Door frames


#1

So, when mum is having a shuffling episode and her feet refuse to move it seems a major hurdle is going from one room to another. It seems that the join in the carpet or door frame, although not a physical barrier causes a mental block for her.

Does anyone else have this issue as if I can get some advice it could really make a difference to her.


#2

Hi @Bow2,

This symptom that you’ve described is actually quite common among people with Parkinson’s.

Floor coverings can sometimes be a hazard. For example, carpet patterns can be visually confusing. The best thing to do would be to speak to an occupational therapist or physiotherapist about applying strips of tape or plastic footsteps on your mum’s carpet. These can guide her in places she may be more likely to fall, such as in doorways. There’s more information on this on our website here - https://www.parkinsons.org.uk/information-and-support/falls-and-dizziness

I hope you find this information useful, however, if you’d like more support on this, please give our helpline a call on 0808 800 0303 from Monday-Friday: 9am-7pm, Saturday: 10am-2pm, or you can email [email protected].

Best wishes,
Reah


#3

That is brilliant, thank you so much. I’m so glad I’ve find this forum. It really helps to ask questions that only those involved in PD can understand.

Thank you


#4

Hi Bow2. As already suggested I would see an OT or physio who specialises in PD. There are many techniques that can help with this common problem but different people respond better to different things. Programs such as PD Warrior and LSVT Big are great at helping people use internal strategies and getting people to think big and powerful with their movements - helping to overcome shuffling and freezing to some degree. Visual prompts such as lines of tape work for some people but this won’t help when they’re not in their own environment. Marching on the spot, stepping while counting, walking to a beat are all good for more advanced difficulties. If you can’t get a therapist through the NHs to see you at home I think it’s worth finding a private one. A good therapist will be worth their weight in gold. Hope you find something that works!


#5

Hi,
I know a fellow sufferer who has to waltz through doorways.
My problem is doorways with ramps. Even slight ramps cause me to hesitate.
My local pharmacy has ramps but fortunately there are two doorways and I find I can go in one and out the other. Going up ramps is OK, just not down. Medication has helped.

Occupational Therapists are great for helping you find a solution that works.

Jim


#6

I remember when I was visiting a friend in Palestine. I didn’t have my trike so I had brought a cane. One day I was walking about the place ok practicing my pidgin arabic, but the next I struggled to make it to the corner shop. I had to keep kicking the cane to get my legs moving. When I started to freeze my friend tried giving me a push up the hill. Not a good idea as you are likely to keel over as postural stability impaired.

I used to go to a Dance for Parkinson’s group and at the end we would form a circle and hold hands. My legs would start to tremble as if they were revving up to charge in for the Hokey- Cokey.

Before I got my new walker I was pushing a wheelchair around to help my balance and for ‘just in case’ when my walking got too slow or I froze. I was about to go through the security frame at the airport. They took the wheelchair round the side. Then the woman beckoned me forwards, warning me to be careful not to touch the sides. This froze me to the spot as my arms can to fling about when I’ve got nothing to hang onto and I thought I might set the alarm off.

My speech had frozen too so I was just standing there getting tearful, trying to explain what the problem was through mime – that my eyes were telling my brain that THE frame was too narrow so my legs would not move. Eventually they twigged and opened the door at the side to let me through – of course I managed that perfectly fine.

Another time I had taken a cab for a dental appointment. Unfortunately the driver took a wrong turning in the one-way system. I’ve got akathisia and I can’t stand having to sit doing nothing so as he farted around trying to figure out which way to go I was getting more and more stressed. When I finally got out of the cab I stood in the middle of the zebra crossing and froze. A very kind lady actually got out of her car and helped me across the road .

The most stressful freeze was when I was visiting Pals (PATIENT ADVIcE AND LIAISon service). I think it was my third visit trying to get a neurology appointment. The woman’s face just said ‘haven’t you got the message - what are you doing here again?’ No she couldn’t help me. No the consultant didn’t want to see me again. I put my arms on the counter to show her my rest tremor and it was “I’m not a clinician”.

My whole body was shaking by this time. I turned to leave and couldn‘t move. She looked at me like ‘Are you expecting ME to help you?’. Then she realized that for me to leave the office she would have to physically help me. She even had to go and find my trike, which someone had moved. “She needs it.” she said to the security guard, pleased at her sudden transformation into Florence NightingaLE.

Freezing Phenomenon, the Fifth Cardinal Sign of Parkinsonism Nir Giladi, Stanley Fahn Progress in Alzheimer’s and Parkinson’s Disease ed Fisher et al Plenum Press 1998 Vol. 49 of the series Advances in Behavioural Biology pp329-335

Charcot (1877) appears to have been the first to describe the freezing phenomenon – both start hesitation and freezing when arising – in patients with PD.

Wechsler 50 years later I(1927) gave the first detailed description of start hesitation in a parkinsoniaN Patient, and during the next 40 years, in the pre-levodopa period, freezing was mentioned by several authors as part of parkinsonian akinesia (Luria 1932 , Schwab 1954; Martin 1967)

Schwab et al (1959) were the first to include start hesitation as part of parkinsonian “akinesia” and to use the term “freezing” for the “difficulties patients experience shifting from one motor task to another”

…It seems to be part of the general slowness of movement (bradykinesia) seen in PD or more precisely related to abnormal execution of complex motor tasks such as repetitive, simultaneous or sequential motor acts (Schwab et al 1954, Marsden , 1989)

Pathophysiology of Motor Dysfunction in Parkinson’s Disease as the Rationale for Drug Treatment and Rehabilitation F. Magrinelli, A. Picelli, P. Tocco, A.Federico, L. Roncari, N. Smania, G. Zanette, and S. Tamrin Parkinson’s Disease Vol. 2016

The hypotheses on FOG [freezing of gait] pathophysiology have recently shifted towards a multisystem dysfunction, where cognition plays a significant role. Although gait has been long considered a low-level automated motor activity that requires minimal higher cortical functions, growing evidence suggests a role for cognition, especially attention and executive functions in gait control.