Highlights
- •Postural instability is a major disability in spinocerebellar ataxia type 3.
- •Patients with spinocerebellar ataxia type 3 show large body sway.
- •Single-centered spatial patterns are predominant in both patients and controls.
- •A larger body sway is not related to the predominance of ankle or hip strategies.
Abstract
Background
Postural instability with an excessive body sway is a disabling manifestation in spinocerebellar
ataxia type 3. Whether the larger body sway reflects distinct movement strategies
for postural control remains uncertain. This study compared the control of postural
stability of people with spinocerebellar ataxia type 3 with healthy subjects using
body sway and movement strategy analyses derived from bi- and three-dimensional posturography.
Methods
Twenty-three patients (7 men, 16 women, 47 ± 11 years) and 102 healthy participants
(34 men, 68 women; 44 ± 22 years) underwent posturography while standing with eyes
open/closed tasks. Postural stability was assessed using elliptical area and average
velocity of body sway. Spatial patterns (single-, double-, or multi-centered) were
derived from the number of high-density regions in the three-dimensional statokinesigram.
Findings
Repeated measures two-way analysis-of-variance showed a vision-by-group interaction
effect for area (F1,122 = 28.831, P < 0.001, η2 = 0.037) and velocity (F1,123 = 59.367, P < 0.001, η2 = 0.073); sway area and velocity were higher in spinocerebellar ataxia type 3 and
increased under eyes-closed condition, with a higher increase in the spinocerebellar
ataxia type 3. A main effect for group (F1,123 = 11.702, P < 0.001, η2 = 0.061) but not vision (F1,123 = 2.257, P = 0.136, η2 = 0.005) was found for the number of high-density regions. Spatial patterns were
different between groups under trials with eyes closed (χ22,125 = 7.46, P = 0.023) but not open (χ22,125 = 2.026, P = 0.363), with a shift from single- to double- or multi-centered spatial patterns.
Interpretation
Compared to healthy subjects, a larger body displacement and velocity in spinocerebellar
ataxia type 3, mainly under visual constraints, are not related to the predominance
of either ankle or hip movement strategies.
Keywords
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References
- Ataxia Rating Scales — Psychometric Profiles, Natural History and Their Application in Clinical Trials.2011https://doi.org/10.1007/s12311-011-0316-8
- Mini Exame Do Estado Mental e O Diagnóstico de Demência no Brasil.Arq. Neuropsiquiatr. 1998; 56: 605-612https://doi.org/10.1590/S0004-282X1998000400014
- Atendimento Fisioterapêutico para Indivíduos com Ataxia Espinocerebelar: Uma Revisão da Literatura.Rev. Neurociências. 2013; 21: 126-135https://doi.org/10.4181/RNC.2013.21.777.10p
- The effect of a constraint on the maximum number of controls matched to each treated subject on the performance of full matching on the propensity score when estimating risk differences.Stat. Med. 2021; 40: 101-118https://doi.org/10.1002/sim.8764
- Postural responses to multidirectional stance perturbations in cerebellar ataxia.Exp. Neurol. 2006; 202: 21-35https://doi.org/10.1016/j.expneurol.2006.05.008
- Postural tasks are associated with center of pressure spatial patterns of three-dimensional statokinesigrams in young and elderly healthy subjects.Hum. Mov. Sci. 2013; 32: 1325-1338https://doi.org/10.1016/j.humov.2013.06.005
- Measuring balance in the elderly: validation of an instrument.Can. J. Public Health. 1992; 83: S7-11
- Translation and validation into Brazilian version of the Scale of the Assessment and Rating of Ataxia (SARA).Arq. Neuropsiquiatr. 2010; 68: 228-230https://doi.org/10.1590/s0004-282x2010000200014
- Stance instability in spinocerebellar ataxia type 6.Mov. Disord. 2013; 28: 510-516https://doi.org/10.1002/mds.25163
- Visuo-postural dependency index (VPDI) in human postural control.BMC Sports Sci. Med. Rehabil. 2021; 13: 7https://doi.org/10.1186/s13102-021-00235-x
- Dynamic gait index - Brazilian version.Braz. J. Otorhinolaryngol. 2006; 72: 817-825https://doi.org/10.1590/S0034-72992006000600014
- Augmented movement strategies for postural control in patients with spinocerebellar ataxia type 3: a case-control study.Rev. Bras. Neurol. 2016; 52: 18-26
- Test-retest reliability for assessment of postural stability using center of pressure spatial patterns of three-dimensional statokinesigrams in young health participants.J. Biomech. 2014; 47: 2919-2924https://doi.org/10.1016/j.jbiomech.2014.07.010
