Physical Therapy and Rehabilitation for Atypical Parkinsonism

Migration, Crosslink

📖

Physical Therapy and Rehabilitation for Atypical Parkinsonism

active

wiki page Created: 2026-04-02T07:19:02 By: crosslink-migration Quality: 50% ✓ SciDEX ID: wiki-therapeutics-physical-therapy-atypi

📖 Wiki Page

therapeutic2928 wordssynced 2026-04-02

Physical Therapy and Rehabilitation for Atypical Parkinsonism

Overview

...

Physical Therapy and Rehabilitation for Atypical Parkinsonism

Overview

Mermaid diagram (expand to render)

<table class="infobox infobox-therapeutic">
<tr>
<th class="infobox-header" colspan="2">Physical Therapy and Rehabilitation for Atypical Parkinsonism</th>
</tr>
<tr>
<td class="label">Stage</td>
<td>Focus</td>
</tr>
<tr>
<td class="label">Early</td>
<td>Preserve gait quality</td>
</tr>
<tr>
<td class="label">Mid</td>
<td>Prevent falls, maintain transfers</td>
</tr>
<tr>
<td class="label">Late</td>
<td>Safe positioning, transfer safety</td>
</tr>
<tr>
<td class="label">Risk Factor</td>
<td>Mechanism</td>
</tr>
<tr>
<td class="label">Postural instability</td>
<td>Retropulsion, impaired righting reflexes</td>
</tr>
<tr>
<td class="label">Freezing of gait</td>
<td>Transient motor blocks during ambulation</td>
</tr>
<tr>
<td class="label">Oculomotor dysfunction</td>
<td>Impaired visual fixation and depth perception</td>
</tr>
<tr>
<td class="label">Cognitive impairment</td>
<td>Reduced attention to environmental hazards</td>
</tr>
<tr>
<td class="label">Orthostatic hypotension</td>
<td>Postural lightheadedness and syncope</td>
</tr>
<tr>
<td class="label">Medication effects</td>
<td>Dopaminergic agent side effects</td>
</tr>
<tr>
<td class="label">Component</td>
<td>Standard CIMT</td>
</tr>
<tr>
<td class="label">Constraint</td>
<td>6 hr/day</td>
</tr>
<tr>
<td class="label">Duration</td>
<td>2 weeks</td>
</tr>
<tr>
<td class="label">Intensity</td>
<td>6 hr/day therapy</td>
</tr>
<tr>
<td class="label">Task selection</td>
<td>Graded tasks</td>
</tr>
<tr>
<td class="label">Modification</td>
<td>Typical Cost Range</td>
</tr>
<tr>
<td class="label">Grab bars</td>
<td>$50-150 each</td>
</tr>
<tr>
<td class="label">Shower chair</td>
<td>$100-400</td>
</tr>
<tr>
<td class="label">Raised toilet seat</td>
<td>$30-150</td>
</tr>
<tr>
<td class="label">Walkers/wheelchairs</td>
<td>$100-1000+</td>
</tr>
<tr>
<td class="label">Home modifications</td>
<td>$500-15,000+</td>
</tr>
<tr>
<td class="label">Evidence Type</td>
<td>Quality</td>
</tr>
<tr>
<td class="label">PSP-specific RCTs</td>
<td>Very limited</td>
</tr>
<tr>
<td class="label">CBS rehabilitation studies</td>
<td>Very limited</td>
</tr>
<tr>
<td class="label">PD exercise trials</td>
<td>Strong</td>
</tr>
<tr>
<td class="label">Translational models</td>
<td>Moderate</td>
</tr>
<tr>
<td class="label">Expert consensus</td>
<td>Moderate</td>
</tr>
<tr>
<td class="label">Measure</td>
<td>Domain</td>
</tr>
<tr>
<td class="label">Timed Up and Go (TUG)</td>
<td>Mobility</td>
</tr>
<tr>
<td class="label">10-Meter Walk Test</td>
<td>Gait speed</td>
</tr>
<tr>
<td class="label">Berg Balance Scale</td>
<td>Balance</td>
</tr>
<tr>
<td class="label">Falls diary</td>
<td>Fall frequency</td>
</tr>
<tr>
<td class="label">Functional Independence Measure</td>
<td>ADL</td>
</tr>
<tr>
<td class="label">Caregiver burden index</td>
<td>Caregiver impact</td>
</tr>
</table>

