Session Information
Date: Wednesday, June 22, 2016
Session Title: Ataxia
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: This case report describes the use of sensory augmentation and an exercise routine to improve balance and gait in a patient with lithium-induced ataxia. In addition, compare the condition of balance and gait before and after using the Balance Wear Therapy. It reports results after 12 months of evolution and proposed a design evaluation and physiotherapy treatment.
Background: Lithium administration is a common treatment for people with bipolar disease, and can result in lithium-toxicity. This patient is a 52-year-old male with 21-month history of ataxia resulting from lithium intoxication and rehabilitation to improve gait and balance in Chile. Previous medical history includes diabetes, and bipolar disorder. Patient goals were to improve gait and balance.
Methods: The patient begins his physiotherapy treatment in Clinica Alemana in December 2014. In July 2015 go to the United States to access Balance Wear Therapy (BTW). The patient continues training of balance and gait in Chile using the BTW every day with a workout designed to improve amplitude of movements and dynamic postural control. The patient have been evaluated each month with clinical scales from the beginning of treatment. The scales used were: Minibestest, Berg Balance Scale, Modified Motor Assessment Scale, Functional Gait Assessment, International survey of perceived risk of falls and dynamic posturography before and after BTW.
Results: Gait velocity increased by 0.15 m/s.
| IWalk Measure | Value: Day 1 with BWT | Value Day 4 with BWT | Normal Range | % change |
| Sride length (m) | 48.3 (+1.91) | 56.6 (*1.61) | 79.2-93.1 | 15 |
| Stride velocity (m/s) | 0.576 | 0.729 | 0 | 21 |
| Cadence (steps/min) | 79.4 | 85.7 | 106-132 | 8.6 |
| Gait cycle time (s) | 1.52 | 1.4 | 0.909-1.14 | 8.0 |
| Double support | 42.5 | 37.8 | 17.2-27 | 12 |
| Stance (%) | 28.8(-0.317) | 31.1(-0.822) | 36.5-41.4 | 0 |
| Peak arm swing ( degrees/s) | 71.2 (+0.317) | 68.9 (*0.822) | 58.6-63.5 | 3.0 |
| Peak arm Swing ( dregrees/s) | 68.4 (-5.81) | 90.4 (-6.8) | 129-280 | 24 |
| ROM arm (degrees) | 8.07 (-0.618 | 12.6 (+3.66 | 5.96-27.4 | 36 |
| Scales | December 2014 | July 2015 ( Before BTW) | July 2015 ( After BTW) | December 2015 ( Without BTW) |
| Minibestest | 3 | 19 | 25 | 26 |
| Berg Balance Scale | 43 | 48 | 52 | 53 |
| Modified Motor Assessment Scale | 44 | 44 | 45 | 46 |
| Functional Gait Assessment | 0 | 9 | 20 | 25 |
| International Survey of perceived risk of falls | 64 | 56 | 48 | 28 |
Conclusions: BTW, a form of sensory, augmentation appeared to assist this patient with ataxia in balance, gait and confidence. While the physical to improve range and accuracy of movement exercise has been a factor of significant change in the balance and gait, more research is needed to identify a dosage of exercise in order to know their real impact on brain plasticity. More research should be done in patients with ataxia.
To cite this abstract in AMA style:
M.D. Maldonado. Relationship between sensory augmentation and exercise routine in the improvement in balance and gait in a patient with lithium-induced ataxia [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/relationship-between-sensory-augmentation-and-exercise-routine-in-the-improvement-in-balance-and-gait-in-a-patient-with-lithium-induced-ataxia/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-sensory-augmentation-and-exercise-routine-in-the-improvement-in-balance-and-gait-in-a-patient-with-lithium-induced-ataxia/