【論文摘要】Effects of Conventional Physical Therapy Combined With Core Muscle Stability Training on Ataxia, Balance and Falls Efficacy in a Patient With Spinocerebellar Ataxia: A Case Study

【論文摘要】傳統物理治療結合核心穩定訓練於小腦共濟失調患者的共濟失調、平衡及跌倒之成效：個案報告

何浚銘(Jun-Ming Ho) ； 謝堃宏(Kun-Hung Hsieh) ； 林子琪(Tzu-Chi Lin)

《物理治療》 46卷4期 (2021/12) Pp. 319-319

https://doi.org/10.6215/FJPT.202112.P32

摘要

Background and Purpose: Studies have demonstrated that core muscle training can improve balance and postural stability in patients with stroke and multiple sclerosis. Minimal research, however, has investigated the effects of core muscle stability training on patients with spinocerebellar ataxia (SCA). The purpose of this study was to investigate the effects of conventional physical therapy combined with core muscle stability training on ataxia, balance, and falls efficacy in a patient with SCA. Methods: This 42-year-old male had been diagnosed as having SCA 2 years earlier and had not received any medication or treatment. Due to an increasing frequency of falls, he sought assistance at our outpatient department. The intervention programs were included (1) exercise modalities for 30 min and (2) core muscle stability training for 30 min. The total training duration was 60 min per session and 12 sessions over 4 weeks. The outcomes were evaluations of the severity of ataxia symptoms by using the Scale for the Assessment and Rating of Ataxia (SARA). The Berg Balance Scale (BBS) and Dynamic Gait Index (DGI) assessed the effects of balance. The fall effects were assessed using the Activities-specific Balance Confidence (ABC) scale and the Fall Efficacy Scale (FES). Results: After a 4-week intervention, we discovered no significant difference in SARA scores; however, the section of the ＂transfer＂ demonstrated improvement in BBS scores. The DGI score increased from 14 to 18 points postintervention, which met the criteria for minimal detectable change. The balance confidence measured using ABC scale scores, improved 0.19%, and efficacy of fall increased by over 40% according to FES scores. Conclusion: In this case study, conventional physical therapy combined with core muscle stability training was shown to improve the balance and fall confidence of a patient with SCA. Clinical Relevance: For patients with SCA, balance impairment and limitations in daily life participation are usually observed. In our study, we introduced stability training to enhance the patient's motor control ability. We hope that in the future, required long-term interventions and follow-up can improve participation in activities of daily living and reduce falls among patients with SCA.