The Positive Impacts of Visual and Auditory Cueing on Freezing of Gait
An important part of living with Parkinson’s is leading an active lifestyle. Exercise has become increasingly difficult to maintain with the coronavirus pandemic, however, with this, it is an even more critical aspect of treatment. In fact, exercise is the only thing proven to slow the progression of Parkinson’s. Freezing of gait (FOG) is one of the most debilitating symptoms of Parkinson’s because it keeps people from moving around with confidence, decreasing activity levels. So, what can you do to lead an active lifestyle if FOG is an issue for you?
Freezing of gait is often described as feeling like your feet are “glued to the floor” or “stuck in cement.” Simply, it is the inability to take another step when you want to, and occurs because of a disconnect between the brain and the body. This interruption keeps the neural signal from reaching the motor neurons that should activate muscle movement. Freezing negatively impacts quality of life, daily activities, and is the leading cause of falls for people living with Parkinson’s. Fortunately, visual and auditory cueing has been shown to reduce the duration of freezing episodes by 69%, reduce the frequency of freezing episodes by 43%, and reduce the frequency of falls by 40%.
External visual cues, such as a green laser line, have been shown to improve gait significantly. Specifically, visual cues can help with sizing step length. External cues create a specific focus that allows someone to shift their attention from an outside trigger to their walking.
Auditory cues, such as a metronome, have been shown to decrease the number of freezing episodes during step initiation, turning, and obstacles. They have also been shown to increase gait velocity, step length, steps per minute, and improve gait variability. This is important to note because freezing episodes often occur when gait mechanics deteriorate.
There are solutions available on the market that integrate these visual and auditory cues. One example is NexStride, a daily assistive device that attaches to canes, walkers, and walking poles, and provides on-demand cueing to help overcome freezing. The green laser line and metronome are customizable, and NexStride can be easily added into your life by attaching to whatever assistive device you are already using.
For more information about NexStride or research on visual and auditory cueing please click the link below.
Jessica Chellsen, PT, DPT, CSCS is a Doctor of Physical Therapy and has a Bachelor of Science in neuroscience. Dr. Chellsen’s doctoral defense was a research study on a multi-dimensional physical therapy intervention program with emphasis on dual task training for individuals with Parkinson’s disease. She is passionate about neurologic physical therapy and helping her patients achieve their highest level of functional mobility and independence.