Progressive supranuclear palsy

Disease

Progressive supranuclear palsy (PSP) is a neurodegenerative disease that affects regions of the brain related to cognition, eye movements, posture, as well as control of walking and balance. The causes of PSP are not currently known but genetic and environmental factors have been proposed. At the onset of symptoms, PSP can often be confused with Parkinson’s disease, although their progression is quite different and drugs that are effective in treating Parkinson’s disease are only marginally effective in treating PSP.

Symptoms

The main symptoms of the disease are supranuclear ophthalmoplegia (fixed and reduced visual field mainly vertical), pseudo-bulbar paralysis (motor disorders in the mouth, throat and tongue), dystonia in the neck, parkinsonism (stiffness and bradykinesia), behavioral (e.g., apathy) and cognitive disorders, as well as walking problems that lead to loss of balance and falls (reduction of postural reflexes). Postural instability and falls are the most disabling aspects for people with PSP.

Other symptoms may include limb dystonia, blepharospasm (repeated contractions in the eyelids), asymmetric motor apraxia, progressive apraxia of language, aphasia, incontinence of the urinary tract, and photophobia. It is important to note that there will be great variability in presentation and intensity of symptoms from one patient to another.

Exercise and Illness

Although there is an urgent need for more information on the optimal options for the rehabilitation of people with PSP, there are very few scientific studies on the subject. The few case studies that have been published to date are however very clear on one point: an adapted exercise program is beneficial in the short and long term [1,2]. An adapted physical activity program allows an improvement in transfers from a lying to a seated position and from a seated to a standing position [3] as well as walking [3,5,6,7,8], balance [ 5,8], the performance of everyday activities [3] and reduces falls [3,5]. A personalized NeuroMotrix program will allow you to obtain optimal results in the short and long term.

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Sources

[1] Steffen et al (2007) Long term locomotor training for gait and balance in a patient with mixed progressive supranuclear palsy and corticobasal degeneration. Phys Ther. 87:1078–1087.

[2] Steffen et al (2014) Long-term exercise training for an individual with mixed corticobasal degeneration and progressive supranuclear palsy features: 10-year case report follow-up. Phys Ther. 94:289–296.

[3] Ashol et al (2013) Physiotherapy management for progressive supra-nuclear palsy. Int J Physioth Res 2013(2):41-45.

[4] Sale et al (2014) Effects of robot assisted gait training in progressive supranuclear palsy (PSP): a preliminary report. Front. Hum.Neurosci. 8:207.

[5] Suteerawattananon et al (2002) Supported treadmill training for gait and balance in a patient with progressive supranuclear palsy. Phys Ther. 82:485–495.

[6] Sosner et al (1993) Progressive supranuclear palsy: clinical presentation and rehabilitation of two patients. Arch Phys Med Rehabil. 74:537–539.

[7] Izzo et al (1986) Rehabilitation in progressive supranuclear palsy: case report. Arch Phys Med Rehabil. 67:473–476.

[8] Suteerawattananon et al (2002) Supported treadmill training for gait and balance in a patient with progressive supranuclear palsy. Physical Therapy . 82(5):485-495.

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