Movement coordination disorder (PCD) — this is a disorder of the processes of coordination of muscle activity when performing movements. One of the forms of PCD is ataxia. The condition is observed when the cerebellum, frontal lobes, leading pathways of proprioceptive (deep) sensitivity are affected. The pathology manifests itself through a disorder of coordination of movements (dynamic ataxia) or a violation of balance in a standing position (static ataxia). Moderate dynamic ataxia is characterized by a lack of smoothness and accuracy of movements. With moderate static ataxia, the ability to maintain a normal body position at rest is lost.
Hereditary ataxias are also divided into several types: Friedreich, Pierre Marie, Louis-Bar syndrome and others.
Signs of spinocerebellar ataxia — tremor, dysarthria (slurred speech), change in handwriting (letters of different sizes), dysdiadochokinesis (inability to quickly perform alternating movements).
Patients with cerebellar ataxia have problems with determining the direction, speed, and rhythm of muscle contractions, which are visible in an unstable gait. Late cerebellar ataxia in an adult is characterized by dysarthria and dysphagia (swallowing disorder). Violations depend on which structures of the cerebellum were damaged and the type of damage (bilateral or unilateral). The initial symptoms manifest themselves through a disorder of static coordination, such as the inability to stand on one leg. As the disease progresses, there is a feeling of impaired coordination of movements when walking. The gait is characterized by high lifting of the leg and jerks from side to side.
Symptoms of sensitive ataxia — gait with ""stomping"", with heavy heel strikes, as well as postural instability (inability to maintain balance in any position).
Symptoms of vestibular ataxia — it is a unique combination of nystagmus (involuntary oscillating movements of the eyes around one or more axes), strabismus and diplopia (double vision). Vision disorders are among the early symptoms of pathology, which can appear in childhood. Movement coordination disorders are usually observed between the ages of 30 and 60. Patients experience bouts of dizziness and ringing in the ears when changing the position of the head. The diagnosis of vestibular ataxia is based on the results of neuroimaging studies (CT, MRI).
Methods of therapy for ataxia and their effectiveness depend on the underlying cause that caused this condition. Treatment of impaired coordination of movements in brain damage in the elderly can reduce the manifestation of ataxia, but not completely eliminate the problem. The results of therapy are more noticeable in patients with one focal damage (for example, a stroke or a benign tumor). In people with degenerative diseases of the central nervous system, therapy is less effective.
Treatment of cerebellar ataxia is complex — this is the reception of pharmacological drugs, supplemented by a set of special exercises. To improve the condition of patients with a diagnosis of ""impaired coordination of movements"" appoint:
Physical rehabilitation contributes to the adaptation of activity and facilitating motor learning. For cerebellar ataxia, Frenkel exercises, proprioceptive neuromuscular facilitation (PNF) and balance training are indicated.
Scientific studies show that if a person can walk, physical rehabilitation should include an exercise program with the following components:
When the patient can perform the exercises independently and safely, the doctor will advise them to perform them at home. Systematic performance of a complex of exercises contributes to further improvement of the condition. To prevent the risk of falling due to imbalance or poor coordination, patients are recommended to use a cane or a walker. Ataxia can lead to severe disability requiring the use of a wheelchair, so in addition to ataxia therapy, measures to increase muscle strength and general endurance are also necessary.
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