The frozen gait of Parkinson’s disease. This is so typical that in the absence of tremor it provides the
most reliable sign of the disease. Its main feature is axial rigidity—resulting in a rather slow walk, characterized by a series of small and narrow-based steps that barely clear the ground. It is especially
difficult to initiate the gait, not only when trying to rise from a chair, but also when starting to walk after long
standing. Very characteristic are also the freezing episodes, which typically occur when crossing a threshold, facing a door, turning a corner, or simply transitioning from hardwood to carpet floor. Turns are also rather slow (en bloc) due to bradykinesia and postural instability. Overall, patients walk with trunk bent forward, arms immobile at the side (or flexed ahead of the body—but never swinging), and legs bent at the hips, knees, and ankles. Other typical features include:
Festination (progressively shorter and accelerated steps after the walk has finally begun, from the Latin
festino, accelerate)
Propulsion (a tendency to fall forward, and the reason for festination)
Retropulsion (a tendency to involuntarily walk backward)
Rigidity, causing not only a forward stoop, but also small shuffling steps, with dragged feet that scrape
the ground
Festination is usually a late phenomenon, resulting from all the manifestations of the disease: flexion of
hips and knees, forward stoop, and shuffling steps. Especially crucial is the forward leaning (and
advancing center of gravity), since patients have to keep moving in order to regain it. This is eventually
inadequate, thus causing them to fall. As for stance, Parkinson’s is characterized by a stooped, rigid, and
primarily flexed posture: in the head (bent downward), thoracic spine (bent forward), arms (moderately flexed at the elbows), and legs (slightly flexed at both hips and knees). This may resemble the “simian stance” of spinal stenosis (which is an antalgic posture, since it reduces the pull on the compressed lumbosacral nerves), but in contrast to spinal stenosis, the stance of Parkinson’s is completely painless. It is also associated with the typical Parkinsonian gait.
most reliable sign of the disease. Its main feature is axial rigidity—resulting in a rather slow walk, characterized by a series of small and narrow-based steps that barely clear the ground. It is especially
difficult to initiate the gait, not only when trying to rise from a chair, but also when starting to walk after long
standing. Very characteristic are also the freezing episodes, which typically occur when crossing a threshold, facing a door, turning a corner, or simply transitioning from hardwood to carpet floor. Turns are also rather slow (en bloc) due to bradykinesia and postural instability. Overall, patients walk with trunk bent forward, arms immobile at the side (or flexed ahead of the body—but never swinging), and legs bent at the hips, knees, and ankles. Other typical features include:
Festination (progressively shorter and accelerated steps after the walk has finally begun, from the Latin
festino, accelerate)
Propulsion (a tendency to fall forward, and the reason for festination)
Retropulsion (a tendency to involuntarily walk backward)
Rigidity, causing not only a forward stoop, but also small shuffling steps, with dragged feet that scrape
the ground
Festination is usually a late phenomenon, resulting from all the manifestations of the disease: flexion of
hips and knees, forward stoop, and shuffling steps. Especially crucial is the forward leaning (and
advancing center of gravity), since patients have to keep moving in order to regain it. This is eventually
inadequate, thus causing them to fall. As for stance, Parkinson’s is characterized by a stooped, rigid, and
primarily flexed posture: in the head (bent downward), thoracic spine (bent forward), arms (moderately flexed at the elbows), and legs (slightly flexed at both hips and knees). This may resemble the “simian stance” of spinal stenosis (which is an antalgic posture, since it reduces the pull on the compressed lumbosacral nerves), but in contrast to spinal stenosis, the stance of Parkinson’s is completely painless. It is also associated with the typical Parkinsonian gait.