Which strategy is NOT recommended when a patient struggles with maintaining big movements during cognitive challenges?

Maintaining big movements during cognitive challenges is a critical focus of LSVT BIG therapy, as it is essential to integrate both motor and cognitive functions for optimal patient outcomes. When a patient struggles with this integration, it is crucial to adapt the session to support their learning and movement quality.

Keeping the cognitive challenge unchanged, even when it is clear that the patient is struggling, may lead to frustration and decreased performance. This approach doesn't provide the patient with the necessary support to achieve successful movement. Instead, by modifying the cognitive challenge or related strategies, therapists can create a more conducive environment for skill acquisition and retention. This may involve simplifying the cognitive task, reducing distractions, or even providing additional guidance.

In contrast, discontinuing the cognitive challenge or adding resistance could allow for assessment of movement abilities without overwhelming the patient, paving the way for a more successful integration of big movements with cognitive tasks in future sessions. Therefore, option D, maintaining the cognitive challenge as is when the patient is struggling, does not align with the best practices outlined in LSVT BIG therapy.