Freezing in PD

People who know about freezing in Parkinson's Disease (PD) usually think of 'freezing of gait' (FOG) or the experience of being unable to initiate a step.  It can feel like one's feet are stuck to the floor.  But someone with PD can also experience freezing of arm and hand movements, freezing of speech, or cognitive freezing where they lose their train of thought or momentarily forget what they are doing.  These resources will help you understand freezing and what can be done to prevent freezing and to get 'unstuck.'


Downloadable Documents | Online Articles | Videos, Podcasts & Webinars | Expert-level Resources


Downloadable Documents

Freezing

Published by Parkinson's UK, November 2018

This 20-page PDF discusses what freezing is, why people freeze, where and when it can happen, who freezing is likely to affect, whether freezing is the same as having an OFF episode, whether freezing can be dangerous, treatment options, and what you can do to help yourself, including movement strategies and cueing.  There is a short section on what to do if you freeze in a busy place.


Freezing and Parkinson's

Published by the Parkinson’s Foundation

Learn what freezing is, what causes or triggers freezing, why freezing it dangerous, how to manage freezing episodes, tricks to get moving again, and how someone can help you during a freezing episode.


Online Articles

5 Tricks to Move Through Freezing Episodes in Parkinson's Disease

Published by the Michael J. Fox Foundation, February 4, 2015

A list of five things to try if you experience freezing of gait.


6 Ways to Reduce Parkinson's Freezing of Gait

By Sarah King, PT, DPT. Published by the Davis Phinney Foundation, March 14, 2019

If you experience freezing of gait, the first course of action is to maximize your PD meds to keep you in an ON state for longer. However, there is a cognitive component of freezing that medication and deep brain stimulation (DBS) do not help. Therefore, the best treatment option is to work with a physical therapist to retrain your brain, wear the right shoes, walk with intention, keep your feet wide, keep your head up, and shake off your stress.


Ten Tips to put the Freeze on Freezing!

Published by the American Parkinson Disease Association

A list of 10 things to try if you experience freezing of gait.


Coping With Freezing in Parkinson's Disease

By Patrick McNamara, PhD, Published by Very Well Health, January 30, 2020

This short article is not just focused on freezing of gait, but explains several ways the body can freeze, along with causes, common triggers, management with tips to get moving again, and support (how someone can help during a freezing episode).


Freezing

Published by the European Parkinson's Disease Association, June 2020

This extensive article discusses why people with PD freeze, whether freezing is related to the intake of dopaminergic medications, treatment and management (medication, physical and occupational therapy, exercise, and DBS), and what you can do to help yourself (compansation strategies like rhythmic and auditory cues).  Also included is a chart from 2019 showing classification of compensation strategies for gait impairments in Parkinson's disease and their possible working mechanism.  


Freezing

By Parkinson's UK

This lenghthy webpage discusses freezing of gait and how to help yourself, including two short videos with tips.  The first video is 2-minutes demonstrating how to use masking tape on the floor as a visual cue to overcome freezing of gait.  The second video is a 45-second clip showing how a person with PD uses a clip-on metronome to prevent freezing while walking.


Freezing of Gait in Parkinson's Disease

Published by the American Parkinson Disease Association, April 9, 2019

This short webpage explains what freezing of gait is, why it occurs, and treatment.  It also offers 10 tips to prevent freezing or get 'unstuck.'  Finally, there is a discussion of walkers that can prevent injury due to falls when freezing episodes are severe and the future of treatments for freezing of gait.


Overcoming "Freeze"

By Editorial Team, Published by ParkinsonsDisease.net, March 24, 2017

This short article briefly describes freezing but focuses on freezing of gait when describing the negative consequences of freezing and techniques to overcome freezing.


To Freeze or Not to Freeze: Strategies to Circumvent Freezing

By Marina Noordegraaf, Published in the Sparks Blog, April 2, 2019

A discussion of how the blogger circumvents mental freezing in the same ways people with PD overcome freezing of gait.  She found inspiration in an article by Jorik Nonnekes, et. al., which collected videos of patients who bypassed freezing episodes and supplemented their findings with literature research. The end result is the dozens of unique freezing compensation strategies visualized in this blog post.


Videos, Podcasts & Webinars

Current Approaches and Hurdles in Parkinson’s Disease Freezing of Gait

By Beth Israel Deaconess Medical Center, November 12, 2019

In this 52-minute talk Lan Luo, MD, from the Parkinson’s Disease and Movement Disorders Center at BIDMC explains freezing of gait (FOG), including how FOG manifests, FOG triggers, 'on,' vs. 'off' FOG, the brain pathways that are implicated in FOG, who gets FOG, several available treatments, and how to avoid falls.


