The freezing doorway — cueing, not a cane

Freezing of gait is an initiation failure, not a strength problem, and the treatment evidence is cueing: the RESCUE trial put cueing training in the home and improved gait-related mobility, and the visual-cue work goes back to stride-length regulation in the mid-nineties. Measure it with the instruments that provoke it — the New FOG-Q and a dual-task TUG — because comfortable corridor speed is the one thing she still does well. What you do with it: lines on the floor, a beat in the ear, strategies practiced in her own doorways, and the medication question sent back to the prescriber only if the freezes start appearing “off”.

• A fall with head strike, fracture or loss of consciousness — medical review before the next session
• Freezing newly present in the “off” state or rapidly worsening — refer back to neurology; the medication map may need redrawing

• The backward faller — the pull test and the next fallTier 2
• The dyskinetic hour — exercise against the diaryTier 3

This page carries the case’s first decision. The full sequence — every decision, the examination by domain, and the debrief that grades you — is in the drill, and the library is included with membership.