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In January this year, I wrote about how I was starting to experience festinating gait when I woke up each morning. My feet would shuffle along the floor as if my shoelaces were tied together, and this lasted until my first round of meds kicked in, about 30 minutes later. As I walked around the house I had to hold on to furniture, countertops, and doorways. There was severe likelihood that I could fall, and indeed, I fell twice.
However, I found that I could control this problem if I worked out for an hour on a spin bike, pedaling at a cadence of 100 rpm or higher, or if I had my twice-a-week ping pong lesson. As long as I was physically active five days a week, I could walk with no disturbances the moment I got out of bed.
Then I entered an active phase at my job, and I didn’t have time to work out often. Festinating gait reared its ugly head again. I had my first fall in May and another in June. By that time, my legs muscles were so weak I could no longer pedal over 100 rpm on my spin bike. Furthermore, my ping pong teacher left New York to compete in the Tokyo Olympics. I was back to shuffling my feet every morning and sometimes at night if my meds wore off before I went to bed. If I needed to use the bathroom in the middle of the night, I would crawl on my hands and knees.
What to do?
As before, I fought back and believe I’ve mostly cured myself. I rejoined my local gym and started working out with weights again. I focus on strengthening my legs (see photo above – I’m leg pressing 240 lbs), but I also work on my arms, shoulders, and abs. If I work out five to six days a week, my stride in the morning is strong and confident. However, if my work life gets super busy or I get pulled into other projects, I neglect going to the gym and I’m back to those dangerous, mincing steps in the morning.
This training regimen is working for me at the moment, but who knows how long I can stay on top of the situation? I’ve also resumed riding a spin bike at the gym or home (an hour per session, pedaling over 100 rpm), and my ping pong teacher finally returned from his Olympics experience; we’ve resumed my lessons.
I must say, when my legs are working fine as soon as I wake up, my life seems rosy. But my rosy attitude is somewhat tempered by what I’ve read in the academic literature. One article I found, “Falls and Freezing of Gait in Parkinson’s Disease: A Review of Two Interconnected, Episodic Phenomena,” offers scary facts about falling.
To wit:
Balance is typically preserved early in the course of idiopathic PD, and falls are rare during the first few years after disease onset. However, eventually most patients will sustain recurrent falls.
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Most falls in PD are intrinsic in nature, that is, they are caused primarily by the underlying balance disorder and not by an obvious environmental cause such as collision or loose rug on the floor.
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The mobility problems related to falls…have a devasting impact on the patients’ lives…Hip fractures are perhaps the most feared consequence of falls, as these are associated with a high morbidity and mortality in PD and commonly lead to nursing home admission. Within 10 years after diagnosis of the disease, approximately 25% of patients will have developed a hip fracture.
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A common, yet frequently overlooked, consequence is a fear of future falls, which can be incapacitating in its own right as it leads to restriction of daily activities…Not surprisingly, falls in PD are often associated with depression.
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Well…what to do?
I’ve started keeping track of my gym workouts on this website’s calendar. (It goes back only to September – my previous calendar is no more.) I hope it keeps me laser-focused on regular workouts. Follow along, if you want!
Note: Since I wrote this post I have still been exercising, but I’ve “fallen” behind on updating my calendar. I’ll get back to updating it soon.
