Hereditary spastic paraparesis is a group of inherited neurological diseases. Only symptomatic treatments exist for the moment. The Modifspa study (cf citation) carried out by the team showed that patients perceived a feeling of effectiveness of physiotherapy on lower limb spasticity. The aim of the Walk-up study is to objectivize this feeling of efficacy on gait disorders in these patients.

This is an interventional study using physical training. The study is prospective, open, randomized in 2 parallel groups, one of which is a control group. Analyses will be comparative between the 2 groups during the course of the study.

Following an initial study carried out by the team (cf citation), physiotherapy appeared to be the most useful therapy for coping with spasticity, particularly when practised at least 3 times a week. The hypothesis is that this feeling experienced by patients is accurate, and that more frequent physiotherapy (3 additional sessions/week) significantly improves patients' walking speed, with a functional objective.

The main aim of the WALK-UP study is to evaluate the efficacy of a 6-week intensive physical rehabilitation program on walking speed in patients with SPG4 / SPAST-HSP. This is the most frequent genotype in Hereditary Spastic Paraparesis. All patients included in the study will receive at least one physiotherapy session per week in a liberal practice.

Inclusion Criteria:

• Patient with molecular diagnosis of hereditary spastic paraparesis based on pathogenic variant of SPAST gene,
• Walking possible for 6 minutes without human assistance (one or more technical aids are authorized: e.g. cane, walker, orthoses),
• At least 1 physiotherapy session per week already in place.
• Understanding of the protocol
• Possibility of connecting to the Internet from home to access video material provided as part of the protocol.

Exclusion Criteria:

• Botulinum toxin injection within 2 months of protocol inclusion
• Discontinuation of private physiotherapy,
• Refusal to participate in the protocol,
• Participation in another interventional clinical trial evaluating a health product or in a randomized clinical trial
• Pregnant women
• Not affiliated to a social security scheme or beneficiary of such a scheme
• Patient under guardianship or trusteeship