Bridgett Piernik-Yoder, PhD, OTR UT Health Science Center at San Antonio Department of Occupational Therapy. OCCUPATIONAL Therapy for Management of Ataxia.
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Current evidence for rehabilitation intervention in the management of ataxia
Role of OT
Participated in a 4-week therapy program, followed by 8-week home program
Experienced improvements in motor control and reduction of ataxia symptoms
Found those who maintained home program were more likely to retain gains
Therapy may result in gains but continuous therapy may be most beneficial
Ilg, W., Synofzik, M., Brotz, D., Burkard, S., Giese, M., Schols, L. (2009). Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology, 73, 1823–1830.Evidence TO SUPPORT rehabilitation
Richards, L., Senesac, C., McGuirk, T., Woodbury, M., Howland, D., Davis, S., Patterson, T. (2008). Response to intensive upper extremity therapy by individuals with ataxia from stroke. Topics in stroke rehabilitation, 15(3), 262 – 271.Evidence TO SUPPORT rehabilitation
Examined outcome of postural training with an individual with ataxia due to stroke
Received four weeks of neuromuscular postural control intervention by an OT
Participant improved function of ataxic upper extremity yet still required assistance for all ADLs
Addressing postural control may be beneficial for some
Stoykov, M. Stojakovich, M., Stevens, J. (2005). Beneficial effects of postural intervention on prehensile action for an individual with ataxia resulting from brainstem stroke. Neurorehabilitation, 20(2), 85 – 89.Evidence TO SUPPORT rehabilitation
Intensive therapy has potential to improve motor function in some with ataxia
Systems model of motor control
Research shows that therapy can be beneficial in addressing some aspects of motor control
Focus of OT intervention is function
OT will address skills, task requirements, environment
Strategies will be aimed at supporting function, or daily “occupations”Summary