One of the major problems in Parkinson’s Disease is called “bradykinesia,” which means “slow” (brady) “movement” (kinesia). This is somewhat different than “akinesia” which is discussed in a different section.

Bradykinesia is one of the most disabling features of PD

They move slowly, so they do everything more slowly than they used to. This means that they have to get up earlier to get ready for work, that they do less at work, that they do fewer chores in a given time period at home, that it takes longer to eat, to prepare meals. People have to wait for them when they are going to appointments. Others have to slow down when they are walking together, and on and on.

There are several basic problems that contribute to this. One is simply slow movements. In the neurologist’s office, you are generally asked to perform a number of maneuvers such as tapping your fingers or your feet, opening and closing your hand, and other things. Two problems usually are seen. The movements are slow, and the amplitude, or range, of the movements, diminishes with the effort. Finger movements are particularly affected so that maneuvers that require coordination of the fingers are slowed more than movements of the hands and feet. Buttoning, for example, is challenging.

Complicating this may be the tremor, as most Parkinson’s Disease patients have tremor in their fingers or hands, and although this goes away with movements, it usually returns when the hands are staying in one position in the air, as is required for buttoning. Parkinson’s Disease patients also lose their “automatic pilot” as I like to call it. Most of our routine activities are performed without conscious thought. When we brush our teeth, comb our hair, scratch an itch, we simply “will” it and it happens. This may not be the case with PD. People with Parkinson’s Disease often have to consciously guide their hand to perform a maneuver that used to happen by itself. This need for conscious supervision causes significant slowness.

Furthermore, this is worsened with people have to do two things at the same time. Many Parkinson’s Disease patients simply cannot do this. So, instead of scratching an itch as they take out their car keys, they choose to do one, and then the other. While this may not sound like a major problem, if you stop and think about all the multiple tasks we all perform daily, many at the same time, you will see what a drag this is on one’s efficiency.

Slowness of movement is one of the symptoms of PD that causes the most problems and which is not fully recognized by those who don’t have the illness. After all, you look fine, so why not push yourself and move a bit faster?