Changes in Gait After Training for Individuals With Cerebellar Ataxia

To investigate gait changes for individuals who performed either home aerobic or balance training.

Single-blind randomized clinical trial.

Home training and outcome assessments at large, tertiary, urban hospital.

Individuals with cerebellar ataxia (N=52).

Individuals in the aerobic group trained 30 minutes per session, 5 times per week at up to 85% predicted maximum heart rate. Individuals in the balance group (control) performed 30 minutes of balance exercises of varying difficulty 5 times per week. Participants in both groups were expected to train for 1 year.

Gait parameters (step length, step variability, stride width, gait velocity) were determined at 0, 6, and 12 months.

Of the 52 individuals who agreed to participate, 24 individuals in each group had gait analysis performed. At 12 months, 20 and 19 participants had gait analysis performed in the balance and aerobic groups, respectively. Linear mixed effect model analysis was used to determine difference between individuals in the balance versus the aerobic group. Step length was the only parameter that showed statistically significant improvement with aerobic training over balance training (6mo: $\beta$ , 4.1 cm; 95% CI, 0.76-7.42; P=.03; 12mo: $\beta$ , 4.1 cm; 95% CI, 0.33-7.82; P=.04). We also found that individuals who hit training goals (either balance or aerobic) had statistically significant improvements in step length (6mo: $\beta$ , 7.15 cm; 95% CI, 3.87-10.42; P<.001; 12mo: $\beta$ , 7.16 cm; 95% CI, 4.20-10.13; P<.001), stride width (6mo: $\beta$ , -2.72 cm; 95% CI, -4.33 to -1.11; P=.001; 12mo: $\beta$ , -2.29 cm; 95% CI, -3.72 to -0.86; P=.002), and gait speed (6mo: $\beta$ , 15.26 cm/s; 95% CI, 5.16-25.36; P=.004; 12mo: $\beta$ , 16.85 cm/s; 95% CI, 7.89-25.80; P<.001) compared to those who did not hit training goals. Step variability was not improved with either training.

There was a minor improvement of increased step length in individuals with ataxia who performed home aerobic training compared to home balance training. However, individuals with ataxia who regularly performed either type of home training had statistically significant improvements in multiple gait parameters compared to those who did not train regularly.