Academy of Neurologic Physical Therapy Podcast · Academy of Neurologic Physical Therapy

DD SIG Episode 55: Freezing of Gait with Alice Nieuwboer

May 1, 2025·55 min·2 clips

Parm Paget opens the discussion by introducing Dr. Alice Neubauer, an emeritus professor in rehabilitation sciences at the Catholic University of Leuven in Belgium. She describes her path from physical therapy into research, including work in England and the PhD work that brought her to Leuven. The episode centers on freezing of gait. Rather than treating it as a single failure of walking, the conversation breaks it into subtypes and clinical patterns. One thread looks at cognitive load and dual tasking, with stress and worrisome thoughts treated as a kind of distractor. Another thread looks at stress. Neubauer explains that inducing stress can increase freezing, and she notes that it is hard to fully separate overload from attention effects in real patients. The conversation does not force a neat boundary between those mechanisms. It treats the overlap as part of the clinical problem. A third subtype is the motor subtype. Here the emphasis is on how patients adjust their gait to environmental demands. Turning becomes the central trigger. Neubauer says that turning is the trigger of freezing, and recent work she discusses points to a fast 360-degree turn as the most consistent provocation. That task can bring on freezing quite regularly. It can even do so in people who say they are not freezers. The finding matters because self-report alone may miss the most reliable trigger conditions. The episode stays grounded in what clinicians can observe at the bedside or in the clinic. It keeps returning to practical testing, trigger identification, and the difference between what patients describe and what their movement reveals. By the end, the conversation has built a layered picture of freezing of gait as a problem shaped by stress, attention, and turning demands.

As heard by us

A grounded look at what can trigger freezing of gait.

The episode treats freezing of gait as a practical clinical problem, and it stays strongest when it keeps the focus on stress, attention, dual tasking, and turning.

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You want a sharper read on what triggers freezing of gait.

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