Impact of Psychological Treatment in Freezing of Gait: A Pilot Study

One common gait issue associated with advanced Parkinson's disease (PD) is freezing of gait (FoG). FoG impacts approximately half of people with PD and negatively impacts quality of life. Studies have suggested that anxiety may contribute to FoG. Individuals with FoG exhibit higher rates of anxiety, but it is unclear if anxiety contributes to FoG development. No known studies have assessed the impact of treating anxiety to improve FoG symptoms. Objective: This pilot study evaluated the efficacy of cognitive behavioral therapy (CBT) training in reducing anxiety and improving gait in persons with PD following standard physical therapy (PT) treatment. Method: Ten participants who had completed PT treatment for FoG were evaluated for psychological distress and gait parameters at baseline. They were then seen for four weekly virtual individual CBT sessions. Outcome measures were subsequently obtained 1 week after the CBT intervention and 5 weeks after the CBT intervention. Results: Comparisons of baseline and postintervention Depression Anxiety Stress Scale-21 scores 1 week after the intervention were not statistically significant; however, improvements were both statistically and clinically significant a few weeks after the intervention, likely reflecting ongoing positive impact of CBT treatment. Gait parameters were noted to be clinically but not statistically significant after CBT treatment. Conclusion: This study suggests that a brief course of CBT may help to reduce emotional distress and to improve aspects of gait in a cohort of PD patients with FoG. Future research using a larger cohort and providing concurrent CBT/PT interventions is needed.