Bradykinesia (slowness of movement)

What does bradykinesia mean?

Bradykinesia is when your natural movements slow down and it becomes more difficult to start or maintain amplitude of movement and the progressive slowing of sequential movements.

It affects up to 98% of people with Parkinson’s and is one of the key symptoms looked for to make a diagnosis.

Taken from Greek words meaning ‘slow’ and ‘movement’, the term was first used by Dr James Parkinson in 1817.

Bradykinesia symptoms and signs

The impact bradykinesia can have on daily activities and social interactions may include:

• Your movements slowing down until the movement breaks down or becomes fatigued
• Reduced coordination
• A shuffling walk – taking slower, shorter steps
• Hypokinesia – where your movements become smaller, such as a softer voice and smaller handwriting
• Akinesia, (loss of movement), such as less facial expressions and less eye blinks
• Feeling tired more quickly
• Finding it difficult to chew and swallow

Bradykinesia is a key sign of Parkinson’s, often noticed first by family and friends. It commonly affects one limb, one side of your body, and progresses to affect both sides of your whole body, which can make you unnaturally still.

If bradykinesia is not present the doctor may investigate for other diagnoses, but for a clear diagnosis of Parkinson’s, it has to be present.

The condition often varies from moment to moment. This can be frustrating, as good quality of movement can quickly be followed by poor quality.

As movements become slower and more difficult, you tend to move less and so Parkinson’s impacts more on daily life. Reduced co-ordination and, surprisingly, increased muscle tone, may contribute to bradykinesia.

How is bradykinesia diagnosed and is there a test?

Bradykinesia is a feature of a number of illnesses, so it needs to be accurately diagnosed.

Bradykinesia causes difficulties with rapidly repeated movements. To make an assessment, the doctor will ask you to perform rapid, repetitive hand movements, such as tapping your finger and thumb together, gripping and releasing, or moving your palms up and down. Or you may be asked to rapidly tap your foot up and down. They will assess the asymmetry, the amplitude, fatiguability and breaking down of movement.

The doctor will investigate your family history and also your medical history, since certain medications can cause slowness of movement. In a few cases, the assessment may involve a test such as an MRI scan, to exclude the possibility of a tumour or stroke.

What causes bradykinesia?

Bradykinesia is caused by reduced levels of dopamine in the brain and is often first noticed by family and friends.

Can you have bradykinesia without Parkinson’s?

Yes. While Parkinson’s disease is the most common cause of bradykinesia, other causes can include Lewy body dementia, progressive supranuclear palsy, and use of certain antipsychotic medications (haloperidol and metoclopramide).

Bradykinesia treatments

Medication

Bradykinesia generally responds well to Parkinson’s medication, especially in the early stages. As with all Parkinson’s medicines, treatment is very individual. What works for one person may not work for another, so your doctor may try several approaches to see what works best for you.

Levodopa is the drug most often used to treat bradykinesia. Other drugs, such as dopamine agonists, anticholinergics or amantadine may also help. Your doctor will usually be your first point of contact and can help by adjusting your medication. They might also refer you to a doctor who specialises in movement disorders.

In some countries, there are Parkinson’s Disease Nurse Specialists or nurses who specialise in neurology who can help.

Adjunct non-pharmacological therapy

Once diagnosed, your doctor may refer you to a physiotherapist or occupational therapist who will look at your symptoms and recommend exercises and techniques to help with slowed movement.

• Physiotherapists can give advice on how to improve the quality of movement during everyday activities, and suggest exercises to maintain or improve amplitude and speed of movements.
• Occupational therapists can also help with changes to your routine and adaptations to the environment to help you stay mobile and independent.
• Both occupational therapists and physiotherapists can advise on devices and aids to help with mobility.
• Speech and language therapists can show you ways to increase the loudness and clearness of your voice, and also help to improve issues with swallowing and breathing.
• Massage or therapies with heat can help to keep your muscles more relaxed and alleviate any pain from muscle contraction.

The type of therapist you are referred to will depend on where you live, the resources available and your individual needs. Treatment may or may not be funded through your country’s national health system.

What can I do at home to manage or relieve the impact of bradykinesia?

It is important to keep active despite slowed movement. These suggestions can help you to maintain your independence and mobility:

• Make an effort to take your medication on time and be attentive to when you may need adjustments.
• Maintain mobility as much as possible and do the daily exercises that have been recommended to keep your muscles active, strong and flexible.
• Adjust your daily routine to your level of physical capacity. For example, do things that require more effort at the time of day you feel most mobile. Build in rest periods during the day.
• Make life easier by using helpful devices such as Velcro instead of buttons, elastic waistbands, height-adjusting beds and raised seat cushions, which make it easier to get out of a chair.
• Parkinson’s tends to shrink movements without you realising it, so consciously exaggerating them helps counter that. Take bigger steps, swing your arms, write larger, project your voice. It feels over-the-top from the inside but usually looks just right from the outside.
• When a movement won’t start, or your feet feel stuck, an external prompt can unlock it. Counting “1, 2, 3, go,” marching to a beat in your head or to music, or stepping over a line on the floor (real or imagined) all give your body a signal to lock onto.
• Try to break big movements into steps. For example, getting out of a chair is easier as a sequence than as one go: shuffle to the edge, feet back, lean forward so your nose is over your toes, then push up. Mentally rehearsing a movement before you do it can help too.
• Aim to get good sleep, stay hydrated and manage fatigue. These all affect how well you move, and slowness is often worse when you’re tired or run down.
• Maintain a positive attitude – this can be very helpful in overcoming all sorts of difficulties.

Is bradykinesia the same as akinesia or hypokinesia?

No, but you may hear the terms akinesia and hypokinesia used in relation to bradykinesia. Akinesia means a loss of movement, for example, lack of facial expression or rarer eye blinks.

Hypokinesia refers to movements that are reduced in scale, such as the small handwriting (micrographia) or soft voice (hypophonia) associated with Parkinson’s. It is possible to experience all of these conditions.

Does levodopa help with bradykinesia?

Levodopa is the most widely used Parkinson’s medication, and can help with slowness of movement, as well as stiffness and non-motor symptoms.

Does bradykinesia get worse over time?

Bradykinesia is expected to worsen as Parkinson’s progresses, but not everyone will experience its progression in the same way. If you are taking levodopa, over time it may not last as long in your system, leading to ‘off periods’. So it is important to keep speaking to your doctor so they can decide if you may need a different treatment regime.

References and acknowledgements

We would like to thank the following:

• Parkinson’s UK for permission to use the following source: Slowness of movement.
• Prof Jorik Nonnekes (Radboud University Nijmegen Medical Centre, The Netherlands) for his help in reviewing an earlier version of this information.
• Physiotherapist Parkinson’s Specialist (Egas Moniz School of Health & Science, Lisbon) Prof Josefa Domingos for reviewing this information

Content last reviewed: June 2026