Frequent moving to minimize the pressure a position imposes on body structures. Position changes are especially important for people whose symptoms confine them to wheelchairs or to bed. At a minimum, a person should change position every two hours during waking hours and should not remain in the same position more than four hours even at night. Most people even when sleeping change position frequently; position changes become challenging for the person with Parkinson’s, who may fidget and have trouble falling asleep and then remain in the same relative position much of the night. Skin that is in contact, under pressure, with a surface for a prolonged period is vulnerable to tissue tenderness and breakdown.
People with Parkinson’s tend to maintain one position for extended periods often because moving requires too much effort or they cannot move independently. Standing to stretch, or at least stretching out the arms and legs, for a few minutes every hour during waking hours is good for the muscles; relieves pressure, even if slightly, on contact points; and helps maintain alertness. Engaging in movement such as walking is even better. When changing positions becomes a problem because of Parkinson’s disease’s physical limitations, creativity is often required to create the support the person needs.