Evaluation of the gait and posture in patients with ataxia

Introduction: Ataxia is a lack of movement coordination in the absence of primary motor dysfunction. It is usually due to lesions of cerebellum, spinal cord and/or peripheral sensory system. This study is planned to evaluate the features of gait and postural stability in patients with spinocerebellar ataxia during dual and multipl task interferance.Method: Thirty patients (15 male) with spinocerebellar ataxia who were followed at the Cukurova University School of Medicine Neurology clinic were enrolled in this study. The control group included 30 healthy subjects. We performed complete neurological exam and Mini Mental Status test for each subject. International Cooperative Ataxia Rating Scale and Tinetti Balance Scale were applied. Then gait tests which were planned for double task interference were carried out in each subject. The changes in the gait speed and step frequency were evaluated during additional motor, cognitive and simultaneous motor and cognitive tasks. After that, static posturography was performed with eyes open, eyes closed and eyes closed together with a cognitive task. The SPSS 16 was used for statistical analysis.Results: In ataxic patients the gait speed decreased and the step frequency increased in relation to the number and type of the additional task. Cognitive task slowed the gait speed more than the motor task in these patients. Postural stability was significantly impaired in patients with ataxia compared to the healthy subjects. It was particularly abnormal with eyes closed. However cognitive task did not have an additional effect on the postural stability in both groups with eyes closed. Furthermore, polyneuropathy altered the postural stability, but not the gait speed.Conclusions: Further gait disturbance occurs in patients with ataxia when the patients were expected to complete additional tasks simultaneously. This depends on the type and the number of task. Moreover postural stability was significantly impaired with the elimination of visual inputs and in the presence of polyneuropathy. In order to improve the quality of life in patients with ataxia, we should find better strategies to eliminate the negative impact of multi tasking on the gait and postural stability. For that, new studies must be designed to determine other factors, which may impair the gait and postural balance in patients with ataxia.Key Words: Double task interference, gait, multiple task interference, posturography,Spinocerebellar ataxia.