Core Stability Exercises and Hereditary Ataxia

NCT04750850 | Completed

• 1 other identifier: Core protocol 1
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The hereditary ataxias are a group of genetic disorders characterized by slowly progressive incoordination of gait and balance impairments in sitting and standing. Trunk local stability during gait is lower in patients with degenerative ataxia than that in healthy adult population. Given the fact that drug interventions are rare in degenerative diseases and limited to only specific type of diseases and symptoms, physiotherapy is a major cornerstone in current therapy of ataxic gait. Core stability exercises training could be included as an adjunct to conventional balance training in improving dynamic balance and gait. Due to the nature of the interventions, the study will have a single blind design.

Conditions

Hereditary Ataxia; Spinocerebellar Degenerations; Cerebellar Ataxia

Keywords

ataxia; balance; gait ataxia; activities of daily living; core stability exercises; postural balance

Outcome Measures

Primary Outcomes (3)

• Rate of dynamic sitting balance and trunk coordination

  Spanish-version of Trunk Impairment Scale 2.0. Each item will be performed three times and the highest score counts. Otherwise, no practice session allowed. The patient can be corrected between attempts. The tests are verbally explained to the patient and can be demonstrated if needed. There are two subscales: dynamic sitting balance and coordination. The first have 10 items and second 6. The highest possible total score is consequently 16 points, which indicates a good dynamic sitting balance and correct trunk control and sitting coordination. If the patient cannot maintain a sitting position for 10 seconds without back and arm support, with hands on thighs, feet in contact with the ground and knees bent at 90° (starting position), the total score for the scale is 0 points.

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

• Rate of static sitting balance

  Sitting section of Scale for the assessment and rating of ataxia (SARA). Patient is asked to sit on an examination bed without support of feet, eyes open and arms outstretched to the front. 0 Normal, no difficulties sitting \>10 seconds, 1 Slight difficulties, intermittent sway, 2 Constant sway, but able to sit \> 10 s without support, 3 Able to sit for \> 10 s only with intermittent support, 4 Unable to sit for \>10 s without continuous support

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

• Rate of ataxia severity

  Scale for the Assessment and Rating of Ataxia (SARA). The scale is made up of 8 items related to gait, stance, sitting, speech, finger-chase test, nose-finger test, fast alternating

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

Secondary Outcomes (8)

• Rate of standing balance

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

• Rate of gait ability

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

• Rate of balance confidence

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

• Rate of lower limb strength

  T1: Baseline, T2: 5 weeks and T3: follow up 5 weeks

• Rate of adherence

  T2: 5 weeks

Study Arms (2)

Core stability exercises group

EXPERIMENTAL

30 minutes of core stability exercises program at a light intensity and take a rest breaks if is necessary. They will be instructed in the use of the 4-5 points of the Borg 10 Rating of Perceived Exertion for self-monitoring of exercise intensity. The exercises will performed twice a day for 5 days a week during 5 weeks. A physiotherapist conducted an initial home visit to ensure correct execution of the exercises. He or she will teach the exercises and then the patient will perform them alone in your home. Once a week the physiotherapist will phone the patient and will ask her/him for doubts.

Other: Therapeutic core stability exercises

Control group

ACTIVE COMPARATOR

The patients to continue as normal and not change their routine in terms of exercise and physical activity during the period of study.

Other: Usual care

Interventions

Therapeutic core stability exercises OTHER

exercises focused on trunk muscle strengthening, proprioception, selective movements of the trunk and pelvis muscle, and coordination, and will be carried out in supine, sitting on a stable surface and sitting on an unstable surface (ball). The exercise involves changes in the position of the body with or without resistance, aiming to improve strength, endurance, proprioception and coordination. Training is determined by the patient's ability to undertake easy exercises and progress to more challenging exercises.

Also known as: trunk exercises

Core stability exercises group

Usual care OTHER

Usual routine as walking and activities of daily living.

Also known as: Conventional physiotherapy

Control group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• Universitat Internacional de Catalunya: lead
• Universitat de Lleida: collaborator

Study Sites (1)

Rosa Cabanas Valdés

Cardedeu, Barcelona, 08440, Spain

Location

Related Publications (21)

• Chen DH, Latimer C, Yagi M, Ndugga-Kabuye MK, Heigham E, Jayadev S, Meabon JS, Gomez CM, Keene CD, Cook DG, Raskind WH, Bird TD. Heterozygous STUB1 missense variants cause ataxia, cognitive decline, and STUB1 mislocalization. Neurol Genet. 2020 Feb 10;6(2):1-13. doi: 10.1212/NXG.0000000000000397. eCollection 2020 Apr.

