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Parkinson’s Disease – Feet

Parkinson’s disease is a degenerative condition of the central nervous system. It is characterised by a deficiency in the brain’s ability to release dopamine. Dopamine is a neurotransmitter that is used to control movement; otherwise known as motor function.

A 2011 report estimates the prevalence as 1 in 350 in Australia. It is a condition that typically affects those over 50, however cases of younger onset Parkinson’s are reportedly becoming more common.

Early stages of Parkinson’s can be detected through numerous signs. These may include reduced sense of smell, handwriting changes, a decrease in facial expression, walking with a smaller base of support and smaller step length, and single sided arm swing while walking. Reduced volume of voice and drooling due to weakening of the muscles in the voice and face may present later on. General rigidity of the muscles, tremor, or repetitive trembling movements, and poor balance are all hallmarks of this condition.

Parkinson’s sufferers require assistance from a number of different healthcare professionals. Podiatrists are typically interested in walking patterns (gait), footwear, and preventing falls.

Parkinson’s gait often includes periods of freezing, where the patient is unable to activate the correct muscles at will. This usually occurs when the patient is looking to take the first step, or when they need to turn. Festinating gait is also often seen. This occurs when the patient is moving. They will take short, progressively more rapid steps, as though they are trying to catch up to the rest of their body.

Falls prevention is a big concern with Parkinson’s patients. As reflexes, balance, and motor control are diminished, a loss of stability can have dire consequences. The patient’s surroundings – such as floor surfaces, furniture placement, and lighting are to be taken into account. In addition, the correct footwear is essential to provide a strong base of support. Strengthening and exercise work is essential to maximise muscular flexibility and strength.