Telerehabilitation, Core Stability Exercises and Hereditary Ataxia (TRCore-ataxia) (TRCore-ataxia)
Effects of a Telerehabilitation Program of Central Stability Exercises to Improve Balance and Gait in Hereditary Ataxia. A Randomized Controlled Pilot Study.
Hereditary ataxias (HA) are a heterogeneous group of degenerative diseases of the cerebellum, brain stem and spinal cord. People who suffer from AH, among other symptoms, present deficiencies in the stability of the trunk, which leads to an alteration in postural control, with a strongly influential factor in the loss of balance and gait disorders. Improving the functionality of these physical aspects can help reduce the rate of falls, increase autonomy and quality of life for people with HA.
Evidence suggests that rehabilitation strategies based on core stability exercises (CSE) are effective in improving balance and postural control in several neurological diseases, such as stroke. However, there is little evidence with people with HA. In a previous study carried out by researchers of this project, in which an EEC exercise program was piloted at home, low adherence to treatment was perceived due to the little follow-up that was given to the participants. Therefore, including telerehabilitation in these programs would increase follow-up and could influence adherence.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Maria Masbernat, PT, PhD
- Phone Number: +34 973702282
- Email: maria.masbernat@udl.cat
Study Contact Backup
- Name: Selma Peláez-Hervas, PT
- Email: s.pelaez.hervas@gmail.com
Study Locations
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Lleida, Spain, 25198
- University of Lleida
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Suffer from degenerative HA at any stage of the disease (Spinocerebellar ataxia, Friedreich's ataxia, sporadic idiopathic cerebellar ataxia and neurodegenerative diseases where ataxia is the dominant symptom).
- Adults over 18 years of age.
- Be able to use a computer or mobile phone (It will be evaluated using the DILE scale)
- Have an internet connection.
Exclusion Criteria:
- Suffer from other neurological diseases and inability to follow simple instructions. -
- Suffering from a musculoskeletal injury that prevents you from performing the exercises.
- Being unable to maintain standing for more than 10 seconds without support (assessed with item 2 on the SARA scale).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Telerehabilitation Core stability exercises group
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exercises focused on trunk muscle strengthening, proprioception, selective movements of the trunk and pelvis muscle, and coordination, and will be carried out in supine, sitting on a stable surface and sitting on an unstable surface (ball).
The exercise involves changes in the position of the body with or without resistance, aiming to improve strength, endurance, proprioception and coordination.
Training is determined by the patient's ability to undertake easy exercises and progress to more challenging exercises.
Other Names:
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Active Comparator: Core stability exercises group
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exercises focused on trunk muscle strengthening, proprioception, selective movements of the trunk and pelvis muscle, and coordination, and will be carried out in supine, sitting on a stable surface and sitting on an unstable surface (ball).
The exercise involves changes in the position of the body with or without resistance, aiming to improve strength, endurance, proprioception and coordination.
Training is determined by the patient's ability to undertake easy exercises and progress to more challenging exercises.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of dynamic sitting balance and trunk coordination
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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panish-version of Trunk Impairment Scale 2.0.
Each item will be performed three times and the highest score counts.
Otherwise, no practice session allowed.
The patient can be corrected between attempts.
The tests are verbally explained to the patient and can be demonstrated if needed.
There are two subscales: dynamic sitting balance and coordination.
The first have 10 items and second 6.
The highest possible total score is consequently 16 points, which indicates a good dynamic sitting balance and correct trunk control and sitting coordination.
If the patient cannot maintain a sitting position for 10 seconds without back and arm support, with hands on thighs, feet in contact with the ground and knees bent at 90° (starting position), the total score for the scale is 0 points.
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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Static sitting balance and Standing balance
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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Static sitting balance will be recorded with the sitting section of SARA, standing balance will be recorded with the standing section of SARA as well, as well as walking.
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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Walking Speed
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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The walking speed will be determined with the 4 meter walking test.
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
ADLs
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
|
ADLs will be assessed with the Activities-specific Balance Confidence (ABC)
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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Lower extremity strength
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
|
Lower extremity strength will be assessed with the 30 s Sit-to-stand test.
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
|
|
Adherence to treatment
Time Frame: T1: 7 weeks and T0: follow up 7 weeks
|
Adherence to treatment will be asses with the Exercise Adherence Rating Scale (EARS) (Newman-Beinart 2017).
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T1: 7 weeks and T0: follow up 7 weeks
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Risk of falls
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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The risk of falls with the Timed Up and GO scale
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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Severity of ataxia
Time Frame: T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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The severity of ataxia will be evaluated with the SARA scale
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T0: Baseline, T1: 7 weeks and T0: follow up 7 weeks
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Treatment compliance
Time Frame: T1: 7 weeks and T0: follow up 7 weeks
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treatment compliance measured as the rate of sessions performed/prescribed (Capecci 2023), we will obtain the % compliance for each participant with the calculation Total number of minutes performed by the patient / Total number of minutes that should have been done (1400 minutes) x 100.
Or with the calculation Total number of exercises per session performed by the patient / Total number of exercises that should have been done (23 per session) x 100
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T1: 7 weeks and T0: follow up 7 weeks
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Program satisfaction
Time Frame: T1: 7 weeks
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A questionnaire will be administered to participants to evaluate both their experience and satisfaction with the program, as well as its adverse effects.
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T1: 7 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neurologic Manifestations
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Genetic Diseases, Inborn
- Neurodegenerative Diseases
- Heredodegenerative Disorders, Nervous System
- Spinal Cord Diseases
- Dyskinesias
- Cerebellar Diseases
- Ataxia
- Cerebellar Ataxia
- Spinocerebellar Ataxias
- Spinocerebellar Degenerations
Other Study ID Numbers
Other Study ID Numbers
- 01 (Miami VAHS)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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