Longitudinal tracking of gait and balance impairments in cerebellar disease

Authors

  • Susanne M. Morton PhD, PT,

    1. Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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  • Ya-Weng Tseng PhD, PT,

    1. Department of Physical Therapy, Temple University, Philadelphia, Pennsylvania, USA
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  • Kathleen M. Zackowski PhD, OTR,

    1. Kennedy Krieger Institute, Baltimore, Maryland, USA
    2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    3. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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  • Jaclyn R. Daline PT, DPT,

    1. Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Amy J. Bastian PhD, PT

    Corresponding author
    1. Kennedy Krieger Institute, Baltimore, Maryland, USA
    2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    3. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • Kennedy Krieger Institute, 707 N. Broadway, Room G-04, Baltimore, MD 21205
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  • Potential conflict of interest: Nothing to report.

Abstract

Cerebellar damage typically results in ataxia and can be caused by stroke, tumor, or one of many forms of degenerative disease. Since few pharmacological options are available, most treatments rely heavily on rehabilitation therapy. Little data exist on methods for tracking the progression of ataxia, which is critical for assessing the efficacy of current and newly developing treatments. Here, we tracked the severity of ataxia, with a particular emphasis on gait and balance dysfunction, in a group of individuals with cerebellar damage using the International Cooperative Ataxia Rating Scale (ICARS) and several instrumented laboratory measures of gait and balance impairments over 1 year. We found that the ICARS was able to distinguish between subjects with static lesions and those with degenerative disorders, was sensitive to increases in ataxia severity occurring over 1 year, and correlated well with specific instrumented measures of gait in persons with cerebellar degeneration. These results suggest the ICARS is a valuable tool for clinicians and investigators to document and track long-term changes in gait and balance performance in individuals with cerebellar degenerative disorders. © 2010 Movement Disorder Society

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