1. Cerebellar Ataxia

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

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

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

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

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

11. 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

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