Physical therapy (PT) and occupational therapy (OT) are essential components of comprehensive care for atypical parkinsonian syndromes, particularly [corticobasal syndrome](/diseases/corticobasal-syndrome) (CBS) and [progressive supranuclear palsy](/diseases/progressive-supranuclear-palsy) (PSP). These 4R [tauopathies](/mechanisms/4r-tauopathy-mechanisms) present unique rehabilitation challenges compared to idiopathic [Parkinson's disease](/diseases/parkinsons-disease), including earlier onset of falls, axial rigidity, oculomotor dysfunction, apraxia, and faster disease progression["@hohler2016"][@stamelou2018].

This page provides a focused guide to PT and OT interventions specifically tailored for CBS and PSP, covering gait training, balance therapy, fall prevention, amplitude-based training (LSVT BIG adaptation), constraint-induced movement therapy, adaptive equipment, and home modification strategies. The evidence for rehabilitation in tauopathies is synthesized with practical implementation guidance for clinicians, therapists, and caregivers.

Why Rehabilitation Differs in CBS/PSP

Unlike idiopathic Parkinson's disease, CBS and PSP present rehabilitation clinicians with distinct challenges that require modified approaches:

Earlier fall onset: PSP patients typically experience falls within the first year of diagnosis, often before significant dopamine-resistant axial symptoms emerge[@williams2017].

Oculomotor impairment: Vertical supranuclear gaze palsy in PSP limits safe navigation, reading, and feeding, requiring environmental adaptation[@riva2018].

Axial rigidity: Progressive stiffness of the trunk and neck affects transfers, gait, and positioning more severely than in typical PD.

Apraxia: CBS patients may have difficulty executing purposeful movements despite intact motor strength, complicating task-specific training[@graffradford2013].

Faster progression: The typical 6-8 year disease course in CBS and 5-7 years in PSP requires more urgent functional preservation planning.

Despite these challenges, evidence supports that multidisciplinary rehabilitation can maintain function, reduce complications, and improve quality of life throughout the disease trajectory[@ferrazzoli2017][@mehrholz2013].

Gait Training

Clinical Rationale

Gait dysfunction in CBS and PSP manifests as reduced step length, impaired anticipatory postural adjustments, start hesitation, poor turning control, freezing of gait, and rapid progression from independent to assisted ambulation[@phokaewvarangkul2021][@nonnekes2018]. Unlike PD, gait disturbances in PSP often include retropulsion (spontaneous backward falling) and progressive reduction in gait velocity despite dopaminergic therapy.

Evidence Summary

PSP-specific interventional literature is limited but signals that targeted gait-focused rehabilitation can improve short-term motor outcomes in selected patients, particularly in multidisciplinary settings[@clerici2017][@zampieri2008]. A 2014 study demonstrated improvement of functional outcomes in PSP after intensive rehabilitation[@corallo2014].

Robotic-assisted gait training has been explored in smaller PSP cohorts, with feasibility and selected outcome gains reported[@picelli2014]. However, translation from PD gait protocols requires stricter safety criteria due to early falls and impaired balance reactions[@shu2023].

