Ataxia is a movement disorder resulting from uncoordinated movements in the arms or legs and inadequate postural control causing imbalances and walking disturbances. Ataxia can result from damage to several different motor or sensory regions of the central nervous system, as well as peripheral nerve pathology (Bastian 1997). In general, problems in the proprioceptive system, visual system and vestibular system, the cerebellum and/or any problem in the interconnections of these systems, can lead to ataxia.
Ataxia has three subcategories: sensory, cerebella, and vestibular ataxia. Sensory ataxia is used to indicate ataxia due to loss of proprioception (sensitivity to joint and body part position). Cerebellar ataxia develops as a result of lesions to the cerebellum, and/or the afferent and efferent connections of the cerebellum. Vestibular ataxia develops as a result of peripheral or central diseases that directly affect the vestibular nuclei and/or the afferent and efferent connections of the vestibular nuclei. Vestibular ataxia may be accompanied by vertigo, nausea, vomiting, blurred vision and nystagmus due to the vestibular system’s role in sensing and perceiving self-motion and stabilizing gaze via the vestibulo-ocular reflex (Horak&Shupert 1994).
Some researchers regard frontal ataxia as the 4th category. Mixed ataxia involves symptoms of at least two basic types of ataxia and are observed together, such as the occurrence of sensory and cerebella ataxia symptoms. In some diseases, mixed ataxia may be observed frequently. For instance, in a disease such as multiple sclerosis, cerebella, vestibular and sensory ataxia may be observed together; whereas in cases of spino-cerebellar ataxias, cerebella and sensory ataxia may be seen.
Different clinical symptoms, interference of different neurological structures, and different diseases play roles in the formation of each ataxia type. Since ataxia is resistant to medical treatments, physical therapy treatment applications are of major importance. Physical therapy applications involve proprioceptive training, balance exercises, stabilization techniques regarding the extremity ataxia and vestibular exercises for accomplishing functional improvement and restoration of the ataxic patient. The goal of physical therapy and rehabilitation of ataxia is to improve the function level of patients through restorative techniques. When this is not possible your therapist may make use of compensation strategies to teach the patient strategies to perform as independently as possible within the present level of functionality. Physical therapy at Harris Therapy will try to aid in the following results from ataxia restorative physical therapy.
- Improving balance and postural reactions against external stimuli and gravitational changes
- Improving and increasing postural stabilization following the development of joint stabilization
- Developing upper extremity functions
- Through developing independent and functional gait, improving the life quality of the patient by increasing the patient’s independence while performing daily life activities
- Improving balance