title: Balance training using an iPhone application in people with familial dysautonomia: three case reports.
abstract: OBJECTIVE
  Familial dysautonomia (FD) is a rare genetic autosomal recessive disease that impairs vital functions and causes neural and motor deficiency. These motor deficits often are characterized by static and dynamic instability and an ataxic gait. As a result, people with FD are at risk for significant physical impairment and falls and pose unique challenges for delivering rehabilitation exercise. Consequently, there is a need for challenging ways to safely and feasibly deliver active exercise rehabilitation to these individuals.
  
  
  METHODS
  This case report describes 3 people with FD (ages 11, 12, and 22 years) with gait and stability problems who attended rehabilitation exercises augmented by the use of an iPhone application specifically developed for the program.
  
  
  RESULTS
  The Berg Balance Scale and the Four Square Step Test were conducted prior to training, after training, and after 2 months of follow-up without training. Two patients showed improvements on both measures at the posttest, which were maintained throughout follow-up testing.
  
  
  CONCLUSIONS
  Although greater experience is needed to more fully evaluate the efficiency of the iPhone application used in this program for people with FD, the results of these initial cases are encouraging. Systematically and prospectively tracking motor abilities and other functional outcomes during rehabilitation of individuals with FD who use the suggested application in balance training is recommended in order to provide greater evidence in this area.
authors.affiliation: R. Gefen, PT, MA, MPE, The Zinman College of Physical Education and Sports Sciences, Netanya, Israel.
authors.forename: Rosalee
authors.initials: R
authors.lastname: Gefen
authors.affiliation: A. Dunsky, PhD, The Zinman College of Physical Education and Sports Sciences, Wingate Institute 4290200, Netanya, Israel. ayelet@wincol.ac.il.
authors.forename: Ayelet
authors.initials: A
authors.lastname: Dunsky
authors.affiliation: Y. Hutzler, PhD, The Zinman College of Physical Education and Sports Sciences.
authors.forename: Yeshayahu
authors.initials: Y
authors.lastname: Hutzler
mesh_terms: D002648:Child; D004402:Dysautonomia, Familial / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D063731:Mobile Applications; D004856:Postural Balance; D055815:Young Adult