Scale for the Assessment and Rating of Ataxia (SARA): Development of a Training Tool and Certification Program

Abstract

Monitoring of disease severity is of great importance for treatment and management of clinical trials. The Scale for Assessment and Rating of Ataxia (SARA) is a frequently used, short and easily applicable clinical scale used to assess the severity of ataxia. The objective of our study was to develop a training and certification tool for the SARA. SARA scores were recorded according to a standardized protocol and rated by three clinical experts in consensus. Four hundred thirty-eight videos of 67 patients were included in the SARA training tool. The tutorial section demonstrates a complete SARA examination on a healthy control. In the training section, users can compare their ratings to consensus ratings and access a video library covering the complete SARA range. The tool also includes a section that allows optional certification. The SARA training tool provides comprehensive and standardized training material and certification to reduce variability in applying the SARA. Standardization aims to improve the quality of patient care and research in ataxia.

Classic and Atypical Late Infantile Neuronal Ceroid Lipofuscinosis in Latin America: Clinical and Genetic Aspects, and Treatment Outcome with Cerliponase Alfa

“…Regular assessment of functional performance in patients with CLN2 using scales validated in the literature [ 21 ] including the Hamburg [ 22 ], Weill Cornell [ 23 ] and CLN2 clinical rating scales [ 24 ], as well as the SARA scale [ 25 ] (supplement 1), allows to evaluate motor and language parameters, determine disease progression, and assess the degree of disability, among other things [ 21 ]. These patients require comprehensive management with a multidisciplinary approach to ensure early diagnosis and treatment initiation with the aim of achieving a positive impact on quality of life [ 13 ].…”

Sensor-free motion registration and automated movement evaluation: Leveraging machine learning for clinical gait analysis in ataxia disorders

“…An unimpaired, normal gait with no difficulties in walking and turning as well as an unimpaired tandem walk is rated with 0, while the combination of an unimpaired normal gait but slight difficulties only visible when walking 10 consecutive steps in tandem is rated with 1. A subset of video recordings has been rated a posteriori by three clinical experts in consensus as part of the SARA training tool development (Grobe-Einsler et al, 2024) (N = 44). These posterior ratings were considered a human prediction and compared with the ground truth (onsite ratings).…”

Effects of cerebellar repetitive transcranial magnetic stimulation plus physiotherapy in spinocerebellar ataxias – A randomized clinical trial

“…To reduce intra‐ and inter‐rater variability, all investigators that were involved in the clinical assessments (MGE and FB) were SARA trained and certified. 25 Other clinical assessments included the 8 Meter Walk Test (8MW), the Nine‐Hole Peg Test (NHPT), PATA rate, and the Cerebellar Cognitive Affective Syndrome Scale (CCAS). Computerized dynamic posturography was performend using a standardized balance perturbation method (PosturoMed CMS10; zebrisMedical GmbH, Isny im Allgäu, Germany).…”