Exercise and Physical Therapy Interventions for Children with Ataxia: A Systematic Review

Helen Hartley, Elizabeth Cassidy, Lisa Bunn, Ram Kumar, Barry Pizer, Steven Lane, Bernie Carter, Helen Hartley, Elizabeth Cassidy, Lisa Bunn, Ram Kumar, Barry Pizer, Steven Lane, Bernie Carter

Abstract

The effectiveness of exercise and physical therapy for children with ataxia is poorly understood. The aim of this systematic review was to critically evaluate the range, scope and methodological quality of studies investigating the effectiveness of exercise and physical therapy interventions for children with ataxia. The following databases were searched: AMED, CENTRAL, CDSR, CINAHL, ClinicalTrials.gov, EMBASE, Ovid MEDLINE, PEDro and Web of Science. No limits were placed on language, type of study or year of publication. Two reviewers independently determined whether the studies met the inclusion criteria, extracted all relevant outcomes, and conducted methodological quality assessments. A total of 1988 studies were identified, and 124 full texts were screened. Twenty studies were included in the review. A total of 40 children (aged 5-18 years) with ataxia as a primary impairment participated in the included studies. Data were able to be extracted from eleven studies with a total of 21 children (aged 5-18 years), with a range of cerebellar pathology. The studies reported promising results but were of low methodological quality (no RCTs), used small sample sizes and were heterogeneous in terms of interventions, participants and outcomes. No firm conclusions can be made about the effectiveness of exercise and physical therapy for children with ataxia. There is a need for further high-quality child-centred research.

Keywords: Ataxia; Exercise; Paediatrics; Physical therapy; Systematic review.

Conflict of interest statement

Helen Hartley, Elizabeth Cassidy and Lisa Bunn are chartered physiotherapists. As professionals who may be involved in the delivery of exercise interventions, it is plausible that they may be seen to have a bias favouring the effectiveness of exercise interventions. The authors confirm no other conflicts of interest.

Figures

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Fig. 1
PRISMA flow diagram: search results

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