Feasibility of an exercise program for static and dynamic balance improvement in individuals with spinocerebellar ataxia

Abstract

Introduction: Spinocerebellar ataxia (SCA) is an autosomal dominant, degenerative and progressive condition that presents with postural balance and gait impairments. These impairments increase the risk of falls and may affect the functional independence
of their patients. In addition, it is known that the first complaint of patients with SCA is related to changes in balance and, consequently, gait. Objective: To verify the feasibility and safety of an exercise program for static and dynamic balance in
individuals with SCA. In addition, gait performance, balance, functional independence, disease severity, non-ataxia signs and risk of falls were assessed before and after program implementation. Methods: This is a quasi-experimental pre-post design study
with a sample composed of 13 individuals diagnosed with SCA. Participants were evaluated before and after the application of a static and dynamic balance exercise program, both of which were associated with progressively higher degrees of difficulty,
performed in 18 sessions, often 3 times a week. Adverse events were computed, and viability was assessed by attendance and by individuals' ability to perform the exercises. The evaluations were composed of kinematic gait analysis, posturography and the
following functional scales and tests: Berg Balance Scale (BSE), Scale for the Assessment and Rating of Ataxia (SARA), modified Dynamic Gait Index (mDGI), Inventory of Non-Ataxia Signs (INAS), Timed Up and go test (TUG) and Four Stage balance test (4Stage). The level of statistical significance considered was p <0.05. Results: Significant differences were found in the comparisons before and after the intervention for the SARA (p = 0.006), BBS (p = 0.004), mDGI (p = 0.003), TUG (p = 0.006) and4Stage (p = 0.007) indicating an improvement both static and dynamic balanceand of the research participants. Throughout the intervention, participants were
not injuredor otherwise adversely affected. Conclusion: The exercise program of the present study was feasible and safe to be applied and provided a significant improvement in the static and dynamic balance of individuals with SCA.