Rehabilitation and Social Inclusion Center of Veracruz (CRIS-DIF), Xalapa, Veracruz, Mexico.
Laboratory of Genomic Medicine, Department of Genetics, National Rehabilitation Institute- Luis Guillermo Ibarra Ibarra (INR-LGII), México-Xochimilco No. 289, Col. Arenal Guadalupe, C.P, 14389, Ciudad de México (CDMX), Mexico.
Cerebellum. 2019 Jun;18(3):397-405. doi: 10.1007/s12311-019-1006-1.
Today, neurorehabilitation has become in a widely used therapeutic approach in spinocerebellar ataxias; however, there are scarce powerful clinical studies supporting this notion, and these studies require extension to other specific SCA subtypes in order to be able to form conclusions concerning its beneficial effects. Therefore, in this study, we perform for the first time a case-control pilot randomized, single-blinded, cross-sectional, and observational study to evaluate the effects of physical neurorehabilitation on the clinical and biochemical features of patients with spinocerebellar ataxia type 7 (SCA7) in 18 patients diagnosed with SCA7. In agreement with the exercise regimen, the participants were assigned to groups as follows: (a) the intensive training group, (b) the moderate training group, and (c) the non-training group (control group).We found that both moderate and intensive training groups showed a reduction in SARA scores but not INAS scores, compared with the control group (p < 0.05). Furthermore, trained patients exhibited improvement in the SARA sub-scores in stance, gait, dysarthria, dysmetria, and tremor, as compared with the control group (p < 0.05). No significant improvements were found in daily living activities, as revealed by Barthel and Lawton scales (p > 0.05). Patients under physical training exhibited significantly decreased levels in lipid-damage biomarkers and malondialdehyde, as well as a significant increase in the activity of the antioxidant enzyme PON-1, compared with the control group (p < 0.05). Physical exercise improved some cerebellar characteristics and the oxidative state of patients with SCA7, which suggest a beneficial effect on the general health condition of patients.
如今,神经康复已成为脊髓小脑共济失调的一种广泛应用的治疗方法;然而,支持这一观点的强有力的临床研究很少,这些研究需要扩展到其他特定的 SCA 亚型,以便能够对其有益效果形成结论。因此,在这项研究中,我们首次进行了一项病例对照、随机、单盲、横断面、观察性研究,以评估物理神经康复对 18 例 SCA7 患者的临床和生化特征的影响。根据运动方案,参与者被分为以下三组:(a)强化训练组,(b)中度训练组,和(c)非训练组(对照组)。我们发现,与对照组相比,中度和强化训练组的 SARA 评分均降低,但 INAS 评分无变化(p<0.05)。此外,与对照组相比,训练组的 SARA 子评分在站立、步态、构音障碍、共济失调和震颤方面均有所改善(p<0.05)。然而,在日常生活活动方面,Barthel 和 Lawton 量表并未显示出显著的改善(p>0.05)。与对照组相比,接受物理训练的患者的脂质损伤生物标志物和丙二醛水平显著降低,抗氧化酶 PON-1 的活性显著增加(p<0.05)。
物理运动改善了 SCA7 患者的一些小脑特征和氧化状态,这表明对患者的整体健康状况有有益的影响。