At the University of Florida Center for Movement Disorders and Neurorestoration a patient can partake in a physical therapy evaluation that includes an analysis of your gait. Freezing of gait occurs in Parkinson’s disease and can contribute to loss of balance and subsequent falls. Our physical therapist will work with you to determine the triggers that contribute to freezing and then provide compensatory strategies to help decrease freezing.
Common triggers of freezing include:
- Crowded environments
- Turning corners
- Tight enclosed spaces (such as a saturated closet in your home)
- Changes in flooring such as when walking from a room with wood flooring to a room with tile flooring
- Crossing over thresholds, **particularly from outside to inside or from inside to outside
- Turning around in a circle
- Divided attention or distractions
What can be done to “thaw” one out when freezing occurs?
There are various cues and/or tricks that can be tried with your physical therapist to determine which cue will work best for you. Examples of such cues include:
- Visual cues: Provide feedback to through your eyes and visual system to provide you with a location to place your foot when stepping. Visual cues include: lasers on canes and U-step walkers, placing lines of tape on the floor, placing X’s of tape in a semi-circle in tight spaces, and stepping over the foot of the therapist while gait training.
- Auditory cues: We rely on feedback through our ears to establish a rhythm “step to the beat”. These cues come in the form of music, counting out loud “1,2, 3..”, or using a metronome. There are also applications for smart phones that can provide sounds like a metronome that your therapist can demonstrate for you!
Not every cue works for every patient! But it is important to consult with your PT to find which one will help you.
For more information, please consult with your Neurologist or contact Shands Rehabilitation at the Center for Movement Disorders and Neurorestoration @: 352-294-5385
Lohnes CA, Earhart GM. The impact of attentional, auditory, and combined cues on walking during single and cognitive dual tasks in Parkinson disease. Gait and Posture 33 (2011) 478-483.
Plotnik M, Giladi N, Balash Y, Peretz C, Hausdorff J. Is freezing of gait in Parkinson’s Disease Related to Asymmetric Motor Function? Annals of Neurology. Vol 57 No 5, May 2005