Objective: In ambulant EOA children, we aimed to study the effect of a medically designed “ice-skating exergame” on balance, posture and muscle force parameters

Background: Non-lesional cerebellar Early Onset Ataxia (EOA) concerns a heterogeneous group of progressive disorders with limited therapeutic options. Recent EOA studies have shown that exergame (video-game) training may improve motor coordination, but the underlying mechanism is unclear. If cerebellar motor learning is involved, we hypothesized that exergame training would improve cerebellar parameters, independent of muscle force alterations.

Method: We included 5 ambulant age-matched EOA children and controls (age range: 4-9 years). Each child completed home-based exergame training sessions (duration: 30 minutes, frequency: 3x/week, period: 6 weeks). We determined the training effect on: 1. Scale for Assessment and Rating of Ataxia (SARA, -total and –posture) scores, 2. Pediatric Balance Scale (PBS) scores, 3. muscle force alterations (i.e. altered muscle force ≥ ± 1 SD) and 4. personal goal attainment scores (GAS).

Results: Included children revealed “improved” calculated median points of: SARA-total and -posture: -1(-6 to -1) and -1 (-3 to -1) versus 0 (-2 to 0) and 0 (-2 to 0); PBS 3 (-3 to 11) versus 0 (1 to 0) and GAS: 2 (0 to 2) versus n.a., [median (range); EOA versus controls, respectively]. Muscle force did not change

Conclusion: In EOA children, ice-skating exergame data revealed a potentially beneficial effect on balance and posture, independent of muscle force. Since the motor learning effect seems stronger in children with cerebellar pathology than in controls, it is tempting to speculate that other mechanisms (such as prefrontal visual-motor compensation) could be involved. Hopefully, our future data will elucidate this.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exergame-training-in-early-onset-ataxia-patients/