I am 82. I have had a minor stroke and have Parkinson’s disease. The main problem seems to be my balance. When I walk it is difficult to put my heels down first. And I find it hard to straighten my legs after sitting for a while. Could you suggest any way to improve my mobility and balance?
Parkinson’s disease and stroke both upset the links between brain and body, creating a wide and sometimes distressing range of physical problems in doing everyday tasks – including things that are normally completely automatic.
Stroke usually affects one side of the body, immobilising or weakening it. This causes you to make many changes in the way you move, so that you become gradually lop-sided, favouring your good or stronger side. This alone will cause balance problems.
Parkinson’s disease also increasingly affects balance, and crucially, your ability to react quickly and instinctively to something like a trip or stumble. This will leave you at greater risk of a nasty fall.
The most disabling aspect of Parkinson’s disease is how it “freezes up” your muscles, making all movement slower and sometimes making it impossible to get started on moving at all.
Without knowing much more about you, I cannot give you specific exercises, because the physical effects of your combined conditions will be unique to you. An advanced fitness instructor should be able to set you a suitable exercise programme: ask your GP surgery or council leisure department for names of qualified local trainers. Here are some general exercise priorities for you:
Stay upright: it is vital that you work hard on keeping good posture, whether sitting, standing or walking. If you stoop forwards and walk without putting your heels down properly, your centre of gravity and steadiness will be undermined. It is possible to teach yourself to walk better, so try to make the effort (see below).
Do stretching: to combat the stiffening effects of tight muscles, you should stretch every day. Even doing some in bed first thing will help to ease your mobility once you get up. To help with your heels, do calf stretches sitting on a kitchen chair: sit near the front and put one leg out straight in front with the heel resting on the ground. Then hook at towel round the foot, and holding the ends of the towel in both hands, gently pull your foot towards you, holding the stretch for 20 seconds or more, once you feel the calf tensing up. Remember to keep breathing throughout. Other stretches that are particularly important are chest, front and back of your thighs, neck and shoulders.
Keep moving: despite the difficulties, it is very important to keep your body moving, and regular exercise will help. The Parkinson’s Disease Society has an excellent home exercise booklet, “Keeping Moving”, with clear instructions and photos. It covers mobility and balance, as well as advice on how to improve your walking. Click here to find out more, download the book or order an accompanying exercise DVD.