For a patient with Parkinson disease and a shuffling gait, which intervention would be MOST appropriate to improve gait quality?

• A. Ascending and descending stairs
• B. Walking using a metronome to time steps
• C. Step training on a treadmill without cues
• D. Sidestepping with a braiding pattern

Answer: (B)

In Parkinson disease, internal timing of steps is often disrupted, leading to a shuffling, hesitant gait. External cues, like a regular beat, help the nervous system organize movement by providing a predictable tempo that the brain can synchronize with. Using a metronome gives a consistent rhythm that patients can match their steps to, which tends to increase stride length, improve cadence, and normalize walking speed. This cueing effect is particularly effective for gait quality, making walking with a metronome to time steps the best choice.

The other options don’t provide the same targeted timing cue. Stair practice is beneficial for strength and confidence but doesn’t specifically address gait rhythm. Treadmill training without cues lacks the external timing signal that can help regularize step initiation and pace. Sidestep patterns aren’t a standard, evidence-backed method for improving PD gait and may not translate to steadier forward walking.