Physical Therapy Strategies and Recommendations for Multiple System Atrophy( MSA)
For Bradykinesia
• Aerobic and flexibility exercises
• Large movements
For Orthostatic Hypotension
• Increase salt in diet( with physician’ s approval).
• Rise slowly and rest after position changes.
• Wear abdominal compression binder( not pressure stockings).
• Elevate head of bed.
• Eat smaller, more frequent meals.
• Avoid increased time in motionless positions.
• Avoid warmer temperatures.
• Avoid movements that could provoke dizziness.
For Parkinsonian-Type Gait
• Focus on large steps and heel stride.
• Use appropriate assistive devices for walking.
• Practice safe-turning techniques: U-turns in open spaces, avoiding pivot turns, and crossing one foot over the other.
• Make appropriate home modifications.
• Use appropriate adaptive equipment / devices.
51
For Cerebellar-Type Gait
• Heavier or weighted devices may be helpful
Practice Safe Turning Techniques
• U-turns in open spaces
• Avoiding pivot turns
• Avoid crossing one foot over the other