Physical Therapy and Rehabilitation

Physical Therapy and Rehabilitation

ISSN 2055-2386
Original Research

Telehealth delivery of a high-intensity motor priming intervention in cerebellar ataxia: a single-case experimental design

Chelsea E. Macpherson1, Bria Bartsch1, Miriam King1, Ashrita Satchidanand1, Sheng-Han Kuo2 and Lori Quinn3*

*Correspondence: Lori Quinn lq2165@tc.columbia.edu

1. Department of Biobehavioral Sciences, Teachers College, Columbia University.

Author Affiliations

2. Department of Neurology, Columbia University Irving Medical Center. The Initiative for Columbia Ataxia and Tremor, Columbia University.

3. Department of Biobehavioral Sciences, Teachers College, Columbia University, and Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center.

Abstract

Background: Hereditary Cerebellar Ataxias (HCA) cause symptoms that affect balance, gait, and motor learning. Balance training (BT) and aerobic exercise (AE) improve motor function in HCA. Motor-priming is a non-conscious process of learning, where exposure to one stimulus will alter response to another. Studies in Parkinson Disease have used AE before BT as motor priming to enhance motor learning. This study describes a novel application of motor priming in HCA.

Methods: Single-case experimental design with repeated measures. Participants (n=4) completed 16, 45-minute Telehealth-sessions of AE before BT, twice-weekly for 8-weeks. Outcomes evaluated at baseline, mid- and post-intervention, and included: Cerebellar Cognitive Affective Syndrome Scale (CCAS), modified Scale for Assessment and Rating of Ataxia (mSARA), Static Postural Sway (SPS), feasibility metrics.

Results: Participants’ mean (SD) age was 58.5(4.4) yrs; 3M/1F with early-mid progression of spinocerebellar ataxia type 2, 3, 6, and cerebellar ataxia. All participants had 100% adherence to intervention without adverse events and improved on the CCAS (range 1-11 pt), mSARA (range 1-3 pt), SPS Neutral Stance (range 0.005-0.009 m/s2).

Conclusions: Impaired motor learning in HCA likely impacts sustained benefits following rehabilitation. Motor priming has potential to improve disease-specific measures and may enhance motor learning for functional gain.

Keywords: Cerebellar Ataxia, Balance, Aerobic Exercise, Motor Priming, Motor Learning, Physical Therapy, Neurorehabilitation, Telehealth

ISSN 2055-2386
Volume 10
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