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Movement signs and symptoms of Parkinson’s disease | NCLEX-RN | Khan Academy

– [Voiceover] Just before we
jump into the movement-related signs and symptoms of Parkinson’s disease, let’s remind ourselves of
what Parkinson’s disease is. And that’s a progressive brain disease. And this progressive disease,
it ends up causing a reduction in the amount of a signalling
chemical called dopamine. And when dopamine levels are lowered, what we really see are a bunch
of problems with movement. So there are four main movement
signs that we talk about when we’re talking about
Parkinson’s disease. And we call them the main signs because they’re usually
the ones that we look for if someone actually has the disease. Not everyone with Parkinson’s disease will develop all of these signs, but most people will at
some point in the disease. And as the disease worsens over the years that the person has it, because remember, it’s a progressive disease, these signs and symptoms
usually worsen as well. The first main sign that
we’ll talk about is a tremor. And this tremor usually
starts off in the hand or maybe in the finger. A tremor is involuntary shaking. And it actually happens
because of lots and lots of relaxations and
contractions in our muscles. You’ve probably noticed
before that your hands can get a little shaky when you do certain things, maybe doing something
like threading a needle. People are always making
fun of me for having rips in my jeans, so I’m
always patching them up, and I find that my hands get super-shaky when I’m threading a needle. Or maybe you’ve noticed it
when you’ve done something like putting eye drops in your eyes. But the kind of tremor that
someone with Parkinson’s disease has, it’s a lot worse than this. It’s more frequent, and
it’s more debilitating. And we actually have a name for it. It’s a particular kind of
tremor called a resting tremor. A resting tremor happens
when the body part is as it sounds, at rest. And the tremor actually
stops when the body part is not at rest. So a good way to think
about when a tremor would and wouldn’t be around, is to imagine that you’re about to go and grab a pen. If you had a resting tremor,
your hand would be shaking before you went to grab for the pen, when it was just resting on the table. And this is because the
hand would’ve been at rest. You wouldn’t have been using it. But once you actually
started to move your hand, your hand and the muscles in your hand wouldn’t be at rest anymore,
you’d be using them. And so the tremor would actually stop. So this sounds okay, you may be thinking, “Okay, I’ll just make sure
I’m always moving my hand.” But it’s not that easy. For a lot of people with
Parkinson’s disease, they actually still have trouble writing because the tremor can return again once they’ve finished grabbing the pen, and they’re just holding
their hand ready to write. So resting tremors are just
one of the types of tremors that are out there, and
there are lots of other different types that you may
see in different conditions or even in just normal healthy people. But it’s these resting
tremors that are the kind that we see in someone
with Parkinson’s disease. The next main movement
sign that we’ll talk about is rigidity. Rigidity basically feels like
really, really stiff muscles. When someone with rigidity
goes to bend their arm, say they were gonna pick up
some food from their plate and put it in their mouth,
the movement between the plate and their mouth wouldn’t
be one smooth movement like it normally is. Instead, it’s kind of
like that movement happens in a few jerky movements, rather than that one smooth movement. We actually have a name for
this series of jerky movements as someone with Parkinson’s disease has. And it’s called cogwheel rigidity. We call it cogwheel rigidity
because this movement, in this case, bending the arm, it kind of looks like
cogwheels moving together in that clunky sort of way. You know, like the
cogwheels that you would see in a grandfather clock, for example. This rigidity, this feeling
of stiffness that causes these clunky movements,
it’s not just a feeling for the person with Parkinson’s disease. Their arm actually is more rigid. So it’s not just something
that’s in their head. A third main movement sign is
these really slow movements, and we actually call these
slow movements bradykinesia, where the word brady means slow, and the word kinesia means movement. So for the person with bradykinesia, it can feel like a few different things. It can feel like weakness,
or maybe fatigue, or even just this kind of general feeling like they can’t move the
body part that is affected. And there are actually
lots of parts of the body that can be affected. This bradykinesia could
happen just in one limb, or it can even happen to
one whole side of the body, and it can even happen to the whole body. This bradykinesia, this
slowing down of movements, actually makes it really
hard for the person to complete movements at a normal pace. So to picture what this is like, imagine the last time you
were in a swimming pool. Maybe you were just trying to walk around from one point to another,
or maybe you were running in the water because you were trying to catch your friend who stole your ball. You can probably remember that walking or running in the water was really slow. It takes you a lot longer
to do those movements when you’re in the water
compared to when you’re on land. And that’s kind of what
bradykinesia is like. So the person can do the movements, but they just feel like
they’re a lot slower. So this is quite a bit
different than the rigidity that we talked about earlier. I often find it a little
confusing to think about stiff versus slow muscles, they
sound kind of similar. So the way I like to think about it, is I think about our muscles responding to the messages that we send them. You know how you tell your arm to move? Well, with rigidity, we send
the message to our muscles telling them to move, and our
muscles receive that message and they start to move right away. But because of that extra resistance, the movements are just really jerky. But with bradykinesia, we send
the message to our muscles telling them to move,
maybe we’re telling our leg to kick a ball or arm
to reach for an apple. And our muscles do receive that message, but it takes them a
while to actually respond to the message, to kick that
ball or reach for that apple. And it’s this delay between
us saying to our muscles, “Hey, time to move,” and
them actually responding is what makes the movements
feel really, really slow. Alright, so the fourth main movement sign of Parkinson’s disease
is postural instability, being really unstable, really
unbalanced when standing or trying to move around. We call it postural instability because it’s our postural
reflexes, which are these reflexes that normally help us
stay nice and balanced. It’s those that actually stop working. And when these stop working properly, that’s when someone
with Parkinson’s disease starts to get really unbalanced
and unstable on their feet. Postural instability is
actually one of the signs that crops up later on in the disease, once the person has had
it for quite a few years. And it’s actually one of the
most debilitating movement problems that someone with
Parkinson’s disease can have. This is because that
instability that they feel on their feet can make it
a lot more likely for them to have a fall, and makes
it really hard for them to stay independent and walk around. So those are the four main movement signs of Parkinson’s disease. Other than postural instability, they normally start early in the disease. And over time, they can get a lot worse. And that’s because the disease,
as we talked about before, is a progressive disease. It worsens over the
years the person has it. And not only can these get worse, but they can actually cause
a lot of the other movement problems that we see in someone
with Parkinson’s disease. For example, the tremor, it can be really subtle
earlier in the disease. The person may not even
notice it themselves. But as the disease gets
worse over the months and the years that the person has it, the tremor can actually get a lot worse, and it can even spread to
other parts of the body. So if started in the hand or the finger which is really common,
it can move to the legs, even the lips or the
tongue, so that’s something that can happen over time with the tremor. And rigidity can eventually
affect a person’s posture. They can actually start
to bend over all the time into this stooped
posture, and this happens because of all the stiffness
that they’re feeling in the muscles that would
otherwise keep them upright. This stooped posture can
cause problems as well. With the person being
bent over all the time, this can increase their chances of falling and hurting themselves. Because rigidity affects all
sorts of muscles in the body, rigidity can also cause other problems. So, later on, the person can actually lose their ability to make facial expressions. They have trouble smiling or frowning, or even showing you how they feel. And it’s not because
they don’t feel anything. It’s actually because of all the stiffness that they’re feeling in
their facial muscles. It makes it really hard for them to move their mouth or their eyes. So those are some of the problems that rigidity can cause over time. And bradykinesia can also cause problems. One thing that can happen is the person can actually change
the way that they walk. The person will start
to shorten their stride, and they’ll start shuffling their feet. The reason this happens is
because those slowed-down movements just make it hard for the person to step up so high or step
out as far as they used to. One thing that can happen
because of bradykinesia much later on, after quite a few years, is they’ll be walking
around and everything seems totally fine, but then all of a sudden, they’ll just stop in place, and they won’t be able
to even move themselves. And this can last for quite a few seconds. This is because, after quite a few years, those muscle responses
have just become so slow. There’s actually a name for
this, and it’s called freezing. We call it freezing
because just as it sounds, the person actually feels
like they’re frozen in place, like they can’t even move. And that postural instability
that we talked about, that can also cause
more problems later on. What can often happen,
is the person’s balance kind of gets worse and worse over time. And as this happens, they can eventually lose
their ability to walk. So they may start off just
feeling a little unbalanced. Maybe they can’t walk for as
long as they normally could, or maybe they just need a
little help when they’re tired. But after a while, as things get worse, their balance is just so bad
that they don’t feel safe being upright, and they
actually may fall quite a bit.

