Search our website

Freezing of gait

 

Freezing of gait is a sudden, short, temporary, unpredictable inability to walk. This occurs despite the fact that the person wants to and is trying to walk.

It is described as “…feeling like my feet are stuck to the floor”.  The feet stay in place and the body continues the forward motion – increasing the risk of falling and injury.

It can be a common symptom of Parkinson’s but not everyone living with Parkinson’s experiences freezing.  Many people experience issues with freezing of gait when they are in middle or advanced stages of their Parkinson’s journey – it is dependent on the duration and severity of the Parkinson’s.

Dopamine in the brain is very involved in the movement of the body.  People with Parkinson’s have reduced levels of dopamine in their brain which then affects movement including walking, falling, and freezing.

The brain circuitry that controls movement is very complex with different parts of the brain interacting to produce controlled movement.  The frontal lobe of the brain plans and initiates movement.  The basal ganglia controls and regulates voluntary movement so that it can be performed smoothly.  The brainstem regulates balance and coordination.

The cause of freezing is not fully understood, and it cannot be explained by slow movement or stiff muscles.  It is thought to be linked to the medication cycle and occurs more commonly during ‘off’ periods.

Freezing can occur with other repetitive tasks including speaking, writing and teeth cleaning.  It can also occur whilst attempting to multitask.

Start hesitation occurs when there is trouble starting a movement.  It can happen when trying to step forward after standing up, starting to get out of bed or trying to swallow either food or fluid.

Causes of freezing of gait

  • It is not fully understood as to why a person freezes
  • It happens when there is a disruption to the normal pattern of movement
  • Anxiety and stress
  • Losing concentration whilst walking
  • Missed medication
  • Constipation

Triggers for freezing

  • Walking through doorways
  • Turning around
  • Turning a corner
  • Multitasking
  • Starting to walk
  • Navigating obstacles or narrow or crowded spaces

Managing Freezing

  • There is no magic treatment
  • Medication review
  • Physiotherapy to build core strength and reduce risk of injury
  • Occupational Therapy review to minimize injury and advise on assistive devices
  • Learn about triggers and strategies to manage a freezing episode
  • Exercise regularly for fitness, strength, and balance
  • Wear supportive footwear at all times
  • Use prescribed walking aids
  • Have regular vision checks
  • Wear clean glasses
  • Ensure that care is taken when wearing bi/multi focal glasses
  • Maintain good posture by focusing and maintaining an exercise regime

Tips to Get Moving

  • Take medication on time every time
  • Focus, as attention is required for balance
  • Wait and remain calm
  • Do not rush
  • Shift weight from side to side
  • Sing, hum to a rhythm
  • Use a metronome for the beat
  • March on the spot
  • Stand still and swing the arms
  • Turn in a square or half circle instead of pivoting
  • Avoid distractions
  • Focus on taking long strides
  • Pretend that there is an imaginary line to step over.

Useful resources

  • Want to take part in Parkinson’s research or studies? Visit this link on our website
    Take part in research
  • Clock Yourself application – combines cognitive and physical challenges into a brain game that makes you think on your feet. Available for Apple and Android devices https://www.clockyourself.com.au/
  • What is a metronome? Thanks to Viv, Nepean Blue Mountains Support Group leader for this explanation:  It’s a musical machine that gives the beat.  Its adjustable for faster and slower beats, and available on your smart phone. Metronome Beats is a free application for Apple App Store (Apple) and Android phones: Google Play.
  • Dance for Parkinson’s is offering online exercise classes three days per week. For more information visit this link Dance for Parkinson’s online classes
  • Speech and voice: The link to the free recorded lessons from the Parkinson Voice Project
  • UTS runs a speech therapy clinic. For more information: UTS free speech pathology
  • Wellness Wednesday Video Series offers information and guided exercise  –  Wellness Wednesday videos

Related research

  • NeuRA and Sensoria Health are preparing to start a study to test smart sock prototypes that vibrate in order to stimulate the feet and encourage a smooth rhythm while walking. The project is called Walking Tall.
  • Shake it Up is also doing research into brain exercises/training to increase reaction times but so far has only been a small group and needs to be undertaken in a larger study to gain real understanding and knowledge.
  • Sydney University Brain & Mind Institute are doing some research in a stimulator to the spinal cord, but this is in the very earliest research stage

References

  • Parkinson’s UK
  • American Parkinson’s Disease Association
  • Michael J Fox Foundation
  • Parkinson’s NSW
  • Parkinson’s Victoria
  • Parkinson’s Foundation
  • Shake it Up
  • NeuRA
  • Professor Simon Lewis

Menu