Abstract

Many studies have examined aspects of balance in progressive supranuclear palsy (PSP), but guidance on the feasibility of standardized objective balance assessments and balance scales in PSP is lacking. Balance tests commonly used in Parkinson's disease often cannot be easily administered or translated to PSP. Here we briefly review methodology in prior studies of balance in PSP; then we focus on feasibility by presenting our experience with objective balance assessment in PSP-Richardson syndrome and PSP-parkinsonism during a crossover rTMS intervention trial. We highlight lessons learned, safety considerations, and future approaches for objective balance assessment in PSP.

Highlights

  • Many studies have examined aspects of balance in progressive supranuclear palsy (PSP) [1,2,3,4,5,6,7,8,9,10,11,12], but guidance on the feasibility of standardized objective balance assessments in PSP is lacking

  • To capture the known backward postural instability in PSP-Richardson syndrome (PSP-RS), we focus on postural sway in the sagittal plane

  • Feasibility far in six subjects with PSP, we find that subjects diagnosed with probable PSP-RS or PSP-P are unable to complete all portions of the mini-Balance Evaluation System Test (BESTest) without adjustments that invalidate results

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Summary

Introduction

Many studies have examined aspects of balance in progressive supranuclear palsy (PSP) [1,2,3,4,5,6,7,8,9,10,11,12], but guidance on the feasibility of standardized objective balance assessments in PSP is lacking. Static force plate posturography tests sagittal and medio-lateral sway in PSP [3, 4, 6, 7, 9], and can examine limits of stability the maximum excursion or lean without taking a step or losing balance [5, 8].

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