Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2019


Frey Law, Laura


Background: Frequent falls, progressive postural instability, and gait abnormalities are common functional impairments in patients with Progressive Supranuclear Palsy (PSP). PSP can initially present like Parkinson’s Disease (PD), but these patients will show signs of progressing symptoms and poor response to dopaminergic therapy. Physical therapy treatment for patients with PSP is largely understudied and there is no known effective pharmacotherapy. Thus, the purpose of this case study is to describe the short-term outcomes of a modified LSVT BIG program for a patient with PSP. Case Description: A 69-year old male, with a recent diagnosis of PSP, was treated in a hospital-based outpatient facility. The patient and his wife were seeking treatment to assist with gait and postural instability, frequent falls, and impairments in bed mobility and cervical range of motion. Intervention: Treatment sessions consisted of postural and strengthening exercises, functional movement exercises, and balance exercises, with an emphasis on large-amplitude movements, adapted from the LSVT BIG program regimen. The patient was instructed in a home program that emphasized large-amplitude movements and stretches in a safe environment. Outcome Measures: The Functional Gait Assessment, Berg Balance Scale, and the 6-Minute Walk Test were assessed to objectively measure the patient’s response to physical therapy interventions to improve or maintain his prior level of function in spite of the progressive nature of his diagnosis. Discussion: There is a need for more evidence-based research to assist clinicians with symptomatic treatment of patients with PSP. Due to the symptom progression in PSP, interventions, education, and goals should be focused on maintaining the patient’s quality of life and mobility status with strategies to minimize fall risk and increase patient and caregiver safety.


Progressive Supranuclear Palsy; neurology; rehabilitation; physical therapy; LSVT BIG; outcome measures; postural instability; falls


9 pages


Copyright © 2019 Elise Brown