Challenge Your Parkinson's Symptoms

Focus your attention and consciously control your habitual activities.

Check out these pages for more information:

Attentional Endurance

Loss of dopamine in the midbrain affects movement speed. Your habitual movements deteriorate without conscious control. Conscious control strengthens different brain pathways. Override your dysfunctional habitual movements by focusing your attention and consciously controlling them.

Attentional endurance is the ability to concentrate:

  • When you learn something new.
  • If you perform a known task in a different manner.
  • Whenever you are doing something risky.
  • When you are trying to hear or see something that is not obvious to you.

It is difficult because:

  • We receive too much information for the brain to process.
  • We try to multi-task.
  • Stress is a big distraction.
  • Few of us are ever taught to concentrate.

Your long term safe movements are at risk.

  • Walking safely, breathing deeply, swallowing may all become more risky
    unless you focus your attention on their safe execution.
    • D'Ostilio, K., Cremers, J., Delvaux, V., Sadzot, B., and Garraux, G. (2013).
    • Impaired automatic and unconscious motor processes in Parkinson's disease.
    • Science Reports.
    • 3:2095. doi: 10.1038/srep02095.
    • [PubMed]
    • Lee, J.H., Lee, K.W., Kim, S.B., Lee, S.J., Chun, S.M., and Jung, S.M. (2016).
    • The Functional Dysphagia Scale Is a Useful Tool for Predicting Aspiration Pneumonia in Patients With Parkinson Disease.
    • Annals of Rehabilitation Medicine.
    • 40(3):440-6. doi: 10.5535/arm.2016.40.3.440.
    • [PubMed]
  • Paying attention to these activities puts you in control.
    • Wu, T., Liu, J., Zhang, H., Hallett, M., Zheng, Z., and Chan, P. (2015).
    • Attention to Automatic Movements in Parkinson's Disease: Modified Automatic Mode in the Striatum.
    • Cerebral Cortex.
    • 3330-42. doi: 10.1093/cercor/bhu135.
    • [PubMed]
  • Conscious control promotes safe movements.
    • Peterson, D.S., and Smulders, K. (2015).
    • Cues and Attention in Parkinsonian Gait: Potential Mechanisms and Future Directions.
    • Frontiers in Neurology [electronic resource].
    • 6:255. doi: 10.3389/fneur.2015.00255.
    • [PubMed]
  • Mental training strengthens attentional endurance.
    • Parker, K.L., Lamichhane, D., Caetano, M.S., and Narayanan, N.S. (2013).
    • Executive dysfunction in Parkinson’s disease and timing deficits.
    • Frontiers in Integrative Neuroscience [electronic resource].
    • doi: 10.3389/fnint.2013.00075.
    • [PubMed]
  • Train attentional endurance during your daily activities.
    • Petzinger, G.M., Fisher, B.E., McEwen, S., Beeler, J.A., Walsh, J.P., and Jakowec, M.W. (2013).
    • Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease.
    • The Lancet Neurology.
    • 12(7):716-26.
    • [PubMed]


Pick one of the following suggestions, or something else

  • Practice focusing attention on your breathing.
    • Notice whether your belly distends, or not (it should);
    • Be aware of how much your chest moves (try to make it expand);
    • Pay attention to how loud you talk (you may need to practice);
    • Blow up a balloon, notice what your chest and belly are doing (see above).
  • Pay close attention to your swallowing.
    • When swallowing liquid, do you inhale first? Practice this.
    • Do you aspirate saliva (allow saliva to drip into your trachea)?
    • Notice when you have the urge to cough. Do you cough?
    • Behavioral therapy may help to reduce the risk of aspiration pneumonia.
      • Troche, M.S., Brandimore, A.E., Okun, M.S., Davenport, P.W., and Hegland, K.W. (2014).
      • Decreased cough sensitivity and aspiration in Parkinson disease.
      • Chest.
      • 146(5):1294-9.
      • [PubMed]
  • Focus attention on walking safely.
    • Move rhythmically to your favorite music.
    • Use music as an attentional motivator.
    • Optimally, play music with an easily recognizable beat.
    • While sitting or standing, practice synchronizing your elbow swings with a musical beat.
    • In a safe place, step in place to a musical beat; add elbow swing if possible.
    • March to a musical beat; focus on your elbow swing; the legs will follow.
  • Practice safe attention-demanding activities.
    • Note:Get assistance if you do not feel safe.
    • When standing, keep your feet about hip-width apart.
    • Try safely stepping with a slightly longer stride.
    • Count your steps as you walk.
    • Practice turning safely by focusing on transferring your weight from one foot to the other.
    • Walk to a chair, turn around and sit down without touching the chair with your hands.
  • Play rhythm games.
    • Non-musical rhythm games may help maintain your timing capability :
      • Cameron, D.J., Pickett, K.A., Earhart, G.M., and Grahn, J.A. (2016).
      • The Effect of Dopaminergic Medication on Beat-Based Auditory Timing in Parkinson's Disease.
      • Frontiers in Neurology [electronic resource].
      • 7:19. doi: 10.3389/fneur.2016.00019.
      • [PubMed]
    • Tap your fingers or feet to a rhythm of your choice.
    • Play a hand movement game with yourself (like tapping fingers to thumb).
    • Make up your own rhythmic games.
  • Focus attention on your speaking.
    • Consider a professional course like LSVT-LOUD. (It works if you practice often every day).
    • If you can, obtain a sound-level meter
      • Speak at your normal level.
      • Take note of the sound level indicated on the meter.
      • Speak loud enough so that others nearby can hear easily.
      • Take notice of the sound level on the meter.
      • Practice speaking at the new sound level until you do not need to look at the meter.
    • Practice speaking clearly.
      • Slow down, if necessary.
      • Read something, focusing on speaking loud and clearly.
      • Try a web-based free language course like ""
    • Before you speak; think LOUD, CLEAR.
  • Practice something new and attention-demanding.
    • Attentional endurance is the goal. Becoming adept is optional.
    • Learning a new language forces you to pay attention to what you say and how you say it.
    • Pick something easy to learn.
    • To maintain finger and arm flexibility, try American Sign Language. ASL trains arms, fingers, and brain.
  • Practice writing.
    • Use lined paper and write big letters
    • Sign your name slowly and clearly
    • Slow your writing hand by forming unfamiliar characters (e.g. Cyrillic or Japanese characters)
  • Try other things that are attention demanding.
    • Prepare a favorite recipe;
      • Focus on following the instructions.
      • Get help if tremor is a problem.
      • Also, get help if hot pans are a problem. It's still your recipe.
    • Do math problems in your head or with paper and pencil;
    • Read a story in the news and discuss it with someone;
    • Socialize with neighbors, friends, relatives.

Don't feel like it?
Lack of motivation (aka "apathy") is a significant barrier to coping with Parkinson's.