About physical therapy

hi there , i’m a relative of a person who was diagnosed with SCA about 10 months ago , i would like to ask about the effectiveness of physical therapy ,what does it do .Does it actually slow down the disease or just helps with alleviating the symptoms ?

Speaking for myself, physical therapy can help with managing symptoms-practicing alternative ways of doing the same movements (like getting into a shower, getting up from a chair, etc). PT can also help with strengthening your core muscles which can help you balance better. But it doesn’t work for everyone. PT doesn’t slow the progression of the condition but rather helps some balance and ADL skills. Oh, I have Cerebellar Ataxia.

thanks for the response lin-da , glad to speak with you again :slightly_smiling_face:

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Hi😊 You’ll be able to read reliable information about various types of ataxia on www.ataxia.org There are helpful Fact Sheets relating to popular questions, medication etc. As well as links to individual ataxia Support Groups (by State) and much more :blush:xB

Hello Beryl_Park, thank you, I will

PT for me was only a few sessions (luckily). Depending on where you live or if you have insurance coverage for this, it can be financially overwhelming. PT taught me many exercises and routines to complete at home (do with a partner for safety). PT can be very effective for ataxic folks, done properly.
I personally would not spend a lot on going to sessions for PT because there are so may exercises you can do on your own. It does not slow the progression of the condition, however, it most certainly helps with the physical aspect and in some cases may help mentally. If the patient notices some benefits from PT, they may be better equipped to handle the emotions that go with ataxia.
Best of luck!

thanks Dave ,i have some exercises that i got from an ataxia website ,do you think they would be enough , or do i have to check with a therapist to get the needed effective exercises ?and since the PT doesn’t slow it down , what does it do ,how does it benefit you ?

PT was about the same as Linda’s comments. PT doesn’t improve but they help with the correct way of doing things and the exercises should work on your core (shoulders to butt). I found that PT changed my life because the things they gave me improved HOW I was doing things so I’m off balance less.
Make sure the PT person works with neurological not orthopedic. I found out the hard way that the orthopedic PT person does not refer you to the neurologic PT. I have SCA type 2.

thanks again Kay2, that was important , so far i learned that all kinds of therapy so not slow progression , PT does not improve balance but rather tells you how to do things to adapt to balance problems , and that orthopedic PT is no good , only neurologic PT , is that a correct summary so far ?

It may be something to try some exercises on your own, make sure they are safe and target the correct areas (core). Otherwise you can learn how to properly do the exercises from a PT. This is important as it may be useless to target the wrong areas of your body.
Each individual is different and the exercises may need some “tweeking” according to your specific stage of progression, your capabilities, this is where the PT did customize some exercises for me. PT should help strengthen your core body to help accommodate for the ataxia. Like RR1234 said orthopedic PT will not really help as it doesn’t really target the correct areas. As Kay mentioned, make sure the PT knows this is a neurological condition. My PT kept in mind safety, my abilities, and altered the exercises to suit my condition.
In my case I made sure that my PT knew what my condition was, how it effected my gait, what I expected from the PT (no need for a long drawn out process). She took my needs and researched the condition and made a list off exercises to suit. Then she showed me the proper way to execute them. And in a few sessions I was on my own.
Some of the exercises I can do on my own, and some I need a partner. For the most part I see some improvements with respect to balance. However, I know I will never be running marathons! I don’t expect miracles, just benefits.
This was my experience, I hope this helps you.

thank you very much for the info Dave , did you hear about these studies that have been done where they see short term improvement of balance itself after like 4 or 6 weeks of intensive work out and balance exercises , but then after the intervention , the patients go back to where they were before .This could mean that intensive correct exercises could improve patients somehow ,here’s the pdf article : Motor Training in SCA yields temporary improvments.pdf (2.7 MB)

Interesting. This article further goes to show that it truly does depend on what causes damage to the cerebellum in first place. Certainly reiterates that ataxians regardless of their prognosis, benefit from some form of PT.
There are so many factors to consider as to whether PT will be of benefit specifically to individual situations. I suppose there comes a point when trial & error is a persons only hope.

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yeah that’s what i guess .In any cases PT is important .

Balance exercises are very helpful. I wish Heinrich Frenkel’s protocols were more widely used today. His work was in Germany in the late 1800s to 1904 when he wrote a book with extensive illustrations of the exercises. The challenge, as he put it, was getting a patient to have a ‘devotion’ to do the exercises…as many as a thousand repetitions. He included accounts of individuals coming to him in wheelchairs and not able to work, and, after following his protocols, they were than able to be out of the wheelchair and back to work again. If anyone wants the title, let me know. JD

senior48, thanks for that, i heard of Frenkel exercises too , i’m not sure whether they would help or not in case of cerebellar degeneration , but i’d love to know more, can you please give me the title ?

Ready for a mouthful? “The Treatment of Tabetic Ataxia by Means of Systematic Exercise and Exposition of the Principles and Practice of Compensatory Movement Treatment” by Heinrich S. Frenkel. I found it on www.abebooks.com It’s printed by a company in India. Takes a couple of weeks to receive a copy. There are numerous photos and illustrations. There are exercises for both the lower and upper body. JD

thank you senior48, do you think it works for degenerative ataxia ?

I’ll read his first chapter and let you know…JD