Bradykinesia: What Can Cause Slowness of Movement?

Medically Reviewed By Shilpa Amin, M.D., CAQ, FAAFP
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The definition of bradykinesia is slowness of movement. Bradykinesia is one of the hallmark signs of Parkinson’s disease. Medication can help to control this symptom of the disease. This article explains bradykinesia, including its possible causes and how to treat it.

Understanding bradykinesia

senior woman with walking sticks
Jimena Roquero/Stocksy United

Bradykinesia (brad-i-ki-nee-zhuh) is a medical term that comes from the Greek roots “brady,” meaning slow, and “kinesis,” meaning movement. With bradykinesia, a person’s body movements are slower than normal. This includes automatic movements, such as blinking, and voluntary movements, such as walking. People with bradykinesia have trouble with fine motor skills, such as cutting food or buttoning shirts.

Almost all people with Parkinson’s disease have bradykinesia, but the parts of the body affected can vary. It may only involve one limb or one side of the body. In some cases, the whole body can be affected, leading to an overall stillness.

Symptoms of bradykinesia may come and go. At times, movements can be relatively normal, while at others, function declines. It can be unpredictable, which might lead to frustration.

Vs. hypokinesia and akinesia

Bradykinesia is different from hypokinesia, or low movement, and akinesia, or lack of movement. However, both can be present with bradykinesia in Parkinson’s disease. Hypokinesia means movements have a reduced scale. It can result in small handwriting or a soft voice. Akinesia means there is a loss of motion. It commonly causes people to have flat facial expressions.

With Parkinson’s disease

Bradykinesia must be present for doctors to consider a diagnosis of Parkinson’s disease. However, other symptoms must accompany slowness of movement, such as tremor or rigidity. The tremor of Parkinson’s disease happens at rest. It can affect a hand or foot, or structures of the face, such as the jaw or mouth. The rigidity is a tightness or stiffness in the limbs or torso.

Postural instability leading to balance problems is another core symptom of Parkinson’s disease. The combination of bradykinesia and postural instability leads to walking or gait problems. Early signs may include decreased arm swinging while walking. As the disease progresses, people with Parkinson’s tend to develop a shuffling gait.

See a list of Parkinson’s disease symptoms here.

When to contact a doctor 

Contact a medical professional if you notice slowness of movement in yourself or someone else. It is one of the earliest signs of Parkinson’s disease. Bradykinesia can also have other causes, so it is important to get an accurate diagnosis.

Possible causes of bradykinesia

Parkinson’s disease and related movement disorders are the main causes of bradykinesia. Bradykinesia results from low levels of the neurotransmitter dopamine in the brain. Other possible causes of bradykinesia and Parkinsonian symptoms include:

  • cerebellar ataxia
  • cerebrovascular disease, such as stroke
  • dyspraxia, which is a developmental coordination disorder
  • neurodegenerative disorders, such as Huntington’s disease 
  • normal-pressure hydrocephalus, which is a buildup of cerebrospinal fluid in the brain
  • psychiatric disorders, such as depression
  • toxins, such as carbon monoxide
  • Wilson’s disease

Certain medications may also cause Parkinsonian symptoms, such as:

  • antidepressants
  • anticonvulsants
  • antipsychotics
  • other dopamine blocking or depleting drugs

Diagnosis of bradykinesia

To evaluate for bradykinesia, a doctor will look at your medical history and perform an exam.

Part of the exam will involve completing rapid, repetitive movements. These might include tapping your foot, pinching a finger and thumb together, or flipping your palm up and down. By observing these motions, your doctor can assess them using a rating scale.

Sometimes doctors order imaging exams, such as an MRI, to rule out certain causes, such as a tumor.

Learn more about how doctors diagnose Parkinson’s disease here.

Treatment options

Bradykinesia in Parkinson’s disease usually responds well to medication. Levodopa is the main drug doctors use to treat movement problems in Parkinson’s disease. It tends to work well for a period of years, but its effectiveness may decrease over time. This can present as intermittent periods where trouble with motor skills return.

There are several strategies doctors can use to minimize these effects. Along with medications, people with bradykinesia can benefit from physical and occupational therapy. Physical therapy can help increase movements with exercises that maintain muscle tone and strength. Occupational therapy can keep you mobile and independent by maintaining skills needed for daily living.

Learn about the types of medications doctors prescribe for Parkinson’s disease.

Managing slowness of movement

According to the European Parkinson’s Disease Association, staying active is important for people with bradykinesia. It is important to resist the urge to do less physically because of slowness of movement. This does not necessarily mean you are weaker — your muscles are just slower. Continuing to use them will help keep you strong and mobile.

Some strategies can help make life easier and allow you to continue doing things for yourself, such as:

  • getting a height-adjustable bed
  • rearranging furniture and household items to make movement and reaching things easier
  • removing rugs and other tripping hazards or securing them to the floor
  • scheduling rests during the day
  • adjusting your schedule to do challenging tasks when you feel best
  • using raised seat cushions and toilet seats
  • wearing clothing with simple closures, such as elastic waistbands and Velcro

Frequently asked questions

Here are some common questions people ask about bradykinesia.

Does bradykinesia always mean Parkinson’s disease? 

Bradykinesia is one of the main symptoms of Parkinson’s disease. In fact, bradykinesia, along with at least two other main symptoms, must be present to make a Parkinson’s diagnosis. However, bradykinesia can have other causes. Excluding them is an important step in the diagnosis.

What are the early signs of bradykinesia?

One of the early signs of bradykinesia is a slowing of the swinging of your arms as you walk. As it progresses, fine motor skills begin to slow, making buttoning clothing, writing, and other small movements difficult. Problems with walking gait are a later sign of bradykinesia.

What is the difference between dyskinesia and bradykinesia?

In medical terms, “dys” means bad, difficult, or troublesome. Dyskinesias are erratic movements that are involuntary, meaning you cannot control them. Unlike bradykinesia, dyskinesia is not a symptom of Parkinson’s disease. Instead, it often develops as a side effect of Parkinson’s disease medications.

How do you test for bradykinesia?

Doctors use rating scales to assess bradykinesia. One of the main scales is the Unified Parkinson’s Disease Rating Scale. During this test, your doctor may ask you to perform specific movements and then rate them on a scale from 0–4. The higher the number, the more bradykinesia is interfering with your movement.

Summary

Bradykinesia means a slowness of movement. It is the main symptom doctors use to diagnose Parkinson’s disease. When you have bradykinesia, your muscles still work, but they respond more slowly than normal. It is caused by a lack of dopamine in the brain.

The drug levodopa is usually effective in treating bradykinesia. However, its effects will diminish with time. There are additional ways to manage bradykinesia. Staying as active as possible will help your muscles maintain strength and flexibility.

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Medical Reviewer: Shilpa Amin, M.D., CAQ, FAAFP
Last Review Date: 2022 Jun 13
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