Cerebellar ataxia is a neurological condition where there is damage to the cerebellum. The cerebellum is a section of the brain that is primarily involved in the coordination of movement and balance, along with being responsible for cognitive functions such as language, speech, and attention. If there is damage or a dysfunction in the cerebellum, this leads to a lack of muscle movement coordination. Cerebella ataxia is typically caused by damage of the cerebellum via a head injury, stroke, brain tumour or it can be inherited via defected genes at birth. Furthermore, cerebellar disease is degenerative in nature, so symptoms of ataxia worsen over time.
Common symptoms of Cerebellar Ataxia include the following.
- Impaired coordination -> difficulty with reaching for objects or picking objects up. Fine motor control is impacted greatly, tasks such as writing eating are impacted. Perception of distance is also impacted.
- Reduced balance -> impairments with postural adjustments and control of balance. Increased postural sway, excessive or diminished responses to perturbations, poor control of equilibrium.
- Gait Abnormalities -> varied step placement due to trouble with leg coordination. Irregular foot trajectories, a widened stance, a veering path of movement and poor coordination of legs is also seen.
- Trouble controlling eye movements -> which can impact balanced as sight is a primary source of balance
- Slurred speech, troubles with eating and swallowing.
- Impacts of Daily living:
- Difficulty with tasks that require fine motor movements such as handwriting or typing.
- Balance and walking ataxia and impact performance in physically demanding jobs
So, what role does exercise play in the management of this disease? Exercise is the primary treatment for gait ataxia and imbalance in individuals with cerebellar damage. Seeing an Accredited Exercise Physiologist is important for managing this, as they can prescribe exercises that challenge strength, static and dynamic balance and incorporate multi-directional movements. Exercise that incorporates these components can result in the following.
- Improved gait: exercise can lead to a decreased variability of steps, postural sway and improved walking speed.
- Improved balance: Improved coordination of legs and trunk, proprioception, improved neuromuscular control of the trunk and leg can lead to reduced falls risk. Repetitive balance exercise has shown to improve locomotor performance and motor learning.
- Improved physical function and posture: Physical, occupational and speech therapy is pivotal in slowing the progression of the degenerative disease as it leads to improvements in strength and mobility, which can lead to improved performance of day-to day tasks and communication. Exercise may help regain and improve functional performance of one or more years of disease progression.
It is important that exercise for these individuals is individualised. As severity of symptoms and characteristics of cerebellar ataxia differ from person to person. The individuals program’s will differ based on the person’s age and the progression of their condition. For younger people, the focus should be on normalising muscle tone and improving abnormal reflex activity. With adolescents and adults, the focus would be more on functional outcomes and performances. It is important to keep in mind that the exercise needs to meet the levels of the individual and is at an intensity that is manageable. This is because people with Cerebellar Ataxia have a higher energy expenditure level to control and execute their movements, which can lead to an early onset of fatigue.