Physiotherapy in Cerebellar disorders

[jebapt]

can u plz suggest specific exercises to control cerebellar symptoms such as tremor, dysmetria and postural instability, and gait

[Gawaine]

for postural instability, gait, and to help decrease ataxia a little bit, i've had fair to good success with anything that helps them find their midline... if you're fortunate enough to have a balancemaster machine or something that gives electronic visual biofeedback as to where their center of gravity is, use that!!
if not, start them in a concave corner. have them stand against the walls so they can experience the feedback that helps them find their center. then progress them to standing against a convex corner... they should be paying attention to their midline and what the wall "Tells them"... you should then progressively have them bring their center of gravity a bit away from the corner point so they can learn to maintain this center of gravity without the feedback..
for gait, start with small, controlled steps... do whatever they can do without ataxia and then progress that toward normal... one good feedback device is to take a LONG theraband (about 5-6 feet), wrap the middle of that long theraband around their foot-- pull it upward (with a bit of pull into eversion if necessary), cross it over then wrap it behind the knee, then wrap it back around to the anterior side of the thigh, then tie both ends off to a belt around their waist... try it on yourself to get the idea... it gives good proprioceptive feedback and it assists with the proper motion of portions of the gait cycle... ankle weights, i feel, are generally less effective but can have some advantages with certain patients... consider ankle weights for stair training...

beyond that, general gait and balance training should also be incorporated into the patient's routine...

i don't know how "proven" this stuff is....... but it's what has worked for me in real situations...


patrick, MPT


ps- let me know if you don't "get" the theraband wrap thing...... i could search for or just draw up/photograph an example...

[jebapt]

Thanxs for ur suggestions.. If possible can you post any videos, illustrations, pictured diagrams for these exercises...

[Neh]

Hi Gawaine..
i tried gettin dat theraband wrap thing but was unable to get it practically ..cud u plz help me wid sum drawing stuff..so dat visually it becomes simpleer to understand..
thanku!!