A study led by Dr Sarah Milne at the Murdoch Children’s Research Institute, Australia, has recently been published in the journal ANNALS of Neurology.
The study looked at the impact of a 30-week goal-directed rehabilitation programme for those with hereditary Cerebellar ataxia (HCA) compared with 30 weeks of standard care. The researchers compared a range of outcomes, including function, ataxia, health-related quality of life, and balance in those with HCA. They found that goal-directed rehabilitation improved function at 7 weeks, with improvement in ataxia and health-related quality of life maintained at 30 weeks in those with HCA, beyond that of standard care.
The study included 71 participants with HCA aged 15 and above enrolled through five study sites across Australia. This included mainly SCA3 (20), Friedreich’s ataxia (19), and SCA6 (8), as well as small numbers of participants with other HCAs. 37 participants were randomised to receive the rehabilitation programme, and 34 were randomised to receive standard care. The rehabilitation programme included 6 weeks of outpatient physiotherapy followed by a 24-week at-home exercise programme supported by fortnightly physiotherapy sessions.
They found that at 7 weeks, participants who received goal-directed rehabilitation showed improvement in the motor domain of the Functional Independence Measure (mFIM) and SARA scores compared to those who received standard care. Rehabilitation improved SARA scores at 30 weeks, but not mFIM.
Dr Sarah Milne reflected on the study results,
Given the decline in walking and balance people with hereditary cerebellar ataxias typically experience, rehabilitation (often delivered by a physiotherapist) has been used as a management strategy aimed at maximising physical function and reducing the symptoms of the disease.
This study showed on average people participating in a rehabilitation program have better physical function and balance, milder ataxia severity and improved health-related quality of life (related to limitation on what they could do because of their physical health).
A more intensive rehabilitation program in a clinic or hospital appears to provide most benefit; and a supported home exercise program maintains some of these benefits over 24-weeks.
Read the full paper here.
