Skip to main content
SpringerLink
Log in

A wearable proprioceptive stabilizer for rehabilitation of limb and gait ataxia in hereditary cerebellar ataxias: a pilot open-labeled study

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

The aim of this pilot study is to test the feasibility and effectiveness of a wearable proprioceptive stabilizer that emits focal mechanical vibrations in patients affected by hereditary cerebellar ataxias. Eleven adult patients with a confirmed genetic diagnosis of autosomal dominant spinocerebellar ataxia or Friedreich’s ataxia were asked to wear an active device for 3 weeks. Assessments were performed at baseline, after the device use (T1), and 3 weeks after (T2). SARA, 9-HPT, PATA, 6MWT, and spatial and temporal gait parameters, measured with a BTS-G-Walk inertial sensor, were used as study endpoints. As expected, no adverse effects were reported. Statistically significant improvements in SARA, 9HPT dominant hand, PATA test, 6MWT, cadence, length cycle, support right/cycle, support left/cycle, flight right/cycle, flight left/cycle, double support right/cycle, double support left/cycle, single support right/cycle, and single support left/cycle were observed between T0 and T1. All parameters improved at T1 did not show statistically significant differences a T2, with the exception of length of cycle. This small open-labeled study shows preliminary evidence that focal mechanical vibration exerted by a wearable proprioceptive stabilizer might improve limb and gait ataxia in patients affected by hereditary cerebellar ataxias.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jayadev S, Bird TD (2013) Hereditary ataxias: overview. Genet Med 15:673–683

    Article  CAS  PubMed  Google Scholar 

  2. Schniepp R, Wuehr M, Schlick C, Huth S, Pradhan C, Dieterich M et al (2014) Increased gait variability is associated with the history of falls in patients with cerebellar ataxia. J Neurol 261:213–223

    Article  PubMed  Google Scholar 

  3. Schieppati M, Crenna P (1984) From activity to rest: gating of excitatory autogenetic afferences from the relaxing muscle in man. Exp Brain Res 56:448–457

    Article  CAS  PubMed  Google Scholar 

  4. Desmedt JE, Godaux E (1978) Mechanism of the vibration paradox: excitatory and inhibitory effects of tendon vibration on single soleus muscle motor units in man. J Physiol 285:197–207

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Burke D, Hagbarth KE, Lofstedt L, Wallin BG (1976) The responses of human muscle spindle endings to vibration during isometric contraction. J Physiol 261:695–711

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Eklund G (1972) General features of vibration-induced effects on balance. Ups J Med Sci 77:112–124

    Article  CAS  PubMed  Google Scholar 

  7. Courtine G, De Nunzio AM, Schmid M, Beretta MV, Schieppati M (2007) Stance- and locomotion-dependent processing of vibration-induced proprioceptive inflow from multiple muscles in humans. J Neurophysiol 97:772–779

    Article  PubMed  Google Scholar 

  8. Smiley-Oyen AL, Cheng HY, Latt LD, Redfern MS (2002) Adaptation of vibration-induced postural sway in individuals with Parkinson’s disease. Gait Posture 16:188–197

    Article  PubMed  Google Scholar 

  9. Nardone A, Schieppati M (2005) Reflex contribution of spindle group Ia and II afferent input to leg muscle spasticity as revealed by tendon vibration in hemiparesis. Clin Neurophysiol 116:1370–1381

    Article  PubMed  Google Scholar 

  10. Bove M, Nardone A, Schieppati M (2003) Effects of leg muscle tendon vibration on group Ia and group II reflex responses to stance perturbation in humans. J Physiol 550:617–630

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Equistasi website. http://www.equistasi.com/en/. Accessed 13 Dec 2013

  12. Necking LE, Lundstrom R, Dahlin LB, Lundborg G, Thornell LE et al (1996) Tissue displacement is a causative factor in vibration-induced muscle injury. J Hand Surg Br 21:753–757

    Article  CAS  PubMed  Google Scholar 

  13. Alfonsi E, Paone P, Tassorelli C et al (2015) Acute effects of high-frequency microfocal vibratory stimulation on the H reflex of the soleus muscle. A double-blind study in healthy subjects. Funct Neurol 30(4):269–274

    PubMed  Google Scholar 

  14. Volpe D, Giantin MG, Fasano A (2014) A wearable proprioceptive stabilizer (Equistasi®) for rehabilitation of postural instability in Parkinson’s disease: a Phase II Randomized Double-Blind, Double-Dummy, Controlled Study. Quinn TJ, ed. PLoS One 9(11):e112065

