What is ataxia?
Ataxia is typically defined as the presence of abnormal, uncoordinated movements. This usage describes signs & symptoms without reference to specific diseases.
An unsteady, staggering gait is described as an ataxic gait because walking is uncoordinated and appears to be ‘not ordered’.
In a repeatable motor task like gait, symptoms of ataxia can become quite clear.
What is Ataxic Gait?
Gait ataxia results from incoordination of the lower extremities due to cerebellar pathology or loss of proprioceptive input.
Patients often feel insecure and have to hold onto the wall or furniture and walk with feet apart.
How to characterize Ataxic gait?
️Ataxic gait is often characterized by difficulty walking in a straight line, lateral veering, poor balance, a widened base of support, inconsistent arm motion, and lack of repeatability.
️These symptoms often resemble gait seen under the influence of alcohol.
What Causes Ataxic Gait?
Ataxic gait can be caused by abnormalities within the brain, spinal cord, and peripheral nervous system.
When caused by issues with the cerebellum, gait deviations resulting from ataxia have distinct features.
The cerebellum sends signals throughout the brain that regulate fine motor movement. When cerebellar neurons are damaged, the cerebellum has difficulty integrating information from the rest of the body and brain.
As a result, coordinating balance, posture, and smooth muscle activity are difficult, clearly impacting gait function.
How to Quantify Ataxia?
While symptoms of ataxic gait stemming from cerebellar dysfunction can be observed, it is important to quantify these gait deviations to improve their understanding.
The common deviations seen in ataxic gait are a widened base of support, cadence, missteps in tandem gait, increased step variability, and poor balance.
Compensations for ataxia may include shortening step length and shuffling.
Deviations caused by ataxia can be quantified by measuring the quantification of the widening of the base of support and the overall variability in step to step. Widening of bade of support can be quantified by measuring the stride width.
The overall variability in step to step measures by using a global score, such as the eGVI or looking at the step to step variability of measurements such as step length, stride time, stance time, and swing time.
Improved characterization and understanding of the gait deviations caused by cerebellar ataxia can lead to improved treatment and earlier diagnosis of these disorders.
Physiotherapy management.
Rehabilitation can improve gait, balance and trunk control for people with ataxia, and can reduce activity limitations and support increased participation.
The prevention of falls is important to consider in patients with progressive ataxia given their high frequency and fall-related injuries being common.
For people with cerebellar dysfunction, dynamic task practice that challenges stability, explores stability limits and aims to reduce upper-limb weight bearing seems an important intervention to improve gait and balance.
Strength and flexibility training may be indicated.
Therapeutic equipment is often provided to support function.
References.
https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/ataxia/conditions/
https://www.protokinetics.com/common-gait-deviations-ataxic-gait/
Malsha Sewwandi.
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