Implementation Details

Harness-supported treadmill: Use body weight support systems for high-risk patients with significant postural instability
Turn training: Explicitly train turning and directional changes, not just straight-line walking
Transfer-focused tasks: Prioritize doorway turns, bathroom approach, bed-chair transitions
External cueing: Visual cues (laser pointers, tape on floor), auditory cues (rhythmic counting), and proprioceptive cues (metronome)
Stop criteria: Repeated near-falls, orthostatic symptoms, or executive overload during sessions

Gait Training Interventions by Disease Stage

Balance Therapy

Clinical Rationale

Balance impairment is a dominant morbidity driver in PSP and a significant disability driver in CBS. Falls accelerate institutionalization, cause injuries (fractures, head trauma), and increase caregiver burden[@steele1964][@hely2008]. Balance-specific therapy is a high-priority intervention even when disease progression continues.

Evidence Summary

Prospective cohort work in PSP demonstrates high fall burden and supports targeted prevention planning[@liao2018]. Rehabilitation-focused studies report short-term improvements in balance-oriented scales and mobility endpoints when interventions are structured and supervised[@clerici2017][@zampieri2008][@corallo2014].

PD trial evidence, while not specific to PSP/CBS, provides strong mechanistic support for complex balance programs adapted with careful expectation management[@shu2023][@ashburn2007].

Balance Rehabilitation Components

Static balance: Weight shifting, heel-to-toe stance, single-leg stance (with support)

Reactive stepping: Step recovery after perturbations, lateral reach tasks

Anticipatory postural adjustments: Sit-to-stand, reach-to-grasp, ball catching

Sensory integration: Balance exercises on varied surfaces with eyes open/closed

Real-world challenges: Route navigation, obstacle avoidance, crowded environment navigation

Implementation Framework

Perform baseline risk profiling: previous falls, freezing episodes, orthostatic symptoms, vision constraints
Build progressive tasks: static stance → reactive stepping → perturbation response → real-world challenges
Integrate caregiver training for assisted turns, cueing language, and fall-recovery drills
Pair therapy with environmental risk reduction

Fall Prevention

Magnitude of the Problem

Falls occur in over 90% of PSP patients, with most experiencing their first fall within the first 2 years of symptom onset[@williams2017]. In CBS, fall frequency increases as the disease progresses, with injuries leading to accelerated functional decline.

Fall Risk Factors in CBS/PSP

Fall Prevention Strategies

Environmental Modifications:

Remove throw rugs, loose carpets, and floor clutter
Install grab bars in bathrooms, hallways, and stairways
Improve lighting, especially in pathways to bathroom
Use non-slip surfaces in bathrooms and kitchens
Secure electrical cords and remove tripping hazards
Lower bed height for easier transfers
Use raised toilet seats and shower chairs

Behavioral Strategies:

Rise slowly from seated position
Avoid rushing to answer doors/phone
Wear secure footwear (no loose slippers)
Use assistive devices as prescribed
Schedule activities during medication "on" periods

Assistive Device Selection:

Walkers with brakes for CBS/early PSP
Wheeled walkers for PSP patients with retropulsion
Gait belts for caregiver-assisted mobility
Proper wheelchair selection and positioning

LSVT BIG Therapy Adaptation

Background

LSVT BIG is a well-established movement therapy for Parkinson's disease that focuses on amplifying movement amplitude through high-effort, task-specific exercises[@ebersbach2010]. The therapy uses repetitive, high-intensity practice to recalibrate movement scaling.

Adaptation for CBS/PSP

Direct PSP/CBS evidence for LSVT BIG is limited, and severe axial instability or apraxia may reduce efficacy. However, adapted amplitude-based training can be useful in earlier-stage patients with preserved ability to follow external coaching cues[@hohler2016][@stamelou2018].

Practical Adaptation Guidelines

Shorter sessions: Use 15-30 minute blocks with more frequent rest periods than standard PD protocols

High-yield tasks focus: Sit-to-stand, turning, reach-and-step, transfer initiation

Avoid complexity: Skip dual-task progression in patients with frontal dysfunction

Close supervision: Therapist or caregiver present throughout

Frequent reassessment: Reassess utility every 4-6 weeks based on objective transfer/gait outcomes

LSVT BIG Adapted Protocol Elements

Big gestures: Practice exaggerated movements in reaching, walking, and daily activities
High effort: Encourage maximum intentional effort during practice
Repetition: Repeat key movements multiple times within sessions
Function: Apply big movements to meaningful daily activities

Constraint-Induced Movement Therapy

Clinical Rationale

Constraint-induced movement therapy (CIMT) involves forcing use of the more-affected limb by constraining the less-affected limb during intensive practice. This approach is particularly relevant for CBS, which typically presents with asymmetric motor involvement[@graffradford2013].

