Journal Home > Volume 1 , Issue 1
Journal of Neurorestoratology 2013, 1(1): 31-36 https://doi.org/10.2147/JN.S49253
Case Report | Open Access | Issue | Published: 02 October 2013

Motor improvement in cerebellar ataxia after integral rehabilitation

Show Author's Information Jorge L Jorge-Rodríguez1,  Elizabeth Fernández-Martínez1,  Daymi Rodríguez Pérez1,  Antonio Peralta-Flores2,  Jorge A Bergado1( )
International Center for Neurological Restoration,
University for Sport Science and Physical Culture, Havana, Cuba
Keywords:
ataxia, plasticity, rehabilitation, strength, motor recovery
Cite this article:
Jorge-Rodríguez JL, Fernández-Martínez E, Pérez DR, et al. Motor improvement in cerebellar ataxia after integral rehabilitation. Journal of Neurorestoratology, 2013, 1(1): 31-36. https://doi.org/10.2147/JN.S49253
Download citation
EndNote(RIS)
BibTeX

439

Views

40

Downloads

Citations

0

Crossref

N/A

WoS

0

Scopus

N/A

CSCD

Abstract Full text About this article

Cerebellar ataxia is a complex motor impairment arising from neurologic disease. The dysfunction significantly impairs quality of movement, equilibrium, and gait. In this study, we evaluated motor function in 20 patients with acquired or degenerative ataxia undergoing rehabilitation using a program developed at the International Center for Restorative Neurology in Havana. All patients were evaluated before and 28 and 42 days after treatment using the International Cooperative Ataxia Rating Scale (ICARS) and measurement of maximal strength. Analysis of variance demonstrated a significant reduction in ICARS score, indicating reduction in the severity of ataxia. A highly significant correlation was found between change in ICARS score and increase in lower limb strength. The program developed at the International Center for Restorative Neurology in Havana for rehabilitation of ataxia was shown to be effective for ameliorating motor impairment in patients with ataxia, independent of its etiology.


menu
Abstract
Full text
Outline
About this article

Motor improvement in cerebellar ataxia after integral rehabilitation

Show Author's information Jorge L Jorge-Rodríguez1, Elizabeth Fernández-Martínez1, Daymi Rodríguez Pérez1, Antonio Peralta-Flores2, Jorge A Bergado1( )
International Center for Neurological Restoration,
University for Sport Science and Physical Culture, Havana, Cuba

Abstract

Cerebellar ataxia is a complex motor impairment arising from neurologic disease. The dysfunction significantly impairs quality of movement, equilibrium, and gait. In this study, we evaluated motor function in 20 patients with acquired or degenerative ataxia undergoing rehabilitation using a program developed at the International Center for Restorative Neurology in Havana. All patients were evaluated before and 28 and 42 days after treatment using the International Cooperative Ataxia Rating Scale (ICARS) and measurement of maximal strength. Analysis of variance demonstrated a significant reduction in ICARS score, indicating reduction in the severity of ataxia. A highly significant correlation was found between change in ICARS score and increase in lower limb strength. The program developed at the International Center for Restorative Neurology in Havana for rehabilitation of ataxia was shown to be effective for ameliorating motor impairment in patients with ataxia, independent of its etiology.

Keywords: ataxia, plasticity, rehabilitation, strength, motor recovery

References(33)

