Freezing in Parkinson’s Disease

Freezing is among common symptoms of Parkinson’s disease (PD), characterized by temporary, involuntary inability to move. The victim may describe it as their feet getting glued to the ground or inability to move forward again for several seconds. Freezing can occur at anytime, anywhere, but tend to transpire more often when an individual is initiating or starting to move.

Having the potential to affect the patient’s different parts of the body or speech, the cause of Freezing is still unknown and subject of various ongoing studies. In some cases, Freezing is reported to be a side effect of dopaminergic medications for PD. At times, multi-tasking, stopping or slowing down the pace while walking can also trigger a freezing episode.

People with mid-stage to advanced PD are more likely to have more freezing episodes, which makes them more prone to falling while turning or changing directions. Usually, this PD symptom lasts only a few seconds during which the patient feels stuck in place, or it may find it difficult to get up from a chair.

Options to treat Freezing in Parkinson’s Disease

If one is having freezing episodes, adjusting the medications may be helpful. While Physical Therapy is mostly suggested to reduce the risk of falling, Occupational therapy interventions can also help to minimize the risk of falls in the home.

Listening to music and stepping with the rhythm can be helpful. This explains why singing, humming, counting, minimize freezing episodes, as reported by several studies. While Deep brain stimulation can help some people with Freezing, it is not suitable for everyone.

Physical Therapy

Physical Therapy cannot absolutely cure PD but can help patients with minimizing Freezing episodes by improving walking, balance, strength, and flexibility. Patient safety can be primarily achieved by prescribing specific exercises that address issues like postural instability, gait imbalance, lack of strength and flexibility.

Through Physical Therapy, one can be trained to focus on foot positioning to stabilize base for posture and gait. Instructing an individual to take longer steps help overcome the effects of Freezing.

Occupational Therapy

Making the patient aware of Freezing triggers and preparing strategies in advance is an occupational therapist’s objective. He looks at how everyday activities should be, making the patient’s home or workplace safer or easier to manage. This includes demonstrating easier ways to do a task or activity such as getting in and out of bed without Freezing.

Occupational Therapy for minimizing freezing episodes include attentional strategies, cognitive and sensory cueing techniques, and conductive education methods. Using different ‘cues’ (things you can do to encourage a movement to restart), help the patient learn to control Freezing in a variety of places and situations. Activities like marching or ‘goose-stepping’, ‘shifting the weight of the body from one leg to another’ and ‘turning by walking half a circle or square’ are commonly adapted strategies.

Medication

Changing a person’s Levodopa (main drugs used to treat Parkinson’s symptoms) dosage may improve Freezing. However, this might not work in all cases. Some practitioners prescribe Apomorphine that is helpful in treating Freezing associated with Parkinson’s disease. The fast-acting dopamine agonist can be injected under the skin when muscles become frozen due to PD.