Freezing of Gait (FoG), is a temporary, sudden inability to start or continue walking that can feel incredibly frustrating for people living with Parkinson’s.

Management strategies for FoG include optimising your medications and using visual or auditory cues to start movement.

What is freezing of gait (FoG)?

Freezing of gait (FoG), or freezing, is where you temporarily lose the ability to move your feet, feeling as if they are glued to the ground when you intend to walk. This phenomenon often occurs during walking, particularly when starting to move, turning, or navigating through narrow spaces.

While these episodes usually last only a few seconds, they can sometimes persist for minutes, which can be very frustrating and increase the risk of a fall.
Freezing doesn’t look the same for everyone, but it generally follows three patterns:
  1. Trembling in place: Your legs or knees shake quickly (usually at a rate of 3–8 times per second), but your feet stay stuck.
  2. Shuffling forward: You take very small, quick, “shuffling” steps that don’t help you move forward.
  3. Total lack of movement (Akinesia): You are completely unable to move your limbs at all for a short time.

What causes freezing of gait (FoG)?

The exact cause is still being researched, but it involves the way Parkinson’s affects the brain’s internal “wiring.” The brain signals for walking, thinking, and feeling emotions get “crossed” in the basal ganglia (the brain’s movement control centre). When the brain gets overloaded with too many signals at once, it simply stops the movement.

Freezing is often triggered by specific situations, such as:

  • Transitions: Starting to walk (start hesitation) or turning around.
  • Narrow spaces: Walking through a doorway, into an elevator, or through a crowded room.
  • Approaching a goal: Approaching a chair to sit down or reaching a destination.
  • Stress: Feeling rushed, hearing a phone ring, or crossing a busy street.
  • Dual-tasking: Trying to walk while doing something else, like talking or carrying a tray.

The ABCDE Self-Management Strategy

You can empower yourself by using the ABCDE mnemonic, a set of “power moves” designed to reset the brain’s motor loops and manage freezing in daily life.

  • A – Attention: Focus entirely on the single task of walking and consciously avoid distractions or trying to do two things at once.
  • B – Balance: When you feel stuck, use the “power move” of shifting your body weight from side to side [41, 98]. This lateral movement helps your brain reset and perform the necessary postural adjustments to take the next step.
  • C – Cues: Use external triggers, such as stepping over visual lines on the floor or walking to the rhythmic beat of a metronome or song, to bypass internal brain blocks.
  • D – Dopamine: Work with your specialist to optimise the timing of your Levodopa medication to ensure you remain in an “on-state” as much as possible.
  • E – Environment: Assess your home for narrow paths or obstacles that trigger “tight quarters hesitation”.

Key Statistics

  • Around a quarter of people experience freezing in the early stages of Parkinson’s, but this rises to over 60% after 10 years with PD.
  • About 38% of people living with Parkinson’s fall each year, and many of these falls are directly related to a freezing episode.
  • Turning is the top trigger responsible for about a third of freezes.
  • While it can happen early, freezing is often considered a sign that your progression and your treatment plan need a review.

Tips for friends, family & carers…

Watching a loved one freeze can be stressful, but your support can help them get moving again.
  • Stay calm: Your calm reaction helps keep their anxiety low, which can shorten the freeze.
  • Never push: Never try to physically push, pull, or rush someone who is frozen. This can make them fall.
  • Be a “human cue”: Place your foot on the floor in front of them and ask them to step over it.
  • Give them time: Wait patiently for several seconds and let them use their learned strategies to restart.

What treats freezing of gait (FoG)?

While there is no single cure, freezing can be managed very effectively through a combination of medication, technology, and clever movement “tricks”.
  1. Optimising Medication: Most freezing happens when your medication is “wearing off” (the OFF state). Your neurologist can help by:
    • Adjusting the timing of your levodopa doses.
    • Adding other medications like MAO-B inhibitors (rasagiline or selegiline) or amantadine to keep your movements smoother.
    • In some cases, using advanced therapies like Duodopa (infusion therapy) or Deep Brain Stimulation (DBS).
  2. The 5S Method: If you find yourself frozen, do not try to push through it, as this can cause you to lose your balance. Instead, try these five steps:
    1. Stop: Recognise the freeze and stop trying to walk.
    2. Stand Tall: Re-set your posture to get your weight off your toes.
    3. Shake it off (or sigh): Take a deep breath to relax your muscles and lower your anxiety.
    4. Shift: Gently rock your weight from side to side to get momentum.
    5. Step: Take one large, exaggerated “marching step” to get moving again
  3. Using Cues: External signals can help “re-route” the brain signals.
    • Visual cues: Imagine a line on the floor to step over, or use a walker that projects a laser line.
    • Auditory cues: Walk to a rhythmic beat from a metronome app, count “1-2-3-GO” out loud, or hum a song.

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 someone with Parkinson‘s experience
  • your state-based Parkinson’s organisation for advice
  • Ask Izzy https://askizzy.org.au/ to search for 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 under review

References

  • Bardakan, M. M., Fink, G. R., Zapparoli, L., Bottini, G., Paulesu, E., & Weiss, P. H. (2022). Imaging the neural underpinnings of freezing of gait in Parkinson’s disease. NeuroImage: Clinical, 35, 103123.
  • Bloem, B. R., Hausdorff, J. M., Visser, J. E., & Giladi, N. (2004). Falls and freezing of gait in Parkinson’s disease: A review of two interconnected, episodic phenomena. Movement Disorders, 19(8), 871-884.
  • Conde, C. I., Lang, C., Baumann, C. R., Easthope, C. A., Taylor, W. R., & Ravi, D. K. (2023). Triggers for freezing of gait in individuals with Parkinson’s disease: A systematic review. Frontiers in Neurology, 14, 1326300.
  • Cucca, A., Biagioni, M. C., Fleisher, J. E., et al. (2016). Freezing of gait in Parkinson’s disease: From pathophysiology to emerging therapies. Neurodegenerative Disease Management, 6(5), 431-446.
  • Giladi, N., & Nieuwboer, A. (2008). Understanding and treating freezing of gait in parkinsonism, proposed working definition, and setting the stage. Movement Disorders, 23(S2), S423-S425.
  • Gilat, M., Nonnekes, J., Factor, S.A. et al. An updated definition of freezing of gait. Nat Rev Neurol (2026). https://doi.org/10.1038/s41582-025-01179-3
  • Nutt, J. G., Bloem, B. R., Giladi, N., Hallett, M., Horak, F. B., & Nieuwboer, A. (2011). Freezing of gait: Moving forward on a mysterious clinical phenomenon. The Lancet Neurology, 10(8), 734-744.
  • Tosserams, A., Fasano, A., Gilat, M. et al. Management of freezing of gait — mechanism-based practical recommendations. Nat Rev Neurol 21, 327–344 (2025). https://doi.org/10.1038/s41582-025-01079-6
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