Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
J Neurol. 2021 Oct;268(10):3690-3705. doi: 10.1007/s00415-020-09938-6. Epub 2020 Jun 24.
The group of genetic degenerative ataxias shares the same feature of gradual deterioration in balance and coordination. However, no cure is yet available for this group of disorders, while rehabilitation remains a cornerstone in the current therapy. This review aims to present a summary of the current knowledge of balance and coordination training in patients with inherited degenerative ataxia and to discuss the training effectiveness accordingly.
A comprehensive search was performed in 5 electronic databases (i.e., Cochrane Library, PEDro, EMbase, PubMed and MEDLINE) to identify the related publications from January, 1999 to January, 2020. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) grading system and the PEDro scale.
A total of 33 out of 515 studies met the eligibility criteria, and were categorized and discussed by their training methods including: (1) conventional physical/occupational therapy, (2) virtual reality/videogame-based training, and (3) adapted physical activity. Despite the substantial variation among included studies, most patients achieved significant improvement in the aspect of balance and coordination following individually-tailored rehabilitation programs. The effects of training showed a relative consistency regardless of the functional dependency level on admission.
Balance and coordination training, especially the conventional physical/occupational therapy, is able to improve the balance and coordinative function of patients with genetic degenerative ataxia, but more high-quality studies are needed to formulate recommendations for clinical practice.
遗传性退行性共济失调组具有平衡和协调逐渐恶化的共同特征。然而，目前还没有针对这种疾病的治疗方法，而康复仍然是当前治疗的基石。本综述旨在总结遗传性退行性共济失调患者平衡和协调训练的最新知识，并讨论相应的训练效果。
在 5 个电子数据库（即 Cochrane 图书馆、PEDro、EMbase、PubMed 和 MEDLINE）中进行全面检索，以确定从 1999 年 1 月至 2020 年 1 月的相关出版物。使用苏格兰校际指南网络（SIGN）分级系统和 PEDro 量表评估方法学质量。
在 515 项研究中，有 33 项符合入选标准，并根据其训练方法进行了分类和讨论，包括：（1）常规物理/职业疗法；（2）虚拟现实/视频游戏训练；和（3）适应性身体活动。尽管纳入的研究存在很大差异，但大多数患者在接受个体化康复计划后，在平衡和协调方面都取得了显著的改善。训练效果显示出相对一致性，与入院时的功能依赖程度无关。
平衡和协调训练，特别是常规物理/职业疗法，能够改善遗传性退行性共济失调患者的平衡和协调功能，但需要更多高质量的研究来为临床实践制定建议。
