Fatigue Limits Motor and Cognitive Improvements after High-intensity Exercise Prior to Balance Training over Telehealth in People with Spinocerebellar Ataxia
DOI:
https://doi.org/10.63144/ijt.2025.6713Keywords:
Ataxia, Balance, Fatigue, High Intensity, TelehealthAbstract
Objective: This pilot randomized controlled trial explored feasibility, and preliminary effects from remotely delivered high- versus low-intensity exercise prior to balance training for people with Spinocerebellar Ataxia (SCA). Methods: Twenty participants with SCA (types 1, 2, 3, or 6) were randomized to high- or low-intensity exercise (30 min), followed by balance training (30 min), delivered via telehealth twice-weekly for 8-weeks. Exercises were progressive and individualized based on ataxia severity, mobility, and home equipment. Outcomes included disease-specific measures (Scale for Assessment and Rating of Ataxia at home, Cerebellar Cognitive Affective Syndrome Scale), and fatigue (Fatigue Severity Scale) assessed at baseline, mid- and post-intervention. Results: Eighteen participants completed the intervention with high adherence. Both groups improved on disease-specific measures, with greater gains in cognition and reduced fatigue in the low-intensity group. Conclusions: Remote delivery of exercise and balance training is feasible in SCA. Fatigue may limit tolerability of higher exercise intensities. National Institutes of Health Clinical Trials Registration Number: NCT05826171
References
Ahlskog, J. E. (2011). Does vigorous exercise have a neuroprotective effect in Parkinson disease? Neurology, 77(3), 288–294. https://doi.org/10.1212/WNL.0b013e318225ab66
Bae, M., Zheng, P., & VanNostrand, M. (2025). The effects of balance training on cognitive function in persons with multiple sclerosis: A systematic review and meta-analysis. Multiple Sclerosis and Related Disorders, 94. https://doi.org/10.1016/j.msard.2025.106274
Barbuto, S., Martelli, D., Omofuma, I. B., Lee, N., Kuo, S. H., Agrawal, S., Lee, S., O’Dell, M., & Stein, J. (2020a). Phase I randomized single-blinded controlled study investigating the potential benefit of aerobic exercise in degenerative cerebellar disease. Clinical Rehabilitation. https://doi.org/10.1177/0269215520905073
Ben-Pazi, H., Browne, P., Chan, P., Cubo, E., Guttman, M., Hassan, A., Hatcher-Martin, J., Mari, Z., Moukheiber, E., Okubadejo, N. U., Shalash, A., Bajwa, J., Bloem, B. R., Galifianakis, N. B., Gatto, E., Goetz, C. G., Katz, M., Pantelyat, A., Tanner, C., … the International Parkinson and Movement Disorder Society Telemedicine Task Force. (2018). The Promise of Telemedicine for Movement Disorders: An Interdisciplinary Approach. Current Neurology and Neuroscience Reports, 18(5), 26. https://doi.org/10.1007/s11910-018-0834-6
Bogaert, A., Romanò, F., Cabaraux, P., Feys, P., & Moumdjian, L. (2023). Assessment and tailored physical rehabilitation approaches in persons with cerebellar impairments targeting mobility and walking according to the International Classification of Functioning: A systematic review of case-reports and case-series. Disability and Rehabilitation, 0(0), 1–23. https://doi.org/10.1080/09638288.2023.2248886
Boutron, I., Moher, D., Altman, D. G., Schulz, K. F., & Ravaud, P. (2017). Annals of Internal Medicine Academia and Clinic Extending the CONSORT Statement to Randomized Trials of Nonpharmacologic Treatment: Explanation and Elaboration. 295–310. https://doi.org/doi: 10.7326/0003-4819-148-4-200802190-00008.