  PMID: 32211513 BACKGROUND

• Ruano L, Melo C, Silva MC, 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. Epub 2014 Mar 5.

  PMID: 24603320 BACKGROUND

• OVERTON, Caroline E.; O'BRIEN, Kate. Guidelines on the Diagnosis and Management of Miscarriage. Early Pregnancy, 2017, 129.

  BACKGROUND

• Marquer A, Barbieri G, Perennou D. The assessment and treatment of postural disorders in cerebellar ataxia: a systematic review. Ann Phys Rehabil Med. 2014 Mar;57(2):67-78. doi: 10.1016/j.rehab.2014.01.002. Epub 2014 Feb 6.

  PMID: 24582474 BACKGROUND

• Chini G, Ranavolo A, Draicchio F, Casali C, Conte C, Martino G, Leonardi L, Padua L, Coppola G, Pierelli F, Serrao M. Local Stability of the Trunk in Patients with Degenerative Cerebellar Ataxia During Walking. Cerebellum. 2017 Feb;16(1):26-33. doi: 10.1007/s12311-016-0760-6.

  PMID: 26811155 BACKGROUND

• Park J, Gong J, Yim J. Effects of a sitting boxing program on upper limb function, balance, gait, and quality of life in stroke patients. NeuroRehabilitation. 2017;40(1):77-86. doi: 10.3233/NRE-161392.

  PMID: 27792020 BACKGROUND

• Cabanas-Valdes R, Urrutia G, Bagur-Calafat C, Caballero-Gomez FM, German-Romero A, Girabent-Farres M. Validation of the Spanish version of the Trunk Impairment Scale Version 2.0 (TIS 2.0) to assess dynamic sitting balance and coordination in post-stroke adult patients. Top Stroke Rehabil. 2016 Aug;23(4):225-32. doi: 10.1080/10749357.2016.1151662. Epub 2016 Mar 11.

  PMID: 26922850 BACKGROUND

• Haruyama K, Kawakami M, Otsuka T. Effect of Core Stability Training on Trunk Function, Standing Balance, and Mobility in Stroke Patients. Neurorehabil Neural Repair. 2017 Mar;31(3):240-249. doi: 10.1177/1545968316675431. Epub 2016 Nov 9.

  PMID: 27821673 BACKGROUND

• Cabrera-Martos I, Jimenez-Martin AT, Lopez-Lopez L, Rodriguez-Torres J, Ortiz-Rubio A, Valenza MC. Effects of a core stabilization training program on balance ability in persons with Parkinson's disease: a randomized controlled trial. Clin Rehabil. 2020 Jun;34(6):764-772. doi: 10.1177/0269215520918631. Epub 2020 Apr 29.

  PMID: 32349543 BACKGROUND

• Cabanas-Valdes R, Bagur-Calafat C, Girabent-Farres M, Caballero-Gomez FM, Hernandez-Valino M, Urrutia Cuchi G. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: a randomized controlled trial. Clin Rehabil. 2016 Oct;30(10):1024-1033. doi: 10.1177/0269215515609414. Epub 2015 Oct 8.

  PMID: 26451007 BACKGROUND

• Synofzik M, Ilg W. Motor training in degenerative spinocerebellar disease: ataxia-specific improvements by intensive physiotherapy and exergames. Biomed Res Int. 2014;2014:583507. doi: 10.1155/2014/583507. Epub 2014 Apr 27.

  PMID: 24877117 BACKGROUND

• He M, Zhang HN, Tang ZC, Gao SG. Balance and coordination training for patients with genetic degenerative ataxia: a systematic review. J Neurol. 2021 Oct;268(10):3690-3705. doi: 10.1007/s00415-020-09938-6. Epub 2020 Jun 24.

  PMID: 32583055 BACKGROUND

• Milne SC, Corben LA, Georgiou-Karistianis N, Delatycki MB, Yiu EM. Rehabilitation for Individuals With Genetic Degenerative Ataxia: A Systematic Review. Neurorehabil Neural Repair. 2017 Jul;31(7):609-622. doi: 10.1177/1545968317712469. Epub 2017 Jun 9.

