Falls in Progressive Supranuclear Palsy

Brown, Fraser S; Rowe, James B.; Passamonti, Luca; Rittman, Timothy

doi:10.1002/mdc3.12879

Cited by 19 publications

(15 citation statements)

References 82 publications

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“…We have reviewed the approach to falls management in PSP elsewhere. 6 While there is no strong evidence-based approach to reducing falls risk in PSP, we advocate a personalised approach to address polypharmacy, nocturia and impulsivity.…”

Section: Reducing Riskmentioning

confidence: 99%

Progressive supranuclear palsy: diagnosis and management

2021

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Treating patients with progressive supranuclear palsy (PSP) is both effective and rewarding. This review aims to share our experience in the proactive management of PSP, considering the patient, the family and the medical context in which the illness unfolds. There are many opportunities to assist your patients, ameliorate their symptoms, reduce their risks and harm, and guide them through the complex medical, social and legal minefield that characterises life with chronic neurological illness. We summarise the challenges of early diagnosis, consider PSP mimics and the role of investigations in excluding these, and discuss the available pharmacological and non-pharmacological treatment strategies to tackle the common and challenging symptoms of PSP. The best treatment will be patient centred and as part of a multidisciplinary team.

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Section: Reducing Riskmentioning

confidence: 99%

Progressive supranuclear palsy: diagnosis and management

2021

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“…A central diagnostic feature of PSP is the early appearance of gait dysfunction and postural instability, resulting in increasing falls (31,32) (Table 2). Relative to other Parkinsonian syndromes, gait dysfunction in PSP is characterized by step asymmetry and large lateral deviations and may be described as stiff, clumsy, and lurching "like a drunken sailor" (33).…”

Section: Gait Dysfunction and Postural Instabilitymentioning

confidence: 99%

“…PSP patients' fall risk may be assayed at a clinic visit by careful observation of turning. Those characterized as frequent fallers have been found to have disproportionately poor performance on turning and pivoting, which can be evaluated clinically to identify those at greatest risk (32).…”

Section: Causes Of Gait and Postural Instabilitymentioning

confidence: 99%

Best Practices in the Clinical Management of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Consensus Statement of the CurePSP Centers of Care

et al. 2021

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Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS; the most common phenotype of corticobasal degeneration) are tauopathies with a relentless course, usually starting in the mid-60s and leading to death after an average of 7 years. There is as yet no specific or disease-modifying treatment. Clinical deficits in PSP are numerous, involve the entire neuraxis, and present as several discrete phenotypes. They center on rigidity, bradykinesia, postural instability, gait freezing, supranuclear ocular motor impairment, dysarthria, dysphagia, incontinence, sleep disorders, frontal cognitive dysfunction, and a variety of behavioral changes. CBS presents with prominent and usually asymmetric dystonia, apraxia, myoclonus, pyramidal signs, and cortical sensory loss. The symptoms and deficits of PSP and CBS are amenable to a variety of treatment strategies but most physicians, including many neurologists, are reluctant to care for patients with these conditions because of unfamiliarity with their multiplicity of interacting symptoms and deficits. CurePSP, the organization devoted to support, research, and education for PSP and CBS, created its CurePSP Centers of Care network in North America in 2017 to improve patient access to clinical expertise and develop collaborations. The directors of the 25 centers have created this consensus document outlining best practices in the management of PSP and CBS. They formed a writing committee for each of 12 sub-topics. A 4-member Steering Committee collated and edited the contributions. The result was returned to the entire cohort of authors for further comments, which were considered for incorporation by the Steering Committee. The authors hope that this publication will serve as a convenient guide for all clinicians caring for patients with PSP and CBS and that it will improve care for patients with these devastating but manageable disorders.

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“…Non-motor symptoms, such as fatigue, anxiety, and depression, are also common ( 5 , 6 ). Falls are a prominent feature of PSP and become more frequent as the disease progresses ( 7 ). It has been estimated that over 80% of people living with PSP experience falls ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…Falls are a prominent feature of PSP and become more frequent as the disease progresses ( 7 ). It has been estimated that over 80% of people living with PSP experience falls ( 7 , 8 ). Currently, there is no cure for PSP, and even symptomatic support can be challenging.…”

Section: Introductionmentioning

confidence: 99%

Enablers to Exercise Participation in Progressive Supranuclear Palsy: Health Professional Perspectives

et al. 2021

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Background: People living with progressive supranuclear palsy (PSP) can experience considerable difficulties with movement, walking, balance, and oculomotor control. The role of exercises and physical activities in mitigating the motor and non-motor symptoms of PSP remains uncertain.Aims: The aim of this study was to identify the perspectives and beliefs of health professionals about the benefits, enablers, and barriers to participation in exercise and physical activity across the course of disease progression of PSP.Methods: Qualitative methods, within a phenomenological framework, were used to obtain nursing and allied health professional perspectives and recommendations. Focus group and in-depth interview questions were derived from a systematic review on exercise for PSP. Expert opinions also guided the interviews, which were audio-recorded, transcribed verbatim, and de-identified. Two researchers independently conducted a thematic analysis.Results: Nineteen health professionals participated from the disciplines of nursing, physiotherapy, occupational therapy, and speech pathology. Four main themes emerged: (i) exercise and physical activities are important for living well with PSP; (ii) provision of information about the benefits of exercise and physical activities facilitates uptake; (iii) interdisciplinary teams work together to improve outcomes; and (iv) care partners can assist with the implementation of exercise and physical activities.Conclusion: Health professionals advocated physical therapies for people living with PSP. The expectation is that structured exercises and physical activities can help to optimize health and well-being, enabling people to continue to participate in social roles. The actual merits of such interventions must now be tested in large-scale controlled clinical trials.

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Falls in Progressive Supranuclear Palsy

Cited by 19 publications

References 82 publications

Progressive supranuclear palsy: diagnosis and management

Progressive supranuclear palsy: diagnosis and management

Best Practices in the Clinical Management of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Consensus Statement of the CurePSP Centers of Care

Enablers to Exercise Participation in Progressive Supranuclear Palsy: Health Professional Perspectives

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