BACKGROUND: Progressive supranuclear palsy (PSP) is a neurodegenerative condition, typically presenting with, but not limited to, impairments of postural instability, gait, and gaze stability. PURPOSE: This case report describes the multifactorial assessment and rehabilitation of a patient with atypical PSP who has significant gaze deficits, asymmetrical stepping responses, trunk rigidity, and reduced posterior excursion on limits of stability. CASE DESCRIPTION: Evaluation utilized computerized gait and balance assessments, foot clearance analysis, a squat test, and a timed stepping test. The intervention included boxing, stepping tasks, and treadmill training each with eye movement challenges. A total of 15 hours of physical therapy was provided; 1 hour, 2 times a week. OUTCOMES: Post-intervention improvements were noted subjectively, on eye-body coordination, and objectively, on limits of stability, foot clearance, and task performance (squats, timed stepping). Follow-up demonstrated some decline from posttest results; however, patient-reported adherence to the program was less than recommended. CONCLUSION: A multifactorial rehabilitation program can improve balance, eye-body coordination, and strength in a high functioning patient with atypical PSP. Longitudinal randomized controlled studies are suggested to further investigate this interventional approach in high functioning individuals diagnosed with atypical PSP.
BACKGROUND: Progressive supranuclear palsy (PSP) is a neurodegenerative condition, typically presenting with, but not limited to, impairments of postural instability, gait, and gaze stability. PURPOSE: This case report describes the multifactorial assessment and rehabilitation of a patient with atypical PSP who has significant gaze deficits, asymmetrical stepping responses, trunk rigidity, and reduced posterior excursion on limits of stability. CASE DESCRIPTION: Evaluation utilized computerized gait and balance assessments, foot clearance analysis, a squat test, and a timed stepping test. The intervention included boxing, stepping tasks, and treadmill training each with eye movement challenges. A total of 15 hours of physical therapy was provided; 1 hour, 2 times a week. OUTCOMES: Post-intervention improvements were noted subjectively, on eye-body coordination, and objectively, on limits of stability, foot clearance, and task performance (squats, timed stepping). Follow-up demonstrated some decline from posttest results; however, patient-reported adherence to the program was less than recommended. CONCLUSION: A multifactorial rehabilitation program can improve balance, eye-body coordination, and strength in a high functioning patient with atypical PSP. Longitudinal randomized controlled studies are suggested to further investigate this interventional approach in high functioning individuals diagnosed with atypical PSP.
Authors: Fuzhong Li; Peter Harmer; Kathleen Fitzgerald; Elizabeth Eckstrom; Ronald Stock; Johnny Galver; Gianni Maddalozzo; Sara S Batya Journal: N Engl J Med Date: 2012-02-09 Impact factor: 91.245
Authors: Giselle M Petzinger; Beth E Fisher; Sarah McEwen; Jeff A Beeler; John P Walsh; Michael W Jakowec Journal: Lancet Neurol Date: 2013-07 Impact factor: 44.182
Authors: Laurie A King; Jennifer Wilhelm; Yiyi Chen; Ron Blehm; John Nutt; Zunqiu Chen; Andrea Serdar; Fay B Horak Journal: J Neurol Phys Ther Date: 2015-10 Impact factor: 3.649