Parkinson’s disease is a chronic progressive neurodegenerative disease that is characterized by motor symptoms, that is, tremor, bradykinesia, and rigidity, all of which contribute to impaired smoothness and coordination of muscle movements.

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It happens when nerve cells in the brain, especially those that produce a certain chemical known as dopamine, are damaged. This is another critical and debilitating motor symptom that greatly increases fall risk and negatively affects quality of life.

Postural instability, or postural control impairment, is another major motor symptom with an impact on balance and fall risk (Bergquist et al., 2015). This instability will have static and dynamic aspects due to impaired postural reflexes, slowness and stiffness.

Genetic risk factors and age-related decline in (postural) sensory and motor function also contribute to postural instability in people with PD. Postural instability is a major contributor to falls, injuries, and impaired quality of life.

Medications used to treat PD can often lead to side effects, one of which may become dyskinesias (involuntary movements) which in turn can compound balance problems.

Balance exercises are shown to prevent falls, improve quality of life, and also improve cognitive function in patients with Parkinson’s disease.

Balance training consists of two types of exercises.

Static standing balance

Standing facing a chair

Standing (heel-to-toe)

Standing on one leg

Side weight shift

Dynamic balance

Tandem walking – walking heel to toe

Sideways stepping

Wall leans

Reverse walking

The flamingo exercise is a simple balancing training that means standing on one leg like the way the bird stands. It builds balance and stability and lower-body strength, making it a good choice for recovering athletes, older adults, and people with conditions such as Parkinson’s. As per a

published in the Journal of Back and Musculoskeletal Rehabilitation, “dynamic flamingo therapy combined with balance exercises with a static posturography device improves balance disorder in PD patients compared to therapy restricted to individual training.”

Balance training tips: How to do it if done well, safe

Start slowly

Do not miss medications (potential worsening of motor symptoms)

Use support

Relaxed breathing

Add in progression to more challenge such as ground svays, uneven evoke and run multi multi-tasking.

Using external cues, such as verbal or proprioceptive feedback, can enhance balance.

Include new equilibrium practices into daily exercises, for example, when strolling, turning around, preparing or utilizing cutlery, preparing the showcase, closet, etc.

Dr. Amrut SD, Associate Consultant – Neurology, Manipal Hospitals Goa

A woman’s rare condition of hyperosmia, an incredibly sensitive sense of smell, helped her sniff out the Parkinson’s disease; talk about miracles!

The medical marvel!

It’s not a new invention, Joy Milne herself is quite a bit of a medical marvel!

The Scotswoman, who had been with her now-late husband, Les, since she was 16 years old, had been accustomed to his smell, given their familiarity with each other for such a long time.

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A few years after marrying her husband, Joy noticed an unusual whiff coming from his body. The oddly “musty” odor was being emitted by his shoulders and from the back of his neck. While she kept telling him that he must not be showering properly, he dismissed her suspicions with anger at that moment.

However, as years went by and the smell didn’t go away, the couple became concerned. At last, when Joy took Les to the doctor, he was diagnosed with Parkinson’s disease.

What followed after that diagnosis revealed that Milne could actually “smell the Parkinson’s disease” with her heightened sense of smell. Her rare ability is helping scientists develop a faster diagnosis for Parkinson’s, as per a report published in the

It is noteworthy here, that Science has already worked out why a person’s smell changes as they age, which all comes down to the substance 2-nonenal that’s found in the human body increasing as we get older.

However, Les’ changing smell wasn’t just age related, but health related as well.

The minute change!

Joy has had the rare condition of hyperosmia, which refers to a heightened or increased sensitivity to smells, often described as a “super-smeller” condition, where individuals perceive odors more strongly than average, which enabled her to have an ability to sniff out things – something that the rest of us wouldn’t be able to.

Noticing a change in smell in her husband, Joy revealed what she had told the same to Les.

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When Les was around 29 years old, Joy revealed, “there was a definite change, a very distinct change,” and by the time he was 31 “his smell had completely changed” and other things had “begun to happen”, leading her to think “maybe he had a brain tumour”.

Recalling the time, she told The Guardian: “In 1982, before Les’s 32nd birthday, I noticed a musky, dank odour on him – he knew about my heightened sense of smell. I thought it might be the unprocessed air of the operating theatres he worked in and told him to shower more.

That caused arguments.”

Eventually, a neurologist diagnosed Les with Parkinson’s.

Now, ancient healers had such finely tuned senses that they could detect a disease simply by observing a person up close.

However, in the modern day, Joy miraculously has a similar ability called ‘hyperosmia’, a hypersensitivity to smell.

After Les’ diagnosis, the couple went on to make the connection between Joy’s sense of smell and his diagnosis, but it wasn’t until later that they discovered that Joy was able to detect the disease in other people too.

The aftermath:

Several years after Les’s diagnosis, the couple became part of a Parkinson’s support group. As they entered the room, Milne realized that several people there emitted the same “musty” smell she had first detected in her husband.

