PSP, PD, and Alzheimer's disease (AD) share some common pathophysiology and movement disorders so clinicians sometimes use PD or AD rehabilitation strategies to manage movement problems associated with PSP. One of the challenges faced by current clinicians is knowing which modes of exercise and gait rehabilitation to use.
PSP MUSICPLAYER PSP
There may be potential for exercise to modify the trajectory of PSP disease progression over time, although this has not yet been verified with RCTs. Exercise studies in animals ( 10– 12) and for people living with Parkinson's disease (PD) ( 13– 15) reported a slowing in the rate and level of basal ganglia (BG) disease progression with intensive exercise.
PSP MUSICPLAYER TRIAL
The only randomized controlled trial (RCT) of rehabilitation for PSP reported improvement in gait, balance, and number of falls compared to baseline for both groups using an intensive, aerobic, goal-based intervention including treadmill training in an inpatient setting ( 9). The effects of physiotherapy, including exercise, and task-based training for people with PSP have not been robustly investigated despite clinical reports of benefit ( 6) together with findings that their functional disability is mostly due to physical, and not cognitive or psychiatric problems ( 8). Costs of care are significantly associated with symptom severity so interventions to improve mobility have the potential to reduce these costs ( 7). People living with PSP are generally referred for rehabilitation with the aim of helping them to walk more easily and to prevent falls which are a hallmark of the disease ( 5), however evidence to support rehabilitation strategies is scant ( 6). The cause of PSP is not known, hence treatment is currently symptomatic ( 5). It is associated with early decline in gait, balance, and movement speed ( 4).
It is commonly misdiagnosed as Parkinson's disease (PD) so this may be a conservative estimate ( 3). It has a reported prevalence of only five per 100,000 ( 3) or about 380,000 people worldwide, despite being the most frequently occurring form of atypical parkinsonism ( 1). Progressive Supranuclear Palsy (PSP) is a debilitating and rare disease ( 1, 2).
PSP MUSICPLAYER REGISTRATION
Movement to music is engaging and enjoyable which can facilitate adherence to therapy.Ĭlinical Trial Registration : ANZCTR 12616000851460. All participants reported high satisfaction levels with the program.Ĭonclusions: When delivered at home with the support of caregivers, music-cued gait training can provide a feasible approach to improving disorders of gait stability in people with this rare, degenerative condition. Four participants reduced their timing variability at retest and three reduced step length variability.
Of the remainder who walked with slower, more variable patterns, two walked faster at retest, one by a clinically meaningful amount. Results: At baseline, two of the five community-dwelling participants with Progressive Supranuclear Palsy walked with normal speed and low gait variability. Addenbrooke's Cognitive Examination-III, Geriatric Depression Scale, Assessment of Personal Music Preference Scale, and Physiological Profile Assessment were administered at baseline and retest. The Progressive Supranuclear Palsy and Unified Parkinson's Disease Rating Scales were administered at baseline.
Participants walked without cues at self-selected comfortable pace. Main Outcome Measures: Spatiotemporal gait measures were recorded using an 8 m long GAITRite® mat.
PSP MUSICPLAYER PORTABLE
Rhythmic auditory cues were played via a portable digital music player and consisted of metronome beats and individually chosen, commercially available rhythmic music tracks. Each home training session consisted of a range of activities in standing or walking, with, and without auditory cues. Interventions:Two training sessions per week, conducted by experienced physiotherapists over 4 weeks. Setting: Human movement laboratory and participants' homes. Objectives: To understand the benefits and feasibility of using supervised, home-based, music-cued training to improve gait speed and stability in community-dwelling people with Progressive Supranuclear Palsy.ĭesign: Feasibility trial incorporating a single group repeated-measures design.
0 kommentar(er)
