Improvement of gaze control after balance and eye movement training in patients with progressive supranuclear palsy: a quasi-randomized controlled trial

Cris Zampieri, Richard P Di Fabio
Archives of Physical Medicine and Rehabilitation 2009, 90 (2): 263-70

OBJECTIVE: One of the main oculomotor findings in progressive supranuclear palsy (PSP) is the inability to saccade downward. In addition, people with PSP have difficulty suppressing fixation, which may contribute to vertical gaze palsy. The objective was to investigate the effectiveness of a rehabilitation intervention tailored to enhance suppression of fixation and gaze shift in participants with PSP.

DESIGN: Controlled trial with a quasi-randomized design. Measures occurred at week 1 and 5. Researchers assessing participants were blind to the group assignments.

SETTING: Movement disorders assessment laboratory.

PARTICIPANTS: Nineteen adults with possible or probable PSP who were ambulatory for short distances and had far visual acuity of 20/80 and a Folstein Mini-Mental State score of more than 23.

INTERVENTIONS: Balance training complemented with eye movement and visual awareness exercises was compared with balance training alone.

MAIN OUTCOME MEASURES: Gaze control was assessed using a vertical Gaze Fixation Score and a Gaze Error Index.

RESULTS: Gaze control after the balance plus eye exercise significantly improved, whereas no significant improvement was observed for the group that received balance training alone.

CONCLUSIONS: These preliminary findings support the use of balance and eye movement exercises to improve gaze control in PSP.

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