OBJECTIVE: To investigate the efficacy of a two-week programme of repetitive exercise with cueing and movement strategies upon freezing of gait in people with Parkinson's disease. DESIGN: Randomized cross-over trial. SETTING: Specialist clinic for Parkinson's disease. SUBJECTS: A total of 22 patients with Parkinson's disease and freezing while other symptoms had favorably responded to dopaminergic treatment. INTERVENTION: Patients were randomized into a four-week cross-over trial, and received either treatment (group 1) or no treatment (group 2) during period 1, and switched during period 2. Treatment consisted of a two-week programme during which the patients exercised cueing, and movement strategies together with a physiotherapist. MAIN MEASURE: The primary outcome measure was a freezing score assessed from blinded and random ratings of video recordings. The secondary outcome measure was a patient-reported freezing questionnaire. Mean differences between the treatment periods (treatment arms) were evaluated for treatment (period) effects. Sums of treatment periods were evaluated for carry-over effects. RESULTS: The programme led to a significant treatment effect in the freezing score of 3.0 improvement (95% confidence interval 0.9 to 5.0; p < 0.01). No carry-over or period effects were detected. The questionnaire revealed a period effect, so groups were compared after period 1, where a significant difference was found (15.0 versus 11.7; p < 0.05). CONCLUSIONS: The two-week physiotherapy programme reduced the severity of freezing in patients with Parkinson's disease.

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