From clutter to confidence: home environmental triggers and adaptive solutions for freezing of gait in Parkinson's disease.

Freezing of gait (FOG) is a disabling symptom in Parkinson's disease (PD), often triggered by home environmental factors such as cluttered or poorly lit spaces. Despite growing recognition of these factors, home environmental adaptations (HEA) remain an underexplored yet modifiable domain in FOG management. This scoping review synthesises current evidence on HEA and their potential to mitigate FOG by addressing environmental triggers and enhancing person-environment fit. It highlights case examples, summarises literature on environmental triggers, and discusses multidisciplinary assessment and intervention roles. Despite the significant impact of home environmental factors, recognition amongst neurologists is limited, leading to missed opportunities for intervention. Proactive home environment assessments and early referrals to multidisciplinary teams, including movement disorder specialists and therapists, are essential for comprehensive care. These interventions can identify modifiable home environmental triggers, reduce the frequency of FOG episodes, and minimise fall risks. However, barriers such as limited clinician awareness, resource constraints, and psychosocial resistance impede widespread implementation. Promoting neurologists' recognition of environmental influences on FOG and encouraging timely multidisciplinary referrals are crucial for optimising functional outcomes and quality of life in PD. Integrating environmental assessment into routine care, alongside patient and family education, is key to comprehensive FOG management.