Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 2 , Pages 263-270, February 2009

Improvement of Gaze Control After Balance and Eye Movement Training in Patients With Progressive Supranuclear Palsy: A Quasi-Randomized Controlled Trial

Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, MN

Abstract 

Zampieri C, Di Fabio RP. Improvement of gaze control after balance and eye movement training in patients with progressive supranuclear palsy: a quasi-randomized controlled trial.

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.

Key Words: Eye movements, Rehabilitation, Supranuclear palsy, progressive, Reflex, vestibulo-ocular

List of Abbreviations: ANOVA, analysis of variance, FEF, frontal eye field, PD, Parkinson disease, PSP, progressive supranuclear palsy, RMS, root-mean-square, UPDRS, Unified Parkinson Disease Rating Scale, VOR, vestibuloocular reflex

 

 Supported by the National Institute of Disability and Rehabilitation Research (grant no. H133G030159).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author

PII: S0003-9993(08)01603-1

doi:10.1016/j.apmr.2008.07.024

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 2 , Pages 263-270, February 2009