MANAGING SYMPTOMS( continued)
Examples of Devices
• Rolling walkers( rollators) for walking
• Transfer aids
• Gait belts
• Bed rails
• Chair and bed risers to make surfaces higher
• Motorized lift chairs
• Specialized wheelchairs
With Any of the Diseases
• Maintain a wide and staggered stance while assisting someone with activities of daily living.
• For freezing of gait, do not fight the freeze in an attempt to break free from it.
At the First Sign of Shuffling or Freezing, Remember the Four S’ s:
• Stop
• Stand tall and take deep breaths
• Shift weight side to side
• Step— take a large step
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Physical Therapy Strategies and Recommendations for PSP
• Begin physical therapy sooner rather than later. Early training in the correct way to stand can be helpful, but many individuals will eventually need someone with them at all times for safety.
• Because of problems with eye movements, particularly the downward gaze, individuals with PSP often trip or fall on uneven floor surfaces or objects on the floor. Training in new ways to scan the environment, performing eye movement exercises, and having the correct amount of support and a clutter-free space are crucial.
• The“ rocket response”( moving to stand too quickly and unsafely because of impulsivity) can be problematic in individuals with PSP. Simply reminding the individual with PSP to not get up without help may not be enough. A bed or chair alarm to alert others of the patient moving about can be helpful in these situations.
• Individuals with PSP tend to fall frequently, and oftentimes backwards. Weighting the front of rollators and heel wedges in shoes may be helpful in these cases. Ultimately, most individuals will need someone with them at all times when walking, both for verbal cues and for physical assistance.
• Generally, rollators with front swivel wheels work nicely to help improve walking safety. It is very important to have a PT evaluation to determine which device is best. With disease progression, different gait and mobility devices will be needed at different times.
• It is recommended that you try various techniques with the assistance of a therapist to determine which technique works best.