Perspective: Balance Assessments in Progressive Supranuclear Palsy: Lessons Learned

Area of Science:

• Neurology
• Movement Disorders
• Rehabilitation Science

Background:

• Progressive supranuclear palsy (PSP) significantly impacts balance.
• Existing balance assessments, often used for Parkinson's disease, are not readily applicable to PSP.
• There is a lack of guidance on feasible, standardized objective balance assessments for PSP.

Purpose of the Study:

• To review methodologies for balance assessment in prior PSP studies.
• To present experiences with objective balance assessment in PSP subtypes (Richardson syndrome and parkinsonism).
• To highlight feasibility, safety, and future directions for objective balance assessment in PSP.

Main Methods:

• Review of existing literature on balance assessment in PSP.
• Feasibility assessment of objective balance tests during a crossover repetitive transcranial magnetic stimulation (rTMS) intervention trial.
• Observation of balance in patients with PSP-Richardson syndrome and PSP-parkinsonism.

Main Results:

• Standardized objective balance assessments present unique feasibility challenges in PSP.
• Specific considerations and adaptations are necessary for administering balance tests in PSP.
• Lessons learned regarding safety and practicality were identified during the intervention trial.

Conclusions:

• Objective balance assessment in PSP requires tailored methodologies.
• Further research is needed to establish reliable and feasible balance assessment tools for PSP.
• Adapting existing methods and developing new approaches are crucial for understanding and managing balance deficits in PSP.