A new global study to standardise how freezing of gait is measured

Up to eighty per cent of people living with the condition eventually experience the sudden, frustrating sensation of their feet being glued to the floor. Despite how common and disruptive freezing of gait is, finding effective new treatments has been surprisingly difficult. A major reason for this roadblock is not a lack of scientific effort, but a measurement problem. Until now, researchers around the world have lacked a single, agreed upon way to test how severe freezing is, whether a new therapy is actually working, and how much these episodes truly affect a person's everyday life. To solve this, a global team of scientists from the International Consortium on Freezing of Gait, led by Erika Howe, Pieter Ginis, Alice Nieuwboer, and Jeffrey Hausdorff, published an important new study protocol in the European Journal of Neuroscience in October 2026. Their project introduces and tests two brand new assessment tools designed to become the global standard for future clinical trials. The challenge of catching a freeze in the clinic Anyone who experiences freezing knows that it is notoriously unpredictable. You might freeze ten times in your own kitchen while trying to make a cup of tea, only to walk smoothly down a spacious hospital corridor when your neurologist is watching. Because freezing is triggered by specific situations like tight spaces, turning around, or doing two things at once, standard clinic visits often miss it completely. Currently, the most accurate way scientists measure freezing is by filming people as they walk and having experts watch the videos later, frame by frame, to count every single second spent frozen. While thorough, this process is slow and impractical for large clinical trials. On the other hand, existing questionnaires that ask people to recall their freezing episodes over the past month were created years ago and do not meet the strict modern standards set by medical regulators like the US Food and Drug Administration for approving new drugs or devices. Two new tools that put real life at the centre To bridge the gap between what doctors see in a clinic and what people actually live through at home, the international team developed two complementary tools. The first is a practical physical assessment called the Giladi Protocol, named in tribute to the late Professor Nir Giladi, a pioneering researcher and clinician in the field of movement disorders. Instead of a simple walk up and down a hallway, this protocol puts participants through eight specific, real world tasks known to trigger freezing. These include walking normally, walking while thinking of something else, carrying an object, making full turns in both directions, shuffling through a tight box space, and navigating through a narrow doorway. Each task has a strict sixty second time limit to keep the test manageable and safe, and trained observers score both how often a freeze happens and how long it lasts. Because a physical test in a clinic only captures a brief snapshot in time, the researchers paired it with a second tool called the Freezing of Gait Quality of Life questionnaire. Rather than just asking how many times your feet get stuck, this questionnaire focuses on the emotional, social, and practical ripple effects of freezing on daily independence. Furthermore, because family members and partners often notice subtle moments of hesitation or daily adjustments that the person experiencing them might brush off, the study also includes a separate questionnaire specifically for a spouse, relative, or close friend who spends time with the participant at least three times a week. How the global validation study works Creating new tests is only the first step; proving that they work reliably across different clinics and countries is what makes them useful for science. Across seven international research centres, the team is recruiting one hundred and five people who experience freezing and thirty five people who do not. Participants will attend two clinic visits spaced one to two weeks apart. During each visit, they will wear small movement sensors and complete the eight physical tasks twice: once when their regular dopamine medication has worn off, and again after they have taken their dose and it has kicked in. Testing in both states allows the researchers to see if the new physical protocol is sensitive enough to pick up the clear difference that medication makes. At the same time, two independent experts will score the tasks in real time without comparing notes, and their scores will be checked against detailed GoPro video recordings to prove the test is accurate and consistent. In addition to the physical tests, forty participants will take part in detailed interviews to share in their own words how the clinic tasks compare to their struggles at home, ensuring that the quality of life questionnaire asks the questions that actually matter to the community. Why this matters for future treatments It is easy to overlook studies about measurement protocols because they do not announce a shiny new pill or piece of technology. However, you cannot prove a new treatment works if you do not have a reliable ruler to measure it. When pharmaceutical companies and medical device makers design clinical trials, they need assessment tools that regulators trust and that accurately reflect what people with the condition care about. By establishing a fast, accurate physical test alongside a meaningful quality of life questionnaire, this global project lays the essential groundwork to speed up the testing and approval of future therapies aimed at unsticking frozen feet for good.