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Bradykinesia (Slowed Movements)

Reviewed by: HU Medical Review Board

One key movement (motor) symptom of Parkinson’s disease (PD) is bradykinesia, or slowed movements. The slowing of movements in PD can make it challenging to move around. A person with bradykinesia may take longer to perform everyday bodily movements, such as lifting the arms and legs. Bradykinesia can also be seen as a decrease in facial expressions.1

Not everyone with PD experiences the same symptoms. However, all people with PD develop bradykinesia.1

What does bradykinesia look like?

People with PD have symptoms that vary in severity. The severity of symptoms changes over time, and they get worse as the disease progresses. Bradykinesia may show up in different ways, including:1,2

  • Generalized slowness in movements of the body
  • Trouble with automatic movements, like blinking
  • Short, shuffling steps when walking
  • Problems with everyday activities, such as getting dressed, cutting food, or brushing teeth
  • Less swinging of the arms when walking
  • Difficulty starting movements, such as standing up from a chair
  • Speaking in a voice that is softer than average (hypophonia)
  • Smaller writing (micrographia)
  • Speaking with no variation in pitch or a monotone voice
  • Mask-like appearance to the face (hypomimia)

Why does PD cause bradykinesia?

The basal ganglia and motor cortex of the brain are responsible for movement. The motor cortex and basal ganglia are a group of cells in the brain that help regulate movement and help us plan specific actions, like buttoning a shirt. The basal ganglia works with the motor cortex to send messages to muscles to be activated.3,4

Over time, PD gets worse (progresses). This causes the impulses from the basal ganglia to become weaker. This leads to less communication between the basal ganglia and the motor cortex, resulting in less coordination and cooperation of the muscles. The result is bradykinesia or slow muscle movement.3,4

Treatment

There is currently no cure for PD, but therapies can help manage symptoms like bradykinesia. These include medicine, surgery, and complementary or alternative medicine.1

Most people with PD start taking medicine to manage their symptoms. Different types of therapy are used to treat bradykinesia. The most common treatments are:1,3

  • Levodopa/carbidopa
  • Dopamine agonists
  • Anticholinergics
  • Amantadine
  • MAO-B inhibitors
  • Physical and occupational therapy
  • Exercise

Physical therapy (PT) can be especially helpful for some people with bradykinesia. PT can reduce muscle cramping, improve balance and posture, and help gain strength and flexibility. Exercises that help address balance and flexibility might help you stay active for longer.1,5

An occupational therapist (OT) can help you with activities of daily living like getting dressed, feeding yourself, and going to the bathroom. An OT can also help you with ways to manage housework and chores, which might be challenging when you have bradykinesia.1,6

Managing your symptoms

You may have "good" and "bad" days when it comes to movement. Many times, this relates to the timing of your medicines. If you notice changes in your ability to move or other PD symptoms worsen, talk to your doctor. Adjusting your medicine dose or schedule might help. But do not do this on your own. You and your doctor work best as a team, and managing your PD symptoms should be a team effort.1

You might need assistive devices like walkers or canes at times. Your physical therapist can help you with this. Again, you are not alone. Motor symptoms like bradykinesia can be challenging, but you can get the treatment and resources you need to live a fulfilling life with PD.1

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