Category: MSA, PSP, CBS (Other)
Objective: To evaluate the effects of rehabilitation on functional and clinical outcomes in patients with multiple system atrophy (MSA).
Background: Currently, disease-modifying treatments for MSA remain unavailable, and pharmacological management is largely symptomatic, with limited and often transient benefits. As a result, patients frequently experience continuous functional decline despite optimal medical treatment. In this context, rehabilitation has emerged as an essential component of multidisciplinary care.
Method: Patients diagnosed with MSA and referred for rehabilitation were retrospectively analyzed. Functional outcomes, including the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Modified Barthel Index (MBI), as well as clinical outcomes, including the Unified Parkinson’s Disease Rating Scale (UPDRS), Unified Multiple System Atrophy Rating Scale (UMSARS), and Scale for the Assessment and Rating of Ataxia (SARA), were assessed before and after rehabilitation. Changes were analyzed in the total cohort and according to MSA subtype: parkinsonian-predominant MSA (MSA-P) and cerebellar-predominant MSA (MSA-C).
Results: In the total cohort of 31 patients, rehabilitation was associated with significant improvements in balance and mobility, with BBS increasing from 38.6 to 41.1 (p < 0.001) and TUG decreasing from 19.8 to 17.7 seconds (p = 0.035). No significant change was observed in MBI. In subgroup analyses, a significant improvement in BBS was observed in the MSA-C group (37.7 to 40.6, p = 0.009), whereas no other functional outcomes showed statistically significant changes. In a subset of 20 patients with paired clinical evaluations, clinical disease severity significantly progressed despite rehabilitation. The UPDRS Part III score worsened from 24.7 to 31.8 (p < 0.001), and UMSARS Part II scores also showed significant worsening (14.7 to 18.0, p = 0.020). Subgroup analysis showed significant worsening of UPDRS Part III specifically in the MSA-C group (p = 0.005). No statistically significant changes were observed in UMSARS Part I or SARA scores.
Conclusion: Rehabilitation was associated with improvements in balance and functional mobility, as reflected by improvements in BBS and TUG. However, rehabilitation alone was insufficient to prevent clinical disease progression in patients with MSA.
To cite this abstract in AMA style:
GY. Lee, S. Cha, S. Jo, J. Lee, M. Choi, SJ. Chung, SH. Lee. The Feasibility and Safety of Rehabilitation Program in Patients with Multiple System Atrophy [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/the-feasibility-and-safety-of-rehabilitation-program-in-patients-with-multiple-system-atrophy/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-feasibility-and-safety-of-rehabilitation-program-in-patients-with-multiple-system-atrophy/