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What is Progressive Supranuclear Palsy?


Progressive Supranuclear Palsy (PSP) is a degenerative neurological condition that primarily affects individuals over the age of 60.

What causes Progressive Supranuclear Palsy?

The exact underlying cause of Progressive Supranuclear Palsy is not fully understood. It appears to involve the abnormal accumulation of a specific protein into strands within the brain. However, this effect is common to several different types of neurological disorder and may only be an effect of the illness, rather than a cause.

Although there appears to be a general connection to the prevalence of neurological conditions within a families’ broad medical history, there is still no good evidence of any hereditary genetic factor involved.

What are the signs and symptoms of Progressive Supranuclear Palsy?

Progressive Supranuclear Palsy (PSP) is a degenerative neurological condition, meaning symptoms and limitations will become more severe over time. Typically half of individuals with PSP will require some form of walking aid within 3 years of diagnosis and be restricted to a bed or chair within 8 years.

The onset of the condition is insidious, with initial symptoms being common to many neurological conditions, particularly Parkinson’s. Some of the signs and symptoms of PSP include;

  • Headaches
  • Depression
  • Dizziness and poor postural reflexes leading to frequent falls.
  • Increased muscle tone and stiffness in the body core and neck.
  • Fatigue
  • Retrocollis, involuntary pattern of contractions resulting in neck extension.
  • Bradykinesia, the global slowing or all movements.
  • Joint pain
  • Abnormal gait pattern, with wide stance and poor balance.
  • Loss of control over facial muscles resulting in involuntary expressions.
  • Inability to wilfully control movement of the eyes.
  • Loss of active eyelid control, can be open or tightly shut.
  • Chronic conjunctivitis can result from infrequent blinking.
  • Dysphagia, difficulty in swallowing.
  • Impaired cognition, slowing of planning and actions.
  • Increased apathy with mild memory impairment

Often the early signs of the condition relating to behavioural or cognitive changes are more apparent to family and friends than to the person affected.

Neurological physiotherapist  supervising knee mobilisation exercisesAbove: Neurological physiotherapist supervising knee mobilisation exercises

How is Progressive Supranuclear Palsy diagnosed?

As many of the symptoms for PSP are common to a broad range of neurological conditions much of the diagnosis process concerns the elimination of other possible conditions that may be easier to test for. The most typical presentation of PSP is a culmination of some of the previously mentioned symptoms that produces a permanently startled expression on the individuals face. The eyelids and brows will be raised, the eyes themselves may also be fixed looking upwards, with high tone or contractions of the remaining facial muscles.

If you suspect you or a family member may suffer from this condition than you should consult your doctor. If you have a confirmed diagnosis and begin to experience physical limitations you can book yourself in for an assessment with us, please email for more information or call us on 0330 088 7800.

What would a physiotherapy assessment for Progressive Supranuclear Palsy involve?

At, we want to gain as much information as possible about your condition to ensure we give you the best treatment. In your first appointment with us, our physiotherapists will carry out an assessment which has two parts:


A discussion between you and our physiotherapist to find out what symptoms you are experiencing, and how your condition is affecting you and your lifestyle.


An assessment to discern the presence of any pain, your range of movement, and a series of special tests to identify the presence of any movement disorders or limitations.

There can be great variation in the symptoms displayed, depending on the progression of the condition and any complicating factors. The assessment process will be important in identifying your current symptoms and needs, so that treatments can be targeted and effective.

What would physiotherapy treatment for Progressive Supranuclear Palsy involve?

An initial assessment with one of our specialist neurological physiotherapists will look at your current level of function and an individualised rehabilitation program will be developed. Physiotherapy treatment at may include:

  • Practicing functional tasks with support and teaching you how to achieve activities in different ways.
  • Structured activity programme which will include passive and active stretching and muscle strengthening exercises to keep the muscles strong and flexible.
  • Balance training
  • Correcting and varying posture in lying, sitting and standing
  • Gait re-education
  • Advice on walking aids and equipment to improve safety and make your home or work life easier.

Physiotherapy treatment at will help a person with Progressive Supranuclear Palsy achieve their optimal functional independence. Benefits of neurological physiotherapy treatment for PSP include:

  • Improving function – rolling, sitting balance, sit to stand, standing balance and walking
  • Improving transfers
  • Enhancing control of head and trunk in different postures
  • Improving gross and fine motor control
  • Retraining normal patterns of movement
  • Increasing energy levels
  • Improving muscle strength and flexibility
  • Improving posture
  • Relieving pain
  • Promoting independence
  • Enhancing quality of life

For more information on physiotherapy for PSP, or to book an appointment please call 0330 088 7800.

How can I arrange a physiotherapy assessment for Progressive Supranuclear Palsy?

If you have been diagnosed by your doctor as having PSP and your symptoms have begun to limit your physical independence, you would benefit from an assessment with one of our experienced physiotherapists.

You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, and give you advice on self-management. To arrange an appointment please email or call 0330 088 7800.


Physiotherapy treatment for PSP will help relieve painful symptoms and maximise physical potential. Our neurological physiotherapists at Liverpool Physio are experienced at treating neurological disorders and understand that its sudden and unexpected onset can have a significant impact on you and those close to you.

At we can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of physical ability and independence. We can also advise on activity and home adaptations to make daily living easier. Along with advice for you and your family on appropriate self-management techniques to maximise your functional ability between therapy sessions.

For more information on how physiotherapy can help treat joint sprains, or to book yourself an assessment, please email us at or call 0330 088 7800.

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