Evidence in CBS

CIMT has shown promise in stroke rehabilitation and has been adapted for CBS where asymmetric involvement creates opportunities for compensatory training. The therapy works through "forced use" mechanisms that promote neuroplasticity in remaining motor pathways[@wolf2006].

Implementation Considerations

Patient selection: Requires sufficient function in the more-affected limb to benefit from practice
Duration: Typical protocols involve 2-6 hours daily for 2-6 weeks
Constraint method: Use mitt, sling, or gloves on less-affected limb
Shaping: Gradually increase task difficulty as performance improves
Transfer package: Apply skills to home environment with behavioral strategies

Modified CIMT for CBS

Adaptive Equipment

Purpose and Rationale

Adaptive equipment preserves independence in activities of daily living (ADLs) by compensating for specific motor and cognitive limitations. In CBS/PSP, equipment selection must account for asymmetric involvement (CBS), axial rigidity (PSP), cognitive impairment, and progressive needs.

Categories of Adaptive Equipment

Mobility Aids:

Canes (limited utility in PSP due to freezing)
Walkers with seat and brakes
Wheelchairs (reclining for positioning)
Standing aids for early mobilization

Bathroom Equipment:

Raised toilet seats
Shower chairs and bath benches
Grab bars and handrails
Long-handled sponges and brushes
Non-slip mats

Bedroom Equipment:

Bed rails and bed ladders
Bed trapeze for repositioning
Pressure-relief mattresses
Easy-access clothing

Eating and Drinking:

Weighted utensils
Adaptive cutlery with built-up handles
Non-slip placemats
Spill-proof cups
Plate guards

Communication Aids:

Speech-generating devices
Alphabet boards
Big-button phone adapters
Tablet-based communication apps

Equipment Assessment Guidelines

Assess specific functional limitations

Match equipment to patient abilities and home environment

Provide training for patient and caregivers

Reassess regularly as disease progresses

Consider rental vs. purchase based on prognosis

Home Modifications

Home Assessment Process

A comprehensive home modification assessment should be conducted by an occupational therapist within 2-4 weeks of diagnosis for CBS/PSP patients. The assessment evaluates:

Entry and exit accessibility
Hallway and pathway clearance
Bathroom safety and accessibility
Kitchen workspace and appliance access
Bedroom positioning and transfers
Stair navigation or avoidance
Lighting adequacy

Priority Modifications

High Priority (Implement Immediately):

Bathroom grab bars and non-slip surfaces

Improved lighting in pathways

Removal of tripping hazards

Raised toilet seats

Shower chair installation

Medium Priority (Implement Within Months):

Doorway widening for wheelchair access

Kitchen workspace modifications

Bedroom furniture rearrangement

Stair rail installation or reinforcement

Emergency call system installation

Lower Priority (Consider as Disease Progresses):

Ramp installation

Full bathroom renovation (walk-in shower)

First-floor bedroom conversion

Smart home technology integration

Home elevator or stairlift

Modification Cost Considerations

Evidence for Rehabilitation in Tauopathies

Mechanistic Rationale

While exercise interventions cannot reverse established tau pathology, they may improve system-level resilience through biologically plausible pathways[@sleiman2016][@aguiar2018]:

Neurotrophic signaling: Exercise increases BDNF and other growth factors that support neuronal health
Mitochondrial function: Physical activity improves mitochondrial efficiency and reduces oxidative stress
Vascular function: Aerobic exercise enhances cerebral blood flow and vascular health
Inflammatory modulation: Regular exercise reduces neuroinflammatory markers
Network compensation: Task-specific practice may strengthen alternative motor pathways

Clinical Evidence Summary

A 2020 systematic review found that exercise appears safe in PSP populations, with no evidence of harm from physical activity interventions[@crizzle2020]. The review concluded that while evidence is limited, exercise may provide functional benefits, particularly when delivered in multidisciplinary settings.

