The most important factor in treating freezing is to establish whether or not it responds to standard Parkinson’s medications. Freezing that occurs during ‘off ’ periods, when other symptoms such as stiffness, tremor and slowness return, often responds well to adjustments in the timing and dosage of medications, as this should prevent wearing off periods.
People who do experience freezing when they are ‘off’ must recognise that freezing and ‘off’ periods are separate phenomena requiring different management.
Freezing that is not related to ‘off’ periods and occurs during ‘on’ periods does not generally respond well to standard Parkinson’s medications or adjustments to timings or dosage. For those who take small doses of levodopa during the day, there may be an improvement if larger but less frequent doses are taken, although this may not be effective for everyone.
Research carried out on the medication selegeline (Eldepry® and Zelapar® ) suggested that people who take it may be less likely to develop freezing problems, but there is no evidence that selegeline can be used to as a treatment.
Deep brain stimulation (DBS) can be effective in treating some Parkinson’s symptoms and can help with some, but not all, freezing episodes.
Who can help?
There are a lot of things you can do to help yourself but there are also experienced professionals who can offer very useful advice. Depending on the country in which you live your doctor may be your first contact and they may refer you to another expert. Alternatively, you might be able to book an appointment direct, although you may have to pay for this yourself.
In some countries there may be Parkinson’s Disease Nurse Specialists or nurses who specialise in neurology who can help as they will have considerable experience in dealing with freezing.
You may be referred to a physiotherapist or an occupational therapist. Which therapist you are referred to will depend on the country you live in, the resources available, and your individual needs, so it is hard to generalise but the following broadly outline the help you may receive:
- a physiotherapist can help in teaching techniques, including cueing, to avoid freezing and will recommend strategies to deal with it if it does occur. They will also suggest techniques to improve posture and balance so there is less chance of falling forward if you freeze.
See also
Physiotherapy.
For information on how physiotherapy can help with posture and falls prevention, see Treatment and management of falls
- a physiotherapist, occupational therapist or podiatrist should also be able to advise on the most suitable footwear for you. Some people find leather soles help their movement and allow them to walk without conscious thought. But leather soles can increase the risk of slipping and falling. Others prefer soles that grip well as it encourages them to think more about lifting their feet properly. This in turn allows them to continue walking for longer. However, if festination or shuffling occurs, soles with too much grip can increase the risk of falling as the feet will not slide easily. As each individual has different needs it is important to seek advice from a physiotherapist, occupational therapist or podiatrist
- an occupational therapist will be able to help you retain as much independence as possible whatever your disabilities or symptoms. They can assess your home and daily routine and should be able to recommend ways of adapting your home to avoid episodes of freezing, or overcome them if they occur. For example, moving furniture may widen narrow spaces that trigger freezing, or lines on the floor to step over in doorways may be helpful
See also
How can I help myself?