- Revisão sobre posturografia baseada em plataforma de força para avaliação do equilíbrio.Rev. Bras. Fis. 2010; 14: 183-192https://doi.org/10.1590/S1413-35552010000300003
- “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.J. Psychiatr. Res. 1975; 12: 189-198https://doi.org/10.1016/0022-3956(75)90026-6
- Gait adaptability training improves obstacle avoidance and dynamic stability in patients with cerebellar degeneration.Gait Posture. 2014; 40: 247-251https://doi.org/10.1016/j.gaitpost.2014.04.190
- Compared to what? Finding controls for case-control studies.Lancet. 2005; 365: 1429-1433https://doi.org/10.1016/S0140-6736(05)66379-9
- A method for the display of balance center of pressure data.J. Biomech. 1982; 15: 741-745https://doi.org/10.1016/0021-9290(82)90088-4
- Cervical receptors and the direction of body sway.Arch. Otorhinolaryngol. 1989; 246: 61-64https://doi.org/10.1007/BF00454137
- Intensive coordinative training improves motor performance in degenerative cerebellar disease.Neurology. 2009; 73: 1823-1830https://doi.org/10.1212/WNL.0b013e3181c33adf
- Spinocerebellar ataxia.Nat. Rev. Dis. Prim. 2019; 5: 24https://doi.org/10.1038/s41572-019-0074-3
- Cerebellar transcranial direct current stimulation in spinocerebellar ataxia type 3 (SCA3-tDCS): rationale and protocol of a study.Nat. Rev. Dis. Prim. 2013; 18: 433-442https://doi.org/10.1007/s12311-011-0316-8
- Quantitative assessment of postural instability in spinocerebellar ataxia type 3 patients.Ann. Clin. Transl. Neurol. 2020; 7: 1360-1370https://doi.org/10.1002/acn3.51124
- The assessment and treatment of postural disorders in cerebellar ataxia: a systematic review.Ann. Phys. Rehabil. Med. 2014; 57: 67-78https://doi.org/10.1016/j.rehab.2014.01.002
- Therapies for ataxias.Curr. Treat. Options Neurol. 2014; 16: 300https://doi.org/10.1007/s11940-014-0300-y
- Abordagem fisioterapêutica da ataxia espinocerebelar: uma revisão sistemática.Fisioter. e Pesqui. 2013; 20: 293-298https://doi.org/10.1590/S1809-29502013000300015
- Brazilian version of the Berg balance scale.Braz. J. Med. Biol. Res. 2004; 37: 1411-1421https://doi.org/10.1590/S0100-879X2004000900017
- Stance instability in preclinical SCA1 mutation carriers: a 4-year prospective posturography study.Gait Posture. 2017; 57: 11-14https://doi.org/10.1016/j.gaitpost.2017.05.007
- Calculation of area of stabilometric signals using principal component analysis.Physiol. Meas. 1996; 17: 305-312https://doi.org/10.1088/0967-3334/17/4/008
- Standardized assessment of hereditary Ataxia patients in clinical studies.Mov. Disord. Clin. Pract. 2016; 3: 230-240https://doi.org/10.1002/mdc3.12315
- Efeito da reabilitação vestibular em idosos: quanto ao equilíbrio, qualidade de vida e percepção.Cien. Saude Colet. 2010; 15: 2805-2814https://doi.org/10.1590/s1413-81232010000600018
- The assessment of body sway and the choice of the stability parameter(s).Gait Posture. 2005; 21: 48-58https://doi.org/10.1016/j.gaitpost.2003.11.006
- A cross-sectional validation study of the FICSIT common data base static balance measures.J. Gerontol. Ser. A Biol. Sci. Med. Sci. 1995; 50A: M291-M297https://doi.org/10.1093/gerona/50A.6.M291
- A public data set of human balance evaluations.PeerJ. 2016; 4e2648https://doi.org/10.7717/peerj.2648
- Uses of the postural stability test for differential diagnosis of hereditary ataxias.J. Neurol. Sci. 2012; 316: 79-85https://doi.org/10.1016/j.jns.2012.01.022
- Application of a scale for the assessment and rating of Ataxia (SARA) in Friedreich’s ataxia patients according to posturography is limited.J. Neurol. Sci. 2014; 341: 64-67https://doi.org/10.1016/j.jns.2014.04.001
- Clinical stabilometry standardization.Gait Posture. 2013; 37: 290-292https://doi.org/10.1016/j.gaitpost.2012.07.009
- Spinocerebellar ataxia: an update.J. Neurol. 2019; 266: 533-544https://doi.org/10.1007/s00415-018-9076-4
- Strengthening the reporting of observational studies in epidemiology (STROBE).Epidemiology. 2007; 18: 805-835https://doi.org/10.1097/EDE.0b013e3181577511
- Estimation procedures affect the center of pressure frequency analysis.Braz. J. Med. Biol. Res. 2009; 42: 665-673https://doi.org/10.1590/S0100-879X2009000700012
- Health Research Methodology: A Guide for Training in Research Methods.2nd ed. World Health Organization, Geneva2001
- Reabilitação vestibular com realidade virtual na ataxia espinocerebelar.Audiol. - Commun. Res. 2013; 18: 143-147https://doi.org/10.1590/S2317-64312013000200013
Article Info
Publication History
Published online: June 23, 2022
Accepted:
June 21,
2022
Received:
October 7,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
