How can the sentence "Shaking from head to toe, Josie's anxiety would not go away before her big presentation" be improved?

The first choice enhances the sentence by clarifying the subject and making it more direct. By stating that “Josie was shaking from head to toe,” it identifies Josie as the one experiencing the physical reaction to her anxiety. This construction shifts the focus from a passive description of anxiety to an active portrayal of Josie's condition, thereby creating a stronger connection between her physical state and the emotion she is experiencing.

This choice also maintains the cause-and-effect relationship between shaking and anxiety. The phrase "as her anxiety" suggests that her physical reaction is a direct result of her state of mind, which adds depth to the understanding of her experience.

In contrast, the other options do not effectively portray Josie's anxiety or her physical reaction. They either result in awkward constructions or fail to maintain the clarity of the subject's actions and feelings, making them less effective than the first option.