## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) ## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) # Movement Symptoms ## 💡 Quick Summary - Parkinson’s disease primarily affects movement, causing [bradykinesia (slowness)](/understanding-parkinsons/movement-symptoms/bradykinesia "Bradykinesia (Slowness of Movement)"), tremor and rigidity, which are key to diagnosis. - Other movement symptoms, such as postural instability, [stooped posture](/understanding-parkinsons/movement-symptoms/stooped-posture "Stooped Posture") and difficulty walking can develop later and vary between individuals. - [Exercise](/living-with-parkinsons/treatment/exercise "Exercise") and physical therapy are essential for maintaining mobility, easing symptoms and slowing disease progression. ![Multigenerational family of men with their backs to the camera. Grandfather stands in the middle with his grandson on the left and his son on the right. Son's left hand is placed on his father's back](/sites/default/files/styles/no_sizing/public/images/movementsymptoms.jpg?itok=tTzUl89e) ## How does Parkinson's affect movement? Parkinson’s disease (PD) is called a movement disorder because of the tremors, slowing and stiffening movements it can cause, and these are the most obvious symptoms of the disease. However, Parkinson’s affects many systems in the body. Its symptoms are different from person to person and usually develop slowly over time. [Read about Non-Movement Symptoms](/understanding-parkinsons/non-movement-symptoms "Non-Movement Symptoms") ## Primary Movement Symptoms There is no single test or scan for Parkinson’s, but there are three telltale symptoms that help doctors make a diagnosis: 1. **Bradykinesia** (slowness of movement) 2. **Tremor** 3. **Rigidity** Bradykinesia plus either tremor or rigidity must be present for a PD diagnosis to be considered. Another movement symptom, [**postural instability**](/understanding-parkinsons/movement-symptoms/postural-instability "Postural Instability (Balance & Falls)") (trouble with balance and falls), is often mentioned as a primary symptom, but it does not occur until later in the disease progression. In fact, problems with walking, balance and turning around early in the disease are likely a sign of an [**atypical parkinsonism**](/understanding-parkinsons/what-is-parkinsons/types-parkinsonisms "Types of Parkinsonisms"). Though each person's path with PD is unique, active engagement in [**exercise and wellness**](/resources-support/online-education/pdhealth "PD Health @ Home") is central to maintaining balance and movement for everyone who lives with PD. Slowness, stiffness and shakiness can impact daily living. [**Exercise**](/living-with-parkinsons/treatment/exercise "Exercise") is [**proven**](/advancing-research/our-research/parkinsons-outcomes-project "Parkinson’s Outcomes Project") to ease these and other PD symptoms and can slow disease progression. Verified [**exercise strategies**](/library/fact-sheets/exercise-recommendations "Parkinson's Exercise Recommendations") can keep you moving well. A physical therapist with Parkinson’s expertise can help you get started. ## Secondary Movement Symptoms Parkinson’s affects everyone differently and symptoms can change throughout the course of the disease. Only half of all people with PD will experience tremor, for instance. Though Parkinson's is diagnosed based on primary movement symptoms, it can produce many secondary movement symptoms too. When alpha-synuclein, a common brain protein, misfolds and clumps specific areas of the brain, it diminishes the brain chemical dopamine. Dopamine is vital to smooth, coordinated movements and other body processes. Parkinson's symptoms arise from dopamine declines and affect people who live with the disease differently. - ### Types of Secondary Movement Symptoms - **Decreased arm swing** when walking. - **Difficulty turning over in bed** and **difficulty getting out of bed, a deep chair, or a car seat.