Parkinson’s Disease – Introduction to “TRAP”

November 5, 2017

Today, we’re going to talk about Parkinson’s Disease (PD), as well as the common characteristics we see in patients with PD.

As a general introduction, we use the acronym “TRAP” to describe the most common changes in movement patterns:

I explain everything in detail in the video above, but here’s a quick overview of TRAP:

• T = Tremors
• R = Rigidity
• A = Akinesia
• P = Posture

Tremors:

If you’re at all familiar with Parkinson’s, you’re probably well aware that tremors in the arms and legs are one of the most common early signs.

The key with PD is that these tremors are noticeable at rest, and they tend to go away with movement (which is actually nice in some ways).

Rigidity:

Although the tremors tend to smooth out with movement, the overall coordination and smoothness of movement tends to decline with people with PD.

Rigidity refers to this breakdown in the normal, smooth movement patterns.

Akinesia:

This is a general term that primarily describes the breakdown in people’s walking coordination, and it goes hand in hand with a decline in posture as well.

The most common presentation you’ll see with people with PD when they walk is decreased trunk rotation and arm swing, shorter steps, general unsteadiness, and what we call a “festinating” gait pattern.

The festinating pattern basically describes someone taking very small, shuffling steps with a forward bent posture. In essence, the person looks like they’re falling forward.

Posture:

Lastly, people with Parkinson’s tend to exhibit a forward bent posture. This is why so many of the exercises focus on opening up the posture, and pulling the arms and head back.

This posture is very noticeable when people with PD are walking, and it can be worse if they use a walker, especially if the walker is set too low.

2 More Key Points

Towards the end of the video, I mention 2 additional key points to successfully improving the “TRAP” presentation, which will allow people with PD to improve their posture, balance, walking and general mobility and independence:

1. Key Point #1: the LVST BIG exercises have been specifically designed to help people with Parkinson’s. If you do a quick Google or YouTube search, there are several good videos that demonstrate the exercises. (I’m not sure if I’m allowed to share these exercises on one of my videos, but I will in the future if able).
2. Key Point #2: anyone who’s been less active for a period of time, will also tend to experience a decrease in balance, strength and flexibility. This includes a decrease in the function of your vestibular system (aka the inner ear). Keep this in mind if you have Parkinson’s and are looking to improve not only “TRAP”, but your overall balance and mobility as well. While the LVST BIG exercises are very beneficial, you’ll want to make sure you target your balance systems, as well as any other specific muscle weaknesses.

If you combine these 2 key points, you should have a great shot at staying active and mobile, while minimizing the symptoms of PD. (And of course other medical and pharmaceutical interventions are also very helpful!)

If you have any other questions about how we help people with Parkinson’s stay active, mobile and independent (and not falling!), please reach out to me at any time via email at Luke@GordonPhysicalTherapy.com.

Good luck!