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Parkinson's Disease

Unexplained improvement.

03/01/2010

Question:

My friend has had Parkinson`s Disease for 14 years and is now severely disabled. He can barely walk, freezes and uses a wheelchair outside of the house; he also has some confusion. However, when he visits the specialist or is being assessed at home (e.g. for physiotherapy) his conditions improved markedly for a brief spell and he is able to do far more than he normally can. This is not linked to the timing of his medication. His wife finds this very frustrating because he is percieved as being far more able than he is and they fail to get the help they both need. She gets very angry with him, but it is not deliberate on his part, and he cannot remember it happening. After these episodes he is left more helpless and exhausted than he is normally. Professionals glibly say they know this happens with Parkinson`s Disease, but an explanation (if there is one) would be most helpful. Thank you.

Answer:

Unfortunately, Parkinson's disease (PD) is a progressive neurodegenerative condition with marked impaired mobility without a current cure. It is not uncommon for walking trouble and mobility to fluctuates in relationship to fatigue, stress, medications, and likely numerous other unrecognized factors. Working with a therapist can often help improve overall mobility temporarily, and it is not uncommon for a therapist to find someone with PD doing better during the therapy sessions as a result the increased activity level. In general, activity has been felt to have a marked influence on overall movement. It is quite common for people with PD to have marked worsening gait and mobility after long periods of sitting, and a good daily practice is getting up to move around at least every 3-45 minutes. There is no good answer to your question, but hopefully this helps.

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Response by:

Punit  Agrawal, DO Punit Agrawal, DO
Assistant Professor of Neurology
College of Medicine
The Ohio State University