Freezing

By the Parkinson's Foundation

In addition to several bullet point facts about freezing, falls due to freezing, and tips to get over a freezing episode, this webpage has two short videos.  The first video is a 30 second demonstration by a person with PD, showing how she breaks a freezing episode.  The second is a 3-minute video by a movement disorders specialist with several tips for overcoming freezing of gait.


Freezing

By Parkinson's UK

This lenghthy webpage discusses freezing of gait and how to help yourself, including two short videos with tips.  The first video is 2-minutes demonstrating how to use masking tape on the floor as a visual cue to overcome freezing of gait.  The second video is a 45-second clip showing how a person with PD uses a clip-on metronome to prevent freezing while walking.


Freezing of Gait

By The Lancet TV, July 13, 2015

This two and a half minute video shows a patient with PD manifesting the typical features of freezing of gait. The first segment shows the walking pattern during the off-phase. The freezing of gait episodes have an intermittent character and worsen when turning and while approaching a narrow passage (crossing a doorway). The second and third segments show the beneficial effect of visual and auditory cueing. The fourth segment shows the patient during the on-phase, showing a clear therapeutic effect of dopaminergic medication.

 


Freezing of Gait

By PD-Connect, April 1, 2023

Physical therapist Maria Allen, PT, shares the cluster of Parkinson's (PD) symptoms that tend to go together and include freezing of gait. She explains what freezing is, why it happens in people with PD, and that it doesn't just affect walking, but can also affect thinking, speech, and the hands. Most of the hour is spent discussing how a physical therapist should help you retrain habits to compensate for freezing and maintain independence. Finally, she discusses how to find a physical therapist who specializes in treating PD and answers questions.

 


Freezing of Gait & Interventions For Freezing Triggers. Tips for people with Parkinson's

By Mia Boelen, Published by Parkinson's PT, July 3, 2021

Miriam "Mia" Boelen, PT, specialized in the treatment of those with PD from 1990 until her retirement in 2019.  In this 27-minute video she demonstrates a 4-step method of specific maneuvers to break a freezing of gait episode. She also discusses common triggers and situational freezing, like crowded areas with tips for overcoming freezing in every case.

 


Freezing or Sweating Falls When Walking with Parkinson's Disease

By the Parkinson's Foundation, January 16, 2018

In this 1-hour webinar Fay B. Horak, PhD, PT, shares ways to improve brain function to minimize freezing and falls with Parkinson's Disease.  Viewers will understand how the brain controls walking and balance, discover what types of balance and gait impairments in Parkinson’s disease result in freezing and falls and explore what can be done to minimize freezing and falls.


Parkinson's & Freezing of Gait

By PMD Alliance, March 27, 2019

During his time at the Stanford Movement Disorders Center Brent Bluett, DO, researched indicators for who is most likely to develop freezing of gait (FOG) in PD.  In this 45-minute Lunch with Docs episode Dr. Bluett provides an overview of FOG, shares tips for breaking a freeze, treatment options (medication management, physical therapy), summarizes the results of his research and other research into FOG.  He spends about half the webinar answering questions.


Thawing Out - Strategies to Reduce Freezing in Parkinson's Disease

By Parkinson Society British Columbia, September 21, 2020

In this 1-hour webinar neuro-physiotherapist Shelly Yu discusses how freezing manifests itself in different parts of the body, the complexities of why people with PD freeze, barriers to treatment of freezing, what works to prevent or break a freeze, like cueing.  Shelly shares agility/cognitive exercises that help keep the body and brain working together.


Expert-Level Resources

A Case of Apparent Upper-Body Freezing in Parkinsonism while Using a Wheelchair

By Samuel T. Nemanich, et. al., Frontiers in Neurology, 2017, 8:205

This case study reports on a 60-year-old female with a 24-year history of parkinsonism who experienced significant freezing of gait (FOG) when ambulatory. Disease progression resulted in her permanent use of a powered wheelchair. While using the power chair, the patient experiences apparent paroxysmal freezing in the hand and arm used to steer and propel the chair. These episodes, some lasting up to several minutes, occur only in circumstances (e.g., entering and leaving an elevator) that are similar to environments known to elicit and exacerbate FOG. Episodes are transient and can be volitionally interrupted by the patient but sometimes require external assistance.


Last updated June 2022 by Stanford Parkinson's Community Outreach