Abstract

Background: Patients with ataxia tend to have most issues with balance as people disturb the path of cerebellar or sensorial communication. Conventional treatment procedures primarily involve individual activities and cannot entirely deal with everyday functioning problems. To evaluate and compare the effects of Dual Task Training (DTT) and Task-Oriented Circuit Training (TOCT), both incorporated with Conventional Therapy (CT) on improving balance and quality of life in ataxic patients, the study was carry out a crossover clinical trial. Objective: To evaluate the comparative effectiveness of dual task training and task-oriented circuit training combined with conventional therapy for enhancing balance in patients with ataxia. Methods: Fifty-eight subjects with ataxia were randomly selected and divided into two groups. Group A was given DTT conjoined with CT, whereas Group B was given TOCT with CT. Both groups had three sessions per week for 12 weeks. The Berg Balance Scale (BBS), Scale for the Assessment and Rating of Ataxia (SARA), and EQ-5D-5L to measure quality of life were used at baseline, week 6, and week 12.

• 1.   Ashizawa T., Xia G. Ataxia. Continuum (Minneap Minn). 2016 Aug; 22(4): 1208–1226. DOI: 10.1212/CON.0000000000000362.
• 2.   2. Ojoga F., Marinescu S. Physical therapy and rehabilitation for ataxic patients. Balneo Res J. 2013 May 20; 4(2): 81–84. DOI: 10.12680/ balneo.2013.1044
• 3.   3. Zhang Q., Zhou X., Li Y., Yang X., Abbasi Q.H. Clinical Recognition of Sensory Ataxia and Cerebellar Ataxia. Front Hum Neurosci. 2021 Apr 1; 15: 639871. DOI: 10.3389/ fnhum.2021.639871.
• 4.   Marsden J., Harris C. Cerebellar ataxia: pathophysiology and rehabilitation.Clin Rehabil. 2011; 25(3): 195–216. DOI: 10.1177/0269215510382495.
• 5.   5. Takakusaki K. Functional neuroanatomy for posture and gait control. J Mov Disord. 2017; 10(1): 1-17. DOI: 10.14802/jmd.16062.
• 6.   6. Buckner R.L. The cerebellum and cognitive function: 25 years of insight from anatomy and neuroimaging. Neuron. 2013 Oct; 80(3): 807– 815. DOI: 10.1016/j.neuron.2013.10.044
• 7.   7. Ruano L., Melo C., Silva M.C., Coutinho P. The Global Epidemiology of Hereditary Ataxia and Spastic Paraplegia: A Systematic Review of Prevalence Studies. Neuroepidemiology. 2014; 42(3): 174-83. DOI: 10.1159/000358801.
• 8.   Salman M.S. Epidemiology of Cerebellar Diseases and Therapeutic Approaches. Cerebellum. 2018; 17(1): 4–11. DOI: 10.1007/s12311-017-0885-2.
• 9.   Akbar U., Ashizawa T. Ataxia. Neurol Clin. 2015 Feb; 33(1): 225–248. DOI: 10.1016/j. ncl.2014.09.004
• 10.   Erichsen A.K., Koht J., Stray-Pedersen A, Abdelmoor M., Tallaksen CME. Prevalence of hereditary ataxia and spastic paraplegia in southeast Norway: a population-based study. Brain. 2009; 132(6): 1577–1588. DOI: 10.1093/ brain/awp056.
• 11.   Musselman K.E., Stoyanov C.T., Marasigan R., Jenkins M.E., Konczak J., Morton S.M., et al. Prevalence of ataxia in children: A systematic review. Neurology. 2014 Jan 7; 82(1): 80-89. DOI: 10.1212/01.wnl.0000438224.25600.6c.
• 12.   Rosa C.V. Effect of a home-based core stability exercise program in hereditary ataxia: a randomized controlled trial. Harvard Dataverse. 2023 Jan 1. DOI: 10.1002/mdc3.14036
• 13.   Pavone P., Praticò A.D., Pavone V., Lubrano R., Falsaperla R, Rizzo R, et al. Ataxia in children: early recognition and clinical evaluation. Ital J Pediatr. 2017; 43: 6. DOI:10.1186/s13052-016- 0325-9.
• 14.   Hartley H., Cassidy E., Bunn L., Kumar R., Pizer B., Lane S., et al. Exercise and physical therapy interventions for children with ataxia: a systematic review. Cerebellum. 2019; 18:951– 968. DOI: 10.1007/s12311-019-01063-z
• 15.   Mitoma H., Manto M., Hampe C.S. Immunemediated cerebellar ataxias: from bench to bedside. Cerebellum Ataxias. 2017; 4:16. DOI: 10.1186/s40673-017-0073-7.
• 16.   Kwei K.T., Kuo S.H. An overview of the current state and the future of ataxia treatments. Neurol Clin. 2020; 38(2): 449-467. DOI: 10.1016/j.ncl.2020.01.008.
• 17.   Jen J.C., Graves T.D., Hess E.J., Hanna M.G., Griggs R.C., Baloh R.W., et al. Primary episodic ataxias: diagnosis, pathogenesis and treatment. Brain. 2007; 130(9): 2484–2493. DOI: 10.1093/brain/awm126
• 18.   Ilg W., Synofzik M., Brötz D., Burkard S., Giese M.A., Schöls L. Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology. 2009; 73(22): 1823-1830. DOI: 10.1212/ WNL.0b013e3181c33adf.
• 19.   Kisner C., Colby L.A. Therapeutic exercise: foundations and techniques. 5th ed. Philadelphia:F.A. Davis Company; 2007.
• 20.   Martin C.L., Tan D., Bragge P., Bialocerkowski A. Effectiveness of physiotherapy for adults with cerebellar dysfunction: a systematic review. Clin Rehabil. 2009; 23(1): 15–26. DOI: 10.1177/0269215508097853
• 21.   Silsupadol P., Shumway-Cook A., Lugade V, van Donkelaar P., Chou L-S, Mayr U., et al. Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial. Arch Phys Med Rehabil. 2009; 90(3): 381–387. DOI: 10.1016/j.apmr.2008.09.559
• 22.   Park J.H. Is dual-task training clinically beneficial to improve balance and executive function in community-dwelling older adults with a history of falls? Int J Environ Res Public Health. 2022 Aug 17; 19(16): 10198. DOI: 10.3390/ijerph191610198
• 23.   Sarasso E., Parente M.P., Agosta F., Filippi M, Corbetta D. Dual-task vs. single-task gait training to improve spatiotemporal gait parameters in people with Parkinson’s disease: a systematic review and meta-analysis. Brain Sci. 2024 May 1; 14(5): 517. DOI: 10.3390/ brainsci14050517
• 24.   Hiyamizu M., Morioka S., Shomoto K., Shimada T. Effects of dual-task balance training on dual-task performance in elderly people: A randomized controlled trial. Clin Rehabil. 2011; 25(1): 69–78. DOI: 10.1177/0269215510394222
• 25.   Ali A.S., Darwish M.H., Shalaby N.M., Abbas R.L., Soubhy H.Z. Efficacy of core stabilityversus task-oriented trainings on balance inataxic persons with multiple sclerosis: a singleblinded randomized controlled trial. Mult Scler Relat Disord. 2021 May; 50:102866. DOI: 10.1016/j.msard.2021.102866

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Funding