Ask the Physical Therapist
Understanding the Body-weight Shift as it Effects Mobility
By Len Norfleet, PT
No matter what your physical status, or the progression of your Parkinson’s, this “rule” can dramatically change your balance, improve your posture, and increase your fluidity of movement.
The Importance of Vision
Where are you looking? Your vision often becomes more important as you age. Accounting for 30% of your natural balance, vision allows you to judge where you are in relationship to the external world. Your visual line dictates your direction while moving forward and backward. Often with balance problems one tends to “double check” one’s position. Although this is a normal reaction, oftentimes with PD one’s gaze tends to remain fixed downward not really looking at anything in particular.
Understanding where to look: First and foremost you must stop that double-checking system that is forcing your visual line down. This downward gaze is the precursor to a shuffling gait (festinating) as well as freezing behavior often associated with PD. Next, find your anterior (frontal) horizon line by focusing your vision level in front of you. It is important that you look and focus on something along this line in order to judge your speed, distance, balance, and progression as you move forward in your gait pattern. For people with PD a great tool is to mark several distinct reference points related to the visual horizon using color or a distinct object.
The Rule of Opposites
When going forward: Look straight ahead, know where you are going, and focus on your direct line of sight. Lean slightly back with your chest, keeping your chin level, and begin your gait. Remember to stay focused and lean back slightly. This may seem counterintuitive, but it really works.
Going backward: (this is the easy part for some of us!) Knowing that your natural tendency is to look slightly downward, lean forward slightly with your chest, keeping your chin level, and step backward making sure that you extend your leg by bending the knee then touching your toe to the floor as you step back. Do not rock back or lean back onto your heels!
Side to Side: When side-stepping to your right, lean slightly to your left, pushing off with your left leg. Do not shift your bodyweight to the right when going right as this will make you catch the edge of your foot and either fall or have to hop to avoid falling. When side-stepping to your left, simply reverse these movements.
Turning: The key to turning without multiple tiny steps (yes I know you all do it) is to step and pivot opposite. To turn to your left, first step forward with your right foot, then turn left and pivot through, being careful not to step forward and turn to your right.
Please practice the strategies often and always with assistance and direction at first to make sure you are safe. I hope the “Rule of Opposites” helps you.If you have question please call or email: Len Norfleet (509) 838-6060 / firstname.lastname@example.org. Remember to keep on moving!
Ask the Physical Therapist is not intended to treat or diagnose any condition. Always consult with your doctor before beginning any new exercise regime. Len Norfleet has 20+ years’ experience in physical therapy and is the owner/founder of Neuro-Kinetic Systems, a specialized movement and therapeutic exercise regiment specifically developed for people with movement disorders.