Combined rehabilitation program for postural instability in progressive supranuclear palsy

BACKGROUND: Progressive supranuclear palsy (PSP) is an atypical parkinsonism clinically characterized by prominent axial extrapyramidal motor symptoms with frequent falls. The clinical response to L-dopa is poor and there is strong need for alternative treatment strategies. METHODS: We tested the efficacy of a rehabilitative program combining a dynamic antigravity postural system (SPAD) and a vibration sound system (ViSS) on postural instability of 10 patients affected by PSP. The patients underwent SPAD and VISS treatments with a 3 sessions/week schedule for 2 months. Patients were clinically examined at baseline, every week during the 2-months treatment, and at 1 month after the end of treatment for the following parameters: baropodometry static, baropodometry dynamic and stabilometry. PSP rating scale and PD36 quality of life scale were also administered. RESULTS: The combined rehabilitative program produced improvement of all the parameters explored (p = 0.01-0.05) at the end of treatment as compared to baseline. Baropodometric dynamics improvement lasted until the end of follow-up. CONCLUSION: Our results suggest that a specific rehabilitation program could improve postural instability in PSP patients. A more continuous treatment protocol would allow stabilizations of results.