Rehabilitation Management of Friedreich Ataxia: Lower Extremity Force-Control Variability and Gait Performance  

Oleh:

Harris-Love, Michael O. ; Siegel, Karen Lohmann ; Paul, Scott M. ; Benson, Kimberly

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Neurorehabilitation and Neural Repair vol. 18 no. 2 (Jun. 2004), page 117–124.
Topik: Friedreich ataxia; Force control; Rehabilitation.
Fulltext: 117NNR182.pdf (106.68KB)

Isi artikel

We describe the rehabilitation management during a 12- month period of a 14-year-old female with Friedreich ataxia. Interventions included task-oriented bimanual reaching activities, functional strengthening, and gait training using a walker featuring tension-controlled wheels and a reverse-braking system. Her physical status was assessed with the Nine-Hole Peg Test, single limb stance time, manual muscle testing, self-reported falls, isometric force control testing, and 3-dimensional gait analysis in a motion-capture laboratory. Although measures of the patient’s Nine-Hole Peg Test, single limb stance time, and manual muscle testing reflected minimal changes, her gait speed decreased by 69.4%. However, the force-control targeting of her dominant knee extensors showed a 43.7% increase in force variability that was concomitant with her decline in gait performance. The decrement of her initial gait speed was reduced to 42.9% on replacing the wheeled walker with the U-Step Walking Stabilizer at the end of the intervention period. Although the patient’s gait remained significantly impaired, extended use of the U-Step Walking Stabilizer modestly improved her gait performance, and her rate of falls decreased from 10 to 3 per month. Our observations suggest that use of force-control testing as proxy measures of ataxia and tension-controlled gait aids show promise in the management of Friedreich ataxia and merit further investigation.

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