Coordination and Balance Dysfunction: cerebellar disorders

Question 1

What are the three vertical sections

Answer 1

• midline vermis
• intermediate zone or paravermis
• lateral hemispheres

Question 2

What does cerebellar damage impact

Answer 2

• voluntary coordinated movement
• rate
• range
• force (how much is necessary)

Question 3

Common signs of cerebellar damage

Answer 3

• ataxia: can happen with sensory loss as well
• dysmetric
• dysdiadochokinesia
• hypotonia
• intention tremor
• postural instability and gait disturbances
• dysarthria
• if unilateral damage = ipsilateral lesion

Question 4

Vestibulocerebellum: signs of lesions

Answer 4

• unsteadiness
• truncal ataxia
• head tilt (ipsilateral)
• bilateral horizontal nystagmus
• circling away from and falling toward side of lesion

Question 5

Signs of lesions: spinocerebellum

Answer 5

• intention tremor
• ataxic gait
• dysarthria
• dysdiadochokinesia
• dysmetria
• movement decomposition

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Question 6

signs of cerebrocerebellum lesion

Answer 6

• finger ataxia
• dysarthria

Question 7

Common effects of cerebellar damage on locomotion

Answer 7

• increased postural sway
• excessive or diminished responses to perturbation
• abnormal oscillations of the trunk
• gait ataxia
• movement decomposition

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Question 8

look at the somatopic oganization

Question 9

Damage to anteiror lobe:
1. common causes
2. where does it occur?
3. Effects on locomotion due to damage to anterior lobe

Answer 9

• common causes: atrophy due to alcoholism (damage perkinje cells), MS
• begins in anterior vermis and intermediate portions of anterior lobe
• gait ataxia: legs affected first
• unable to perform unilateral stance
• ataxia with heel to shin test
• deficits in reaching and speech as disease progresses posterior

Question 10

damage to posterior vermis:
1. common cause
2. Effects on locomotion

Answer 10

• common cause: tumor in the fourth ventricle
• gait ataxia without limb ataxia: marked deficit in tandem gait
• may be able to reach, kick and perform unilateral stance

Question 11

what is the role of cerebellum in motor learning

Answer 11

• ability to adapt to change
• store adaptions
• damage to cerebellum results in decreases ability to adapt to change and a decreased capacity to store adaptions

blocked practice

Question 12

interventions for cerebellar dysfunction

Answer 12

• impairment-based: weight-bearing and approximation to reduce ataxia, (stability)
• functional rehabilitation: functional coordination,
• gait training: decomposition of movement
• balance training: anticipatory and reaction