The effects of functional trunk training on trunk control and upper extremity functions in patients with autosomal recessive hereditary ataxia

This study was performed to examine the effects of functional trunk training on trunk control, postural sway and upper limb functions in patients with autosomal recessive hereditary ataxia. Twenty patients included in the study were divided into two groups (n=10 each), treatment and control groups. While a rehabilitation program consisting of trunk stabilization and balance exercises were applied to both groups, a rehabilitation program to activate the trunk muscles was applied to the treatment group additionally in accordance with the principles of the Neurodevelopmental Treatment. The treatment group received trunk stabilization training for 2 days a week and functional trunk training once a week and control group received trunk stabilization training for 3 days a week, for a total of 8 weeks. The International Ataxia Rating Scale was used for the assessment of the severity of ataxia, the Trunk Impairment Scale and Functional Reach Test for trunk control, Microgate Gyko for postural sway, Nine-Hole Peg Test and Quick Disabilities of the Arm Shoulder and Hand questionnaire for upper limb functions, the Pediatric Quality of Life Inventory for quality of life and the Functional Independence Measure for Children for functional independence levels for both groups at baseline. Improved trunk control, increased upper limb functions and reduced postural sway were observed in the treatment group (p<0.05). There was no significant difference between the groups in terms of trunk control, upper limb functions and postural sway (p>0.05). The treatment group showed an increase in the upper limb performance bilaterally, whereas increased performance was seen only in the dominant upper limb in the control group (p<0.05). While dynamic trunk balance improved in the AP and ML directions in the treatment group, it was improved only in the AP direction in the control group (p<0,05). Postural sway showed improvement in the ML direction in the treatment group and in the AP direction in the control group (p<0.05). Functional trunk training was found to be a more effective method to improve non-dominant upper limb performance, dynamic trunk balance in the ML direction and postural sway. Functional trunk training may be used as a supportive treatment method to improve upper extremity functions, trunk control and postural sway in hereditary ataxia.