Week 3.10 Ataxia

Question 1

what does an ataxic gait look like

Answer 1

like you are drunk!

Question 2

damage to the ____ causes ataxia

Answer 2

cerebellum

Question 3

the cerebellum is responsible for

Answer 3

coordinating movement

Question 4

what does the cerebellum compare

Answer 4

the intended output and actual movement

Question 5

what does the cerebellum do in preparation of movement

Answer 5

it makes predictive and anticipatory modifications

Question 6

the cerebellum has a huge role in motor…

Answer 6

learning

Question 7

TF: the cerebellum learns, memorizes and stores motor programs

Answer 7

true

Question 8

what is so important about the role of adaptation in the cerebellum

Answer 8

the cerebellum must adapt to the changing environment, and the speed of the changing environment.

Question 9

TF the cerebellum controls balance and equilibrium

Answer 9

true

Question 10

TF: the cerebellum does not control motor tone

Answer 10

false, it does

Question 11

the cerebellum makes sure movement has what 4 things

Answer 11

direction
extent
force and timing

Question 12

how does the cerebellum affect speech and eye movements

Answer 12

responsible for all of those !

Question 13

what are some signs and symptoms of cerebellum infarct, and what side of the lesion

Answer 13

nausea, vomit, ataxia, nystagmus, headache all ipsilateral to the lesion

Question 14

what happens in a lateral lesion and a vermin/flocculonodule lesion

Answer 14

lateral: limb ataxia

vermis and flocculonodule: more midline, so the drunk gait.

Question 15

name some things that result from cerebellar dysfunction

Answer 15

disorganized movements 
impaired balance and postural control  hypotonicity 
dysmetria 
decomposition 
ataxia 
dysdiadochokinesia 
tremor 
asthenia 
dysarthria 
occular dysmetria

Question 16

what are some acquired mechanisms of cerebellar damage

Answer 16

stroke, tumor, structural changes, toxicity (alcohol drugs), immune mediated (MS, Gluten), trauma, infection (cerebellitis) or endocrine (hypothyroidism)

Question 17

what are some degenerative non-hereditary causes of cerebellar damage

Answer 17

MSA

idiopathic late onset cerebellar ataxia.

Question 18

what are some hereditary causes of cerebellar damage

Answer 18

autosomal dominant disorders (like episodic of spinocerebellar ataxia's)
autosomal recessive (Friedrich, early onset cerebellar)
X-linked disorders (mitochondrial, fragile X associated tremors)

Question 19

define/describe ataxia

Answer 19

without order, incoordination, slurred speech, stumbling, falling, incoordination, trouble eating and swallowing, eye movement abnormalities, tremors, cardiac issues

Question 20

what are 3 traditional function and activity outcome measures

Answer 20

FIM
Balance/postural control measures
gait speed

Question 21

what are 2 ataxia specific outcome measures

Answer 21

International cooperative ataxia rating scale (ICARS)

Scale for the assessment and rating of ataxia (SARA)

Question 22

TF: there is a lot of evidence for treatment of ataxia

Answer 22

false

Question 23

what do we treat in patients with ataxia

Answer 23

the symptoms

Question 24

what kinds of things can we treat in patients

Answer 24

postural stability
gait
balance
accuracy of limb movements

Question 25

do we do an intensive long or short term motor training

Answer 25

long term

Question 26

what should the HEP focus on

Answer 26

static and dynamic balance activities like sitting standing and walking

Question 27

TF: there is a lot of evidence for BW supported treadmill training

Answer 27

false, not much evidence

Question 28

can we use biofeedback in patients with ataxia

Answer 28

yes, like a mirror, EMG, or do it in a small space so they can bump into things

Question 29

do we want to increase or decreases DOF, and how

Answer 29

decrease, by adding an AD, resistance, kneeling, 1/2 kneeling

Question 30

activity should focus on what 3 things

Answer 30

stability
co-contraction
midrange control

Question 31

can we use resisted movements

Answer 31

yes

Question 32

what are some compensatory strategies

Answer 32

slow it down ,
reduce the number of moving segments 
widen BOS 
minimal distractions 
weighting axial and limb 
AD
orthotics (decrease DOF)