PD – Freezing of Gait Management — SCE Neurology MCQ

Correct answer: E — External cueing within task-specific gait training

The best answer is “External cueing within task-specific gait training”. External cues can bypass impaired internal movement scaling and improve step initiation and cadence; physiotherapy should practise relevant gait tasks while also addressing turning, falls risk and safe assistive strategies. “Advise complete avoidance of walking to prevent all falls” is less appropriate because prolonged avoidance causes deconditioning and loss of participation “Use passive limb movement without practising the triggering tasks” is less appropriate because passive movement alone does not train initiation at doorways or turns “Increase antipsychotic treatment to suppress freezing” is less appropriate because dopamine-blocking antipsychotics can worsen parkinsonism “Recommend dual-task walking from the outset without cueing or supervision” is less appropriate because unstructured dual tasking can aggravate freezing and falls before a stable strategy is learned

Reference: NICE NG71: Parkinson’s disease in adults — recommendations. https://www.nice.org.uk/guidance/ng71/chapter/Recommendations