Festination, or shuffling gait, is a common motor symptom in Parkinson’s.

Management strategies include physiotherapy, gait training, falls prevention strategies and optimising your medications.

What is festination?

Festination is a motor symptom of Parkinson’s where walking becomes hurried and unsteady. People affected by shuffling gait may take short, rapid steps that feel involuntary and uncontrolled, often leaning forward with a stooped posture. This happens because the centre of gravity shifts too far forward, prompting the body to take quick steps to avoid falling.

  • A shuffling gait is a motor symptom in which you take small, rapid steps that can result in a tendency to move forward uncontrollably, like a run, to prevent falling.
  • A stooped posture gait pattern occurs because the body’s centre of gravity is too far forward, often making a forward-leaning posture.
  • It is a very common and characteristic gait disturbance for people with Parkinson’s.

Festination can make walking difficult and increase the risk of falls. It can feel like an involuntary acceleration of walking, with your steps becoming quicker and shorter. The severity of festination can vary, with some experiencing mild episodes and others facing more severe, uncontrollable episodes that may require an assistive device. Festination becomes more frequent as the condition progresses.

Treatments & strategies

Managing festination involves a combination of therapies and lifestyle adjustments:

  • Gait training: Techniques like rhythmic cueing (e.g., stepping to a beat) help regulate walking speed and step training helps to enhance individual’s stepping response. They are usually delivered by a trained physiotherapist or exercise physiologist.
  • Medication review: Optimising Parkinson’s medications can reduce motor symptoms that contribute to festination and consequently your safety.
  • Assistive devices: Walking aids prescribed by your OT, like rollators may improve stability and confidence.

Confident walking strategies

  • Think before you move: Pause and plan your steps before starting.
  • Use visual cues: Place tape or markers on the floor to guide step length. Alternatively, use the floor pattern in your favour, stepping onto lines on the floor or over them.
  • Step to a rhythm: Use music or a metronome to maintain pace.
  • Avoid multitasking: Focus solely on walking to reduce risk of freezing or festination.

Falls prevention tips

  • Declutter your space: Remove trip hazards like rugs and cords.
  • Install grab rails: Especially in bathrooms and stairways.
  • Wear supportive footwear: Avoid slippers or loose shoes.
  • Stay physically active: Regular movement helps maintain strength and coordination.

Key Statistics

  • Up to 60% of people with Parkinson’s experience festination at some point.
  • Festination often worsens as Parkinson’s progresses, especially in later stages.
  • Gait impairments are linked to higher fall risk, with falls affecting nearly half of people with Parkinson’s annually.
  • Physiotherapy and cueing strategies can significantly improve your walking and reduce festination episodes.

How do I access supports?

It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:

  • getting a GP referral to form a multidisciplinary care team with Parkinson‘s experience
  • your state-based Parkinson’s organisation for advice on local services to access
  • private health to see what is covered in relation to consultations and expenses
  • DVA, NDIS or My Aged Care plan supports.

Infosheet kindly reviewed by Dr Paulo Henrique Silva Pelicioni

Dr Paulo Henrique Silva Pelicioni is an NHMRC Early Leadership Fellow and Senior Lecturer at UNSW Sydney and a conjoint senior research fellow at Neuroscience Research Australia, specialising in movement disorders and fall prevention in Parkinson’s. His work focuses on developing clinical tools and neurorehabilitation strategies to reduce fall risk and improve mobility for Australians living with Parkinson’s. He leads interdisciplinary research that bridges physiotherapy, neuroscience, and public health to enhance care and equity for people with Parkinson’s in Australia.

References

Lee, E.-S., Kim, M. S., Oh, J. S., Seo, S. Y., Kim, J. S., Han, Y. M., Chang, S. K., Jo, S. W., & Kang, S. Y. (2025). Neural and dopaminergic substrates of festinating gait in Parkinson’s disease. Journal of Neurology, 272, Article 544. https://doi.org/10.1007/s00415-025-13280-0

Uchitomi, H., Ogawa, K.-I., Orimo, S., Wada, Y., & Miyake, Y. (2016). Effect of interpersonal interaction on festinating gait rehabilitation in patients with Parkinson’s disease. PLOS ONE, 11(6), e0155540. https://doi.org/10.1371/journal.pone.0155540

Scully, A. E., Tan, D., Ramos de Oliveira, B. I., Hill, K. D., Clark, R., & Pua, Y. H. (2023). Scoring festination and gait freezing in people with Parkinson’s: The freezing of gait severity tool-revised. Rehabilitation Ageing & Independent Living Research Centre. https://research.monash.edu/en/publications/scoring-festination-and-gait-freezing-in-people-with-parkinsons-t

Murdoch University Research Portal. (2023). Gait festination and freezing in Parkinson’s disease: Pathogenesis and rehabilitation strategies. Murdoch University Journal Repository. https://researchportal.murdoch.edu.au/esploro/outputs/journalArticle/Gait-festination-and-freezing-in-Parkinsons/991005540649207891

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