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Neurorehabilitation therapy in spinocerebellar ataxia type 2: A 24‐week, rater‐blinded, randomized, controlled trial
Author(s) -
RodríguezDíaz Julio Cesar,
VelázquezPérez Luis,
Rodríguez Labrada Roberto,
Aguilera Rodríguez Raúl,
Laffita Pérez Dalina,
Canales Ochoa Nalia,
Medrano Montero Jacqueline,
Estupiñán Rodríguez Annelié,
Osorio Borjas Marcos,
Góngora Marrero Mariela,
Reynaldo Cejas Lorenzo,
González Zaldivar Yanetza,
Almaguer Gotay Dennis
Publication year - 2018
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.27437
Subject(s) - neurorehabilitation , spinocerebellar ataxia , ataxia , physical medicine and rehabilitation , physical therapy , rating scale , randomized controlled trial , medicine , psychology , rehabilitation , psychiatry , developmental psychology
Background : Neurorehabilitation has become in a widely used approach in spinocerebellar ataxias, but there are scarce powerful clinical studies supporting this notion. Objective : The objective of this study was to assess the efficacy of a 24‐week neurorehabilitative treatment in spinocerebellar ataxia type 2 patients. Methods : A total of 38 spinocerebellar ataxia type 2 patients were enrolled in a rater‐blinded, 1:1 randomized, controlled trial using neurorehabilitation for 24 weeks. The treated group received 6 hours of neurorehabilitation therapy, emphasizing on balance, coordination, and muscle strengthening on weekdays, whereas the control group did not receive this intervention. Primary outcome measure was the Scale for the Assessment and Rating of Ataxia score, whereas secondary outcome measures included the count of Inventory of Non‐Ataxia Symptoms and saccadic eye movement variables. Results : The rehabilitated group had high levels of adherence and retention to the therapy and showed a significant decrease of Scale for the Assessment and Rating of Ataxia score at 24 weeks when compared with the controls, mainly for the gait, stance, sitting, finger chase, and heel‐shin test items. Changes in Scale for the Assessment and Rating of Ataxia scores were inversely correlated with the mutation size in the rehabilitated group. The nonataxia symptom count and saccadic measures were unchanged during the study. Conclusions : A comprehensive 24‐week rehabilitation program significantly improves the motor cerebellar symptoms of spinocerebellar ataxia type 2 patients as assessed by the ataxia rating score likely as result of the partial preservation of motor learning and neural plasticity mechanisms. These findings provide evidence in support of this therapeutic approach as palliative treatment in spinocerebellar ataxia type 2 suggesting its use in combination with other symptomatic or neuroprotective drugs and in prodromal stages. © 2018 International Parkinson and Movement Disorder Society