Skip to main content
SpringerLink
Log in

Turning strategies in patients with cerebellar ataxia

  • Research Article
  • Published:
Experimental Brain Research Aims and scope Submit manuscript

Abstract

Turning while walking is a common but demanding task requiring modification of the motor program from linear walking to lateral turning and it is associated with a high risk of falls. Patients with cerebellar ataxia have unstable gait and report a high incidence of falls. In the present study, we investigated the motor strategies adopted by ataxic patients when performing turns of different degrees and directions of rotation. Ten ataxic patients and 10 controls were analyzed while performing 30°/90° turns to the right/left. We recorded the number of completed turn tasks, the number of steps needed, and the time taken to complete the task, time–distance parameters and the onset of head, trunk and pelvis reorientation. The ataxic patients were less able to complete 90° turns, displayed a greater stride width, shorter step length, and greater number of steps when turning, and were unable to flexibly adjust their stride width across the turning task. The duration of the turning task and of the segmental reorientation did not differ from control values. Our findings indicate that ataxic patients have more difficulties in performing large turns and adopt a series of compensatory strategy aimed at reducing the instability associated with turning, such as enlarge the base of support, shorten the step length, increase the number of steps, and use the “multi-step” rather than the “spin-turn” strategy. Given the high risk of falls related to this task, it would be useful to include turning training in the rehabilitation protocol of ataxic patients.

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
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Akram SB, Frank JS, Fraser J (2010) Effect of walking velocity on segment coordination during pre-planned turns in healthy older adults. Gait Posture 32(2):211–214

    Article  PubMed  Google Scholar 

  • Barak Y, Wagenaar RC, Holt KG (2006) Gait characteristics of elderly people with a history of falls: a dynamic approach. Phys Ther 86(11):1501–1510

    Article  PubMed  Google Scholar 

  • Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54(4):343–349

    Article  PubMed  CAS  Google Scholar 

  • Crenna P, Carpinella I, Rabuffetti M, Calabrese E, Mazzoleni P, Nemni R, Ferrarin M (2007) The association between impaired turning and normal straight walking in Parkinson’s disease. Gait Posture 26(2):172–178

    Article  PubMed  CAS  Google Scholar 

  • Cumming RG, Klineberg RJ (1994) Fall frequency and characteristics and the risk of hip fractures. J Am Geriatr Soc 42(7):774–778

    PubMed  CAS  Google Scholar 

  • Davis RB, Ounpuu S, Tyburski D, Gage JR (1991) A gait analysis data collection and reduction technique. Hum Mov Sci 10:575–587

    Article  Google Scholar 

  • Glaister BC, Bernatz GC, Klute GK, Orendurff MS (2007) Video task analysis of turning during activities of daily living. Gait Posture 25(2):289–294

    Article  PubMed  Google Scholar 

  • Gutierrez-Farewik EM, Bartonek A, Saraste H (2006) Comparison and evaluation of two common methods to measure center of mass displacement in three dimensions during gait. Hum Mov Sci 25(2):238–256

    Article  PubMed  Google Scholar 

  • Huxham F, Gong J, Baker R, Morris M, Iansek R (2006) Defining spatial parameters for non-linear walking. Gait Posture 23(2):159–163

    Article  PubMed  CAS  Google Scholar 

  • Huxham F, Baker R, Morris ME, Iansek R (2008) Footstep adjustments used to turn during walking in Parkinson’s disease. Mov Disord 23(6):817–823

    Article  PubMed  Google Scholar 

  • Lam T, Luttmann K (2009) Turning capacity in ambulatory individuals poststroke. Am J Phys Med Rehabil 88(11):873–883

    Article  PubMed  Google Scholar 

  • Lamontagne A, Fung J (2009) Gaze and postural reorientation in the control of locomotor steering after stroke. Neurorehabil Neural Repair 23(3):256–266

    PubMed  Google Scholar 

  • Mak MKY, Patla A, Hui-Chan C (2008) Sudden turn during walking is impaired in people with Parkinson’s disease. Exp Brain Res 190(1):43–51

    Article  PubMed  Google Scholar 

  • Morton SM, Bastian AJ (2003) Relative contributions of balance and voluntary leg-coordination deficits to cerebellar gait ataxia. J Neurophysiol 89(4):1844–1856

    Article  PubMed  Google Scholar 

  • Morton SM, Bastian AJ (2004) Cerebellar control of balance and locomotion. Neuroscientist 10(3):247–259

    Article  PubMed  Google Scholar 

  • Palliyath S, Hallett M, Thomas SL, Lebiedowska MK (1998) Gait in patients with cerebellar ataxia. Mov Disord 13(6):958–964

    Article  PubMed  CAS  Google Scholar 

  • Paquette MR, Fuller JR, Adkin AL, Vallis LA (2008) Age-related modifications in steering behaviour: effects of base-of-support constraints at the turn point. Exp Brain Res 190(1):1–9

