Individualized exergame training improves postural control in advanced degenerative spinocerebellar ataxia: A rater-blinded, intra-individually controlled trial

Parkinsonism Relat Disord. 2017 Jun;39:80-84. doi: 10.1016/j.parkreldis.2017.03.016. Epub 2017 Mar 28.

Abstract

Background: Treatment options are rare in degenerative ataxias, especially in advanced, multisystemic disease. Exergame training might offer a novel treatment strategy, but its effectiveness has not been investigated in advanced stages.

Methods: We examined the effectiveness of a 12-week home-based training with body-controlled videogames in 10 young subjects with advanced degenerative ataxia unable or barely able to stand. Training was structured in two 6-weeks phases, allowing to adapt the training according to individual training progress. Rater-blinded clinical assessment (Scale for the Assessment and Rating of Ataxia; SARA), individual goal-attainment scoring (GAS), and quantitative movement analysis were performed two weeks before training, immediately prior to training, and after training phases 1 and 2 (intra-individual control design). This study is registered with ClinicalTrials.gov, NCT02874911).

Results: After intervention, ataxia symptoms were reduced (SARA -2.5 points, p < 0.01), with benefits correlating to the amount of training (p = 0.04). Goal attainment during daily living was higher than expected (GAS: 0.45). Movement analysis revealed reduced body sway while sitting (p < 0.01), which correlated with improvements in SARA posture and gait (p = 0.005), indicating training-induced improvements in posture control mechanisms.

Conclusion: This study provides first evidence that, even in advanced stages, subjects with degenerative ataxia may benefit from individualized training, with effects translating into daily living and improving underlying control mechanisms. The proposed training strategy can be performed at home, is motivating and facilitates patient self-empowerment.

Keywords: Ataxia; Cerebellum; Exergames; Motor training; Neurorehabilitation; Postural control.

Publication types

  • Clinical Trial

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Child
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Postural Balance / physiology*
  • Sensation Disorders / etiology*
  • Sensation Disorders / rehabilitation*
  • Spinocerebellar Ataxias / complications*
  • Spinocerebellar Ataxias / psychology
  • Spinocerebellar Ataxias / rehabilitation*
  • Statistics, Nonparametric
  • Time Factors
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02874911