Rehabilitation of Patients With Atypical Parkinsonian Disorders

Atypical parkinsonism encompasses several disorders that may have disease-specific or individualspecific characteristics, however common features include akinesia, rigidity, gait difficulties, and cognitive decline with gradual worsening of the symptoms. These features result in a variety of deficits that affect the patient’s ability to function in their usual capacity at home, on the job, and within their community. As in other neurodegenerative disorders, patients with atypical parkinsonian disorders (APDs) become increasingly disabled and have a decline in their quality of life. The rehabilitation team’s goal is to improve the patient’s functional ability and quality of life. Use of a disablement model provides a conceptual framework helpful in delineating the level at which intervention is best applied. The team must appreciate the impact of intervention at the pathology, impairment, functional, and disability levels in order to choose the appropriate treatment direction. The evidence supporting rehabilitation in idiopathic Parkinson’s disease (PD) can be useful in gaining an appreciation of the impact of treatment across the different levels in order to help guide rehabilitation direction in patient’s with APDs. Treatment direction may encompass both restorative and compensatory strategies to improve function and quality of life and should be considered to supplement pharmacologic and other medical interventions.