A randomized controlled pilot trial of game-based training in individuals with spinocerebellar ataxia type 3

Ray-Yau Wang, Fang-Yi Huang, Bing-Wen Soong, Shih-Fong Huang, Yea-Ru Yang
2018 Scientific Reports  
Exergames are interactive video games used for exercise and may have therapeutic value in people with degenerative ataxia. The purpose of this study was to investigate potential effects of exergaming training on cerebellar ataxia in people with spinocerebellar ataxia type 3 (SCA3). Nine individuals with SCA3 were recruited and randomized to either exergaming or conventional group for a 4-week training period. The severity of ataxia was measured as the primary outcome by the Scale for the
more » ... ent and Rating of Ataxia (SARA) and by the directional control of the limit of stability test. The secondary outcomes included upper-limb function and gait performance. After training, participants in the exergaming group had a significant decrease in the total SARA score and the gait-posture SARA subscore. Participants in the conventional training group did not show a significant improvement in selected outcome measures after the 4-week training period. No significant difference was found between groups for any of these measures. Our results suggested that the exergaming training program significantly decreased ataxia. These results support implementation of exergaming training for people with SCA3. Spinocerebellar ataxia (SCA) is an autosomal, dominantly inherited neurodegenerative disease with multiple subtypes. More than 30 genetic subtypes have been described. The most common subtypes are SCA type 3 (SCA3) in many countries 1,2 . SCA3 is characterized by slowly progressive gait ataxia and is often associated with truncal ataxia, limb ataxia, and dysarthria 3 . There is no effective pharmacologic treatment for decreasing the ataxia or disease progression, although, physical therapy plays an important role in controlling ataxia and improving or maintaining function through exercise training 4 . In general, physical therapy programs for degenerative cerebellar ataxia are based on intensive static and dynamic balance and coordination exercises 5 . There is some evidence that such therapeutic exercise training alleviates ataxic symptoms and improves functional activities in people with cerebellar ataxia 6-10 . A recent systematic review suggested that the use of virtual reality tools appears to have therapeutic value in people with degenerative ataxia 5 . Exergames are video games that incorporate virtual reality and serve as an exercise tool. These video games usually involve balance and coordination challenges and help facilitate the participants' adherence to the intervention. Exergames could present a novel, advantageous treatment tool for training individuals with SCA 10 . A previous study evaluated the effects of an 8-week balance and coordination training program (addressing ataxia, balance, and gait) using Microsoft Xbox Kinect video games in children with progressive SCA 11 . This single-group study showed that the video game-based coordinative training alleviated several signs of ataxia in adolescents with progressive ataxia 11 . Recently, we developed a balance-based exergaming program and demonstrated that it had a positive effect on postural stability in people with Parkinson's disease 12 . In the present study, we modified that program, adding elements for coordinative training. We conducted Published: xx xx xxxx OPEN www.nature.com/scientificreports/ 2 SCIeNTIfIC REPORTS | (2018) 8:7816 |
doi:10.1038/s41598-018-26109-w pmid:29777115 pmcid:PMC5959926 fatcat:dakdka3yfvhynfmc4vbkqqugli