Training balance with opto-kinetic stimuli in the home: a randomized controlled feasibility study in people with pure cerebellar disease

Abstract

Objective:

To investigate the feasibility of a randomized controlled trial of a home-based balance intervention for people with cerebellar ataxia.

Design:

A randomized controlled trial design.

Setting:

Intervention and assessment took place in the home environment.

Participants:

A total of 12 people with spinocerebellar ataxia type 6 were randomized into a therapy or control group. Both groups received identical assessments at baseline, four and eight weeks.

Interventions:

Therapy group participants undertook balance exercises in front of optokinetic stimuli during weeks 4–8, while control group participants received no intervention.

Main measures:

Test–retest reliability was analysed from outcome measures collected twice at baseline and four weeks later. Feasibility issues were evaluated using daily diaries and end trial exit interviews.

Results:

The home-based training intervention with opto-kinetic stimuli was feasible for people with pure ataxia, with one drop-out. Test–retest reliability is strong (intraclass correlation coefficient >0.7) for selected outcome measures evaluating balance at impairment and activity levels. Some measures reveal trends towards improvement for those in the therapy group. Sample size estimations indicate that Bal-SARA scores could detect a clinically significant change of 0.8 points in this functional balance score if 80 people per group were analysed in future trials.

Conclusions:

Home-based targeted training of functional balance for people with pure cerebellar ataxia is feasible and the outcome measures employed are reliable.