Bradykinesia or slowness of movement is one of the three main signs of Parkinson’s, along with tremor and rigidity (stiffness). Taken from Greek words meaning ‘slow’ and ‘movement’, the term was first used by Dr James Parkinson in 1817. Bradykinesia describes slowness in carrying out, rather than initiating, movements. Up to 98% of all people with Parkinson’s experience slowness of movement.
Bradykinesia is one of the early signs of illnesses or movement disorders such as Parkinson’s or Parkinsonism. It is caused by reduced levels of dopamine in the brain and is often noticed by family and friends before the subject becomes aware of it.
Reduced quality of movement is a sign of Parkinson’s rather than a symptom brought on by the illness. A doctor or neurologist who observes bradykinesia may well suspect that a person has Parkinson’s.
Bradykinesia can affect one limb, one side of your body, or your whole body, which can make you unnaturally still. The condition often varies from moment to moment. This can be frustrating, as good quality of movement can quickly be followed by poor quality.
As movements become slower and more difficult, you tend to move less. Your mobility decreases, which can make the condition worse. Reduced co-ordination and, surprisingly, increased muscle tone, may contribute to bradykinesia. You may start to take slower steps for example. Your muscles have not become weaker, they are just reacting more slowly.
You may hear the terms akinesia and hypokinesia used in relation to bradykinesia. Akinesia means a loss of movement, for example, lack of facial expression or rarer eye blinks. Hypokinesia refers to movements that are reduced in scale, such as the small handwriting (micrographia) or soft voice (hypophonia) associated with Parkinson’s. It is possible to experience all of these conditions.
Diagnosis and treatment
If you suspect you, or someone you know, is experiencing slowness of movement, it is important to see a doctor. Bradykinesia is a feature of a number of illnesses, so it needs to be accurately diagnosed.
Bradykinesia causes difficulties with rapidly repeated movements. To make an assessment, the doctor will ask you to perform rapid, repetitive hand movements, such as tapping your finger and thumb together, gripping and releasing, or moving your palms up and down. Or you may be asked to rapidly tap your foot up and down.
The doctor will investigate your family history and also your medical history, since certain medications can cause slowness of movement. In a few cases, the assessment may involve a test such as an MRI scan, to exclude the possibility of stroke or tumour.
Bradykinesia generally responds well to medication, especially in the early stages of the illness. As with all Parkinson’s medicines, treatment is very individual. What works for one person may not work for another, so your doctor may try several approaches to see what works best for you.
Who can help?
Your doctor will usually be your first point of contact and can help by adjusting your medication. He or she might also refer you to a doctor who specialises in movement disorders.
In some countries, there are Parkinson’s Disease Nurse Specialists or nurses who specialise in neurology who can help.
Once diagnosed, your doctor will probably refer you to a physiotherapist or occupational therapist who will look at your symptoms and recommend exercises and techniques to help with slowed movement.
Physiotherapists can give advice on how to improve the quality of movement during everyday activities, and suggest exercises to maintain or improve muscle tone.
Occupational therapists can also help with changes to your routine to help you stay mobile and independent.
Both occupational therapists and physiotherapists can advise on devices and aids to help with mobility.
The type of therapist you are referred to will depend on where you live, the resources available and your individual needs. Treatment may or may not be funded through your country’s national health system.
How can I help myself?
It is important to keep active despite slowed movement. These suggestions can help you to maintain your independence and mobility:
Continue your usual daily activities as long as you are able.
Avoid reducing your physical activities and maintain mobility as much as possible.
Do the daily exercises that have been recommended to keep your muscles strong and flexible.
Adjust your daily routine to make it easier to continue on your own. For example, do things that require more effort at the time of day you feel most mobile. Build in rest periods during the day.
Make life easier by using helpful devices such as Velcro instead of buttons, elastic waistbands, height-adjusting beds and raised seat cushions, which make it easier to get out of a chair.
Remove or firmly secure loose rugs that may trip you, and rearrange furniture to make it easier to move around at home.
Maintain a positive attitude – this can be very helpful in overcoming all sorts of difficulties.