    Article  PubMed  Google Scholar 

  • Patla AE, Adkin A, Ballard T (1999) Online steering: coordination and control of body center of mass, head and body reorientation. Exp Brain Res 129(4):629–634

    Article  PubMed  CAS  Google Scholar 

  • Salman ME (2002) The cerebellum: it’s about time! But timing is not everything—new insights into the role of the cerebellum in timing motor and cognitive tasks. J Child Neurol 17(1):1–9

    Article  PubMed  Google Scholar 

  • Segal AD, Orendurff MS, Czerniecki JM, Schoen J, Klute GK (2011) Comparison of transtibial amputee and non-amputee biomechanics during a common turning task. Gait Posture 33(1):41–47

    Article  PubMed  Google Scholar 

  • Serrao M, Pierelli F, Ranavolo A, Draicchio F, Conte C, Don R, Di Fabio R, Lerose M, Padua L, Sandrini G, Casali C (2012) Gait pattern in inherited cerebellar ataxias. Cerebellum 11(1):194–211

    Article  PubMed  Google Scholar 

  • Stack EL, Ashburn AM, Jupp KE (2006) Strategies used by people with Parkinson’s disease who report difficulty turning. Parkinsonism Relat Disord 12(2):87–92

    Article  PubMed  Google Scholar 

  • Stolze H, Klebe S, Petersen G, Raethjen J, Wenzelburger R, Witt K, Deuschl G (2002) Typical features of cerebellar ataxic gait. J Neurol Neurosurg Psychiatr 73(3):310–312

    Article  PubMed  CAS  Google Scholar 

  • Taylor MJ, Dabnichki P, Strike SC (2005) A three-dimensional biomechanical comparison between turning strategies during the stance phase of walking. Hum Mov Sci 24(4):558–573

    Article  PubMed  CAS  Google Scholar 

  • Thach WT, Goodkin HP, Keating JG (1992) The cerebellum and the adaptive coordination of movement. Ann Rev Neurosci 15:403–442

    Article  PubMed  CAS  Google Scholar 

  • Thigpen MT, Light KE, Creel GL, Flynn SM (2000) Turning difficulty characteristics of adults aged 65 years or older. Phys Ther 80(12):1174–1187

    PubMed  CAS  Google Scholar 

  • Timmann D, Horak FB (2001) Perturbed step initiation in cerebellar subjects: 2. Modification of anticipatory postural adjustments. Exp Brain Res 141(1):110–120

    Article  PubMed  CAS  Google Scholar 

  • Trouillas P, Takayanagi T, Hallett M et al (1997) International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. The Ataxia Neuropharmacology Committee of the World Federation of Neurology. J Neurol Sci 145(2):205–211

    Article  PubMed  CAS  Google Scholar 

  • van de Warrenburg BP, Steijns JA, Munneke M, Kremer BP, Bloem BR (2005) Falls in degenerative cerebellar ataxias. Mov Disord 20(4):497–500

    Article  PubMed  Google Scholar 

  • Winter DA (1979) Biomechanics of human movement. Wiley, New York

    Google Scholar 

  • Xu D, Carlton LG, Rosengren KS (2004) Anticipatory postural adjustments for altering direction during walking. J Mot Behav 36(3):316–326

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Mrs. Catherine Wrenn for English revision.

Conflict of interest

Authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Rehabilitation Centre Policlinico Italia, Rome, Italy

    Silvia Mari, Mariano Serrao, Carmela Conte & Stefano Monamì

  2. Department of Medico-Surgical Sciences and Biotechnologies, University of Rome “Sapienza”, Via Faggiana 34, 40100, Polo Pontino, Latina, Italy

    Mariano Serrao & Carlo Casali

  3. IRCCS C. Mondino, Department of Neuroscience, University of Pavia, Pavia, Italy

    Carmela Conte & Giorgio Sandrini

  4. INAIL, Department of Occupational Medicine, Monteporzio Catone, Rome, Italy

    Alberto Ranavolo, Francesco Draicchio & Sergio Iavicoli

  5. Fondazione Don Gnocchi, Milan, Italy

    Luca Padua

  6. IRCCS Neuromed, Pozzilli, Italy

    Francesco Pierelli

Authors
  1. Silvia Mari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariano Serrao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carlo Casali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carmela Conte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alberto Ranavolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luca Padua
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesco Draicchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sergio Iavicoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Stefano Monamì
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Giorgio Sandrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Francesco Pierelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mariano Serrao.

Additional information

Silvia Mari and Mariano Serrao: Equal contributors.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mari, S., Serrao, M., Casali, C. et al. Turning strategies in patients with cerebellar ataxia. Exp Brain Res 222, 65–75 (2012). https://doi.org/10.1007/s00221-012-3197-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00221-012-3197-2

Keywords

Search

Navigation