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The beginning is the hardest, and it gets easier as you go. But you run out of stamina and can't hold on through the end...

If you're going to bind the early spike, you need a clear path planned out, otherwise just twisting honestly is an option. Once you get past the early spike, it's clearable.

It's a battle of how well you can mash through uncomfortable placements. Since it doesn't take much stamina, clearing it isn't hard, but scoring high (judgment work) will be difficult.

If you're not proficient with brackets, this chart will be quite a struggle. You need to be able to mash the early wide-span sections with brackets without getting too many bads or misses, and you must hit the half-note sections in the middle accurately to keep your gauge alive. For the subsequent holds, research which ones to drop, but make sure to hold the holds. Then, when the big staircase appears, you'll likely be at low health; hold the holds first, hit the single notes in between carefully, and mash the final section in 2-note chunks to clear.

An early-kill chart. Once you get past the twist patterns in the beginning, the rest is easy.