Unit 1: Ataxia

what are the 5 principles of training for ataxia

1. proximal stabilization 2. stabilization and control through isometrics, CKC, PNF combo if isotonics, developmental transitions, rhythmic stabalizations 3. EO and EC 4. Compensatory methods and AD should be used when necessary 5. treatment should be supported by HEP

compensatory strategies

AD's, weighted devices

What is dysarthria?

Explosive or slurred speech caused by incoordination of muscles involved in speech. Classified as a neuromotor problem.

What are the 3 subcategories of ataxia?

Sensory (friedreichs ataxia) vestibular cerebellar (main one)

target training

UE at the board or on a table LE target patterns on the floor in sitting position progressing to standing

developmental sequences

all positions and transitions

Cerebellar ataxia movement dysfunctions

asthenia dysnergia dysarthria and scanning speech hypotonia dysmetria nystagmus dysdiadochokinesia tremor rebound phenomenon gait

Strenghtening

at pelvis/hip core alternating isometric stabilization exercises

Damage that causes ataxia

by tumor, stroke, neurologic or metabolic disease symptoms can be unilateral or bilateral depending in affected areas

Sensory ataxia

caused by damage to any area in the sensory system from the periphery to cortex. Can be distinguished from other types because these patients have problems with movement when their vision is removed

Cerebellum ataxia

cerebellum regulated movements, postural tone, and muscle tone. Provides error correction-> coordinated movement

What is dysnergia?

decomposition of complex movements

Friedreich's ataxia

degeneration of the spinal and peripheral nerves and to a lesser degree, the cerebellum. Results in awkward unsteady movements and impaired sensory function

What is asthenia

generalized weakness

proprioceptive exercises

good for sensory ataxia examples: PNF, uneven surface training, balance boards, dynamic CKC

vestibular training

head turning in supine/sitting rolling supine-> sit head turns with gait

Interventional goals

improve balance and posture reactions improve postural stability improve UE/LE functioning develop functional gait

dysmetria

inability to judge distance/ROM-> decreased target accuracy

coordination exercises

intralimb: movements with a single limb-> reversing motions interlimb: refers to 2 or more limbs working together synchronously or asynchronously Encourage slow, controlled, and reciprocal multi joint movement involves proximal fixation to allow distal motion include exercises for dexterity and agility: finklesteins

Ataxia definition

movement dysfunction that describes uncoordinated limb movements and inadequate postural control often resulting in balance and gait disturbances can include difficulty initiating movements as well as errors in rate, rhythm and timing of movement

dysdiadokinesia

rapidly alternating movements

balance exercises

standing balance feet apart, together with vest, romberg, split stance, weight shift, semi tandem, tandem, high kneel, lunge

gait training

stepping without AD weight vest forward and backward walking, turning ambulate on various surfaces, ambulate while reading training on treadmill with body weight support gait with 4 wheeled walker gait with u step walker footsteps on the floor

swiss ball activities

to control proximally

intervention strategy

you can use areas of poor performance on the tests or coordination as a starting point for intervention. Turn the test into an an exercise and create others with similar challenges. The items on a test can direct your exercise and activity selection but you can be creative with development of activities and insert them into real life situations