Measuring ataxia: quantification based on the standard neurological examination.

Abstract

To quantify ataxia in a simple way four tests were developed and analysed, based on the neurological examination: a tapping test for the arms (test 1), another one for the legs (test 2), a quantified finger-to-nose test (test 3), and a modified Romberg test (test 4). All tests were performed by 115 volunteers, 13 patients with cerebellar ataxia and 25 patients with sensory ataxia due to neuropathy. The test-retest repeatability was excellent. Tests 1, 2 and 4 were age-dependent, with lower scores above age 65. On test 1, 2 and 4 both groups of patients performed worse than controls; the correlation with the ataxia scale of NobileOrazio and the modified disability Rankin scale was good (P < 0.05).Although test 3 could differentiate between sensory and cerebellar ataxia, it was not useful for quantifying the degree of ataxia. To determine the practical value of the four tests, 11 patients performed the tests for a second time after a follow up period of 16 months. The results indicate that tests 1, 2 and 4 are sensitive for the detection of ataxia and of changes in its severity.(

Sensory neuropathies including painful and toxic neuropathies

“…Sensory ataxia can be quantified in a simple way with a tapping test [58]. The device used consists of two push buttons placed at a fixed distance 35 cm apart, connected to an automatic counter.…”

High curvature and jerk analyses of arm ataxia

“…However, assessing performance in the clinic during standard dysmetria tests, such as the ®nger-to-nose test, is in general more qualitative than quantitative. Although advantageous from a clinical perspective, the sensitivity of these tests has been questioned (Notermans et al 1994;Sullivan et al 1991;Sullivan, 1992, 1993). Alternatively, conducting dysmetria tests in a motion analysis laboratory enables objective and accurate quanti®cation of the smoothness of movement, allowing more complex movements, and their submovements, to be analyzed in great detail (Flash and Hogan 1985;Hogan et al 1987;Kaminski and Gentile 1989;Nagasaki 1989;Schneider and Zernicke 1989;Suzuki et al 1996;Gielen et al 1997;Topka et al 1998a,b;Krebs et al 1999).…”

“…Clinicians often use rapid alternating movements, or dysmetria tests, for quantifying cerebella ataxia (Jankovic and Tolosa 1988;Notermans et al 1994). However, assessing performance in the clinic during standard dysmetria tests, such as the ®nger-to-nose test, is in general more qualitative than quantitative.…”

Neuromotor function in ship welders after cessation of manganese exposure

“…However, these clinical tests may be insufficiently sensitive to detect subclinical changes in neuromotor function (Notermans et al 1994). There are several test batteries available for quantitative assessment of tremor, motor speed, fine manual dexterity, postural stability, and eye-hand coordination; these tests are known to detect early signs of impairment in neuromotor function (Meyer-Baron et al 2009).…”