Individualized exergame training improves postural control in advanced degenerative spinocerebellar ataxia: A rater-blinded, intra-individually controlled trial

Conny Schatton, Matthis Synofzik, Zofia Fleszar, Martin A. Giese, Ludger Schöls, Winfried Ilg, Parkinsonism & Related Disorders, Available online 28 March 2017, ISSN 1353-8020, doi:10.1016/j.parkreldis.2017.03.016.

Treatment options are rare in degenerative ataxias, especially in advanced, multisystemic disease. Exergame training might offer a novel treatment strategy, but its effectiveness has not been investigated in advanced stages.
The training improvement of 2.5 SARA points indicates a meaningful improvement, given that a reduction of one SARA point is generally considered as clinically relevant. It represents a treatment effect equivalent to gaining back functional performance of 1.5 years of natural disease progression (e.g. progression in Friedreich’s Ataxia: 1.4 point SARA increase/year). Interestingly, the 2.5 SARA point training improvement is in the same range as training via exergames or via physiotherapy in mild-to-moderate degenerative ataxia. Thus, even largely nonambulatory subjects with advanced degenerative ataxia are still capable of training induced improvements, despite far more progressed and multisystemic neurodegeneration.
This study provides first evidence that, even in advanced stages, subjects with degenerative ataxia may benefit from individualized training, with effects translating into daily living and improving underlying control mechanisms. The proposed training strategy can be performed at home, is motivating and facilitates patient self-empowerment.