Cerebellar Ataxia.

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Presentation transcript:

Cerebellar Ataxia

Functional Role of the Cerebellum It is only 10% of brain’s volum Contains > than half the total # of neurons in the brain. Regulates vestibular, spinal and cortical mechanism through reciprocal neuronal connections.

Functional Role of the Cerebellum cont. Participate in three systems: Vestibulo-cerebellar system modulating vestibular influences on posture & eye movement. Spino-cerebellar system regulating muscle tone, posture & locomotion. Cerebro-cerebellar system regulating skilled movement.

Leiner et al, 1993 showed a role of the cerebellum in perception, cognition & language. It compares performance with motor signals from the cerebral cortex. It contains complete motor & sensory representation of the body.

Role of the Cerebellum Initiation & control of voluntary movement. Timing of movement/muscle action. Moment-to-moment correction of errors. Compensating for lesions of cerebral cortex. Motor learning & adaptive adjustments.

Etiology Developmental abnormality (hydrocephalus or hypoxia at birth) Traumatic brain injury. Stroke. Tumor or other space-occupying lesion. Infection (encephalitis) Demyelinating disease (Multiple sclerosis) Familial or hereditary disease (Friedreich’s ataxia) Degenerative disease. Metabolic disease (myxoedema, Wilson’s disease) Vascular disease (vertebro-basilar artery insufficiency) Drug & alcohol intoxications.

Clinical assessment, measurement & evaluation Finger-to-finger & finger-to-nose Heel-to-shin test Rebound test Rapid alternating movement Romberg test for postural sway

Tests of motor performance Gait: Timed walking test, cadence & stride length measures. Balance: FRT, Standing balance, TUG. Spiral test Nail test.

Causes of motor impairment Individual’s voluntary restriction of activity as an adaptation to motor control deficit. Motor control

Training objective of PT Train optimal & effective performance of any actions with which the individual is having difficulty with.

Training objective of PT Train control during performance of functional movements To increase complexity. To set up a practice environment wich enables the person to develop more control (accuracy) during practice

Training objective of PT Train control during performance of functional movements, during: Standing up Sitting down Walking Reaching to point Take an object