Freezing of gait: A practical approach to management

Jorik Nonnekes, Anke H. Snijders, John G. Nutt, Günter Deuschl, Nir Giladi, Bastiaan R. Bloem*

*Corresponding author for this work

Research output: Contribution to journalComment/debate

260 Scopus citations


Freezing 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.

Original languageEnglish
Pages (from-to)768-778
Number of pages11
JournalThe Lancet Neurology
Issue number7
StatePublished - 1 Jul 2015


FundersFunder number
Radboud University Medical Centre
US National Parkinson Foundation
National Park Foundation
Deutsche ForschungsgemeinschaftSFB 855


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