PTOTCase ReportPhysiotherapy theory and practice2023

Training high level balance and stepping responses in atypical progressive supranuclear palsy: a case report.

Earllaine Croarkin, Krystle Robinson, Christopher J Stanley and 1 others

PMID 35098865

WHAT IT FOUND

A high-functioning man with atypical PSP improved backward balance and stepping after combined physical therapy, occupational therapy and home exercise, but foot clearance gains were lost at follow-up.

Key findings

01The intervention combined physical therapy boxing, stepping tasks and treadmill training with occupational therapy eye-body movement work and home exercise.

02After the combined intervention, backward limits of stability, repeated stepping accuracy and unilateral squat performance improved.

03At follow-up, limits of stability remained normal, but foot clearance decreased below initial testing and unilateral squat asymmetry remained.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

This is a case report, not a controlled trial, so it cannot show that the intervention caused the improvements. The patient received physical therapy, occupational therapy and home exercise together, so the contribution of any single component cannot be separated. The PSP Rating Scale total score came from chart review and itemised scores were unavailable. Some baseline normal tests were not repeated, so change on those tests could not be checked. No fall, step or community activity monitoring was done. At follow-up some gains were lost, and PSP is progressive.

Declared interests

The authors report no conflict of interest.

The easy way to misread this

Do not conclude that boxing, stepping tasks or treadmill training works for PSP. This is one high-functioning patient with concurrent occupational therapy and home exercise, and the gains were partly lost at follow-up.

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