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Physical Therapy and Rehabilitation in Patients with Degenerative Cerebellar Diseases: Current Evidence and Future Direction

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Neurodegenerative Disorders as Systemic Diseases

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Abstract

After brain damage, use-dependent plasticity of the spared neural network plays a crucial role in improving neural deficits and promoting motor learning and relearning using the impaired limbs. In degenerative cerebellar diseases, it is to be elucidated whether a similar mechanism works or not, since pathological processes are basically progressive. The fundamental question regarding the efficacy of neurorehabilitation in cerebellar degenerative diseases, is whether it is beneficial in terms of both the short- and long-term effect. To answer this question, two important issues need to be considered. The first is whether impaired motor learning due to cerebellar dysfunction is compensated for by repeated practice, since the cerebellum plays a crucial role in motor learning. The second issue is how long functional gains can be sustained provided that intensive rehabilitation results in significant gains. Recent studies have shown that intensive rehabilitation focusing on balance and mobility improves motor function for a period of up to 1 year in patients with degenerative cerebellar diseases. To obtain meaningful long-term gains, a combination of intermittent intensive short-term rehabilitation and home-based practice and support may be a practical way of managing patients. Future studies may elucidate a potential role of neuromodulation coupled with rehabilitative intervention to enhance the gains and to minimize functional decline.

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  1. Neurorehabilitation Research Institute, Morinomiya Hospital, 2-1-88, Morinomiya, Joto-ku, Osaka, 536-0025, Japan

    Ichiro Miyai

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Correspondence to Ichiro Miyai .

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  1. National Center of Neurology and Psychiatry, Kodaira, Japan

    Keiji Wada

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Miyai, I. (2015). Physical Therapy and Rehabilitation in Patients with Degenerative Cerebellar Diseases: Current Evidence and Future Direction. In: Wada, K. (eds) Neurodegenerative Disorders as Systemic Diseases. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54541-5_10

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