We often find ourselves asking our medical professionals what stage of a condition we may be in. This can be extra difficult to classify for Parkinson's patients because the symptoms can look so different and unique for each person. It is also important to note that one may fluctuate between stages as medications and therapies improve current situations. Additionally, rarely can stage prediction be made for progression because a person may stay in a certain stage for years and other stages for months. It is also important to remember that every journey with PD is unique. Because a symptom might be listed within a stage, it doesn't necessarily mean a person with PD will experience that symptom.
Joseph H. Friedman, MD writes, "Staging most disease is important in predicting how long people will live or how well they can function. This is not true for staging in PD. Severity of PD is currently not measurable. As physicians, we currently rate different aspects of PD differently and often use multiple different scales. It affects people in so many ways that it defies methods for comparison, just as it has been impossible to measure what we mean when we say disease progression. We have good methods for measuring the motor symptoms of PD. The severity of your own PD is really a matter of how severely it affects your life. A number can never capture this."
At the PAA, we recommend not getting too hung up on what stage classification of Parkinson's you may be in. However, for the purposes of education, we are including the breakdown of stages as presented by the Davis Phinney Foundation in their manual, "Every Victory Counts."
Symptoms on one side of the body
Decreased arm swing on one side when walking
Decreased stride length
Dragging your foot while walking
Scuffing your toes, especially when tired
Change in leg coordination when cycling or running
Sense of muscle fatigue or heaviness in your arm or leg on one side of the body
Difficulty completing repetitive movements due to sense of muscle fatigue
Trouble with hand coordination, especially on one side. This is often apparent doing tasks that use both hands.
Reduced range of motion in your shoulder, shoulder pain, or frozen shoulder.
Mask-like face or change in facial expression.
Decreased or small handwriting.
Symptoms on both sides of the body
Mild swallowing problems, such as difficulty swallowing pills
Flexed or bent posture and shuffling gait
Motor fluctuations and dyskinesia
Postural instability with balance
Walking problems, with increased shuffling, freezing of gait
Significant speech and swallowing problems
Rigidity in the neck and trunk parts of the body
Davis Phinney Foundation for Parkinson's. Every Victory Counts, Your Go-To Resource of Essential Information and Inspiration for Living Well with Parkinson's. "Manual." Sixth Edition, 2021
Friedman, MD. Joseph H. "Making the Connection Between Brain and Behavior: Coping with Parkinson's Disease." Appendix D. Staging Parkinson's Disease. Pages 202-205. Second Edition. DemosHealth 2013