Slowness of movement

Slow movement related to degenerative brain conditions

Slowness of movement, known as bradykinesia, is often accompanied by reduced movement amplitude (smaller movements).

It is one of the core motor features of Parkinson’s disease and commonly affects fine hand movements, walking and facial expression.

Key points

• Unlike weakness where the muscles are less strong, slowness of movement causes the brain to have difficulty planning, initiating and sustaining smooth, efficiently sized movements.
• It often starts subtly on one side of the body, affecting fine finger movements before spreading more widely. Common early complaints include difficulty with buttons, handwriting or getting up from a chair.
• Slowness of movement generally responds well to dopamine-based medication, though the degree of improvement varies between people.

Similar movement difficulties can occur in other neurological conditions, so a specialist should review ongoing or worsening symptoms.

Next steps:

• book a GP visit
• request an assessment for Parkinson’s disease.

Slowness of movement can impact daily activities and general functioning, including:

• difficulty standing up from a chair or getting out of a car
• difficulty with fine finger movements, such as:
  • buttoning clothes
  • tying shoelaces
  • typing.
• general sense of feeling weak, tired or uncoordinated when trying to move
• reduced arm swing when walking, often more noticable on one side
• reduced facial expression (‘masked face’)
• smaller, cramped handwriting (micrographia)
• slower, quieter or less clearly articulated speech
• in later stages, sudden brief 'freezing' episodes or unusually quick, short steps when walking.

Generalised slowness of movement is not unique to Parkinson’s disease. Other possible contributors include:

• dementia with Lewy bodies
• depression
• drug-induced parkinsonism
• multiple system atrophy
• progressive supranuclear palsy
• general frailty, thyroid problems or other medical illness.

Because the pattern and associated features help distinguish these possibilities, new or progressive slowness of movement should always be assessed by a doctor.

When to consider specialist review

Speak with your neurologist or GP if slowness is:

• worsening despite medication
• significantly affecting daily activities
• accompanied by:
  • features such as early falls or marked asymmetry
  • changes in eye movements that might suggest a condition other than typical Parkinson’s disease.

When to seek urgent help

Seek urgent medical attention if you experience:

• a fall with injury or loss of consciousness
• a new difficulty swallowing or breathing
• a sudden or rapidly worsening inability to move
• any new confusion accompanying worsening slowness.

These symptoms may indicate an acute problem requiring prompt assessment rather than a routine review.