** - **Dysarthria** (slurring of speech) and **hypophonia** (soft, sometimes breathy and hoarse, voice). - **Dyskinesia**, involuntary, erratic writhing movements of the face, arms, legs or trunk. - **Dystonia**, sustained or repetitive muscle cramping, twisting or tightening. - Facial masking **(hypomimia)**, a serious or mad facial "masking" appearance**,** and **decreased blink rate**. - **Festination** – short, rapid steps during walking, done in attempt to keep the center of gravity in between the feet while the trunk leans forward involuntarily and shifts the center of gravity forward. It increases fall risk and is often linked with freezing. - **Freezing**, a sensation of being stuck in place, especially when beginning a step, turning or navigating through doorways or other narrow passages. This can also increase risk of falling. - **Masked face (hypomimia):** results from the combination of bradykinesia and rigidity. - **Micrographia:** small, crowded handwriting due to bradykinesia. - **Shuffling gait:** accompanied by short steps and often a stooped posture. - **Stooped posture**, often accompanied by short steps (**shuffling gait**) and trouble walking. - **Soft speech (hypophonia):** soft, sometimes hoarse, voice that can occur in PD. ## What causes Parkinson’s movement symptoms? Dopamine is a chemical messenger (neurotransmitter) that is primarily responsible for controlling movement, emotional responses and the ability to feel pleasure and pain. In people with Parkinson’s, the cells that make dopamine are impaired. As Parkinson’s progresses, more dopamine-producing brain cells die. Your brain eventually reaches a point where it stops producing dopamine in any significant amount. This causes increasing problems with movement. ### More Information For more insights on Movement Symptoms, read [**10 Early Signs of Parkinson's Disease**.](/library/fact-sheets/10-signs "10 Early Signs of Parkinson's Disease") [READ NOW](/understanding-parkinsons/10-early-signs) ## Staying Active Exercise — and tools such as [**PD Health @ Home Fitness Fridays**](/resources-support/online-education/pdhealth "PD Health @ Home") — can minimize movement symptoms. In fact, [**exercise**](/living-with-parkinsons/treatment/exercise "Exercise") is as important to living well with Parkinson’s as medications and other therapies. Find an activity you love and work with your doctor to create a plan to stay well. *Page reviewed by Dr. Jun Yu, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.* ## Related Materials Fact Sheets ### [ Pain in Parkinson's Disease ](/library/fact-sheets/pain) [Read Now](/library/fact-sheets/pain) Fact Sheets ### [ Occupational Therapy & Parkinson's ](/library/fact-sheets/occupational-therapy) [Read Now](/library/fact-sheets/occupational-therapy) Fact Sheets ### [ Managing "Off" Time in Parkinson's ](/library/fact-sheets/managing-off-time) [Read Now](/library/fact-sheets/managing-off-time) ## Related Blog Posts ![Elderly couple enjoying coffee together at home](/sites/default/files/styles/500x360/public/images/practical-pointers-blog-hero.jpg?h=ed9ce7df&itok=w7X3P7DS) Raise Awareness ### [ Six Tips for Managing Daily Life with Advancing Parkinson’s ](/blog/awareness/managing-daily-life) READ NOW ![Seniors stretching outdoors](/sites/default/files/styles/500x360/public/images/eb-1-motor-symptoms-hero.jpg?h=ed9ce7df&itok=by9QZn--) Raise Awareness ### [ Tremor, Shakes & Everything in Between: Tackling Parkinson's Motor Symptoms ](/blog/awareness/tackling-motor-symptoms) READ NOW ![gait and balance blog preview.](/sites/default/files/styles/500x360/public/images/gait%20and%20balance%20blog%20preview_1.png?h=9105c3fe&itok=Cidve2m2) Raise Awareness ### [ Finding Balance: Steps to Move Safely and Minimize Falls with Parkinson’s ](/blog/awareness/finding-balance) READ NOW ## Join the Fight Against Parkinson's Support ground-breaking research, care and community outreach [$35](https://secure3.convio.net/prkorg/site/Donation2?11283.donation=form1&df_id=11283&mfc_pref=T&l&set.DonationLevel=26812) [$50](https://secure3.convio.net/prkorg/site/Donation2?11283.donation=form1&df_id=11283&mfc_pref=T&l&set.DonationLevel=26813) [$100](https://secure3.convio.net/prkorg/site/Donation2?11283.donation=form1&df_id=11283&mfc_pref=T&l&set.DonationLevel=26814) [$250](https://secure3.convio.net/prkorg/site/Donation2?11283.donation=form1&df_id=11283&mfc_pref=T&l&set.DonationLevel=26815) [Donate](https://secure3.convio.net/prkorg/site/Donation2?11283.donation=form1&df_id=11283&mfc_pref=T&l&set.DonationLevel=26822&set.Value=) ### Find Local Support Find your nearest Parkinson's Foundation chapter for local events, support groups, care facilities and more. 10 Miles 25 Miles 50 Miles 100 Miles 250 Miles - Share on Facebook - Share on X - Share on LinkedIn