    Article  PubMed  PubMed Central  Google Scholar 

  15. Spina E, Carotenuto A, Aceto MG, Cerillo I, Silvestre F, Arace F, Paone P, Orefice G, Iodice R (2016) The effects of mechanical focal vibration on walking impairment in multiple sclerosis patients: a randomized, double-blinded vs placebo study. Restor Neurol Neurosci:1–8 (preprint)

  16. Pazzaglia C, Camerota F, Germanotta M, Di Sipio E, Celletti C, Padua L (2016) Efficacy of focal mechanic vibration treatment on balance in Charcot-Marie-Tooth 1A disease: a pilot study. J Neurol 263(7):1434–1441

    Article  CAS  PubMed  Google Scholar 

  17. ATS statement: guidelines for the six-minute walk test, (2002) ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. Am J Respir Crit Care Med 166(1):111–117

    Article  Google Scholar 

  18. Weyer A, Abele M, Schmitz-Hubsch T, Schoch B, Frings M, Timmann D (2007) Reliability and validity of the scale for the assessment and rating of ataxia: a study in 64 Ataxia patients. Mov Disord 22:1633–1637

    Article  PubMed  Google Scholar 

  19. De Nunzio AM, Nardone A, Picco D, Nilsson J, Schieppati M (2008) Alternate trains of postural muscle vibration promote cyclic body displacement in standing parkinsonian patients. Mov Disord 23:2186–2193

    Article  PubMed  Google Scholar 

  20. Thompson M, Medley A (2007) Forward and lateral sitting functional reach in younger, middle-aged, and older adults. J Geriatr Phys Ther 30:43–48

    Article  PubMed  Google Scholar 

  21. Schmitz-Hübsch T, Fimmers R, Rakowicz M, Rola R, Zdzienicka E, Fancellu R et al (2010) Responsiveness of different rating instruments in spinocerebellar ataxia patients. Neurology 74:678–684

    Article  PubMed  Google Scholar 

  22. Schwesig R, Leuchte S, Fischer D, Ullmann R, Kluttig A (2011) Inertial sensor based reference gait data for healthy subjects. Gait Posture 33:673–678

    Article  PubMed  Google Scholar 

  23. Roll JP, Vedel JP (1982) Kinaesthetic role of muscle afferents in man, studied by tendon vibration and microneurography. Exp Brain Res 47:177–190

    Article  CAS  PubMed  Google Scholar 

  24. Marsden CD, Meadows JC, Hodgson HJ (1969) Observations on the reflex response to muscle vibration in man and its voluntary control. Brain 92:829–846

    Article  CAS  PubMed  Google Scholar 

  25. Kording KP, Wolpert DM (2006) Bayesian decision theory in sensorimotor control. Trends Cogn Sci 10:319–326

    Article  PubMed  Google Scholar 

  26. Lackner JR, Levine MS (1979) Changes in apparent body orientation and sensory localization induced by vibration of postural muscles: vibratory myesthetic illusions. Aviat Space Environ Med 50:346–354

    CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

    Authors and Affiliations

    1. Department of SBMC, Sapienza University Rome, Latina, LT, Italy

      Luca Leonardi, Christian Marcotulli, Giuseppe Arcuria, Mariano Serrao, Paolo Paone & Carlo Casali

    2. Dipartimento di Neuroscienze e Scienze riproduttive ed odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy

      Maria Gabriella Aceto, Alessandro Filla & Alessandro Roca

    3. IRCCS-Neuromed, Pozzilli, IS, Italy

      Francesco Pierelli

    Authors
    1. Luca Leonardi
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Maria Gabriella Aceto
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Christian Marcotulli
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Giuseppe Arcuria
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Mariano Serrao
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Francesco Pierelli
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Paolo Paone
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Alessandro Filla
      View author publications

      You can also search for this author in PubMed Google Scholar

    9. Alessandro Roca
      View author publications

      You can also search for this author in PubMed Google Scholar

    10. Carlo Casali
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Luca Leonardi.

    Ethics declarations

    Conflict of interest

    On behalf of all authors, the corresponding author states that there is no conflict of interest.

    Additional information

    L. Leonardi and M. G. Aceto contributed equally to the manuscript conceiving and writing.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Leonardi, L., Aceto, M.G., Marcotulli, C. et al. A wearable proprioceptive stabilizer for rehabilitation of limb and gait ataxia in hereditary cerebellar ataxias: a pilot open-labeled study. Neurol Sci 38, 459–463 (2017). https://doi.org/10.1007/s10072-016-2800-x

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10072-016-2800-x

    Keywords

    Search

    Navigation