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Example of coordination and balance training exercises 60 . 1) Static balance: standing on 1 leg; 2) Dynamic balance: sidesteps; 3) Steps to prevent falling and falling strategies.
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Cerebellar ataxias comprise a heterogeneous group of diseases characterized by motor and non-motor symptoms, which can be acquired, degenerative, or have a genetic cause, such as spinocerebellar ataxias (SCA). Usually, the genetic and neurodegenerative forms of cerebellar ataxias present a progressive and inevitable worsening of the clinical pictur...
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Background:
Muscle mass loss occurs following anterior cruciate ligament reconstruction surgery.
Objective:
To compare the gain in muscle strength in the quadriceps and hamstring muscles in patients following anterior cruciate ligament reconstruction surgery, using exercises with and without blood flow restriction.
Methods:
The isometric muscl...
Citations
... Physiotherapy is the main treatment for gait and balance alterations for CA patients, although few authors have reported its effectiveness (Chien et al., 2022). Promising conventional rehabilitation approaches include dynamic balance training, customized interventions targeting balance and independence in activities of daily living, the Bobath approach, and personalised gait training (Kelly and Shanley, 2016;Yap et al., 2022). ...
... Otherwise, the distribution of forces in the forward-backward direction (anterior-posterior force) and the up-down direction (vertical force) are equally balanced. In our opinion, this result could be due to a variety of factors, such as better neuromuscular control, and/or compensatory mechanisms employed by ataxic patients to maintain balance and stability during gait (Chien et al., 2022). In the context of a VR rehabilitation program, ataxic patients may develop compensatory strategies to maintain balance and stability during gait (Chien et al., 2022). ...
... In our opinion, this result could be due to a variety of factors, such as better neuromuscular control, and/or compensatory mechanisms employed by ataxic patients to maintain balance and stability during gait (Chien et al., 2022). In the context of a VR rehabilitation program, ataxic patients may develop compensatory strategies to maintain balance and stability during gait (Chien et al., 2022). These strategies could result in a more symmetrical distribution of mediolateral (side-to-side) ground reaction forces. ...
Introduction: Ataxia is a neurological symptom that causes decreased balance, loss of coordination, and gait alterations. Innovative rehabilitation devices like virtual reality (VR) systems can provide task-oriented, repetitive and intensive training with multisensorial feedback, thus promoting neuroplastic processes. Among these VR technologies, the Computer Assisted Rehabilitation ENvironment (CAREN) associates a split belt treadmill on a 6-degrees of freedom platform with a 180° VR screen and a Vicon motion capture system to monitor patients’ movements during training sessions.
Methods: Eight patients affected by cerebellar ataxia were enrolled and received 20 sessions of CAREN training in addition to standard rehabilitation treatment. Each patient was evaluated at the beginning and at the end of the study with 3D gait analysis and clinical scales to assess balance, gait function and risk of falls.
Results: We found improvements in kinematic, kinetic, and electromyographic parameters (as per pre-post- CAREN training), as well as in clinical outcomes, such as balance and risk of falls in ataxic patients. In addition, we found that trunk rotation improved, after CAREN intervention, approximating to the normative values.
Discussion: Our results suggested that CAREN might be useful to improve specific biomechanical parameters of gait in ataxic patients.
... Additional clinical symptoms include dysarthria, dysphagia, and diplopia [1]. Despite ongoing exploration of therapeutic interventions, the prevailing treatment strategy for these conditions centers on managing symptoms and incorporating rehabilitation exercises to improve overall quality of life [2,3]. Repetitive transcranial Xia Liu, Lin Zhang and Hao-Lin Xu these authors share the first authorship of this article. ...
Repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuroregulatory technique used to treat neurodegenerative diseases, holds promise for spinocerebellar ataxia type 3 (SCA3) treatment, although its efficacy and mechanisms remain unclear. This study aims to observe the short-term impact of cerebellar rTMS on motor function in SCA3 patients and utilize resting-state functional magnetic resonance imaging (RS-fMRI) to assess potential therapeutic mechanisms. Twenty-two SCA3 patients were randomly assigned to receive actual rTMS (AC group, n = 11, three men and eight women; age 32–55 years) or sham rTMS (SH group, n = 11, three men and eight women; age 26–58 years). Both groups underwent cerebellar rTMS or sham rTMS daily for 15 days. The primary outcome measured was the ICARS scores and parameters for regional brain activity. Compared to baseline, ICARS scores decreased more significantly in the AC group than in the SH group after the 15-day intervention. Imaging indicators revealed increased Amplitude of Low Frequency Fluctuation (ALFF) values in the posterior cerebellar lobe and cerebellar tonsil following AC stimulation. This study suggests that rTMS enhances motor functions in SCA3 patients by modulating the excitability of specific brain regions and associated pathways, reinforcing the potential clinical utility of rTMS in SCA3 treatment. The Chinese Clinical Trial Registry identifier is ChiCTR1800020133.