In fact, Joy revealed that she had received dozens of T-shirts each day at her doorstep from strangers wanting to know if they had Parkinson’s disease. Although nowadays, she doesn’t open the packages herself, as she told The Telegraph, she smelled every T-shirt the first time scientists sent these to her, to test her amplified sense of smell.

Les and Joy had attended a Parkinson’s support group when she was hit with an overwhelmingly familiar smell. After coming to learn about the scale of her unique skill was, Joy has gone on to do all she can to help scientists work out a way to use her sense of smell as a means of early Parkinson’s disease detection.

Joy revealed, “Les and I should have been enjoying retirement, but Parkinson’s had stolen our lives,” adding, “We became determined that others wouldn’t suffer the same way.

When Les died in June 2015, he made me promise I’d carry on. I spent time in labs, smelling sufferers’ T-shirts and swabs for sebum – the skin oil we all produce, which changes with the onset of Parkinson’s. I could detect whether the person had the disease with 95% accuracy.

I was surprised.”

The miraculous invention:

After Les got diagnosed with Parkinson’s disease, he and Joy reached out to Tilo Kunath, a Parkinson’s researcher at the University of Edinburgh in Scotland.

To test her claim, the researchers gave her a set of T-shirts worn overnight, some by Parkinson’s patients and some by healthy people. The researchers asked Joy to sort the garments into two separate piles based on which ones were worn by Parkinson’s patients and which ones by healthy individuals.

Tilo told NPR, “She was incredibly accurate!” In a press release, he said, “Our early results suggested that there may be a distinctive scent that is unique to people with Parkinson’s.

If we could identify the molecules responsible for this, it could help us develop ways of detecting and monitoring the condition.”

As Joy’s sense of smell spurred curiosity in scientists, she then initiated this study funded by the Michael J. Fox Foundation.

Joy, a retired nurse from Perth, started collaborating with throngs of researchers, including Perdita Barran, a professor of mass spectrometry, from the University of Manchester in the UK, to develop a tool for early detection of Parkinson’s.

They ended up developing a unique skin-swab test that could enable doctors to detect this disease in less than three minutes.

Devising the experiment:

Professor Barran told Sky News, “We had to do an experiment to separate the obvious movement symptoms of people with Parkinson’s disease from the smell.”

They had people wear T-shirts and then put the T-shirts in bags, which were given to Joy, who “was 100% correct in smelling the T-shirts and diagnosing from a T-shirt whether someone had Parkinson’s or not”.

Professor Barran said, “So that was the first incredible step change, because it actually meant we could diagnose someone from the material that they were wearing, from clothes.”

They now use gauze or Q-tips to collect samples and analyse them using a method called mass spectrometry, which “weighs molecules and helps us to find out what they are”. The method allows Joy to smell molecules while they are identified by the machine.

Professor Barran explained, “So we split them. Some go to be weighed and some go to Joy’s nose. And that allows us to code to find out which of the very complicated mixture of molecules we have on our skin from skin swabs, are to do with the disease, are the ones that smell of it.”

The impact:

Neurologist Monty Silverdale told EuroNews, “This test has the potential to massively improve the diagnosis and management of people with Parkinson’s disease.”

The study authors described in a press release that people with Parkinson’s have certain lipids of high molecular weight in their “sebum,” an oily substance found on the skin, that are more active. As per them, sebum tends to collect in the upper back region, the same area where Milne noticed the unusual musty smell in her husband.

According to the BBC, the “skin swab test” now collects sebum from patients’ backs and uses mass spectrometry to detect the disease with 95% accuracy under laboratory conditions.

Parkinson’s, according to the Parkinson’s Foundation, is a neurodegenerative disorder that affects the dopamine-producing areas of the brain, often reducing movement and causing postural instability, limb stiffness, pill-rolling tremors, and slowness.

While the cause behind this disease remains largely unknown, an estimated 1 million Americans are living with Parkinson’s. In such a scenario, this swab test could prove to be groundbreaking.

What is Parkinson’s disease?

Parkinson’s disease is a progressive brain disorder that causes movement problems, including tremors, stiffness, and slowness. It’s caused by the death of nerve cells in the brain that produce dopamine, a chemical that controls movement.

Joy, while talking about whether she finds it a blessing or extremely difficult, told Sky News, “I think, because it’s a genetic thing in the female side of the family, my grandmother did warn me when she trained me, she did warn me not to use [it].

She added, “She said I would find it very difficult unless I made the decision that I would go ahead and do it. And I have made that choice. I was a nurse, a carer for my mother-in-law and my husband with Parkinson’s, and really it was the right choice. I think it was the right choice.”

Several countries have notified citizens of new changes Tada Images/Shutterstock

The French Foreign Ministry has updated its travel advice for citizens visiting the United States in relation to new rules for the visa and ESTA (tourist visit) applications.

The Ministry noted that applicants for these documents must use their birth gender when completing the document.

“For new visa or ESTA applications, it should be noted that a section has been added requiring, under the Presidential Decree of January 20, 2025, that “sex at birth” be indicated,” the Ministry states.

