Parkinson's Gait

Walking patterns may be altered in persons with Parkinson's disease (PD). The medical term for walking pattern is gait. These changes in gait are sometimes referred to as Parkinson's gait or Parkinsonian gait.1

Gait problems have the potential to severely limit people with PD. They may be unable to work, exercise, or go about their usual routines due to problems.1

How does it present?

There are several ways Parkinson’s gait presents, such as:1-3

Gait freezing is characterized by a pause before taking a step forward or difficulties in starting to walk. It might feel like you are stuck to the ground or frozen. Gait freezing often occurs intermittently and may not occur for one or several steps before occurring again.1

Gait freezing may also only occur in certain situations, such as trying to initiate walking or while turning. For many people, these episodes are inconvenient, tiring, and even embarrassing. For others, a frozen gait might be quite debilitating and result in harm secondary to falls.1

Shuffling gait refers to quick-stepping, short-stride walking movements. Normally, we step with a heel-toe motion as we walk. This normal gait is dependent on our toes pushing forcefully off the ground to propel us forward. Without the toe push, a shuffling flat-footed gait occurs. With shuffling gait, the foot is still moving even though it drags on the ground.2

Festinating gait is similar to a shuffling gait. Unlike a shuffling gait, a person is in a stooped position at all times. Their center of gravity is always too far forward, so to avoid falling the person takes short, shuffled steps.3

Why does PD cause gait problems?

It is not clear why some people with PD have a problem walking and others do not. Research suggests that there is a link between gait and difficulties with learning, attention, and memory.4

The brain circuitry that controls walking is quite complex, with many connections between various areas of the brain, including:4

  • The motor cortex, which is responsible for planning and initiating movement
  • The basal ganglia, where brain cells that help regulate movement are located
  • The cerebellum, which helps coordinate movements

Treatment

There is currently no known cure for PD. There are no medicines available to slow or stop the disease's natural progression. Most people with PD are given medicine to reduce their symptoms. Dopamine-related medicines might help them manage walking difficulties, but effectiveness of these drugs decreases as the illness worsens.5

Along with medicine, physical therapy, exercise, and occupational therapy are recommended. Walking aids can offer safety and support. Your physical or occupational therapist will help find the best aid for you and teach you how to safely use it.5

Your physical or occupational therapist will use a variety of techniques to help you manage your walking problems. Sometimes using cueing helps. This is a method to "break" a freezing episode by introducing an external stimulus to get your feet moving again. For example, try humming a song to the beat of a song. Time the restart of your steps with the beat of the music.1

Problems with walking can be disabling and frustrating. While there is no cure for PD, you can manage the symptoms with help. Exercise, physical and occupational therapy, and medicine might help with gait issues in PD.1,4,5

Because falls are so common among those with PD, it is essential to talk to your doctor about the best ways to manage your Parkinson’s gait. This can help you avoid complications related to gait problems and enjoy a long, and productive life while living with PD.1,4,5

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Written by: Katie Murphy │Last reviewed: April 2022