Category: MSA, PSP, CBS: Clinical Trials
Objective: Effect on gait and balance of gait-focused physiotherapy compared to standard-of-care physiotherapy in patients with MSA, PSP and PD.
Background: Physiotherapy is a crucial element of care strategies for parkinsonian syndromes, especially in atypical parkinsonian disorders (APD) where levodopa response is limited. The MobilityAPP trial investigated the superiority of gait-focused physiotherapy (GPT) in improving self-paced gait speed, compared to standard-of-care physiotherapy (SPT).
Method: In this multicentre, double-blind, randomized controlled trial (NCT04608604), patients with multiple system atrophy, progressive supranuclear palsy, and Parkinson’s disease (PD) were recruited. Participants were randomized (1:1) to inpatient GPT or SPT for 2 weeks, followed by 5 weeks of home-based training. The primary outcome was the change in self-paced gait speed, measured with wearable sensors during a standardized 2×10-meter walking test. Secondary outcomes included changes in clinical scores, patient reported outcomes (PROMs), and digital mobility measures from daily-life.
Results: Of 167 patients screened, 160 were randomized and 151 completed the study per protocol (85 APD, 66 PD; 76 GPT, 75 SPT). GPT and SPT improved self-paced gait speed with no difference between the two interventions (95% CI: -0.04 to 0.04; p = 0.949). However, changes in daily-life mobility metrics favored the GPT intervention. Furthermore, improvements were also measured for both study arms in Berg Balance Scale scores, and both patient and clinical global impression of change.
Conclusion: This randomized-controlled trial is the first to evaluate the effectiveness and potential superiority of GPT in APD. Physiotherapy yielded favorable trends on daily-life mobility, clinical scales, and PROMs. Although GPT was not superior to SPT, the intervention was safe, well-tolerated, and contributed to a perceived improvement in functional disability.
To cite this abstract in AMA style:
V. Sidoroff, C. Raccagni, H. Moradi, G. Prigent, F. Jagusch, I. Teckenburg, M. Giraitis, E. Schoenfeldt Reichmann, J. Ndayisaba, G. Göbel, K. Seppi, F. Krismer, D. Benninger, J. Winkler, B. Eskofier, J. Klucken, K. Aminian, A. Ionescu, S. Sapienza, H. Gaßner. MobilityAPP: A randomized-controlled trial evaluating gait-focused physiotherapy in Parkinson’s disease and atypical parkinsonian syndromes [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/mobilityapp-a-randomized-controlled-trial-evaluating-gait-focused-physiotherapy-in-parkinsons-disease-and-atypical-parkinsonian-syndromes/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/mobilityapp-a-randomized-controlled-trial-evaluating-gait-focused-physiotherapy-in-parkinsons-disease-and-atypical-parkinsonian-syndromes/