title: Training balance with opto-kinetic stimuli in the home: a randomized controlled feasibility study in people with pure cerebellar disease.
abstract: OBJECTIVE
  To investigate the feasibility of a randomized controlled trial of a home-based balance intervention for people with cerebellar ataxia.
  
  
  METHODS
  A randomized controlled trial design.
  
  
  METHODS
  Intervention and assessment took place in the home environment.
  
  
  METHODS
  A total of 12 people with spinocerebellar ataxia type 6 were randomized into a therapy or control group. Both groups received identical assessments at baseline, four and eight weeks.
  
  
  METHODS
  Therapy group participants undertook balance exercises in front of optokinetic stimuli during weeks 4-8, while control group participants received no intervention.
  
  
  METHODS
  Test-retest reliability was analysed from outcome measures collected twice at baseline and four weeks later. Feasibility issues were evaluated using daily diaries and end trial exit interviews.
  
  
  RESULTS
  The home-based training intervention with opto-kinetic stimuli was feasible for people with pure ataxia, with one drop-out. Test-retest reliability is strong (intraclass correlation coefficient >0.7) for selected outcome measures evaluating balance at impairment and activity levels. Some measures reveal trends towards improvement for those in the therapy group. Sample size estimations indicate that Bal-SARA scores could detect a clinically significant change of 0.8 points in this functional balance score if 80 people per group were analysed in future trials.
  
  
  CONCLUSIONS
  Home-based targeted training of functional balance for people with pure cerebellar ataxia is feasible and the outcome measures employed are reliable.
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK bunn_lisa@hotmail.com.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bunn
authors.affiliation: School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Marsden
authors.affiliation: Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.
authors.forename: Paola
authors.initials: P
authors.lastname: Giunti
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Day
mesh_terms: D002526:Cerebellar Diseases / Q000503:physiopathology* / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D015203:Reproducibility of Results
keywords: Balance; cerebellar disease; opto-kinetic training; rehabilitation; spinocerebellar ataxia type 6 (SCA6)