

2. Impaired Gait: Parkinson's often causes changes in gait, such as shuffling or freezing of gait, which increase the likelihood of tripping and falling.

3. Visuospatial dysfunction: Some people suffer from the cognitive challenge of moving their bodies in 3 dimensions. This can make it difficult to move around obstacles and can lead to misjudging the distance to a chair while trying to sit down for example.

4. Orthostatic Hypotension: Some individuals with Parkinson's may experience drops in blood pressure upon standing, leading to dizziness or lightheadedness, which can result in falls.

5. Medication Side Effects: Certain medications used to manage Parkinson's symptoms may cause dizziness, drowsiness, or orthostatic hypotension, further increasing fall risk.

Importance of Measuring Balance

Accurately assessing balance is important for effectively managing Parkinson's disease and reducing the risk of falls. By regularly measuring balance, healthcare professionals can track changes in stability over time and tailor treatment plans accordingly. Moreover, individuals with Parkinson's can proactively monitor their balance and take appropriate measures to prevent falls.

While some healthcare professionals, like physical therapists, use functional tests to reveal balance deficits (gait, for example) the ZIBRIO Stability scale can add an important holistic measure of a person’s dynamic postural stability.

The Stability scale provides an age-agnostic and objective measure of postural stability and can be used to evaluate how a particular treatment or drug regimen is affecting a patient with Parkinson’s disease. This allows real personalization of treatment and empowers patients to better understand their balance from one day to the next.

Evidence-Based Strategies for Improving Balance

Fortunately, several evidence-based strategies have been shown to enhance balance and reduce fall risk in individuals with Parkinson's disease:

1. Physical Therapy: Engaging in targeted physical therapy exercises can improve strength, flexibility, and coordination, thereby enhancing balance and stability. Exercises may include gait training, stretching, and balance exercises tailored to individual needs.

2. Tai Chi: This ancient Chinese practice combines gentle, flowing movements with deep breathing and mindfulness. Studies have demonstrated that Tai Chi can improve balance, gait, and overall motor function in people with PD.

3. Dancing: This appears to be helpful particularly in individuals with mild to moderate PD, and appears to deliver both external cues and physical improvement, particularly because dance involves practice turning and moving backwards, which are typically challenging for people with PD

4. Cueing Techniques: External cues, such as auditory or visual cues, can help individuals overcome freezing of gait and improve balance. Utilizing cues such as rhythmic auditory stimulation or visual markers can facilitate smoother and more controlled movements. Smart canes, or devices you can attach to them with visual or audible cues can act to both stabilize and overcome gait freezing.

While Parkinson's disease poses challenges to maintaining balance and mobility, proactive management strategies can significantly reduce the risk of falls and enhance overall quality of life. By understanding the underlying causes and risks of falling, individuals with Parkinson's can work with healthcare professionals to implement evidence-based interventions tailored to their specific needs. Regular assessment of balance and adherence to targeted interventions, including physical therapy, Tai Chi, dancing, cueing techniques, and balance training devices, can empower individuals to navigate their Parkinson's journey with greater confidence and stability. Through a holistic approach to care, we can strive to minimize the impact of Parkinson's disease on daily functioning and promote optimal well-being for older adults living with this condition.

Interested in learning more about how ZIBRIO products can help? Individuals can use Stability Home scales in their own homes. Healthcare professionals can book an introduction call here.