... Similarly, a systematic review stated balance exercises, coordination training, aerobic exercises like cycling, gait training, range of motion, and strengthening exercises for the extremities or a combination of these exercises for such patients [10]. These exercises also facilitate motor performance and diminish ataxia symptoms, enabling patients to accomplish personally significant daily goals [11]. ...
The most known of all primary cardiac tumors is myxoma, which is most usually detected in the left atrium. As there are no physical signs or symptoms, a diagnosis is rarely made purely based on clinical evidence. Our study aims to investigate the case of post-operative left atrial myxoma with cerebellar signs. A 50-year-old woman complained of dizziness and syncope, which caused her to collapse on the floor early in the morning. Myxoma in the left atrium and mitral valve regurgitation was discovered after prompt medical assistance. She was recommended for surgery to excise the left atrial myxoma and mitral valve repair. Post the surgery, she developed breathing difficulties and cerebellar signs for which she was referred for physiotherapy. She underwent two weeks of tailor-made inpatient rehabilitation. This case study intends to emphasize the importance of early diagnosis, treatment, and, most importantly, rehabilitation to return the patient to her functional state. A structured exercise regimen assists the patient while also reducing post-surgery problems. Timely monitoring and treatment are projected to improve outcomes in patients treated with a multidisciplinary approach.
... There is no effective treatment and current treatment strategies are based on rehabilitation therapies, including special strength and balance training to increase stability as well as compensatory strategies (25). In the next decade, novel treatments might target in pathogenesis, including mitochondrial dysfunction, impaired DNA repair, by modulation of gene expression, stem cell transplantation, gene transfer, or interventions in viral pathways (26). ...
Ataxia with oculomotor apraxia type 1 (AOA1) is a rare genetic disorder and is inherited in an autosomal recessive manner. It is mainly characterized by childhood-onset progressive cerebellar ataxia, with dysarthria and gait disturbance being the two most common and typical manifestations. Axonal sensorimotor peripheral neuropathy, dystonia, chorea, and cognitive impairment are common associated symptoms, as are hypoalbuminemia and hypercholesterolemia. Oculomotor apraxia (OMA)has been reported to be a feature often, although not exclusively, associated with AOA1. The Aprataxin gene, APTX, is ubiquitously expressed, and numerous APTX mutations are associated with different clinical phenotypes have been found. In the present study, we enrolled a 14-year-old boy who developed ataxia with staggering gait from the age of 4 years. Early-onset cerebellar ataxia, peripheral axonal neuropathy, cognitive impairment and hypoalbuminemia, hypercholesterolemia were presented in this patient, except for OMA. We applied ataxia-related genes filtering strategies and whole-exome sequencing (WES) to discover the genetic factors in a Chinese family. Sanger sequencing was used in the co segregation analysis in the family members. A compound heterozygous mutation in APTX gene (c.739C>T and c.501dupG) was identified. This is the first description of a genetically confirmed patient of AOA1 in a Chinese family in addition to a novel mutation of c.501dupG in APTX.
A Síndrome de Joubert é caracterizada como uma condição genética que compromete o neurodesenvolvimento, ocasionando a hipoplasia cerebelar, resultando em Paralisia Cerebral Atáxica. O presente estudo tem como objetivo relatar o caso de um paciente acometido, quantificando sua debilidade motora e identificando as implicações que a doença trouxe à sua vida. Para a coleta de dados, foram analisados os prontuários de acompanhamento clínico do paciente, e foi feita aplicação da Escala Cooperativa Internacional para Avaliação das Ataxias (ICARS), da Medida da Função Motora Grossa (GMFM) e do Sistema de Classificação da Função Motora Grossa (GMFCS) para definir de forma objetiva o grau de comprometimento apresentado pelo paciente. Como resultados, identificou-se que o paciente em análise apresentou importantes atrasos de seu desenvolvimento neuropsicomotor, notadamente no que se refere ao controle motor axial, tendo adquirido controle cervical apenas aos 4 anos de idade e tornando-se capaz de andar aos 8 anos. Em seu exame físico mais recente, identificou-se comprometimento da capacidade de coordenação motora, bem como oftalmoparesia. Com relação ao estado de vida atual, verificou-se um paciente incapaz de estabelecer relações íntimas, de morar sem uma companhia que o ajude com os afazeres diários, bem como incapaz de manter uma atividade laboral fixa. A escala GMFM pontuou sua debilidade em 77,32%, com nível I na GMFCS, enquanto seu grau de ataxia foi 36/100 na ICARS. A neuroimagem identificou o Sinal do Dente Molar. O estudo concluiu que a Síndrome de Joubert não apenas trouxe comprometimentos físicos ao paciente, como também o impede, na vida adulta, de realizar atividades esperadas, como trabalhar, constituir família e morar sozinho. Ademais, notou-se a importância do diagnóstico e tratamento fisioterápico precoce para o neurodesenvolvimento dos pacientes acometidos pela síndrome, sendo um “divisor de águas” para uma melhor evolução de suas habilidades motoras e um menor impacto em sua qualidade de vida.
