Treatment And Care Of Parkinson's Frozen Gait

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Freezing gait is an inevitable problem for most Parkinson's disease patients to develop to the middle and late stages. Freezing gait is more likely to occur in Parkinson's disease patients who do not have tremors, who are predominantly rigid, who have lower extremity onset, apathy, cognitive decline, and who take a large number of levodopa drugs. The biggest harm caused by freezing gait to patients is falls and trauma, which will make the patient's clinical situation deteriorate sharply, seriously affect the patient's daily life, and cause a great burden to the family. It directly affects the patient's next treatment.

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The frozen gait in Parkinson's disease may be induced by different mechanisms in each patient, and the response to treatment is also different. So general treatments may help some people but not others. In fact, for most people with Parkinson's disease, dopamine replacement therapy helps prevent freezing gait, and in rare cases, the same dopaminergic treatment can make freezing gait worse in other conditions.

Drug therapy: 95% of patients freeze gait in the "off" phase, and the duration of freezing in the "off" phase is significantly longer than that in the "on" phase, and the most severe akinesia of the frozen gait subtype is only seen in the "off" phase, these phenomena all suggest that levodopa can relieve off-phase freezing gait. Therefore, when the frozen gait occurs only or mainly in the "off" phase, it is currently the most conventional treatment method to maintain the patient in the "on" phase by adjusting the dose of levodopa and changing the dosage form of levodopa.

In addition to medication, physical therapy can also help with walking. It is important for patients who experience frozen gait to develop rehabilitation training to deal with these conditions. There are several ways to overcome a freezing gait, including jumping over a low obstacle first or following the rhythm of a metronome. Using visual cues, such as laser beams or straight lines on the floor, can also help with gait. Assistive devices like crutches can help reduce the risk of falls. Of course, these methods must be accompanied by a caregiver, especially when starting training. Physical therapists and other health professionals provide important gait rehabilitation programs that enable people with Parkinson's disease to improve their movement and stay safe. Assistive devices such as wheeled walkers, while preventing falls in some patients, are not always effective for "freezing gait".

Sensory cue training is a very effective way to overcome frozen gait. Sensory cue training refers to providing rhythmic auditory, visual, tactile, or mental stimulation to patients through external or portable sensors to compensate for proprioceptive deficits, such as rhythmic music, metronome, etc., to adjust the gait variation of patients with Parkinson's disease rate, reducing freezing gait. If stripes are drawn on the ground, the distance between the horizontal lines is the size of the patient's normal walking steps, and the tester walks according to the specified step size.

Rhythmic sound stimulation, horizontal visual cues, and somatosensory assistance have certain curative effects on freezing gait. Tai Chi, dance balance training, etc. can improve light freezing gait, while long-term passive exercise (such as limb stretching and relaxation exercises, muscle massage, etc.) and active exercise (such as posture exercise, treadmill training, etc.) May reduce the incidence of falls and improve survival.

If you have Parkinson's, you can try the following:

1. Focusing on the path or steps you need to step on while walking, rather than the way you walk, may help you reduce the occurrence of a frozen gait.

2. Try to avoid turning around on the axis, you can walk around the position where you need to turn to change the direction of the activity, that is, "turn a big corner".

3. When walking, you can download some marching music that is helpful for walking on your mobile phone or music player. Some patients have a frozen gait when walking, but once the rhythmic music is played, they can start dancing to the music, and the patient's walking pace will improve for a short time after the music stops. This phenomenon is so strange that neurologists are still working on it. So when a freezing gait occurs, listening to some rhythmic music can help the patient to take a step.

4. You can also carry a laser pointer with you, try to use the laser pointer to hit a light spot in front of you when you have a frozen gait, and focus all your attention on moving your foot to step on the light spot

If you are a caregiver, here are some things you can try to help someone with Parkinson's:

1. When the patient is walking, do not talk to him or stand in front of his walking route.

2. Put the patient's arm on the caregiver's arm to help relieve the patient's nervousness.

3. If the patient has a frozen gait and cannot move, the caregiver can stand behind him and gently shake the patient to help change the center of gravity of the body, which is helpful for the patient to start again.

In conclusion, all patients with Parkinson's disease should be educated about the risk of falls, environments that predispose to freezing gait, and possible preventive measures.