(Updated 25/07/21)
As buttock and thoracic muscles weaken, an accentuated slumping forward happens. To counter this forwards shift in the centre of gravity, a person will typically walk with their hands tucked behind, often with an additional counterweight such as a handbag. This way of walking reminds me of T-Rex.
Walking with one's hands dangling, or behind one's back, along with its associated shuffle is not safe. The shuffler is likely to catch their toes on something, trip and fall. With their hands behind them, not at the ready, it is more likely they will fall flat on their face!
My first real job was in neurological and cardiovascular rehabilitation. Most of the patients assigned to me were recovering from brain injuries suffered from a stroke, falls, car accidents, or punches to the head. Others had been very ill such as from an infection, an accident or major surgery. A common factor with everyone, to some degree, is they had to relearn basic movements, some beginning with rolling from front to back, lifting one's head, learning how to sit up, stand and eventually walk unaided. These, by the way, are the progressive stages of development of movement for a newborn child. Recovery is very much the process of developing the neural motor patterns that a baby follows: lifting one's head, rolling, crawling, walking, then running - all in this order. If one step is missed or neglected, the latter stages are compromised, and clumsiness may be the consequence.
Anyone, including myself, who has suffered a significant health setback begins recovery after bed rest with a careful shuffle with arms by one's side. It is hoped and expected that this initial cautious shuffle eventually becomes a confident stride. However, the usual trajectory of recovery may stall at any point, mostly due to not practising the appropriate movement patterns, and the confident stride may be lost forever. The Parkinsonian Shuffle is an extreme example of this loss. In the case of Parkinson's it may not be possible to prevent the losses, but practising walking with rhythms, such as to the beat of a metronome, or the sound of a brass band beating out the tune of "Colonel Bogey", can vastly slow the loss of function.
During my mother Maisie's last years, she suffered from a brain condition called Temporal Arteritis. In her case, lead poisoning from the use of hair dye was the most likely cause, but that is another story to be told. In addition, Mum suffered a Bell's Palsy, a nerve condition that causes partial paralysis of the left side of her face. I think it was more than a Bell's Palsy because one side of her body was weak, and her walking became a shuffle with one arm and leg lagging ever-so-slightly. It became habitual for her to walk with her arms tucked behind her back, usually with a handbag as an additional counterweight. Her children were concerned that she was ripe pickings for a handbag snatcher! The way she walked pointed to her having had a stroke rather than a Bell's Palsy, but who was I to question the diagnosis!
What did we do? To get Mum out of the shuffle and to evenly use both sets of limbs as best she could, we got her practising Nordic Walking. "Left, right - left right!" By practising an exaggerated version of walking - marching - the neural patterns are exercised and eventually become embedded as the usual way to move, rather than an old-age shuffle.
The take-home message:
No matter how old or how well we are, don't be a dinosaur - stand tall and march!
I spent time in the army. The first thing we learned at 4 am on the first morning was how to march, "Hup, 2, 3, 4, Hup, 2, 3, 4!" The marching always began with the left foot and opposite arm thrusting forward and away we went, our Sergeant-Major barking out the beat. An army that marches well exudes strength and confidence and is one that is best left alone. A ragged army that shuffles towards its enemy is considered easy takings. This is a lesson for all, including Granny. Stand tall and stride through life with confidence!
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