Parkinson’s disease is a neurological movement disorder that impacts movement and flexibility. There are no special precautions that need to be taken when giving a manicure or pedicure to a Parkinson’s patient or when massaging a patient’s hands or feet. In fact, at any stage of disease progression, the process of hand or foot massage would most likely beg reatly appreciated and beneficial. Almost all persons with Parkinson’s disease can flex their muscles, usually without difficulty. However, sometimes a patient’s hand remains significantly closed. In this case, discuss with her whether it can be flexed at all. If the person can open and close her hand at times, it’s important to encourage that movement, and massage work with the hand would be good. If it seems to be a contracture, or an inability to open the hand, then it is essential that movement not be forced as that could cause injury.
It’s also worthwhile to note that certain times can be more difficult than others due to the significant variability of mobility and dexterity throughout the day; this is common for persons with a more advanced progression ofthe disease. If you are working with someone who has extreme fluctuations throughout the day, referred to as “off ” time (when things aren’t going well), and “on” time (when moving at their best), you may want to schedule appointments accordingly.
Ruth Hagestuen is field services director of the National Parkinson Foundation.