Article

Treatment of genetic degenerative ataxia is currently based on
symptom management and maintenance of function. However, utilization of
rehabilitation is limited due to a lack of evidence supporting its efficacy.
This systematic review evaluated rehabilitation interventions for
individuals with genetic degenerative ataxia. In addition, long-term outcomes
from rehabilitation and optimal duration and intensity of rehabilitation were
examined. METHODS: A comprehensive search of 4 databases (MEDLINE, CINAHL, PEDro,
and Cochrane) identified randomized, nonrandomized controlled, and cohort studies
published from inception through to January 2016. The studies included at least
one measure examining function, ataxia, balance, or gait. Methodological quality
was assessed with the Australian National Health and Medical Research Council
(NHMRC) Hierarchy of Evidence and the randomized controlled trials were rated
according to the PEDro scale. RESULTS: Seventeen studies met eligibility
criteria. Five randomized controlled trials were included; however, the majority
were classified as level III-3 and IV studies. Of 292 participants included, 148
had autosomal dominant ataxia, and 85 had autosomal recessive ataxia.
Rehabilitation interventions included coordination and balance training,
multifaceted inpatient rehabilitation, a cycling regime, balance exercises with
technology assisted biofeedback, respiratory muscle training, and treadmill
training. Two studies examined adjuncts to rehabilitation. Fifteen of the 17
studies demonstrated a statistically significant improvement in at least 1
outcome measuring ataxia, function, gait, or balance. Less than half of the
studies included assessment of long-term outcomes and follow-up time frames
varied considerably. CONCLUSION: There is consistent evidence that rehabilitation
improves function, mobility, ataxia, and balance in genetic degenerative ataxia.

Langue : ANGLAIS