Piano Practice and Bradykinesia

With Parkinson’s Disease, one of the defining symptoms is bradykinesia. What’s that? Yeah, I asked the same thing. Bradykinesia is a slowness of movement that isn’t necessarily explainable with other known effects of PD but is definitely there.

Piano practice is one place where bradykinesia shows up for Michelle. It affects agility in vocal and instrumental play. After tremor, this was the first symptom Michelle noticed: She could no longer strum fast-paced rhythm guitar patterns at full tempo for more than a couple measures before her battery ran out. Since the symptoms started in 2021, she has had to adjust how she plays.

The good news is medication can lessen many of PD’s symptoms. Levodopa has restored much of the mobility that PD stole, but musical agility is still a struggle.

Since all songs need to be practiced at slowly before gradually speeding up, Michelle is able to tackle many pieces with her music. She’s been able to practice and feed her soul with her beloved music. However, at some point she would love to regain the ability to play quickly.

In typical Michelle style, she’s working out the kinks in her musical ability like everything else, with a methodical approach and taking data. She noticed Sunday, Nov 5, that she had trouble doing anything. She wanted to speed up a few short Bergmüller pieces to allegro, but after playing ten or twenty minutes, she crashed.

She tried to get on the exercise bike, because she’s learned it triggers dopamine production and that helps, but it was impossible to rotate her feet faster than they wanted to rotate. Period. So she sat there biking at a super slow speed for an hour in front of the TV until bedtime.

Monday was worse. While there was a girl’s trip and a time change happened on Sunday, she only lasted five minutes for practice. She’s working to understand she has a time limit on playing.

In her notes, musical agility requires more dopamine. Michelle is also determined, so of course she brought out the camera to see how her practice worked on Tuesday. The camera times out, so she started and stopped it after each run of an individual piece or passage.

Below are the videos where Michelle can play at some speed, and then when her battery ran out. After bradykinesia kicks in, she rests with her puppies.

This is a timeline from Tuesday, Nov 7:
8:00 am – morning Levodopa*
10:00ish am – 60 min on stationary bike
11:30 am – late morning Levodopa*
11:33 am – started practicing piano
12:08 pm – video 1 of 2 (the bottom one below)
12:11 pm – video 2 of 2 (the top one below)
1:30 – can move again

*carbidopa/levodopa 25/100 x 2 both times

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