Self-delivered arousal-heightening stimuli to improve mobility in persons with parkinsonism: A case series

Classic accounts of 'kinesia paradoxa' typically involve highly stressful or life-threatening situations, which are difficult to translate to daily life. Here, we describe two patients with parkinsonism who successfully apply self-induced 'arousal-heightening' strategies to improve their mobility. The first patient uses an electronically modified fly swatter to self-deliver a mild electrical shock, enabling him to overcome episodes of freezing of gait. The second patient uses his phone's alarm to alert himself, resulting in improved sit-to-stand transfer. These observations suggest that self-induced arousal-heightening strategies represent a hitherto underexplored compensatory strategy that could help to improve mobility in some individuals with parkinsonism.Plain language summary titleHelping people with Parkinson's disease move more easily using alertness tricks.