26 thoughts on “Movement signs and symptoms of Parkinson’s disease | NCLEX-RN | Khan Academy

  1. With dept of Nerology still trying to make a sinificant impact
    for stoke – atexia it needs to have research -cure dedecated.

  2. ublic comment…

    MRZ12000 1 second ago
    With dept of Nerology still trying to make a sinificant impact
    for stoke – atexia it needs to have research -cure dedecated.
    Reply ·

  3. ublic comment…

    MRZ12000 1 second ago
    With dept of Nerology still trying to make a sinificant impact
    for stoke – atexia it needs to have research -cure dedecated.
    Reply ·

  4. I get tensed whenever I use 2 listen dis deasease name,it's really horrible name bcause ive seen brave person helpless n in grea8 pain infront of his so called officer I pray to ALLAH never ever helples me n 's rather n better 2 die wid heart failure soon.ALLAH is merciful bt dis dunia'z not.

  5. This was the most educational video I saw so far. Better explained than my Nuerologist. Thank you, please keep going… Could my stroke & seizure bring parkinson on?

  6. There is a "verbal tic" in many people these days where almost every sentence is started with the word "SO" and it is irritating and distracting. This otherwise excellent presentation is partly spoiled by the overuse of the word.

  7. Fantastic presentation! Very very helpful.

    But there is something we need to keep in mind, which is that Parkinson's disease is not a disease of the muscle. Think about when your hand or leg falls asleep. It feels as if there is something wrong with the limb, but there isn't. What's happened, is the nerve contact with the brain has been disrupted. In this case, your fingers, or toes feel difficult to move, yet there is nothing wrong with these muscles. Building on this analogy, such is the case with Parkinsonianism. The breakdown is in the signals from the brain, and thus in communication in the brain itself — a loss of sending proper signalling to the muscles while the muscles are fully intact. As a dopaminergic disorder, we can at least trace the cause to the brain itself, though unfortunately, then things become very complicated. Let's all do our best to further the funding of research of this disease since a cure is most certainly in sight.

  8. This is some good stuff and all, but unless i increase the speed to 1.25x, its unbearably slow. Heck, it sounds more natural at that speed and your usual slow tone sounds like your crawling past some deep depression lmao

    Actual criticism aside, good stuff and helped me further understand the diseases and the naunces it brings 🙂

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