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Walking, Freezing and Falling

The dopamine in your brain is heavily involved in controlling the movement of your body. In Parkinson’s, there are reduced levels of dopamine. For this reason the most obvious changes related to Parkinson’s are normally those that affect your movement, including walking, falling, and freezing.

In particular, slowed movement, stiff muscles and changes to posture affect all people living with Parkinson’s. These issues and others can lead to challenges with walking, freezing and falling.

Walking (Gait)

Gait is used to describe your walking pattern or how a person walks. Walking (gait) is often impaired in people living with Parkinson’s. The most common changes to walking include:

  • Slowed movement
  • Small and/or shuffling steps
  • Freezing
  • Little or no swinging of one or both arms
  • Tendency to lean forward

It is also common for people living with Parkinson’s to become easily tired during walking, even after short distances. These changes are likely to become more prominent as Parkinson’s progresses. However, the way these symptoms appear will be different for everyone.

Changes to walking can also be related to the medication cycle. For example, walking can change as a result of the ‘on/off’ cycles of Parkinson’s medications. Regularly reviewing medications with your GP or specialist can help you to manage changes to your walking.

Physiotherapists are considered to be the experts in helping with problems related to walking and can provide a personalised assessment and treatment program.

Freezing

Freezing is another problem that can affect people living with Parkinson’s, particularly those who have had Parkinson’s for some time. Freezing is when a person stops suddenly whilst trying to move and the movement becomes frozen. It feels like your feet have been glued to the ground. 

Freezing normally occurs in specific situations such as when starting to walk, when stepping through a doorway, when attempting to turn a corner or when approaching a chair. It is normally only temporary, and once past that position the person can often start walking freely again. Although it is only temporary, freezing can be hazardous due to the increased possibility of falling.

Freezing doesn’t only happen during walking. People living with Parkinson’s also report episodes of freezing during other repetitive activities such as brushing their teeth or writing. Freezing can also occur to your speech when you’re attempting to talk to someone. Many people who experience freezing also notice that they have difficulty performing multiple or complex tasks.

Freezing is one of the movement symptoms that cannot be explained by slowed movement or stiff muscles. While the cause of freezing is unknown, it can be linked to the medication cycle. It occurs more commonly during ‘off’ periods.

If you have noticed problems with freezing, you should consider seeking an occupational therapy and/or physiotherapy referral. Both of these health professions are able to teach strategies to help overcome episodes of freezing.

Useful Tips

Ways to avoid freezing episodes include:

  • Always taking your medications on time
  • Walking to a rhythm (listening to a beat or music can help)
  • Avoid distractions when you’re walking, just focus on long steps

Ways to overcome an episode of freezing include:

  • Prompt yourself by saying aloud ‘left, right, left, right’ or ‘one, two, one, two’ or ‘one, two, three, step’
  • Stand still and start swinging your arms
  • Start shifting your weight from foot to foot
  • Visualise an imaginary line to step over

Falling

Walking (gait) problems can make people living with Parkinson’s more likely to fall. Some of the more common causes of falling for people living with Parkinson’s include:

Each of these problems can interfere with a person’s balance, resulting in a fall.

Falls are more likely to happen and cause serious injury in the later stages of Parkinson’s. Be aware that falls can occur at any stage of Parkinson’s.

Falling is particularly hazardous because of the risk of serious injury. Falls are a common cause of hospital admission for people living with Parkinson’s. Whilst minor cuts and bruises are common, more serious injuries can occur, and make the challenge of living with Parkinson’s more difficult.

If you have had a fall recently, you should advise your GP and specialist, particularly if falls are becoming more frequent. Adjusting medications can be helpful in some situations. Assessment and treatment by a physiotherapist and/or occupational therapist is also recommended as they can offer advice and strategies to help prevent falls.

Useful Tips

To lower your risk of falling:

  • Always take medications on time
  • Undertake regular exercise to help with balance and leg strength
  • Walk to a rhythm (listening to a beat or music can help)
  • Focus on long steps when you’re walking
  • Remove hazards in your home, such as mats, rugs or furniture that blocks walkways

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