{"id":17373,"date":"2014-10-22T12:56:00","date_gmt":"2014-10-22T10:56:00","guid":{"rendered":"https:\/\/neurologiaclinica.es\/parkinsons-disease-tricks-to-improve-gait-blocks\/"},"modified":"2025-04-21T16:30:19","modified_gmt":"2025-04-21T14:30:19","slug":"parkinsons-disease-tricks-to-improve-gait-blocks","status":"publish","type":"post","link":"https:\/\/neurologiaclinica.es\/en\/parkinsons-disease-tricks-to-improve-gait-blocks\/","title":{"rendered":"Parkinson&#8217;s disease: Tricks to improve gait blocks"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">Parkinson. Feet glued to the floor to the floor. What can we do?  <\/h3>\n\n<p class=\"wp-block-paragraph\">It has been demonstrated that physical exercise and rehabilitation are necessary and complementary to pharmacological treatment in patients with <strong>Parkinson&#8217;s disease.<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">One of the driving symptoms of this disease is frostbite, or <strong><em>freezing or<\/em><\/strong><em> <strong>blockage of gait<\/strong><\/em>. It is a phenomenon that presents with brief and intermittent episodes of inability to walk, which patients describe as <strong>&#8220;feeling as if their feet were<\/strong> <strong>glued to the ground<\/strong>&#8220;. <\/p>\n\n<p class=\"wp-block-paragraph\">It may appear at the onset of walking, in environmental situations that require changes in speed, pattern or direction of gait (e.g. when turning) or when walking in narrow spaces (narrow corridors, in the bathroom, when passing into an elevator&#8230;).<\/p>\n\n<p class=\"wp-block-paragraph\">The causes of these blockages are still not well understood, but what is important is that this gait disorder constitutes one of the most common symptoms in Parkinson&#8217;s disease, in addition to being one of the main factors limiting the autonomy and quality of life of these patients, since it is associated with an increased risk of falls and loss of independence.<\/p>\n\n<p class=\"wp-block-paragraph\">Several studies show that physical therapy is more effective in this type of patient if, in addition to including conventional therapies (aimed at improving posture, strength, elasticity, etc.), the use of <strong>visual, auditory and somatosensory stimuli<\/strong> and strategies to increase <strong>attention,<\/strong> such as mentally rehearsing the next movement to be performed, dividing it into steps or avoiding distractions during the task (talking and walking, for example<sup>)1 are trained.<\/sup><\/p>\n\n<h3 class=\"wp-block-heading\"><strong>The tracks most commonly used to reduce gait blockages are:<\/strong><\/h3>\n\n<ul class=\"wp-block-list\"><li><strong>Visual<\/strong>: strips stuck on the floor, footprints or adhesive tape to create marks that the patient must step on when walking or the use of a cane that projects a light on the floor, following another person&#8230; All of them are useful to mark the way and guide the person between the rooms of the home or in the spaces where blockages tend to occur.<\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">They also help in gait training to normalize stride length and improve cadence.<\/p>\n\n<p class=\"wp-block-paragraph\">The following videos show how a patient who was walking normally in the gym suffers blockages when encountering objects in his path. The second video shows the remarkable improvement in walking with the help of the laser cane. <\/p>\n\n<figure class=\"wp-block-embed-youtube aligncenter wp-block-embed is-type-video is-provider-youtube wp-embed-aspect-4-3 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"Bloqueos por enfermedad de Parkinson\" width=\"800\" height=\"600\" src=\"https:\/\/www.youtube.com\/embed\/r6KfDZOW46M?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n<figure class=\"wp-block-embed-youtube aligncenter wp-block-embed is-type-video is-provider-youtube wp-embed-aspect-4-3 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"Bloqueos por enfermedad de Parkinson - Bast\u00f3n l\u00e1ser\" width=\"800\" height=\"600\" src=\"https:\/\/www.youtube.com\/embed\/xyhflVfz1iM?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n<ul class=\"wp-block-list\"><li><strong>Auditory<\/strong>: the patient has to concentrate on following and synchronizing his movements with the auditory signal used. A metronome can be used to set a constant rhythm, verbal commands (e.g.: heel, heel&#8230; left, right&#8230; one, two) said aloud by the patient or by another person, tapping with a cane&#8230; <\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">Metronome<\/p>\n\n<ul class=\"wp-block-list\"><li><strong>Somatosensory<\/strong>: these are tactile stimuli such as a tap on the leg before stepping, carrying a light backpack on the back to improve posture and avoid leaning forward, etc.<\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">Most of these cues can be used both to initiate movement and to maintain movement. Patients with Parkinson&#8217;s disease can eventually achieve adequate gait in the presence of <strong>regular sensory stimulation<\/strong>. <\/p>\n\n<p class=\"wp-block-paragraph\">For this reason, it is advisable to turn to professionals working in the field of neurorehabilitation, since they are familiar with the use of these cues and strategies and can help in the training and choice of the most appropriate one for each patient.<\/p>\n\n<h3 class=\"wp-block-heading\"><strong>Conclusion<\/strong><\/h3>\n\n<p class=\"wp-block-paragraph\">Rehabilitation, including training in the use of sensory cues or stimuli, associated with pharmacological treatment, improves gait blocks in Parkinson&#8217;s disease.<\/p>\n\n<ol class=\"wp-block-list\" type=\"1\"><li>H.J. KeusI et al. Clinical practice guidelines for physical therapy in patients with Parkinson&#8217;s disease. Dutch Journal of Physiotherapy. Vol 114 \/ Issue 3 \/ 2004   <\/li><\/ol>\n\n<p class=\"wp-block-paragraph\">AUTHOR:  <\/p>\n\n<div class=\"wp-block-image\"><figure class=\"alignleft size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/neurologiaclinica.es\/wp-content\/uploads\/2019\/03\/300PILARFISIO.jpg\" alt=\"\" class=\"wp-image-1473\" width=\"154\" height=\"154\"\/><figcaption><a href=\"https:\/\/neurologiaclinica.es\/que-hacemos\/unidad-de-neuro-rehabilitacion\/equipo-unidad-de-neuro-rehabilitacion\/\" class=\"rank-math-link\">PIlar Rada Romero<\/a><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Pilar is a physiotherapist specialized in neuro-rehabilitation and is part of the <a href=\"https:\/\/neurologiaclinica.es\/que-hacemos\/unidad-de-neuro-rehabilitacion\/\" class=\"rank-math-link\">Neuro-Rehabilitation Team<\/a> of the Neurology Service of the Ruber Internacional Hospital.  <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Parkinson. Feet glued to the floor to the floor. What can we do? It has been demonstrated that physical exercise and rehabilitation are necessary and complementary to pharmacological treatment in patients with Parkinson&#8217;s disease. One of the driving symptoms of this disease is frostbite, or freezing or blockage of gait. It is a phenomenon that [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[558],"tags":[],"class_list":["post-17373","post","type-post","status-publish","format-standard","hentry","category-parkinsons-and-movement-disorders"],"_links":{"self":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts\/17373","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/comments?post=17373"}],"version-history":[{"count":1,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts\/17373\/revisions"}],"predecessor-version":[{"id":17374,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts\/17373\/revisions\/17374"}],"wp:attachment":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/media?parent=17373"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/categories?post=17373"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/tags?post=17373"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}