by Kaaren Slen, MS
- Many symptoms of Parkinson’s affect how a person moves.
- Feeling frozen to the floor when trying to walk is a common symptom.
- This article discusses different ways to help a person with Parkinson’s keep moving.
Many symptoms of Parkinson’s affect how a person moves. Slow movement seen in Parkinson’s is known as Bradykinesia. Persons with Parkinson’s can also experience rigidity or a stiffness in their limbs. Some have tremors and shaking when their body is at rest. Many experience postural instability resulting in poor balance and falling.
What is Freezing?
Freezing is a challenging symptom that can affect how a person walks. Freezing happens when forward movement stops, even when a person is trying to walk. In other words, you want to walk but your legs won’t cooperate. When a person freezes, their movement may stop for seconds or minutes, the stopping of movement may come and go, and movement is no longer smooth. Even though this article is focusing on walking (gait), freezing can affect other types of movement like speech and fine motor activities: brushing teeth, writing, and buttoning a shirt.
Freezing of gait feels like your feet are glued to the floor. Freezing comes on unpredictably and suddenly, increasing fall risk. Researchers estimate 38% of people with Parkinson’s fall per year. Falls often cause injury, resulting disability and even death.
Managing Risk Factors
Managing risk factors for freezing involves talking to your neurologist about freezing, as there are medications which can (or may) help control the symptom. In severe cases, Deep Brain Stimulation can reduce freezing. Physical or occupational therapists can teach coping strategies. It’s important to take your Parkinson’s medications on time, every time. A calendaring system, or a timer can help as a reminder. Always talk to your neurologist about changes in your symptoms. Freezing is more common in the mid to later stages of Parkinson’s. In these later stages 30-67% of people with Parkinson’s will develop freezing.
The Importance of Exercise
Exercise helps slow the progression of symptoms through brain change and adaptation. Exercise improves cognition as well as physical health. Experts (or the World Health Organization) recommend 2.5 hours per week (30 minutes/5 days per week). Aerobic exercise that includes high intensity interval training is also important in protecting brain health. When cognitive impairment affects gait it is important to have a neurologist review medications. Some medications like sleep aides, allergy medications, and opiates cause drowsiness which can affect cognitive abilities.
Visual Cues Help with Movement
There are certain situations in which freezing is more likely to happen. Small spaces often trigger freezing. Being near a bed, a closet, or in a small bathroom or laundry room can cause freezing of gait. Cluttered rooms also have the similar affect. Crossing a threshold or walking from one type of surface to another (carpet to wood floor) can also cause freezing.
Visual cues are a great way to help trigger movement. Taping horizontal lines on the floor, perpendicular to the direction of movement, through a doorway or a narrow passage helps with forward movement. Taped lines can also help when turning. Mobility aides with laser lights, such as laser canes, U-Step walker with laser light, and laser shoes all can help with forward movement when floor tape is not an option. In the absence of mobility aides or floor tape, a care provider can have the person with Parkinson’s step over the care providers’ foot.
Move to Music
Auditory cues are another way to encourage continued movement. A person can count their steps, talk aloud to as they walk, or sing a favorite rhythmic song. Earbuds are another way to listen to music without disturbing others. Care providers can also sing or count to help facilitate movement.
When it comes to movement one of the most important things is to practice moving. Swinging your arms back and forth, rocking from side to side, and marching in place are easy ways to start movement. The rhythmic movement helps continue motion. Other exercises to practice are kicking in place, shifting weight from one foot to the other, and bouncing a tennis ball.
A final tip is to remember to relax. Anxiety can make freezing worse. Take deep breaths, count to ten, and keep moving.
For more information on freezing visit the Parkinson’s Foundation.
Kaaren Slen, MS is a Senior Physical Therapist at Kaiser Permanente, and a speaker for the Parkinson’s Foundation.