Odd
 

A few years ago before diagnosis I noticed that my left arm didn't swing when I walked. It wasn't stiff or rigid. It just didn't swing. I asked my HMO doctor about it and his response was, "Can you still use it?"

I said, yes I could. He laughed and said, "Then don't worry about it."

Now, of course, it turned out to be PD. The odd thing is I noticed recently that my left arm swings fine now but my right arm doesn't!

PD is a strange disease and I grow more suspicious that it is largely psychosomatic with more of a psych component than soma at least for a certain subpopulation. I also read that the placebo effect is strong in PD and can last 6 months or more. Then there is the usual relationship to stressful events.

Perhaps more research should be done on the mind-body connection in PD.

my right arm swings now, before it didn't even though i have progressed significantly. interesting, my right arm would swing if i pressed my left arm against my stomach, i.e., immobilized it.

I absolutely agree that in some people this disease can be psychosomatic. I was diagnosed during a very stressful time in my life. Even now after being diagnosed as not having PD I find myself getting tremor fits when I think too much about very stressful things. I can stop the fits with intense concentration but it is exhausting. It's very annoying to have something so uncomfortable and painful start up when I want to relax and go to sleep. It drives me absolutely bats to be relaxing in bed and think about the tremors and they start up. It's almost become a behavioral component of trying to stop taking sinemet.

My Mom has a friend that was dx'd with MS only to find she didn't have it after her stressful divorce was finalized. My story is much the same.

This mental connection with PD sounds just like the cessation of PD when the man rode the bike. He was stumbling and falling yet when he rode the bike he executed better turns than I could. https://www.youtube.com/watch?v=aaY3gz5tJSk There was also a young lady with Dystonia that could run or walk backward but not walk forward. There appears to be a huge occupied brain component to many movement disorders.

It seems distracting or fooling your brain could be a very big key. This akin to the stutterer stopping when he can no longer hear his own voice or stopping if words are sung. If tricking the body works we just need to capitalize on it.

It occurs to me that I have two tens units for electro stimulation of painful muscles. I wonder if I used that on affected limbs? hmm. Must go dig them out and see. They can be worn for extended periods and come with a belt clip. Has anyone tried this?

Gerry, I've been told by many PwP that they got their arm swing back. Don't know why but it appears to be relatively common. I've haven't gotten it back fully, but I do notice some swing. Two years ago my hand and arm were stiff across my stomach, like Napoleon.

d0gma, I fully agree with you about the occupied brain component, as well as tricking the brain. I have dystonia in my left foot and it cramps rather quickly when walking. However, if I then turn and go backwards, the cramp goes away instantaneously. That's one way to tell the difference between normal muscle cramps due to dehydration, lack of blood circulation, etc., where the cramps last for awhile and ache even longer and dystonia. I just wish someone would have told that to my podiatrist as it would have saved me a lot of money in orthotics and special walking shoes which were worthless, along with foot X-rays, MRI and CAT scans which were all normal.

Interesting thread.

Let's see if we can understand why people swing their arms in the first place.

According to Wikipedia [1]:

"Whether arm swing is a passive, natural motion caused by the rotation of torso or is an active motion that requires active muscle work has been a critical discussion on arm swing that could illuminate its benefit and function. A recent study concentrated on the energy consumption during walking showed that at low speeds arm swing is a passive motion dictated by the kinematics of torso, no different from a pair of pendula hung from the shoulders."

It's obviously more complicated than this, not least because the body flexes, but for what it's worth, here's my theory for arm swing changes in PD.

If the pendula model remains true for PwP, the main thing that we need to look at is the work done at the shoulder joint to allow the rotation of the arm. Any cogwheel rigidity in the shoulder joint could impose a large enough energy cost to reduce or, even, to stop the natural swing.

As the disease progresses the other side is affected and eventually the "friction" at the shoulder becomes enough to stop that swing too.

The partial restraint effect [PRE](the good arm restrained allows the bad arm to swing) can be explained as follows. The energy that forces the pendula (the arms) comes from the jerkiness of the walking gait. I hazard a guess that when this energy can only be used by one pendulum, it leads to an increase in the energy available to the other arm. If this is enough to overcome the cogwheel rigidity, then the previously unswinging arm comes back into action.

Finally, we need to look at the situation where the arm that swung no longer does, and the arm that did not swing now does. The simplest way for this to happen is if the disease progressed to the other side and got worse there than on the original side, and then the PRE takes over. But I've not seen such a severity shift in PD. I have, though, seen localized reversals of severity from one side to another. So, a reversal of the shoulder rigidity is more likely than a complete severity shift from one side to the other. A better theory, in my opinion, comes from taking into account the spread of the disease into the leg on the bad side. If this alters the gait, it is likely to impact more on the good side arm. Thereafter the PRE takes over to give the desired effect.

All this is speculation, but someone must have a lab or, failing that, a workshop to test the theory.

A quick look at the literature gives:

Ford et al. found [2] for healthy adults:

" A comparison between walking with one arm constrained and normal walking revealed decreased, transverse pelvic, thoracic, and trunk rotation, however there were slight increases in non-constrained arm movement amplitude."

My details follow.

At diagnosis:
arm swing: left=normal, right=very reduced, though I could will it to happen
hand tremor: left=none, right=noticeable, no problems

After 5 years and until the present 9 years:
arm swing: as before
hand tremor: left=bad, spilt water from glass, right as before

Reference

[1] http://en.wikipedia.org/wiki/Arm_swi...man_locomotion

[2] Gait Posture. 2007 Jun;26(1):135-41. Epub 2006 Sep 25.
"Arm constraint and walking in healthy adults."
Ford MP1, Wagenaar RC, Newell KM.
http://www.ncbi.nlm.nih.gov/pubmed/16997561

John

psychosomatic
 

I find myself stiffening body parts among other actions to make them less shaky. It's very possible that I stop my arm swing unconsciously. There are a slew of movement habits I now do as a response to what I experience from my body's goings on. Once you develop a habit muscle memory makes it very hard to stop and it could be very susceptible to change depending on the individual.