Muscle stiffness is one of the most common symptoms of Parkinson's disease, and it can significantly affect the quality of life of those affected.
It manifests as resistance to passive limb movements, making it difficult to perform daily activities and affecting overall mobility.
Understanding the causes of this stiffness and available treatment options is critical to improving symptom management and maintaining the best possible quality of life.
What is muscle stiffness in Parkinson's disease?
Muscle rigidity in Parkinson's is characterized by constant, involuntary tension in the muscles, making movements difficult and painful. This symptom results from degeneration of dopaminergic cells in the brain, leading to impaired motor control.
Stiffness can occur uniformly throughout the body or be localized to specific areas such as the neck, shoulders and limbs. It can contribute to the feeling of “stuckness” and difficulty in walking or performing simple gestures, such as dressing or getting up from a chair.
Drug therapies for muscle stiffness
Drug therapies are often the first approach to managing muscle stiffness in patients with Parkinson's disease. The most commonly used drugs are levodopa, which help restore dopamine levels in the brain, reducing motor symptoms and improving fluidity of movement. Levodopa is often combined with other drugs to prolong its effectiveness and reduce side effects, such as carbidopa, which helps prevent degradation of levodopa before it reaches the brain.
In some cases, dopamine agonists, which mimic the action of dopamine, or monoamine oxidase B (MAO-B) inhibitors, which slow the breakdown of natural dopamine, may also be prescribed. However, the efficacy of the drugs can vary from patient to patient, and continuous monitoring is often necessary to adjust the dosage to each individual's specific needs, trying to balance symptom control with reducing long-term side effects.
Exercises and physiotherapy: allies against stiffness
In addition to drugs, exercise and physical therapy play a crucial role in improving muscle stiffness in Parkinson's. Targeted exercises, such as stretching, can help maintain muscle elasticity and reduce tension, improving range of motion and quality of life. Regular stretching, especially of the muscles in the neck, shoulders, legs, and back, is essential to prevent muscle shortening and maintain joint mobility.
Customized physical therapy programs may include stretching exercises, joint mobilization exercises, and techniques to improve balance and posture, such as LSVT BIG therapy, which helps patients perform larger, more decisive movements, counteracting the tendency to take small, stiff steps. In addition, physical therapy may involve the use of equipment such as stationary bicycles, treadmills, or supportive devices to facilitate safe and controlled movements during exercise sessions.
Also activities such as yoga or Tai Chi, which combine slow movements and breathing, can be very helpful in maintaining flexibility and reducing stiffness. These disciplines not only help relax muscles, but also improve body awareness and coordination. Tai Chi, for example, has been shown to be particularly effective in improving balance and reducing the risk of falls, a common problem in Parkinson's patients. Consistent practice of these activities can also contribute to greater psychological well-being by aiding stress management and improving sleep quality.
A regular exercise program, combined with physiotherapy, can therefore be a key element in counteracting muscle stiffness and helping Parkinson's patients maintain greater independence in daily activities. It is important that these programs be followed under the guidance of a trained physiotherapist, who can tailor the exercises to the specific needs of each patient.
Complementary therapies: AMPS therapy
Among the complementary therapies to the treatment of Parkinson's disease, the AMPS therapy, delivered by the Gondola Home medical device, represents an innovative support to improve patients' mobility. This therapy consists of mechanical stimulation applied to specific points on the feet, which activate neurological reflexes involving motor control. Stimulation of plantar receptors helps reactivate areas of the brain such as the sensorimotor cortex, nucleus striatum and cerebellum, helping to improve walking, flexibility, posture and stiffness.
The Gondola Home device, designed for home use, allows patients to integrate this therapy into their daily routine, completely independently. Used two to three times a week, it allows the benefits on mobility to be maintained over time and reduce the sensation of muscle stiffness, without interfering with ongoing drug therapies. It is important for patients to discuss with their physicians the integration of AMPS therapy into their course of treatment, to tailor it to their needs and individual response.
The management of muscle stiffness in Parkinson's requires a Multidisciplinary approach, combining medication, exercise and complementary therapies. Each patient is unique and may respond differently to various treatments, so it is essential to follow your doctor's instructions and tailor the course of treatment to your needs.
With proper management, it is possible to reduce stiffness and regain greater freedom of movement, thus improving quality of life.
References:
- https://www.michaeljfox.org/news/five-ways-help-muscle-stiffness-parkinsons-disease
- https://davisphinneyfoundation.org/rigidity-and-parkinsons-what-it-is-and-how-to-treat-it/
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/physical-therapy-for-parkinsons-disease
- https://www.parkinson.org/sites/default/files/documents/parkinsons-exercise-recommendations-infographic.pdf
- https://www.parkinson.org/blog/awareness/exercise-recommendations
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