PHYSIOTHERAPY MANAGEMENT FOR PROGRESSIVE SUPRA- NUCLEAR PALSY

Background: An elderly patient with disturbances in gait, impaired balance, difficulty moving the eyes and history of frequent falls are not commonly seen in physiotherapy referral cases. Progressive supranu clear palsy (PSP) is relatively uncommon and is the most frequently occurring form of Atypical Parkinsonism with cardinal features of vertical gaze palsy, gait instability with frequent falls. However, because the initial clinical features often resemble Parkinson’s disease (PD) many patients are referred for rehabilitation services with the wrong diagnosis as PD. The progression of the symptoms in PSP is much faster than in PD and there is no cu re or effective medication to manage PSP. We describe a case of 59 years old male, patient who was referre d to physiotherapy department for asymmetric limb apraxia, markedly impaired balance and frequent falls d uring transitional movements. Two years before the patient was diagnosis as PD and later the patient was r e-diag- nosed as PSP based on the progression of the disease. The patient was rehabilitated using coordinati on exer- cises and reciprocal rhythmic movements to reduce rigidity, transfer training exercises for balance, gait training using weights strapped to ankles in parallel bar and visual tracking exercises. The exercises were programmed for 1 ? hours a day, 5 days a week, for 8 weeks. After 15 weeks there was improvement in gait and ba lance of the patient with decrease in fall incidence on a Progressive Supranuclear Palsy Rating Scale (PSPRS) .