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#018- Aerobic Training for People with Cerebellar Degeneration

Estimated reading time: 2 minutes, 0 seconds.*

Aerobic Training can Reduce Ataxia in People with Cerebellar Degeneration

Degenerative cerebellar disease: a group of heterogeneous disorders marked by impaired balance, loss of coordination, and gait deficits.

Rehabilitation is the main treatment option for this disease as there are no disease-modifying medications.

This RCT (PEDro score 8/10) investigated the effect of a 4-week aerobic exercise program on ataxia severity, balance and gait in individuals with cerebellar degeneration.

20 Participant were randomly assigned to aerobic training or no training.

Intervention:

  • Aerobic training using stationary bicycle at home, 5/week for 4 weeks.
  • Intensity prescription was based on the participant’s maximal heart rate during cardiopulmonary exercise testing (CPET).
  • Participants started the first week at 65% of CPET maximal heart rate for 30 minutes.
  • 5% increase in the following weeks until reaching 80% of CPET maximal heart rate for 30 minutes.

Results:

  • Diagnosis of the participant consisted of: spinocerebellar ataxia (6 participants), idiopathic ataxia (7 participants), and Multiple System Atrophy, Cerebellar type (7 participants).
  • 9 of 10 participants achieved their target training heart rates.
  • 8 of 10 participants achieved the target of training at least five days per week with 30-minute training sessions.

The intervention group had a significant improvement in:

  • Scale for the Assessment and Rating of Ataxia scores, reduction of 2.1 points in the intervention group, where in the control group increased by 0.3.
  • Walking speed.
  • Timed Up and Go.
  • Maximal oxygen consumption.
  • Dynamic Gait Index.
  • Static balance and gait parameters also showed improvement with aerobic training, but these measures did not remain significant after correction for multiple comparisons.
  • 1 participant complained of back pain once, it was relieved with medication.

Learned:

  • Aerobic training according to the program mentioned above is effective to improve ataxia, balance and gait in people with cerebellar degeneration.
  • Intensive aerobic exercise appears to be acceptable to people with degenerative cerebellar disease.

Note:

  • The reason behind the improvement after aerobic training in this case is unclear, in other studies, for aerobic exercise to cause a physiological effect a minimum of 8 weeks of training should be performed, one explanation is this 4-week program increased the ability to compensate for deficits by improving the fitness level which in turn decreased fatigue and improved concentration, also, lower limb strength might have increased and improved stability.
  • This study was limited by the sample size and the control group not receiving any treatment.
  • The authors recommend 29 participants in each group

Final Note

Recommended reads:

References

*Calculation is based on the average reading speed that around 200 words per minute (wpm).

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