Ataxia, Cerebellar
How TheraTogs Can Help
Therapy Goal #1: Improve stability in the trunk and hips to improve efficiency and reduce falls and collisions.
TheraTogs undergarments are designed to compress the body and to resist vertical stretch. Together with selected strapping applications, they deliver a customized body hug with vertical joint compression that increases the volume on tactile and somatosensory input and promotes a postural holding response in the trunk muscles.
Therapy Goal #2: Reduce excessive ranges of purposeful limb motions.
TheraTogs garments gently constrain the muscles connecting the thorax to the pelvis against excessive lengthening during movement while adding sensory awareness of the same deviations of those body segments.
Trunk stability has been shown to enhance hand use. [1] Strapping can be applied to the garments to stabilize the scapulae, approximate the upper arms into the shoulder joints, and reduce hip motions in order to promote more precise limb function.
Which TheraTogs Systems to Use
These TheraTogs system can support therapy goals for cerebellar ataxia:
- Posture and Torso Alignment (PTA) System
- The Full Body System (FBS) (includes limb strapping components).
Applicable Evidence, Science, and Therapy Approaches
Evidence. To see the effects of cerebellar ataxia on balance and gait – compared side-by-side with the impact of wearing TheraTogs to address the condition – watch this video of 6-year-old Hannah. In this video, Hannah is wearing her TheraTogs for the first time. For filming purposes, she’s wearing her Full Body system on top of her clothes – so she’s not yet receiving the full benefit of normal wear, which is under the clothes and against the skin.
Sciences that apply to the management of cerebellar ataxia:
- Postural control
- Somatosensory information processing and modulation
- Neural plasticity: cortical mapping and massed practice
Therapy approaches that can be used to address cerebellar ataxia:
- Proprioceptive Neuromuscular Facilitation (PNF)
- Perception-Action Approach (P-A) (formerly TAMO – Tscharnuter Akademie for Motor Organization)
- Sensory Integration Approach
More About Cerebellar Ataxia
Ataxia is defined as an inability to generate a normal or expected voluntary movement trajectory through space that reveals coordinated, functional precision. The ataxic deficit in movement precision is not attributed to weakness or to involuntary muscle activity. [2] (See also: balance deficit, ataxic CP)
Ataxia is rare in pure form. A recent study showed that 6% of children with cerebral palsy have ataxia [3] , while it is considerably more common as a component of a traumatic brain injury, a brainstem stroke, or a sequel to cerebellar tumor resection. (See also: TBI)
The cerebellum – a large brain region located at the base of the skull – functions as a monitor of our movements, detecting and correcting errors by processing somatosensory input – the sensations that inform us about our body’s size limits, position in space, joint angles, limb weight and weight loading, and movement directions and speed. This proprioceptive information is integrated with the rest of the brain’s purposes and expectations in real time.
Hallmark signs of cerebellar ataxia include a wide-base of support in standing, with staggering, frequent collisions with walls and objects, and frequent falling while walking. An intention tremor or overshooting the target is common while reaching. The neural processing of posture- and movement-related sensory input and the ongoing adjustments by the motor areas appear to be delayed, allowing the magnitude of body weight shifts and the path of limb movements to become exaggerated before they are registered and checked.
References
- Stoykov ME, Stojakovich M, Stevens JA. 2005. Beneficial effects of postural intervention on prehensile action for an individual with ataxia resulting from brainstem stroke. NeuroRehabilitation. 20(2): 85-89.
- Sanger TD, Chen D, et al. Definition and classification of negative motor signs in childhood. Pediatrics 2006;118;2159-2167.
- Himmelmann K, Hagberg G, Beckung E, Hagberg B, Uvebrant P. The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995-1998. Acta Paediatr. 2005;94(3):287-94.