Our Experience
Our initial testing of the ResQUp determined its benefit in assisting Parkinson’s patients with their fall management issues. To get direct feedback, the inventor of the ResQUp spoke at a Parkinson’s support group that meets regularly at a local church in Arizona. The group comprised about 40 individuals diagnosed with Parkinson’s disease and their caregivers who also attended.
As a Doctor of Physical Therapy, he spoke generally on:
Hazards associated with lifting and transferring those with mobility limitations
The importance of therapeutic exercises in reducing the risk of falls
Using the ResQUp in exercise therapy and during fall recovery
Following the presentation, several of those in attendance requested an opportunity to demonstrate the ResQUp for fall recovery. All those who attempted to use the ResQUp were able to get themselves to the floor and then back up to a standard height chair! He advised each person how to comfortably move themselves from a chair to the top level of the ResQUp and then back to the chair as a starting a therapeutic exercise activity. He then advised each person how to incrementally work themselves down each level until they became comfortable getting to the floor and then back into the chair.
One caregiver in attendance commented that the cost of the ResQUp would greatly outweigh the cost of a caregiver’s back surgery or a missed day of work. We greatly appreciated those who attended the presentation, those who recognized the value of the ResQUp as a useful tool for therapeutic exercise and floor recovery, and those who made purchases.
Unfortunately, we cannot attend every Parkinson’s Support Group in the country to demonstrate how the ResQUp can assist those with Parkinson’s disease. However, we focus on those who are at risk of falling, in general, and hope we will reach a larger population of disabled persons who fall.
Stages and Symptoms of Parkinson’s
The problem with Parkinson’s patients falling cannot be solved until the stages and symptoms of Parkinson’s disease is fully understood for each patient by their doctors, caregivers, and family members.
Parkinson’s disease is a progressive neurological disorder, and its progression can be categorized into five stages according to the Hoehn and Yahr scale, described in the following overview (www.parkinson.org/):
Stage One: Symptoms are mild and typically affect only one side of the body. They may include changes in posture, walking, and facial expressions.
Stage Two: Symptoms now affect both sides of the body, but balance is not impaired. There may be stiffness and movement difficulties.
Stage Three: This is considered mid-stage PD, where balance impairment begins, and there’s a higher risk of falls. Independent living is still possible, but activities may be more challenging.
Stage Four: Symptoms are severe and limiting. It’s difficult for the person to live alone, and assistance is required for daily activities.
Stage Five: The most advanced stage, where stiffness and freezing make walking difficult or impossible. Full-time assistance is required for all activities.
Correctly evaluating the stage of Parkinson’s disease can help the care team create a treatment plan, which includes therapeutic exercises and lifestyle practices.
Reasons Parkinson’s Patients Fall
Falling affects many people with Parkinson’s and the problem tends to increase over time. Everyone’s experience with Parkinson’s is different. As the disease progresses in Stage three, it can lead to balance issues, muscle stiffness, and reduced coordination. These factors increase the risk of falls. In nearly all cases, people with Parkinson’s typically fall due to the following reasons:
Postural Instability: Parkinson’s affects the brain’s ability to control balance and posture. People with the disease may experience sudden instability or difficulty maintaining an upright position.
Gait Changes: Parkinson’s often causes changes in walking patterns. Individuals may take smaller steps, shuffle, or have difficulty initiating movement. These alterations can lead to tripping and falling.
Muscle Rigidity: Stiffness in muscles can affect flexibility and movement. Rigidity makes it harder to adjust body position quickly, increasing the likelihood of falls.
Freezing of Gait: Some Parkinson’s patients experience “freezing” episodes, where they feel stuck and unable to move forward. This can happen while walking, leading to falls.
Orthostatic Hypotension: Parkinson’s can cause blood pressure to drop suddenly when standing up (orthostatic hypotension). This can result in dizziness or fainting, leading to falls.
Medication Side Effects: Certain Parkinson’s medications can cause drowsiness, dizziness, or low blood pressure, further contributing to fall risk.
Reduced Arm Swing: A reduced arm swing during walking affects balance. People with Parkinson’s may have less natural arm movement, making it harder to maintain stability.
Eye Problems: Some people with Parkinson’s experience problems with their eyes due to difficulty moving their eyes and blurred vision caused some Parkinson’s drugs (including anticholinergics).
Preventing Falls
Each person’s experience with Parkinson’s disease is unique, and falls can vary in frequency and severity. Therefore, fall prevention measures are critical in the therapeutic plan established by doctors and caregivers to include:
Enrolling in a home emergency response system is recommended. Home modifications (e.g., removing tripping hazards, installing handrails) reduce fall risks.
Adapt therapeutic exercises to improve gait and balance and reduce falls. In addition to exercise, early physical therapycan be beneficial.
Care partners should know how to help someone get up after a fall before falls become a problem. They should prepare by having tools like a transfer belt, assistive devices (walker, rollator, cane), and the ResQUp available to use during fall recovery.
Schedule regular check-ups with healthcare providers to allow monitoring of fall risk factors.
Detailed instructions for how to get up from a fall, along with more posture and balance information and tips, can be found in the Parkinson’s Foundation publication Fitness Counts and on www.resqup.com/.
Also consider inquiring about an in-home occupational therapist safety assessment or find a certified aging-in-place specialist (CAPS). Go to the National Association of Home Builders (800-368-5242) to get started (www.nahb.org/).
The Problem with Medications
Doctors also prescribe medications to help with other symptoms of Parkinson’s disease. High blood pressure often leads to dizziness and falls in Parkinson’s patients. Levodopa is a first-line medication that clinicians prescribe for Parkinson’s disease symptoms, but it does not slow disease progression, says the National Institute of Neurological Disorders and Stroke (Parkinson’s Disease | National Institute of Neurological Disorders and Stroke).
Parkinson’s disease medications cannot slow progression and commonly used drug therapies to treat Parkinson’s may increase the risk of dizziness and falling. The safety profile for VYALEV (foscarbidopa/foslevodopa) indicates the most common adverse reactions (>23%) in one clinical trial reported falls in 18% of patients taking oral IR CD/LD and 8% of patients taking VYALEV (www.vyalevhcp.com/).
With GOCOVRI (amantadine), used in the treatment of dyskinesia associated with Parkinson’s, the most common adverse reactions (>10%) were hallucination, dizziness (16%), dry mouth, peripheral edema, constipation, fall (13%), and orthostatic hypotension (www.gocovrihcp.com/).
We recommend the following free reference for managing Parkinson’s at www.michaeljfox.org/ and www.parkinsonsresource.org/.
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