Exercise programme intervention for persons with motor ataxia (Programa de ejercicios de intervención para personas con ataxia motora)

Abstract

Abstract. Introduction: Ataxia affects the nervous system by decreasing balance and coordination most mostly in the trunk, arms and legs. Physical activity is used to help lowering the symptoms of this disease. Objective: The study objective aims to determine the effects of an exercise program intervention focused on quality of life of this person in terms of body composition, hemodynamic parameters and functional capacity. Methods: A Longitudinal study-case with the exercise sessions performed in a gymnasium with a specialized Personal Trainer. A 43 years old male individual with motor ataxia as participated with a pre and post-test assessments with an exercise program comprised sessions twice a week of 30 minutes each, for 6 months, focused on cardio-fitness, strength and body stabilization. The Scale for the Assessment and Rating of Ataxia was applied to evaluate Gait, Stance, Sitting, Finger Chase, Nose-finger Test, Fast alternating hand movements and Heel-chin slide, and the program SPSS (v20) to present descriptive statistics to express the participant’s improvements. Results: This study indicates that rehabilitation can improve health, well-being and life quality improvements in individuals with ataxia, however, a larger study is required to have analyse if these variables would suffer significant changes in all participants. Besides the improvements in body composition and blood pressure, benefits in all variables of SARA scale were observed, except in “Sitting” were the value remained unchanged. Conclusions: This type of exercise programme intervention can promote capacity and health-related quality of life. This study provides evidence for maintaining physical activity programs in patients with ataxia. Resumen. Introducción: La ataxia afecta al sistema nervioso al disminuir el equilibrio y la coordinación, sobre todo en el tronco, los brazos y las piernas. La actividad física se utiliza para ayudar a disminuir los síntomas de esta enfermedad. Objetivo: El objetivo del estudio es determinar los efectos de una intervención de un programa de ejercicio enfocado a la calidad de vida de esta persona en términos de composición corporal, parámetros hemodinámicos y capacidad funcional. Métodos: Un estudio-caso longitudinal con las sesiones de ejercicio realizadas en un gimnasio con un Personal Trainer especializado. Un varón de 43 años con ataxia motora que participó en una evaluación pre y post prueba con un programa de ejercicios compuesto por sesiones dos veces por semana de 30 minutos cada una, durante 6 meses, centradas en el cardio-fitness, la fuerza y la estabilización corporal. Se aplicó la Escala para la Valoración y Clasificación de la Ataxia para evaluar la Marcha, la Postura, la Sentada, la Persecución con los Dedos, la Prueba de los Dedos de la Nariz, los Movimientos Alternados Rápidos de la Mano y el Deslizamiento del Talón-Mentón, y el programa SPSS (v20) para presentar estadísticas descriptivas para expresar las mejoras del participante. Resultados: Esto estudio es indicativo que la rehabilitación puede mejorar la salud, el bienestar y la calidad de vida de los individuos con ataxia, sin embargo, se requiere un estudio más amplio para analizar si estas variables sufrirían cambios significativos en todos los participantes. Además de las mejoras en la composición corporal y la presión sanguínea, se observaron beneficios en todas las variables de la escala de SARA, excepto en "Sentado", donde el valor permaneció sin cambios. Conclusiones: Esta intervención realizada con estos ejercicios puede promover la capacidad y la calidad de vida relacionada con la salud. Este estudio proporciona evidencia para mantener programas de actividad física en pacientes con ataxia.

Adapted Physical Activity and Ataxia

“…Additionally, it has been shown that patients' quality of life can be improved by greater mobility in later stages of cerebellar degeneration [30,31]. This study [27] also established the proper level of intervention. Because rehabilitation cannot stop the progression of cerebellar degeneration, this is a significant contribution to the research.…”

“…The longitudinal case study by Honorio et al might lend support to earlier case studies that advocated for frequent and intense training [27]. Additionally, Milne et al's systematic review study validates and supports that exercise therapies such as coordination and balance training, balance exercises, respiratory muscle training, and treadmill training can improve the participants' quality of life [33].…”

“…This program may enhance the health, happiness, and quality of life for people with ataxia. The findings showed improvements in blood pressure and body composition, as well as gains in all SARA scale items except than "sitting" and "finger chase," where the value remained same [27].…”

“…A comparable longitudinal case study with a specialist personal trainer was carried out in a gym [27]. An exercise program was completed by a 43-year-old man with motor ataxia, and his performance was evaluated both before and after the test.…”

“…Exercises of varying degrees of difficulty were performed during the training sessions, including back rowing (3x: 8,10,12 repetitions), chest and shoulder presses (3x: 8,10,12 repetitions), assisted walking on the treadmill (15 m), spinning on the bike (15 m), astatic body stabilization (2x: 1 m), glute stabilization (2x: 15 repetitions), leg presses (3x: 8,10,12 repetitions), leg extensions (3x: 8,10,12 repetitions), elliptical training (3x: 10,15,20 repetitions), trunk lift on inclined platform and with medicine ball (2x: 15 repetitions), front swing with kettlebell (3x: 8,10,12 repetitions), butterfly (3x: 8,10,12 repetitions), reverse butterfly (3x: 8,10,12 repetitions), squat with and without load (3x: 8,10,12 repetitions to 12, 15, 20 repetitions depending on load), rope jumping (5x: 30s), hill climbing on elliptical trainer (2x: 30s), Jumping jacks (5 times for 30 counts), deadlifts with parallel bars (3 times for 10, 15, and 20 repetitions), TRX rows (3 times for 10, 15, and 20 repetitions), Russian twists with medicine balls (2 times for 30 counts), hack squats (3 times for 10, 15, and 20 counts), push-ups with hands (3 times for 10, 15, and 20 counts), wall ball and lunges with disks on the head (3 times for 20, 25, and 30 reps). A variety of exercises were used, depending on the goal of each session [27]. The treadmill itself might be a useful instrument.…”