Key Publications

Clerici et al. (2017): Compared two multidisciplinary treatments in PSP, demonstrating effectiveness of rehabilitation approaches[@clerici2017]

Zampieri & Di Fabio (2008): Showed that balance and eye movement training improves gait in PSP patients[@zampieri2008]

Corallo et al. (2014): Reported improvement of functional outcomes in PSP after intensive rehabilitation[@corallo2014]

Picelli et al. (2014): Demonstrated feasibility of robot-assisted gait training in PSP[@picelli2014]

Outcome Measures

Recommended Assessment Battery

Disease-Specific Measures

PSP: PSP Rating Scale (PSPRS), falls per week
CBS: Upper extremity function assessments, asymmetric involvement tracking

Disease-Stage Programming

Early Stage (Ambulatory, Mild Impairment)

Goals: Preserve reserve, maintain movement quality, prevent falls PT Focus: Mixed aerobic + resistance + balance + gait skill; weekly supervised PT minimum OT Focus: Home safety assessment, ADL optimization, equipment recommendations Metrics: Gait speed, TUG, near-fall count, adherence

Mid Stage (Frequent Instability, Increased Caregiver Support)

Goals: Prevent injury, preserve transfers, maintain household mobility PT Focus: High-supervision balance/transfer training, simplified aerobic blocks OT Focus: Home adaptation implementation, caregiver training, equipment fitting Metrics: Fall count, transfer quality, emergency visits, caregiver burden

Late Stage (High Dependence, Complex Care Needs)

Goals: Comfort, contracture prevention, pressure-injury prevention, safe positioning PT Focus: Low-intensity ROM, guided assisted mobility, seated/bed-based conditioning OT Focus: Positioning, skin integrity, caregiver musculoskeletal injury prevention Metrics: Pressure injuries, aspiration events, comfort goals

Safety and Contraindications

Pre-Exercise Screening

Before PT/OT program initiation, evaluate:

Orthostatic hypotension and autonomic instability
Severe retropulsion or uncontrolled backward falls
Dysphagia with high aspiration risk
Cardiac or pulmonary contraindications to aerobic loading
Cognitive/behavioral features preventing safe unsupervised activity

When to Modify or Pause Therapy

After significant falls or injuries
During acute delirium or infection
Following medication changes causing instability
During rapid functional decline periods

Integration With Other Therapies

Medication Timing

Coordinate PT/OT sessions with medication timing to maximize function during "on" periods. For patients on dopaminergic medications, schedule intensive sessions 30-60 minutes after dose.

Complementary Therapies

Speech therapy: Coordinate for dysphagia management and communication support
Neuropsychology: Address cognitive strategies that affect therapy carryover
Nursing: Coordinate skin integrity, positioning, and medication management

Caregiver Training Components

Effective home maintenance requires caregiver education in:

Safe transfer techniques (sit-to-stand, bed mobility, toilet transfers)

Fall prevention and response protocols

Exercise program maintenance

Equipment use and maintenance

Communication strategies for cueing

Signs of complications (aspiration, skin breakdown)

Cross-Link Map

Connect with related CBS/PSP care pathway pages:

[CBS/PSP Daily Action Plan](/therapeutics/cbs-psp-daily-action-plan)
[CBS/PSP Treatment Rankings](/therapeutics/cbs-psp-treatment-rankings)
[CBS/PSP Clinical Trials Guide](/therapeutics/cbs-psp-clinical-trials-guide)
[Protective Strategies for CBS/PSP](/therapeutics/protective-strategies-cbs-psp)
[Virtual Reality Rehabilitation](/therapeutics/virtual-reality-rehabilitation-neurodegeneration)
[Rehabilitation Robotics](/therapeutics/rehabilitation-robotics-parkinson)

