Today, neurorehabilitation has become in a widely used therapeutic approach in spinocerebellar ataxias; however, there are scarce powerful clinical studies supporting this notion, and these studies require extension to other specific SCA subtypes in order to be able to form conclusions concerning its beneficial effects. Therefore, in this study, we perform for the first time a case-control pilot randomized, single-blinded, cross-sectional, and observational study to evaluate the effects of physical neurorehabilitation on the clinical and biochemical features of patients with spinocerebellar ataxia type 7 (SCA7) in 18 patients diagnosed with SCA7. In agreement with the exercise regimen, the participants were assigned to groups as follows: (a) the intensive training group, (b) the moderate training group, and (c) the non-training group (control group).
We found that both moderate and intensive training groups showed a reduction in SARA scores but not INAS scores, compared with the control group (p < 0.05). Furthermore, trained patients exhibited improvement in the SARA sub-scores in stance, gait, dysarthria, dysmetria, and tremor, as compared with the control group (p < 0.05). No significant improvements were found in daily living activities, as revealed by Barthel and Lawton scales (p > 0.05). Patients under physical training exhibited significantly decreased levels in lipid-damage biomarkers and malondialdehyde, as well as a significant increase in the activity of the antioxidant enzyme PON-1, compared with the control group (p < 0.05). Physical exercise improved some cerebellar characteristics and the oxidative state of patients with SCA7, which suggest a beneficial effect on the general health condition of patients.
Spinocerebellar ataxia type 7 Physical rehabilitation Neurorehabilitation Cerebellar features Oxidative stress markers
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This paper is dedicated to the patients and members of SCA7-affected families. We also thank Julio C. Rodríguez-Díaz PhD and Emilio Martínez-Cruz MD for technical assistance.
This study was supported by a grant from CONACyT to JJ-M (CB-2015-01-258043).
Compliance with Ethical Standards
The study was approved by the Ethical and Research Committee of the INR-LGII and signed informed consent was obtained from all patients prior to participation. All procedures were carried out according to the Code of Ethics of the Helsinki Declaration.
An informed consent form was signed by all subjects prior to examination and the research protocol was approved by the National Rehabilitation Institute (INR, Mexico City) Research and Ethical Committee.
Conflicts of Interest
The authors declare that they have no conflicts of interest.
Effect of exercise training on extracerebellar features in patients with SCA7. Patients subjected to no training, moderate training, or intensive training were evaluated by INAS at baseline, at 12 weeks, and at 24 weeks of treatment. Black, white, and gray columns represent the no training, moderate training, and intensive training groups, respectively. (PNG 171 kb)
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