Transgender individuals may have an ‘X’ in this section of their passport however US President Donald Trump has ordered US officials to only recognise ‘male’ and ‘female’ as gender responses after coming to office at the end of January.

The Ministry also advises citizens planning to travel to check the US Embassy in Paris website for any further updates.

However, no heightened travel warnings for visitors to the US have been issued on the matter.

Several countries notify citizens of change

It joins several other countries including the UK, Canada, and EU counterpart Germany in advising citizens about the new rules.

Fellow EU country Denmark has gone further, warning transgender people they may be barred from entering the US.

Finland’s foreign ministry has also warned that visitors may be refused entry if their travel documents contain different information than their gender assigned at birth.

The ESTA (Electronic System for Travel Authorization) is a visa-waiver for short-stay travellers (less than 90 days) to the US.

It is similar to the UK’s Electronic Travel Authorisation (ETA) and the EU’s incoming European Travel Information and Authorisation System (Etias).

You can read about the EU and UK counterparts in our explainer articles below.

Read more: What are the rules for the UK’s new border security ‘ETA’?

Read more: Etias travel permit for EU: April 2027 earliest date for enforcement

Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.

Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content.

The United Kingdom and Germany have updated their travel advice for citizens planning to visit the United States, warning of potential arrest or detention if they fail to comply with entry requirements.

Citizens are urged to ensure they have the correct documentation and to adhere to all visa conditions when entering the country.

The U.S. has a range of entry requirements, including needing an Electronic System for Travel Authorization (ESTA) approval for short-term visits under the Visa Waiver Program.

Failure to meet these requirements can result in travelers being denied entry, detained, or deported.

The United Kingdom and Germany have updated their travel advice for citizens planning to visit the United States. The United Kingdom and Germany have updated their travel advice for citizens planning to visit the United States. Benny Snyder/AP

Why It Matters

On March 9, a French scientist was denied entry to the U.S. while on assignment for the French National Centre for Scientific Research (CNRS) after immigration officers searched his phone and found messages that were critical of President Donald Trump, the Guardian reported.

Additionally, U.K. tourist Becky Burke was deported from the U.S. earlier this month after enduring 19 days in a U.S. detention facility, according to the BBC. She was detained by U.S. immigration officials despite believing she had followed the correct procedures for her entry requirement.

What To Know

For many visitors from Visa Waiver Program (VWP) countries, applying for authorization through the Electronic System for Travel Authorization (ESTA) remains a mandatory requirement.

The VWP allows most citizens from 43 countries to travel to the U.S. without a visa for tourism or business for stays of up to 90 days. The ESTA is therefore not a visa, but a pre-screening system used by U.S. Customs and Border Protection (CBP) to determine the eligibility of travelers entering under the VWP.

But the CBP warns: “An approved ESTA does not guarantee entry; the final decision rests with border officers.”

The official ESTA application website processes these applications, and approvals are typically valid for two years. Travelers can visit the U.S. State Department website to see if their country is included in the VWP program.

However, individuals from VWP countries who have travelled to Iran, Iraq, North Korea, Syria, Sudan or Cuba, or who hold dual nationality with those countries, do not qualify for the VWP.

Instead, they must apply for a visa through the U.S. Department of State’s visitor visa process, which includes an in-person interview and fingerprinting.

To apply for a visitor visa (B-1/B-2), travelers must complete the online DS-160 form, pay a non-refundable application fee, and schedule an interview (if you are between the ages of 14 and 79) at a U.S. embassy or consulate.

Applicants must provide a passport, photo, and documentation showing the purpose of the trip and intent to return home, such as proof of employment or family ties.

Additional biometric information may be required depending on the applicant’s country of origin.

What People Are Saying

Germany’s Foreign Ministry wrote on its website on Wednesday: “A criminal conviction in the United States, false information regarding the purpose of stay, or even a slight overstay of the visa upon entry or exit can lead to arrest, detention, and deportation upon entry or exit.”

It added: “Neither a valid ESTA authorization nor a valid U.S. visa constitutes a right to entry into the USA. The final decision regarding entry is made by the U.S. border official. It is recommended that you bring proof of your return journey (e.g. flight booking) upon entry.”

The U.K. issued similar guidance, stating on Thursday: “You should comply with all entry, visa and other conditions of entry. The authorities in the U.S. set and enforce entry rules strictly. You may be liable to arrest or detention if you break the rules.”

Nick Parkinson, partner at the UK-based law firm TravLaw, told Newsweek: “The fact that having a VISA/ESTA does not guarantee entry into the USA is nothing new but, perhaps, occasionally overlooked by many travelers. My assumption is that stories of travelers being detained or refused entry on arrival are on the rise as part of an increase in checks and/or stricter decision making at the U.S. border – no doubt in keeping with the new Trump regime’s desire to appear strict on border control.

“The bottom line is that, so long as travelers meet all the criteria for entry and have ‘nothing to hide’ and have not concealed anything, it is unlikely that they will run into trouble at the border.”

What’s Next

Travelers are advised to verify their visa status and entry eligibility before departing, as U.S. border agents retain discretion to deny travelers entry regardless of prior approval.