Objective: To (i) evaluate the literature on exercise and physical activity for Progressive Supranuclear Palsy and (ii) make PSP-specific recommendations for exercise programs and trial design.

Background: Progressive supra-nuclear palsy (PSP) is a debilitating and rapidly progressing form of atypical Parkinson’s disease. PSP is associated with movement disorders, disabilities and reduced social participation. Although emerging evidence supports exercise there is a need to define optimal content, dosage and scheduling.

Method: The protocol was registered on PROSPERO (CRD42018103845). Systematic review methods were informed by Cochrane guidelines and reported with the PRISMA Statement. English language peer-reviewed exercise studies of any design, and in any setting, were included. Interventions were excluded if they included non-invasive brain stimulation, electrotherapy or other neurological conditions. Nine electronic databases were searched until July 31, 2018. The PEDro scale or Joanna Briggs Institute instruments were used for method quality assessment. Data were extracted under headings such as study, sample and intervention characteristics. Intervention elements were extracted using the Consensus on Exercise Reporting Template. We sought missing data and calculated effectiveness where possible.

Results: From a yield of 7415 titles 10 studies were included. Method quality appraisal indicated overall moderate to high a risk of bias. Study designs included randomised/ quasi-randomised controlled trials, quasi-experimental studies, cohort and case studies. Sample sizes ranged from one to 24 participants. Interventions consisted of treadmill training, robot-assisted walking or balance and gaze training, and ranged from three to five sessions per week for four to eight weeks. Outcome measures were predominantly gait and balance. Function, disability and quality of life were inconsistently reported and adverse events were not reported. Intervention effects were typically small to moderate and statistically non-significant.

Conclusion: Exercises tailored to the specific needs of people living with PSP are needed. Effects of condition-specific exercises requires evaluation with well-designed clinical trials. Complex equipment and facilities are not always accessible. There is a need for a core set of outcome measures to evaluate  exerciseeffects for PSP on function, disability, quality of life and wellbeing.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exercise-and-physical-activity-for-people-with-progressive-supranuclear-palsy/