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Castiglia SF, Trabassi D, Conte C, Gioiosa V, Sebastianelli G, Abagnale C, Ranavolo A, Di Lorenzo C, Coppola G, Casali C, Serrao M. Local Dynamic Stability of Trunk During Gait is Responsive to Rehabilitation in Subjects with Primary Degenerative Cerebellar Ataxia. Cerebellum 2024:10.1007/s12311-024-01663-4. [PMID: 38279000 DOI: 10.1007/s12311-024-01663-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 01/28/2024]
Abstract
This study aimed to assess the responsiveness to the rehabilitation of three trunk acceleration-derived gait indexes, namely the harmonic ratio (HR), the short-term longest Lyapunov's exponent (sLLE), and the step-to-step coefficient of variation (CV), in a sample of subjects with primary degenerative cerebellar ataxia (swCA), and investigate the correlations between their improvements (∆), clinical characteristics, and spatio-temporal and kinematic gait features. The trunk acceleration patterns in the antero-posterior (AP), medio-lateral (ML), and vertical (V) directions during gait of 21 swCA were recorded using a magneto-inertial measurement unit placed at the lower back before (T0) and after (T1) a period of inpatient rehabilitation. For comparison, a sample of 21 age- and gait speed-matched healthy subjects (HSmatched) was also included. At T1, sLLE in the AP (sLLEAP) and ML (sLLEML) directions significantly improved with moderate to large effect sizes, as well as SARA scores, stride length, and pelvic rotation. sLLEML and pelvic rotation also approached the HSmatched values at T1, suggesting a normalization of the parameter. HRs and CV did not significantly modify after rehabilitation. ∆sLLEML correlated with ∆ of the gait subscore of the SARA scale (SARAGAIT) and ∆stride length and ∆sLLEAP correlated with ∆pelvic rotation and ∆SARAGAIT. The minimal clinically important differences for sLLEML and sLLEAP were ≥ 36.16% and ≥ 28.19%, respectively, as the minimal score reflects a clinical improvement in SARA scores. When using inertial measurement units, sLLEAP and sLLEML can be considered responsive outcome measures for assessing the effectiveness of rehabilitation on trunk stability during walking in swCA.
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Affiliation(s)
- Stefano Filippo Castiglia
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy.
- Department of Brain and Behavioral Sciences, University of Pavia, 27100, Pavia, Italy.
| | - Dante Trabassi
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Carmela Conte
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Valeria Gioiosa
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Gabriele Sebastianelli
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Chiara Abagnale
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Alberto Ranavolo
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso Della Repubblica 79, 04100, Latina, Italy
- Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy
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