What is freezing of gait?
Freezing means the feet suddenly stop, as if stuck to the floor, although the person wants to move. It may last a few seconds or longer. The upper body may lean forward while the feet will not follow.
People with Parkinson’s describe it as being glued down. It is a recognised part of the condition, not a lack of effort.
When does it happen?
Freezing tends to show up in certain places and moments.
- At the start of walking, when getting up from a chair.
- At doorways and thresholds.
- When turning, for example at the sink or the bed.
- In narrow spaces, such as a corridor in a shophouse.
- In crowds, such as a busy kopitiam or a market aisle.
- When hurrying, being watched, or feeling anxious.
Notice which of these apply in your home. The aim is to remove the trigger, or give the person a cue for it.
What cues can help?
Cues give the brain another route to start the step. The World Health Organization (WHO) says physiotherapy, including gait and balance training, can improve function in Parkinson’s [1], and cues are part of that training.
- Visual: a line of tape across the doorway to step over.
- Counting: “one, two, three, step” out loud.
- Rhythm: march to a beat, a song or a metronome app.
- Weight shift: sway side to side, then step off the free leg.
- Big step: take one exaggerated first step.
- Imagery: imagine stepping over a log or a puddle.
Different cues work for different people. A physiotherapist can find the best ones for your parent.
How should the family help?
Stand beside the person, not in front. Say the cue, wait and let them move on their own. Do not pull, push or hurry, because tension makes the freeze worse.
If the person freezes while turning, stop. Ask them to take a wide turn in a half circle instead of pivoting on the spot. Our page on Parkinson’s exercise at home covers a weekly routine that includes walking practice.
How can you change the house?
Make doorways clear and wide. Remove door stoppers or thresholds the person catches on. Place tape lines at the places that trigger freezing, and keep the path to the toilet short and well lit.
Rearrange the furniture so the person can turn in an open space. At the kopitiam, choose a table near the entrance with room for the walking aid. Heat and fatigue also worsen freezing, so go early.
When should you tell the doctor?
Tell the doctor if freezing is increasing, if there are falls or near falls, or if it happens when medicine seems to wear off. Go to the emergency department after a fall with a head knock, new confusion or sudden weakness.
How does home physiotherapy help?
We watch your parent walk through the real doorways and corridors at home, then test cues until we find what works. We teach the family and helper to use them calmly and to guard safely. Read more about Parkinson’s rehabilitation and balance and falls.
Our Canning Garden centre, near Fatimah Hospital, is opening soon. Home and centre prices differ and are quoted on WhatsApp.