We have already talked about Freezing of Gait (or Freezing of the March, abbr. FOG) in a post in which, in addition to providing a general description of this very complex (and, unfortunately, more widespread than one might imagine) symptom, we discussed the impact it generates on the everyday lives of patients suffering from it.
Although some of the therapies traditionally employed in the management of Parkinson's Disease (pharmacological, surgical and physiotherapy treatments) are able to mitigate March Freezing in some patients, a good proportion of them come to develop (especially in the more advanced stages of the disease) particularly persistent forms of FOG. In this short article, we have collected a number of useful tips that you can test right away in an effort to prevent the onset of new episodes of Freezing and, should they occur suddenly, to learn how to manage them without fear.
How to reduce the risk of triggering new episodes of Freezing
THE IMPORTANCE OF PERSONALIZED REHABILITATION THERAPY
One of the aspects that makes the management of March Freezing so difficult is its heterogeneity: in fact, the causes that trigger it can vary from patient to patient, and the generic therapies currently available for the treatment of Parkinson's Disease symptoms do not always prove effective against it. However, the intervention of qualified professionals (such as physical or occupational therapists) can prove invaluable in designing a personalized rehabilitation treatment plan that can identify and address each patient's specific difficulties. In the rehabilitation context related to freezing walking, moreover, training of the patient's cognitive, as well as physical, functions becomes particularly important. Make sure that this aspect is also given proper attention in your rehabilitation plan to limit as much as possible the impact that March Freezing can have on your daily activities.
TO MANAGE FREEZING, LEARN TO MANAGE STRESS
A number of scientific studies show that there is a correlation between the perceived stress level of Parkinson's patients and the incidence of episodes of March Freezing. Working on managing one's emotions and reducing stress (for example, through mindfulness techniques or gentle exercise classes) is therefore a complementary option to traditional drug therapies to limit the onset of new episodes of Freezing. Such activities, moreover, are known to provide significant benefits to a number of non-motor conditions often associated with Parkinson's Disease - Such as anxiety, depression and apathy. Considering the benefits (and the absence of contraindications for this type of intervention), it is definitely worth a try!
ATTENTION TO POSTURE AND STABILITY
Choosing uncomfortable or inappropriate shoes can contribute to triggering new episodes of March Freezing. To maximize your stability outside the home and reduce the risk of falls, always be sure to wear shoes that are comfortable and appropriate for the type of route you will be taking throughout your day. Also pay attention to your posture and the position of your legs, trying to correct yourself whenever you assume incorrect postures. Ideally, you should keep your legs with a wide enough opening to provide your body with a solid base of support, especially when you perform particularly delicate actions such as turning around-not coincidentally, many patients develop Freezing precisely when they turn on themselves or around an obstacle. Safety, even outside the home, is crucial: if you feel the need, use a pair of walking sticks or a walker to get around without risking dangerous falls.
FIND OUT HOW GONDOLA AMPS CAN HELP YOU WITH YOUR REHABILITATION
How to behave during a Freezing episode?
The first thing to do in this circumstance is to keep calm and try to remain clear-headed: the best strategy for getting unstuck is to guide your brain in focusing your attention on the actions needed to get going again - Thus avoiding all other distractions. Here are some “tricks” to get out of a Freezing crisis faster:
WALK IN PLACE (IF YOU CAN, SWINGING YOUR ARMS)
One of the main characteristics of walking is its inherent rhythmicity. Any event that interrupts its rhythm can trigger, in a particularly sensitive individual, an episode of March Freezing. If you find that you are stuck as you pass through a doorway or after stopping during a walk, try marching in place, rhythmically lifting first your right and then your left leg up, alternating between them. If you are able, also move your arms in rhythm, swinging them along your sides. These simple actions will restore your regular rhythm and help you naturally restart your walking.
COUNT (IN YOUR HEAD, OR OUT LOUD) TO KEEP THE BEAT
If you think you are close to a new Freezing crisis, start counting rhythmically in your head or scan the rhythm of your walk by repeating “right - left, right - left” so that you stay focused on the movement of your feet and identify on the floor the exact spot where you want to take your next step. If the episode is already in progress, also, you can try to unlock your feet by imagining yourself scanning the command “1, 2, 3, GO!” and moving your first step right at “GO.” Listening to a song with a good beat is another little trick for not letting Freezing overwhelm you. Remember to take a pair of earbuds with you the next time you go for a walk!
FOCUS YOUR GAZE (AND YOUR ATTENTION) ON VISUAL LANDMARKS
If there are specific spots in your home where you frequently have Freezing episodes (narrow hallways or doorways, for example) you can try drawing straight lines at them (with colored tape) to use as a guide as you walk. When your brain focuses on these external visual elements to guide your walk, in fact, the risk of triggering a Freezing episode decreases significantly. If you are out of the house and suddenly find yourself stuck, you can try imagining that there is a straight line drawn on the floor: even the mere thought of following this imaginary guide line may be enough to get you going again with a smooth, steady walk. Finally, if you use a supportive walking stick, try coloring its tip with a bright hue and stare at it whenever you feel a Freezing episode approaching: following this reference external to your body to guide your march will help you overcome your blockage.
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