• Lancet neurology · Jul 2015

    Review

    Freezing of gait: a practical approach to management.

    • Jorik Nonnekes, Anke H Snijders, John G Nutt, Günter Deuschl, Nir Giladi, and Bastiaan R Bloem.
    • Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands.
    • Lancet Neurol. 2015 Jul 1; 14 (7): 768-78.

    AbstractFreezing of gait is a common and disabling symptom in patients with parkinsonism, characterised by sudden and brief episodes of inability to produce effective forward stepping. These episodes typically occur during gait initiation or turning. Treatment is important because freezing of gait is a major risk factor for falls in parkinsonism, and a source of disability to patients. Various treatment approaches exist, including pharmacological and surgical options, as well as physiotherapy and occupational therapy, but evidence is inconclusive for many approaches, and clear treatment protocols are not available. To address this gap, we review medical and non-medical treatment strategies for freezing of gait and present a practical algorithm for the management of this disorder, based on a combination of evidence, when available, and clinical experience of the authors. Further research is needed to formally establish the merits of our proposed treatment protocol. Copyright © 2015 Elsevier Ltd. All rights reserved.

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