Article

Gait and balance disorders are often major causes of handicap in patients with
cerebellar ataxia. Although it was thought that postural and balance disorders in
cerebellar ataxia were not treatable, recent studies have demonstrated the
beneficial effects of rehabilitation programs. This article is the first
systematic review on the treatment of postural disorders in cerebellar ataxia.
Nineteen articles were selected, of which three were randomized, controlled
trials. Various aetiologies of cerebellar ataxia were studied:
five studies
assessed patients with multiple sclerosis, four assessed patients with
degenerative ataxia, two assessed stroke patients and eight assessed patients
with various aetiologies. Accurate assessment of postural disorders in cerebellar
ataxia is very important in both clinical trials and clinical practice. The Scale
for the Assessment and Rating of Ataxia (SARA) is a simple, validated measurement
tool, for which 18 of the 40 points are related to postural disorders. This scale
is useful for monitoring ataxic patients with postural disorders. There is now
moderate level evidence that rehabilitation is efficient to improve postural
capacities of patients with cerebellar ataxia - particularly in patients with
degenerative ataxia or multiple sclerosis. Intensive rehabilitation programs with
balance and coordination exercises are necessary. Although techniques such as
virtual reality, biofeedback, treadmill exercises with supported bodyweight and
torso weighting appear to be of value, their specific efficacy has to be further
investigated. Drugs have only been studied in degenerative ataxia, and the level
of evidence is low. There is now a need for large, randomized, controlled trials
testing rehabilitation programs suited to postural and gait disorders of patients
with cerebellar ataxia.
CI - Copyright (c) 2014 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS ; FRANCAIS