Managing Freezing of Gait

Written by : Ali Kraus, PT, DPT, NCS and Kim Patton, PT, DPT, modified from original post of Meredith Defranco, PT, DPT

What is Freezing of Gait

Freezing occurs when a patient with Parkinson’s disease has difficulty shifting from one brain pattern to another while simultaneously continuing to walk. The brain is unable to continue the automatic component of walking causing a brief period of inhibition which presents as freezing.

It may present initially with hesitation in stepping after the patient first stands up to walk. It can progress to the patient having difficulty continuously walking through doorways or trouble turning in small spaces. They may experience short, quick steps that leads to temporarily being unable to move their feet. Unfortunately, with some patients, your torso will continue to move forward with momentum, despite your feet being “stuck”, placing the patient at a high risk for falling forward. Common triggers of freezing include tight spaces, crowded environments, changes in flooring, dual tasking, emotional stimuli (i.e. being hurried along), and increased anxiety.

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 or a U-step walker
    • Placing lines of tape on the floor
    • Placing X’s of tape in a semi-circle in tight spaces
    • Looking through the doorway vs looking down at the floor
  • 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..”,
    • Using a metronome

Not every cue works for every patient! But it is important to consult with your Physical Therapist to find which one will help you.

For more information, please consult with your Neurologist or contact UF Health Rehab at Norman Fixel Institute for Neurological Diseases @: 352-733-2130.

About the Author


Heather Simpson, OTR/L

Heather Simpson graduated with a B.S. in Exercise and Sport Science with a minor in Early Education from the University of Florida in 2007. Following…

Read all articles by Heather Simpson, OTR/L