Rehabilitation strategies for atypical parkinsonian syndromes: A scoping review of progressive supranuclear palsy, multiple system atrophy, corticobasal syndrome, and dementia with Lewy bodies

Abstract

Background Rehabilitation plays a crucial role in maintaining function and independence in neurodegenerative disorders. However, evidence on its effectiveness in atypical parkinsonian syndromes including progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal syndrome (CBS), and dementia with Lewy bodies (DLB) remains fragmented. Objective This scoping review aimed to comprehensively map the literature on rehabilitation interventions for PSP, MSA, CBS, and DLB, summarize intervention types and outcomes, and identify research gaps. Methods Following PRISMA-ScR guidelines, we searched PubMed, Embase, Web of Science, and Cochrane Library from inception to May 2025. Eligible studies included peer-reviewed English-language reports on non-invasive rehabilitation such as physical, occupational, and speech therapy. Two independent reviewers screened titles, abstracts, and full texts, with disagreements resolved by consensus or a third reviewer. Results Sixty studies met inclusion criteria: PSP (n = 32), MSA (n = 20), CBS (n = 5), and DLB (n = 6). Across disorders, rehabilitation was consistently safe and feasible. Gait and balance training, voice and swallowing therapy, and multimodal programs demonstrated short-term benefits in mobility, speech, and quality of life (Class III–IV based on American Academy of Neurology classification). Conclusions While rehabilitation may offer functional benefits across atypical parkinsonian syndromes, high-quality evidence remains limited. This analysis highlights significant gaps in care and underscores the need for early, multidisciplinary, and disease-specific interventions to support mobility and safety. Standardized outcome measures and long-term trials are essential to establish sustained efficacy.