TY - JOUR
T1 - Effects of therapeutic exercise on disease severity, balance, and functional independence among individuals with cerebellar ataxia: A systematic review with meta-analysis
AU - Winser, Stanley John
AU - Chan, Ho Kwan
AU - Chen, Wing Ki
AU - Hau, Chung Hau
AU - Leung, Siu Hang
AU - Leung, Kimmy
AU - Bello, Umar Muhammad
N1 - Funding Information:
The team of authors would like to acknowledge our Research Assistant Ms Joe Wing Pun and Mr Jason for their assistance with data entry and proofreading. This study was funded by the Early Career Scheme, RGC, Hong Kong (Ref: PP6A).
Publisher Copyright:
© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.
PY - 2022/2/25
Y1 - 2022/2/25
N2 - Background: Balance impairments are common in cerebellar ataxia. Exercises are beneficial in this population. Objective: Explore the benefits of therapeutic exercises on disease severity, balance and functional independence in cerebellar ataxia. Methods: Databases were searched from inception until July 2021. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and the Newcastle-Ottawa Scale (NOS); and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Results: Twenty-six studies were included and eight studies of low to high PEDro methodological quality were meta-analyzed. ‘Low’ to ‘moderate’ GRADE quality evidence supports the use of therapeutic exercises to reduce disease severity, assessed using the Scale for the Assessment and Rating of Ataxia [weighted mean difference (WMD): −3.3; 95% confidence interval (95%CI): −3.7, −2.8; p < .01]; and improve balance, assessed using the Berg Balance Scale (WMD: 2.6; 95%CI: 1.1, 4.2; p < .01). The effect of therapeutic exercises on functional independence was insignificant (WMD: 1.6; 95%CI: −1.5, 4.6; p = .31). Conclusion: Low to moderate evidence from studies of low to high methodological quality provides some support for therapeutic exercises for reducing disease severity among non-hereditary degenerative cerebellar ataxia and improving balance among acquired cerebellar ataxia. Exercises did not benefit functional independence. Additional studies of large sample size and high methodological quality are necessary to substantiate these findings.
AB - Background: Balance impairments are common in cerebellar ataxia. Exercises are beneficial in this population. Objective: Explore the benefits of therapeutic exercises on disease severity, balance and functional independence in cerebellar ataxia. Methods: Databases were searched from inception until July 2021. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and the Newcastle-Ottawa Scale (NOS); and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Results: Twenty-six studies were included and eight studies of low to high PEDro methodological quality were meta-analyzed. ‘Low’ to ‘moderate’ GRADE quality evidence supports the use of therapeutic exercises to reduce disease severity, assessed using the Scale for the Assessment and Rating of Ataxia [weighted mean difference (WMD): −3.3; 95% confidence interval (95%CI): −3.7, −2.8; p < .01]; and improve balance, assessed using the Berg Balance Scale (WMD: 2.6; 95%CI: 1.1, 4.2; p < .01). The effect of therapeutic exercises on functional independence was insignificant (WMD: 1.6; 95%CI: −1.5, 4.6; p = .31). Conclusion: Low to moderate evidence from studies of low to high methodological quality provides some support for therapeutic exercises for reducing disease severity among non-hereditary degenerative cerebellar ataxia and improving balance among acquired cerebellar ataxia. Exercises did not benefit functional independence. Additional studies of large sample size and high methodological quality are necessary to substantiate these findings.
KW - Spinocerebellar ataxia, hereditary ataxia, balance exercises, ataxia severity, functional independence
KW - ataxia severity
KW - hereditary ataxia
KW - Spinocerebellar ataxia
KW - balance exercises
KW - functional independence
UR - http://www.scopus.com/inward/record.url?scp=85125955774&partnerID=8YFLogxK
U2 - 10.1080/09593985.2022.2037115
DO - 10.1080/09593985.2022.2037115
M3 - Review article
SN - 1532-5040
JO - Physiotherapy Theory and Pracitce
JF - Physiotherapy Theory and Pracitce
ER -