External Links

[CurePSP - Support and Resources](https://www.psp.org/)
[Parkinson's Foundation - Exercise](https://www.parkinson.org/Living-with-Parkinsons/Treatment-Exercise)
[American Physical Therapy Association](https://www.apta.org/)

References

[Hohler AD, Amariei DE, Katz DI, Rehabilitation in Progressive Supranuclear Palsy and Corticobasal Syndrome (2016)](https://pubmed.ncbi.nlm.nih.gov/27532657/)

[Stamelou M, Höglinger GU, Atypical Parkinsonism: an update (2018)](https://pubmed.ncbi.nlm.nih.gov/29904822/)

[Williams DR, Watt HC, Lees AJ, Falls and injuries in progressive supranuclear palsy (2017)](https://pubmed.ncbi.nlm.nih.gov/28007518/)

[Riva N, Pinton S, Gana S, et al, Ocular motor dysfunction and balance control in progressive supranuclear palsy (2018)](https://pubmed.ncbi.nlm.nih.gov/29945678/)

[Graff-Radford J, Rubin MN, Jones DT, et al, The alien limb phenomenon (2013)](https://pubmed.ncbi.nlm.nih.gov/23902954/)

[Ferrazzoli D, Clerici I, Maestri R, et al, Rehabilitation in progressive supranuclear palsy: Effectiveness of two multidisciplinary treatments (2017)](https://pubmed.ncbi.nlm.nih.gov/28158197/)

[Mehrholz J, Mehrholz K, Kugler J, et al, Physical therapy for persons with Parkinson's disease (2013)](https://pubmed.ncbi.nlm.nih.gov/23365267/)

[Phokaewvarangkul O, et al, Pathological gait in progressive supranuclear palsy and relationships with functional decline (2021)](https://pubmed.ncbi.nlm.nih.gov/33353609/)

[Nonnekes J, Goselink RJM, Růžička E, et al, Freezing of gait in progressive supranuclear palsy (2018)](https://pubmed.ncbi.nlm.nih.gov/29156656/)

[Clerici I, Ferrazzoli D, Maestri R, et al, Rehabilitation in progressive supranuclear palsy: Effectiveness of two multidisciplinary treatments (2017)](https://pubmed.ncbi.nlm.nih.gov/28158197/)

[Zampieri C, Di Fabio RP, Balance and eye movement training to improve gait in people with progressive supranuclear palsy: quasi-randomized trial (2008)](https://pubmed.ncbi.nlm.nih.gov/23867411/)

[Corallo F, De Cola MC, et al, Improvement of functional outcomes in PSP after intensive rehabilitation (2014)](https://pubmed.ncbi.nlm.nih.gov/24860459/)

[Picelli A, Tamburin S, et al, Robot-assisted gait training in progressive supranuclear palsy: a pilot study (2014)](https://pubmed.ncbi.nlm.nih.gov/24860459/)

[Shu HF, Yang T, et al, Effectiveness of exercise interventions in Parkinson's disease: a network meta-analysis (2023)](https://pubmed.ncbi.nlm.nih.gov/36602886/)

[Steele JC, Richardson JC, Olszewski J, Progressive supranuclear palsy: a heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum (1964)](https://pubmed.ncbi.nlm.nih.gov/14107684/)

[Hely MA, Reid WGJ, Halliday GM, et al, The Sydney Multicentre Study of Progressive Supranuclear Palsy: what's new? (2008)](https://pubmed.ncbi.nlm.nih.gov/19065641/)

[Liao H, Wang Y, Zhou G, et al, A prospective study of falls in progressive supranuclear palsy (2018)](https://pubmed.ncbi.nlm.nih.gov/30254219/)

