Idiopathic Parkinsonism

Idiopathic parkinsonism refers to Parkinson’s symptoms that arise without a known secondary cause. In most people, this term is used interchangeably with Parkinson’s disease. Core features include slowness of movement (bradykinesia) plus rigidity, tremor, and postural instability. Symptoms typically start asymmetrically and progress gradually.

At The Royal Buckinghamshire Hospital, we provide consultant-led inpatient neurorehabilitation for adults living with parkinsonism. Our programmes focus on safer mobility, gait confidence, everyday independence, and self-management alongside your medical treatment plan.

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Symptoms

• Bradykinesia (slow, small or effortful movements)
• Rigidity and muscle stiffness
• Tremor (often at rest, usually starting on one side)
• Gait changes – shuffling steps, reduced arm swing, difficulty turning or freezing of gait
• Balance problems and falls risk
• Soft voice, reduced facial expression, handwriting becoming smaller
• Non-motor symptoms – fatigue, sleep disturbance, constipation, low mood, anxiety, and cognitive slowing

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How Idiopathic Parkinsonism Differs From Other Types

Several conditions can mimic Parkinson’s disease:

• Vascular parkinsonism – lower-body predominance with small-vessel brain disease
• Drug-induced parkinsonism – due to certain medications (e.g. antipsychotics)
• Atypical parkinsonian syndromes – such as MSA, PSP or corticobasal syndrome

A specialist will assess your history and examination and may arrange tests (e.g. DaTscan) or a levodopa trial. We work alongside your neurology team to support function and safety during daily life.

Read about Vascular Parkinsonism

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Treatment Overview (Medical)

Medical management is led by your GP and neurologist and may include levodopa and other dopaminergic medications, plus treatments for non-motor symptoms. Exercise and rehabilitation are key at every stage of the condition.

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Rehabilitation at The Royal Buckinghamshire Hospital

Our inpatient neurorehabilitation programmes are tailored to your goals and stage of condition.

What your programme may include

• Neurophysiotherapy: gait retraining, cueing strategies (auditory/visual), step-length and turning practice, freezing-of-gait management, strength and endurance work, respiratory exercises where indicated.
• Occupational therapy: energy conservation, posture and seating, transfers, handwriting and fine-motor tasks, medication routines, home and work adaptations.
• Falls prevention: balance and postural stability, assistive devices set-up and training, safe-turning drills, strategies for dual-task walking.
• Speech and language therapy: voice projection, articulation, swallowing assessment and compensatory strategies.
• Neuropsychology: support for mood, anxiety, adjustment, attention and executive strategies, sleep hygiene, and carer education.
• Education & self-management: flare and freezing plans, exercise habit-building, community and outpatient follow-up guidance.

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When to Consider Inpatient Rehab

• Recurrent falls, near-falls or freezing episodes impacting safety
• Marked gait deterioration or loss of confidence outdoors
• Difficulties with daily activities, transfers or self-care despite outpatient therapy
• Significant fatigue, sleep or cognitive issues limiting progress
• Need for co-ordinated, multidisciplinary input and carer education

Our team creates a clear discharge plan with home exercises and community therapy recommendations.

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Living Well With Idiopathic Parkinsonism

• Keep active with a structured, achievable exercise plan
• Use external cues (metronome beats, floor lines, counting) to initiate steps or overcome freezing
• Optimise sleep, hydration and nutrition; review constipation and orthostatic dizziness
• Review footwear and home hazards; consider grab rails and seating
• Maintain social engagement and routines; involve family or carers in strategies taught during rehab