Balance, Gait Speed, and Functional Strength in Individuals with Spinocerebellar Ataxia and Healthy Controls: a Cross-Sectional Study on Disease Severity

Equilíbrio, Velocidade da Marcha e Força Funcional em Indivíduos com Ataxia Espinocerebelar e Controles Saudáveis: um Estudo Transversal sobre a Gravidade da Doença

Resumen

Introduction: Despite the importance of assessing functionality in individuals with Spinocerebellar ataxia (SCA), data on performance in these tests are scarce.

Objective: Analyze the performance of these individuals in functional tests and compare them across different levels of dependence and with healthy individuals.

Methods: Thirty-five individuals with SCA and 30 healthy individuals were evaluated using the Five Times Sit to Stand (5TSTS), 10-Meter Walk Test (10MWT), and Functional Reach Test (FRT). Movement patterns during the FRT were analyzed with accelerometry. The Scale for the Assessment and Rating of Ataxia (SARA) determined disease severity. It categorized individuals with SCA into different degrees of dependence on activities of daily living: minimal-moderate (n=11), maximal (n=10), and severe-total dependence (n=12). One-way ANOVA and t-tests were used for analysis.

Results: A main effect of the group was found for all variables (p=0.001). Individuals with SCA performed worse on the 5TSTS, FRT, and 10MWT than controls. On the FRT, controls reached greater distances than the maximal and severe-total dependence subgroups (p<0.001), with the minimal-moderate subgroup performing better than the severe-total subgroup (p=0.003). On the 10MWT, the minimal-moderate subgroup outperformed the maximal and severe-total subgroups (p=0.046). FRT accelerometry revealed a main effect of the group on total movement duration (p=0.003), with the maximal dependence subgroup exhibiting longer durations (p=0.033).

Conclusion: Individuals with SCA exhibit impairments in functional strength, dynamic balance, and gait compared to controls. Disease severity influenced FRT and 10MWT performance, but not 5TSTS. Accelerometry suggests possibly compensatory mechanisms and is affected by disease severity. Further research is necessary.