Herdiman Bernard Purba

By Kevin Triangto, Steven Setiono and Herdiman Bernard Purba

Spinocerebellar Ataxia (SCA) is an autosomal dominant disease with progressive decline towards functional capacity. Although studies had shown that there are various SCA types, physical medicine and rehabilitation approach would focus mostly on functional aspects in each individuals. Analysis through International Classification of Functioning, Disability, and Health would assist clinicians to identify activity and participation aspects of SCA, mostly revolves around mobility function. Good correlation of mobility with quality of life was also reported, and thus it is only natural that this becomes the main focus of rehabilitative intervention. Approximately one hour physical exercise session focusing on postural control and balance was proven to be effective in improving disease related measurement tool, functional capacity, and quality of life. These benefits could be improved through newer therapies such as exercise games and virtual reality, virtually creates a rapidly changing environment, thus providing training through anticipatory actions. It is speculated that neuroplasticity through self-recognition of errors are the main physiology of recovery in SCA. Finally, it could be seen that rehabilitation intervention remains to be a cornerstone in current ataxia therapy, with goals of achieving exercise gains while alleviating the natural functional decline of the disease.

Part of the book: Spinocerebellar Ataxia