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When movement, speech, swallowing, or daily tasks begin to change, families often want a concrete plan. That desire is understandable. For people living with an atypical parkinsonian syndrome, however, the right plan may need more tailoring than a generic list of “Parkinson’s exercises.”
Atypical parkinsonian syndromes include progressive supranuclear palsy, multiple system atrophy, corticobasal syndrome and dementia with Lewy bodies. They share some features with Parkinson’s disease, but symptoms, risks and progression can differ. A scoping review published in August 2026 examined the rehabilitation literature across these conditions and helps clarify both the opportunities and the evidence gaps.
Researchers reviewed the available evidence on rehabilitation for several atypical parkinsonian conditions and included 60 studies in their review: 32 involving progressive supranuclear palsy, 20 involving multiple system atrophy, five involving corticobasal syndrome and six involving dementia with Lewy bodies, with some overlap among the studies.
The findings were encouraging, particularly for gait and balance training, speech and swallowing therapy, and programs that combine multiple rehabilitation disciplines. These approaches showed promising short-term benefits in areas such as mobility, communication and quality of life.
However, the researchers also identified important limitations. Much of the evidence was classified as Class III or IV, meaning it came from study designs that are less able to establish effectiveness than large, randomized clinical trials. Many studies involved small groups of participants and had relatively short follow-up periods. The amount of evidence also varied considerably between diagnoses.
Start with the person’s priorities and the family’s observations.
Is the biggest concern falling backward, freezing while walking, fatigue, getting in and out of a chair, using utensils, speaking loudly enough, coughing during meals, or completing a morning routine?
Sharing a specific example can help the rehabilitation team connect treatment goals to the person’s everyday life.
Some symptoms require more immediate attention and should not wait for a routine therapy appointment. New swallowing difficulties, repeated choking, sudden neurological changes, injuries, or rapid decline warrant prompt medical guidance. Call emergency services when a situation is an emergency.
Different rehabilitation professionals address different areas of daily function:
These roles can overlap, making communication between professionals especially important.
For example, a change in mobility can affect bathroom safety, caregiver techniques, transportation and daily routines. A swallowing concern can affect meals, hydration, medication administration and respiratory safety.
Families can ask which professional is coordinating recommendations and how information should be shared between providers.
The safest home program is one that a qualified professional has matched to the person’s diagnosis, abilities, and home environment.
Before beginning exercises or other rehabilitation activities at home, ask:
Avoid copying an exercise or swallowing technique from social media or applying a strategy that was designed for someone else. An approach that is appropriate for one person may not be safe for another.
Home programs should also be realistic for the person and their caregiver. A complicated plan that is difficult to maintain may not provide much benefit over time.
Atypical parkinsonian conditions can change over time. As needs change, equipment, communication supports, mobility strategies, caregiver techniques and daily routines may need to be reassessed.
Ask the rehabilitation team which changes should trigger an earlier review and how observations should be communicated between appointments.
Keeping a simple record of falls, near-falls, fatigue, coughing during meals, or increasing difficulty with everyday tasks can also help the care team identify changes that might otherwise be forgotten.
Non-medical caregivers do not prescribe or direct rehabilitation treatment. However, when working within an established care plan, they may be able to provide valuable day-to-day support.
Depending on the individual’s needs and the caregiver’s authorized role, this may include helping maintain a safe environment, providing standby assistance, supporting established routines, observing changes and communicating relevant observations to the family.
Clear written instructions and well-defined responsibilities are important. They help ensure that everyone understands their role and that the person receiving care is supported safely and consistently.
For families and referral professionals in North San Diego County, one of the most important lessons from this review is the value of collaboration.
Rehabilitation may offer meaningful benefits for people living with atypical parkinsonian conditions, but the approach should be individualized, based on specific goals and reassessed as needs change. Physical therapists, occupational therapists, speech-language pathologists, physicians, caregivers and families can each play an important role in supporting day-to-day function and quality of life.
This article is intended for general educational purposes and does not replace diagnosis, treatment, or individualized medical or rehabilitation advice. Consult qualified medical and rehabilitation professionals before changing activity, swallowing strategies, mobility techniques, exercises, or assistive-device plans.
ComForCare Home Care North San Diego can help families explore how non-medical in-home support may fit alongside a clinician-directed rehabilitation plan and the family’s goals. Our caregivers can provide practical assistance with daily routines, safety, companionship and other non-medical needs while helping families stay informed about changes in day-to-day functioning. Call Today! 858-247-1005
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