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

Autor: Matthis Synofzik, Zofia Fleszar, Cornelia Schatton, Ludger Schöls, Martin A. Giese, Winfried Ilg
Rok vydání: 2017
Předmět:
Male
0301 basic medicine
Time Factors
Disease
Postural control
law.invention
psychology [Spinocerebellar Ataxias]
0302 clinical medicine
Randomized controlled trial
law
physiology [Postural Balance]
Activities of Daily Living
Outcome Assessment
Health Care
Child
Postural Balance
Exercise Therapy
rehabilitation [Sensation Disorders]
Neurology
Sensation Disorders
Spinocerebellar ataxia
Female
medicine.symptom
Psychology
Adult
etiology [Sensation Disorders]
medicine.medical_specialty
Ataxia
Adolescent
education
Statistics
Nonparametric
Young Adult
03 medical and health sciences
Physical medicine and rehabilitation
methods [Exercise Therapy]
Intervention (counseling)
medicine
Humans
Spinocerebellar Ataxias
ddc:610
Neurorehabilitation
complications [Spinocerebellar Ataxias]
Training (meteorology)
rehabilitation [Spinocerebellar Ataxias]
medicine.disease
030104 developmental biology
Physical therapy
Neurology (clinical)
Geriatrics and Gerontology
030217 neurology & neurosurgery
Zdroj: Parkinsonism & Related Disorders
Parkinsonism & related disorders 39, 80-84 (2017). doi:10.1016/j.parkreldis.2017.03.016
ISSN: 1353-8020
0287-4911
DOI: 10.1016/j.parkreldis.2017.03.016
Popis: 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.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).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.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.
Databáze: OpenAIRE
Externí odkaz: