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01-07-2016 | Original Communication

The interrelationship between disease severity, dynamic stability, and falls in cerebellar ataxia

Authors: Roman Schniepp, Cornelia Schlick, Cauchy Pradhan, Marianne Dieterich, Thomas Brandt, Klaus Jahn, Max Wuehr

Published in: Journal of Neurology | Issue 7/2016

Abstract

Cerebellar ataxia (CA) results in discoordination of body movements (ataxia), a gait disorder, and falls. All three aspects appear to be obviously interrelated; however, experimental evidence is sparse. This study systematically correlated the clinical rating of the severity of ataxia with dynamic stability measures and the fall frequency in patients with CA. Clinical severity of CA in patients with sporadic (n = 34) and hereditary (n = 24) forms was assessed with the Scale for the Assessment and Rating of Ataxia (SARA). Gait performance was examined during slow, preferred, and maximally fast walking speeds. Spatiotemporal variability parameters in the fore-aft and medio-lateral directions were analyzed. The fall frequency was assessed using a standardized interview about fall events within the last 6 months. Fore-aft gait variability showed significant speed-dependent characteristics with highest magnitudes during slow and fast walking. The SARA score correlated positively with fore-aft gait variability, most prominently during fast walking. The fall frequency was significantly associated to fore-aft gait variability during slow walking. Severity of ataxia, dynamic stability, and the occurrence of falls were interrelated in a speed-dependent manner: (a) Severity of ataxia symptoms was closely related to instability during fast walking. (b) Fall frequency was associated with instability during slow walking. These findings suggest the presence of a speed-dependent, twofold cerebellar locomotor control. Assessment of gait performance during non-preferred, slow and fast walking speeds provides novel insights into the pathophysiology of cerebellar locomotor control and may become a useful approach in the clinical evaluation of patients with CA.

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Title: The interrelationship between disease severity, dynamic stability, and falls in cerebellar ataxia
Authors: Roman Schniepp
Cornelia Schlick
Cauchy Pradhan
Marianne Dieterich
Thomas Brandt
Klaus Jahn
Max Wuehr
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 7/2016
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-016-8142-z

At a glance: The STEP trials

Springer Medicine

The interrelationship between disease severity, dynamic stability, and falls in cerebellar ataxia

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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