1.
Annunciato NF, Neves de Oliveira C. La influencia de la terapia sobre los procesos plásticos del sistema nervioso: teoría e investigación. Rev Fisioter. 2008;6:33–39. Spanish.
Google Scholar
2.
Bergado J, Almaguer W. Mecanismos celulares de la neuroplasticidad. Rev Neurol. 2000;31:1074–1095. Spanish.
DOI Google Scholar
3.
Cernak A, Stevens V, Price R, Shumway-Cook A. Locomotor training using body-weight support on a treadmill in conjunction with ongoing physical therapy in a child with severe cerebellar ataxia. Phys Ther. 2008;88:88–97.
DOI Google Scholar
4.
Ferrarin M, Gironi M, Mendozzi L, Nemni R, Mazzoleni P, Rabuffetti M. Procedure for the quantitative evaluation of motor disturbances in cerebellar ataxic patients. Med Biol Eng Comput. 2005;43:349–356.
DOI Google Scholar
5.
Freund JE, Stetts DM. Use of trunk stabilization and locomotor training in an adult with cerebellar ataxia: a single system design. Physiother Theory Pract. 2010;26:447–458.
DOI Google Scholar
6.
Gazulla J. Actualización en neuroquímica y terapeútica farmacológica de las ataxias cerebelosas. Rev Neurol. 2007;45:31–41. Spanish.
DOI Google Scholar
7.
Gómez L. Bases neurales de la recuperación motora en las lesiones cerebrales. Rev Méx Neurosci. 2001;2:216–221. Spanish.
Google Scholar
8.
Hansel C, Linden DJ, D’Angelo E. Beyond parallel fiber LTD: the diversity of synaptic and non-synaptic plasticity in the cerebellum. Nat Neurosci. 2001;4:467–475.
DOI Google Scholar
9.
Harris-Love MO, Lohman K, Paul S, Benson K. Rehabilitation management of Friedreich ataxia: lower extremity force control variability and gait. Neurorehabil Neural Repair. 2004;18:117–124.
DOI Google Scholar
10.
Hernando A, Useros A. Métodos fisioterapeúticos aplicados a pacientes adultos condaño cerebral adquirido. Biociencias. 2008;6:3-23. Spanish.
Google Scholar
11.
Kraemer WJ, Fry AC. Strength testing: development and evaluation. In: Maud PJ, editor. Physiological Assessment of Human Fitness. Champaign, IL: Human Kinetics; 1995.
12.
Ilg W, Brotz D, Burkard S, Giese MA, Schols L, Synofzik M. Long-term effects of coordinative training in degenerative cerebellar disease. Mov Disord. 2010;25:2239–2246.
DOI Google Scholar
13.
Ilg W, Synofzik M, Brotz D, Burkard S, Giese MA, Schols L. Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology. 2009;73:1823–1830.
DOI Google Scholar
14.
Kelly PJ, Stein J, Shafqat S, et al. Functional recovery after rehabilitation for cerebellar stroke. Stroke. 2001;32:530–534.
DOI Google Scholar
15.
López-Bastida J, Perestelo-Pérez L, Montón-Alvarez F, Serrano-Aguilar P. Social economic costs and health-related quality of life in patients with degenerative cerebellar ataxia in Spain. Mov Disord. 2008;23:212–217.
DOI Google Scholar
16.
Marsden J, Harris C. Cerebellar ataxia: pathophysiology and rehabilitation. Clin Rehabil. 2011;25:195–216.
DOI Google Scholar
17.
Martin C, Tan D, Bragge P, Bialocerkowski A. Effectiveness of physiotherapy for adults with cerebellar dysfunction: a systematic review. Clin Rehabil. 2009;23:15–26.
DOI Google Scholar
18.
Hatakenaka M, Miyai I, Mihara M, Yagura H, Hattori N. Impaired motor learning by a pursuit rotor test reduces functional outcomes during rehabilitation poststroke ataxia. Neurorehabil Neural Repair. 2012;26:293–300.
DOI Google Scholar
19.
Mihara M, Miyai I, Hatakenaka M, Kubota K, Sakoda S. Sustained prefrontal activation during ataxic gait: a compensatory mechanism for ataxic stroke? Neuroimage. 2007;37:1338–1345.
DOI Google Scholar
20.
Miyai I. Challenge of neurorehabilitation for cerebellar degenerative diseases. Cerebellum. 2012;11:436–437.
DOI Google Scholar
21.
Miyai I, Ito M, Hattori N, et al. Cerebellar ataxia rehabilitation trial in degenerative cerebellar diseases. Neurorehabil Neural Repair. 2012;26: 515–522.
DOI Google Scholar
22.
Morton S, Bastian A. Can rehabilitation help ataxia? Neurology. 2009;73:1818–1819.
DOI Google Scholar
23.
Morton S, Tseng Y, Zackowski K, Daline J, Bastian A. Longitudinal tracking of gait and balance impairments in cerebellar disease. Mov Disord. 2010;25:1944–1952.
DOI Google Scholar
24.
Morton SM, Bastian AJ. Mechanisms of cerebellar gait ataxia. Cerebellum. 2007;6:79–86.
DOI Google Scholar
25.
Perez I, Fernandez JA, Martinez E, Ochoa R, Velazquez MG. Effects of a physical training program on quantitative neurological indices in mild stage type 2 spinocerebellar ataxia patients. Rev Neurol. 2004;39:907–910. Spanish.
Google Scholar
26.
Rinaldo L, Hansel C. Ataxias and cerebellar dysfunction: involvement of synaptic deficits? Funct Neurol. 2010;25:135–139.
Google Scholar
27.
Rodríguez J, Velázquez L, Sánchez G, et al. Evaluación de la restauración neurológica en pacientes con ataxia SCA2 cubana. Plast Rest Neurol. 2008;7:13–17.
Google Scholar
28.
Schalow G. Improvement after cerebellar injury achieved by coordination dynamics therapy. Electromyog Clin Neurophysiol. 2006;46: 433–439.
Google Scholar
29.
Sentmanat A. Influencia de la Neurorrehabilitación multifactorial intensiva para la recuperación de las capacidades coordinativas en pacientes portadores de ataxia cerebelosa causada por accidente cerebro vascular o esclerosis múltiple. Rev Dep. 2003;3:7–8. Spanish.
Google Scholar
30.
Serrano P, Montón F, Trujillo M, Carrillo R, González A. Efectividad y seguridad de las alternativas terapéuticas frente a las ataxias degenerativas. Colección: Informes, estudios e investigación. Available from: http://ww.gobiernodecanarias.org/sanidad/sescs/http://aunets.isciii.es/, 2006/18. Accessed June 2009. Spanish.
31.
Stephan MA, Krattinger S, Pasquier J, et al. Effect of long-term climbing training on cerebellar ataxia: a case series. Rehabil Res Pract. 2011;2011:525–579.
Google Scholar
32.
Trujillo MM, Serrano P, Monton F, Carrillo R. Effectiveness and safety of treatments for degenerative ataxias: a systematic review. Mov Disord. 2009;24:1111–1124.
DOI Google Scholar
33.
Tyrone E, Atkinson J, Marshall J, Woll B. The effects of cerebellar ataxia on sign language production: a case study. Neurocase. 2009;15:419–426.
DOI Google Scholar
Publication history
Copyright
Rights and permissions

Publication history

Published: 02 October 2013
Issue date: December 2013

Copyright

© 2013 The Author(s).

Rights and permissions

© 2013 Jorge-Rodríguez et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Return