Parkinson’s: Freezing of gait, how to manage it
For Parkinson’s disease, freezing is a common symptom, but it can affect people in different ways.
In freezing episodes, a person freezes while walking, often when they are changing direction or about to take a step, as if their foot were glued to the ground. But freezing can also have repercussions on other movements. Some Parkinson’s sufferers say they have had freezing episodes in the midst of continuous action, such as brushing their teeth or combing their hair.
Freezing can also affect speech and many people with Parkinson’s say they often freeze midsentence. Most of the time, freezing in Parkinson’s is a temporary action, which, although frustrating, is quickly overcome.
There are a few things you can do to prevent freezing episodes and to overcome them quickly when they occur.
Parkinson’s, what to do when you have freezing episodes
If you have regular freezing episodes, you can talk to your physiotherapist or occupational therapist to develop strategies to manage them. In the meantime, in order to help prevent freezing incidents, be sure to take your medication on time and at the correct dosage, walk to a rhythm (listening to music or a beat can help), take long strides when walking and concentrate on walking with no distractions.
When a Parkinson’s freezing incident does occur, here are some tips that can help you get over it quickly.
Pull your legs up one at a time, marching on the spot, so as to regain fluidity and be able to finish the movement. Also try to swing your arms while standing still.
As you walk, count or repeat left, right, left, right while staying focused on the action. Take your next step at a specific point on the floor.
Paint the tip of the stick you use for walking or, if you often have freezing episodes in one particular place in the house, place coloured tape there to mark it as a visual reference to overcome the freezing. Also try to visualise an imaginary line where you are walking.
Ask for help from friends or family; a little encouragement from those around you who love you can help you get through the freezing episode.
Try to move in another direction. For example, shift your weight from one leg to the other, or from your front leg to the back one.
Freezing and Parkinson’s, potential treatments and preventive strategies for freezing of gait
Current treatments are unable to adequately control freezing of gait in Parkinson’s, since the spread and progression of the pathology are different from patient to patient and complex to delineate.
This makes it difficult to adapt drug therapies to the needs of each patient, especially at an advanced stage of Parkinson’s disease, when freezing becomes resistant to dopamine.
Another difficulty in the treatment of freezing in Parkinson’s is its heterogeneity: freezing of gait does not occur in the same way in all Parkinson’s patients.
Dr Gilat, a postdoctoral researcher at the Department of Rehabilitation, University of Leuven in Flanders, Belgium, states:
“This indicates that each Parkinson’s patient likely has a unique neural substrate that causes freezing. Any generic treatment is, therefore, prone to be helpful for some, but not others.”
A multidisciplinary approach is therefore the best solution to treat freezing in Parkinson’s, combining drug and non-drug therapies such as GONDOLA to provide personalized, effective treatment programs.