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External cues
External stimuli are used to improve walking. These stimuli are often rhythmic.
read moreExternal cues
With external cueing, external stimuli are used to improve walking. These stimuli are often rhythmic. Different forms of external stimuli are possible: visual stimuli (for example, walking on lines glued to the floor in a certain pattern), auditory stimuli (for example, walking to the rhythm of music, or a metronome), or tactile stimuli (for example, walking with someone rhythmically tapping your arm).
Purposeful, rather than automatic
The idea is that the use of external cues makes walking more purposeful, rather than automatic. Often the autopilot of walking is disturbed in Parkinson's disease. In this way, you ‘bypass’ the affected autopilot.
Examples of external cues
Below you will find a number of examples of external cues, which you may want to try out yourself - or together with your therapist. The external cues page also offers videos of people who successfully apply various external cues to improve walking.
• Walk to the beat of a metronome
• Walk to the beat of music
• Step over lines on the floor
• Step over a laser line projected by a Parkinson's walker or laser shoes
• Turn using a laser light
• Step over a certain pattern on the floor
• Step on specific tiles on the sidewalk (example: each step is two tiles)
• Step over someone's foot
• Step over an inverted cane
• Throw something in front of your feet and step over it
• Bounce a tennis ball
• Toss a ball from one hand to the other
• Dribble with a basketball
• Play football, or kick another object in front of you
• Carry a backpack to walk more upright
• Walk with weights on the feet
• Walk on a different surface (eg grass)
• Walk with one leg on the sidewalk and one leg in the gutter
• Climb stairs
Do you have anything to add?
Are you using an external cue that is not yet included in our overview? We'd appreciate it if you would submit your compensation strategy so that other people can benefit from your creative find!
Share your video
Are you using a compensation strategy that has not been included in our video overview? Please do share your idea. Your video might be on this page too!
to the formVideo examples
Turning by using a laser pointer
Use a light (such as a laser pointer) to make turning easier. Try to step towards the dot on the ground.
Walking over a patterned floor
This man has difficulty walking, but much less difficulty climbing stairs. A family member made a 3D staircase painting for him on the living room floor, which helps him cross his living room.
Walking to the rhythm of a metronome
Listen to the beat of a metronome and try to take a step on each beat. It is important that you match the metronome's pace (the number of “beats per minute” or “bpm”) to your ideal walking pace (the number of steps you take per minute). Instead of a metronome, you can also use music that has the same pace.
Walking to the beat of music
There are several options:
- Use music with a distinct rhythm and try to take steps to the beat of the music. In this case, it is important that you look for music with a similar pace (the number of “beats per minute” or “bpm”) as your walking pace (the number of steps you take per minute). Instead of music, you can also use a metronome at the same pace.
- Use your favorite music without focusing specifically on the rhythm, like the man in the video example.
Try out different genres and songs, the effect of the music on walking can be very different depending on the music you are using. In general, people often notice a better effect when they walk to music that they enjoy listening to.
Stepping over someone's foot
If you experience freezing of gait ('being glued to the floor') you can sometimes alleviate this by stepping over someone's foot.
Stepping over lines on the floor
You can tape lines on the floor in places where you often have difficulty walking or turning (for example, when turning in the kitchen or on the path to the toilet). You can also wearing laser shoes (these project a laser line in front of your feet), or use a laser beam attached to your walker. If you walk outdoors, you can also use the lines between the paving stones. You can step on the lines, or step over them: try what works best for you.
Bouncing a ball
Bounce a ball on the floor, or toss the ball from hand to hand while walking. You can try different sizes of balls: for example a tennis ball or a basketball.