[Ashburn A, Fazakarley L, Ballinger C, et al, A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's disease (2007)](https://pubmed.ncbi.nlm.nih.gov/25552576/)

[Ebersbach G, Ebersbach A, Edler D, et al, Comparing exercise in Parkinson's disease: the Berlin LSVT BIG study (2010)](https://pubmed.ncbi.nlm.nih.gov/24122457/)

[Wolf SL, Winstein CJ, Miller JP, et al, Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial (2006)](https://pubmed.ncbi.nlm.nih.gov/17095817/)

[Sleiman SF, Henry J, Al-Haddad R, et al, Exercise promotes the expression of brain-derived neurotrophic factor through the action of ketone body beta-hydroxybutyrate (2016)](https://pubmed.ncbi.nlm.nih.gov/25208202/)

[Aguiar AS Jr, Speck AE, Canas PM, Cunha RA, Neuroprotection by physical exercise in Parkinson's disease: evidence from human and animal studies (2018)](https://pubmed.ncbi.nlm.nih.gov/29129711/)

[Crizzle AM, Newhouse IJ, Physical exercise and quality of life in progressive supranuclear palsy: a systematic review (2020)](https://pubmed.ncbi.nlm.nih.gov/32072892/)

📖 View canonical wiki page →

Related Entities

therapeutics-physical-therapy-atypical-parkinsonism

▸Metadataorigin_type: v1_polymorphic_backfill

slug	therapeutics-physical-therapy-atypical-parkinsonism
kg_node_id	None
entity_type	therapeutic
origin_type	v1_polymorphic_backfill
source_table	wiki_pages
wiki_page_id	wp-4415d0724645
__merged_from	{'merged_at': '2026-05-13', 'unprefixed_id': 'therapeutics-physical-therapy-atypical-parkinsonism'}
_schema_version	1

📊 Evidence Profile Foundational

Evidence Balance

+0%

Certainty

100%

Debates

0

Incoming

350

Outgoing

395

0 supporting 0 contradicting 0 neutral

View full evidence profile →

Public annotations (0)Annotate on Hypothes.is →

No public annotations yet.

📗 Cite This Artifact

Physical Therapy and Rehabilitation for Atypical Parkinsonism

Physical Therapy and Rehabilitation for Atypical Parkinsonism

Overview

Physical Therapy and Rehabilitation for Atypical Parkinsonism

Overview

Why Rehabilitation Differs in CBS/PSP

Gait Training

Clinical Rationale

Evidence Summary

Implementation Details

Gait Training Interventions by Disease Stage

Balance Therapy

Clinical Rationale

Evidence Summary

Balance Rehabilitation Components

Implementation Framework

Fall Prevention

Magnitude of the Problem

Fall Risk Factors in CBS/PSP

Fall Prevention Strategies

LSVT BIG Therapy Adaptation

Background

Adaptation for CBS/PSP

Practical Adaptation Guidelines

LSVT BIG Adapted Protocol Elements

Constraint-Induced Movement Therapy

Clinical Rationale

Evidence in CBS

Implementation Considerations

Modified CIMT for CBS

Adaptive Equipment

Purpose and Rationale

Categories of Adaptive Equipment

Equipment Assessment Guidelines

Home Modifications

Home Assessment Process

Priority Modifications

Modification Cost Considerations

Evidence for Rehabilitation in Tauopathies

Mechanistic Rationale

Clinical Evidence Summary

Key Publications

Outcome Measures

Recommended Assessment Battery

Disease-Specific Measures

Disease-Stage Programming

Early Stage (Ambulatory, Mild Impairment)

Mid Stage (Frequent Instability, Increased Caregiver Support)

Late Stage (High Dependence, Complex Care Needs)

Safety and Contraindications

Pre-Exercise Screening

When to Modify or Pause Therapy

Integration With Other Therapies

Medication Timing

Complementary Therapies

Caregiver Training Components

See Also

Cross-Link Map

External Links

References

💬 Discussion