  PMID: 28595509 BACKGROUND

• Seco, C. J., et al. Improvements in quality of life in individuals with friedreich's ataxia after participation in a 5-year program of physical activity: an observational study pre-post test design, and two years follow-up. Int J Neurorehabil, 2014, 1.3: 129

  BACKGROUND

• Chang YJ, Chou CC, Huang WT, Lu CS, Wong AM, Hsu MJ. Cycling regimen induces spinal circuitry plasticity and improves leg muscle coordination in individuals with spinocerebellar ataxia. Arch Phys Med Rehabil. 2015 Jun;96(6):1006-13. doi: 10.1016/j.apmr.2015.01.021. Epub 2015 Feb 7.

  PMID: 25668777 BACKGROUND

• Miyai I, Ito M, Hattori N, Mihara M, Hatakenaka M, Yagura H, Sobue G, Nishizawa M; Cerebellar Ataxia Rehabilitation Trialists Collaboration. Cerebellar ataxia rehabilitation trial in degenerative cerebellar diseases. Neurorehabil Neural Repair. 2012 Jun;26(5):515-22. doi: 10.1177/1545968311425918. Epub 2011 Dec 2.

  PMID: 22140200 BACKGROUND

• Bunn LM, Marsden JF, Giunti P, Day BL. Training balance with opto-kinetic stimuli in the home: a randomized controlled feasibility study in people with pure cerebellar disease. Clin Rehabil. 2015 Feb;29(2):143-53. doi: 10.1177/0269215514539336. Epub 2014 Jul 31.

  PMID: 25082955 BACKGROUND

• Velazquez-Perez L, Rodriguez-Diaz JC, Rodriguez-Labrada R, Medrano-Montero J, Aguilera Cruz AB, Reynaldo-Cejas L, Gongora-Marrero M, Estupinan-Rodriguez A, Vazquez-Mojena Y, Torres-Vega R. Neurorehabilitation Improves the Motor Features in Prodromal SCA2: A Randomized, Controlled Trial. Mov Disord. 2019 Jul;34(7):1060-1068. doi: 10.1002/mds.27676. Epub 2019 Apr 8.

  PMID: 30958572 BACKGROUND

• Rodriguez-Diaz JC, Velazquez-Perez L, Rodriguez Labrada R, Aguilera Rodriguez R, Laffita Perez D, Canales Ochoa N, Medrano Montero J, Estupinan Rodriguez A, Osorio Borjas M, Gongora Marrero M, Reynaldo Cejas L, Gonzalez Zaldivar Y, Almaguer Gotay D. Neurorehabilitation therapy in spinocerebellar ataxia type 2: A 24-week, rater-blinded, randomized, controlled trial. Mov Disord. 2018 Sep;33(9):1481-1487. doi: 10.1002/mds.27437. Epub 2018 Aug 22.

  PMID: 30132999 BACKGROUND

• Tabbassum, Khan Neha, et al. Core stability training with conventional balance training improves dynamic balance in progressive degenerative cerebellar ataxia. Indian Journal of Physiotherapy and Occupational Therapy, 2013, 7.1: 136.

  BACKGROUND

• Schmitz-Hubsch T, du Montcel ST, Baliko L, Berciano J, Boesch S, Depondt C, Giunti P, Globas C, Infante J, Kang JS, Kremer B, Mariotti C, Melegh B, Pandolfo M, Rakowicz M, Ribai P, Rola R, Schols L, Szymanski S, van de Warrenburg BP, Durr A, Klockgether T, Fancellu R. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology. 2006 Jun 13;66(11):1717-20. doi: 10.1212/01.wnl.0000219042.60538.92.

  PMID: 16769946 BACKGROUND

MeSH Terms

Conditions

Spinocerebellar Degenerations; Cerebellar Ataxia; Ataxia; Gait Ataxia

Condition Hierarchy (Ancestors)

Cerebellar Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Heredodegenerative Disorders, Nervous System; Neurodegenerative Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Dyskinesias; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Gait Disorders, Neurologic

Study Officials

• Rosa C Cabanas-Valdés, PhD

  Universitat Internacional de Catalunya

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: February 10, 2021
• First Posted: February 11, 2021
• Study Start: May 20, 2021
• Primary Completion: November 30, 2022
• Study Completion: January 10, 2023
• Last Updated: May 6, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)