Article

Balance and gait problems in patients with cerebellar degeneration lead to
reduced mobility, loss of independence, and frequent falls. It is currently
unclear, however, whether balance and gait capacities can be improved by training
in this group of patients. Therefore, the aim of this study was to examine the
effects of gait adaptability training on obstacle avoidance and dynamic stability
during adaptive gait. Ten patients with degenerative cerebellar ataxia received
10 protocolized gait adaptability training sessions of 1 h each during 5 weeks.
Training was performed on a treadmill with visual stepping targets and obstacles
projected on the belt's surface. As the primary outcome, we used an obstacle
avoidance task while walking on a treadmill. We determined avoidance success
rates, as well as dynamic stability during the avoidance manoeuvre. Clinical
ratings included the scale for the assessment of ataxia (SARA), 10 m walking
test, timed up-and-go test, berg balance scale, and the obstacle subtask of the
emory functional ambulation profile (EFAP). Following the intervention, success
rates on the obstacle avoidance task had significantly improved compared to
pre-intervention. For successful avoidance, participants allowed themselves
smaller stability margins in the sagittal plane in the (shortened) pre-crossing
step. However, in the subsequent steps they returned to baseline stability values
more effectively than before training. SARA scores and the EFAP obstacle subtask
improved significantly as well. This pilot study provides preliminary evidence of
a beneficial effect of gait adaptability training on obstacle avoidance capacity
and dynamic stability in patients with cerebellar degeneration.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS