How does PD affect full range of motion strength training?

As I have mentioned in previous blog posts, it’s quite common to notice musculoskeletal imbalances in people with Parkinson’s “PWP”, often due to asymmetric movement patterns. Many people I work with or know as friends in the Parkinson’s community have been reaching out to me with recurring cases of pelvic, hip, and lower back pain. This is a huge problem that I don’t see addressed often enough and that is, “how do we tackle the corrective issues resulting from a movement disorder?” For example, if we only focus on the tight hip flexors and we don’t address the stooped posture due to somatosensory deficits, we will never fix the root cause.

A few weeks ago, while I was creating a strength program for a client to help with weaknesses in her hips and legs I noticed that she was extremely weak and hardly able to stretch a resistance band with an isometric exercise. Once I gave her a visual cue her strength nearly tripled. Makes me wonder how often in programs where strength and conditioning is enforced is the PWP not maximizing their output due to bradykinesia. This is a confound that makes differentiating between decreased amplitude and strength hard to determine. Although studies show that resistance training can help to improve bradykinesia, how does bradykinesia affect the output of strength training?

I think one of the solutions is to guide the individual through the beginning and end of the movement to ensure they are achieving the entire range of motion (ROM). There are a lot of benefits by not going through the full ROM such as muscular endurance, muscular growth at that specific joint angle, etc. but it doesn’t improve overall movement quality. Because PD already affects a person’s movement and ROM I think it’s something that should be integrated.

-Darbe Schlosser