The management of ataxia differs based upon the causative factors; logistically speaking ataxia can either occur due to cerebellar dysfunction or due to loss of sensory information to the cerebellum. Thus the patient of cerebellar ataxia differs slightly from the ones caused due to sensory impairment.
Certain principles need to be applied while treating cases of ataxia which are as follows:
- The intense concentration of the patient.
- Active participation of the patient should be encouraged rather than making the treatment program passive.
- Frequent rest period needs to be given to prevent fatigue.
- The training room should be quite to avoid any distraction that can aggravate ataxia.
- A patient should be always relaxed and should be given a comfortable as well as properly supported position.
- Repetition of task or sequence of a task is very important for recovery.
- The guidance given by the therapist holds a very important significance in the treatment. Certain important goals towards which the physiotherapist can work with the patient are:
- Regulate the limb movements accurately during activities.
- Develop postural stability and balance.
- Improve the tone of the muscle.
- Functional transfers and gait.
While exercising patients within coordination one should always progress from exercises done at a lower centre of gravity to exercises that are done at a higher centre of gravity. This consideration is necessary to prevent any chances of fear or insecurity that may interfere in the rehabilitation program. Various functional activities of the patient can be achieved by giving the following exercises to the patient.
Head and Trunk Control:
Patient with poor head control can be treated prone with one or two pillows under the chest of the patient. Prone on the elbow is not her position that can be considered to stimulate proper head control in these patients.
Facilitation of neck extensors and shoulder girdle retractors can be achieved by using techniques like brisk stroking, quick stretch or vibration given directly on the muscle bulk.