Brusse, E., Brusse-Keizer, M. G. J., Duivenvoorden, H. J., & van Swieten, J. C. (2011). Fatigue in spinocerebellar ataxia: Patient self-assessment of an early and disabling symptom. Neurology, 76(11), 953–959. https://doi.org/10.1212/WNL.0b013e31821043a4
Callesen, J., Cattaneo, D., Brincks, J., & Dalgas, U. (2018). How does strength training and balance training affect gait and fatigue in patients with Multiple Sclerosis? A study protocol of a randomized controlled trial. NeuroRehabilitation, 42(2), 131–142. https://doi.org/10.3233/NRE-172238
Camarda, S. R. de A., Tebexreni, A. S., Páfaro, C. N., Sasai, F. B., Tambeiro, V. L., Juliano, Y., & Barros Neto, T. L. de. (2008). Comparison of maximal heart rate using the prediction equations proposed by Karvonen and Tanaka. Arquivos Brasileiros De Cardiologia, 91(5), 311–314. https://doi.org/10.1590/s0066-782x2008001700005
Casamento-Moran, A., Mooney, R. A., Chib, V. S., & Celnik, P. A. (2023). Cerebellar excitability regulates physical fatigue perception. The Journal of Neuroscience, 43(17), 3094–3106. https://doi.org/10.1523/JNEUROSCI.1406-22.2023
Cella, D., Nowinski, C., Peterman, A., Victorson, D., Miller, D., Lai, J.-S., & Moy, C. (2011). The neurology quality-of-life measurement initiative. Archives of Physical Medicine and Rehabilitation, 92(10 Suppl), S28-36. https://doi.org/10.1016/j.apmr.2011.01.025
Chirra, M., Marsili, L., Wattley, L., Sokol, L. L., Keeling, E., Maule, S., Sobrero, G., Artusi, C. A., Romagnolo, A., Zibetti, M., Lopiano, L., Espay, A. J., Obeidat, A. Z., & Merola, A. (2019). Telemedicine in neurological disorders: Opportunities and challenges. Telemedicine and E-Health, 25(7), 541–550. https://doi.org/10.1089/tmj.2018.0101
Clarke, D. J., Godfrey, M., Hawkins, R., Sadler, E., Harding, G., Forster, A., McKevitt, C., Dickerson, J., & Farrin, A. (2013). Implementing a training intervention to support caregivers after stroke: A process evaluation examining the initiation and embedding of programme change. Implementation Science, 8(1), 1–15. https://doi.org/10.1186/1748-5908-8-96
Conradsson, D., Nero, H., Löfgren, N., Hagströmer, M., & Franzén, E. (2017). Monitoring training activity during gait-related balance exercise in individuals with Parkinson’s disease: A proof-of-concept-study. BMC Neurology, 17(1), 19. https://doi.org/10.1186/s12883-017-0804-7
De Marchi, F., Contaldi, E., Magistrelli, L., Cantello, R., Comi, C., & Mazzini, L. (2021). Telehealth in neurodegenerative diseases: Opportunities and challenges for patients and physicians. Brain Sciences, 11(2), Article 2. https://doi.org/10.3390/brainsci11020237
De Zeeuw, C. I., & Ten Brinke, M. M. (2015). Motor learning and the cerebellum. Cold Spring Harbor Perspectives in Biology, 7(9), a021683. https://doi.org/10.1101/cshperspect.a021683
Di Liegro, Schiera, Proia, & Di Liegro. (2019). Physical activity and brain health. Genes, 10(9), 720. https://doi.org/10.3390/genes10090720
Diallo, A., Jacobi, H., Tezenas du Montcel, S., & Klockgether, T. (2020). Natural history of most common spinocerebellar ataxia: A systematic review and meta-analysis. Journal of Neurology. https://doi.org/10.1007/s00415-020-09815-2
El-Sayes, J., Harasym, D., Turco, C. V., Locke, M. B., & Nelson, A. J. (2019). Exercise-induced neuroplasticity: A mechanistic model and prospects for promoting plasticity. The Neuroscientist: A Review Journal Bringing Neurobiology, Neurology and Psychiatry, 25(1), 65–85. https://doi.org/10.1177/1073858418771538
Fernandes, B., Barbieri, F. A., Arthuso, F. Z., Silva, F. A., Moretto, G. F., Imaizumi, L. F. I., Ngomane, A. Y., Guimarães, G. V., & Ciolac, E. G. (2020). High-intensity interval versus moderate-intensity continuous training in individuals with Parkinson’s disease: Hemodynamic and functional adaptation. Journal of Physical Activity & Health, 17(1), 85–91. https://doi.org/10.1123/jpah.2018-0588
Gentile, A. (2000). Skill acquisition: Action, movement, and neuromotor processes. In J. & S. Carr R (Ed.), Movement science: Foundations for physical therapy in rehabilitation (2nd ed.). Aspen.
Gill-Body, K. M., Hedman, L. D., Plummer, L., Wolf, L., Hanke, T., Quinn, L., Riley, N., Kaufman, R., Verma, A., Quiben, M., & Scheets, P. (2021). Movement system diagnoses for balance dysfunction: Recommendations From the Academy of Neurologic Physical Therapy’s Movement System Task Force. Physical Therapy, 101(9), pzab153. https://doi.org/10.1093/ptj/pzab153
Grobe-Einsler, M., Taheri Amin, A., Faber, J., Schaprian, T., Jacobi, H., Schmitz-Hübsch, T., Diallo, A., Tezenas du Montcel, S., & Klockgether, T. (2021). Development of SARAhome, a new video-based tool for the assessment of ataxia at home. Movement Disorders: Official Journal of the Movement Disorder Society, 36(5), 1242–1246. https://doi.org/10.1002/mds.28478
Guadagnoli, M. A., & Lee, T. D. (2004). Challenge point: A framework for conceptualizing the effects of various practice conditions in motor learning. Journal of Motor Behavior, 36(2), 212–224. https://doi.org/10.3200/JMBR.36.2.212-224
Gunn, H., Markevics, S., Haas, B., Marsden, J., & Freeman, J. (2015). Systematic review: The effectiveness of interventions to reduce falls and improve balance in adults with Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation, 96(10), 1898–1912. https://doi.org/10.1016/j.apmr.2015.05.018
Heusel-Gillig, L. L., & Hall, C. D. (2023). Effectiveness of vestibular rehabilitation for patients with degenerative Cerebellar Ataxia: A retrospective cohort study. Brain Sciences, 13(11), 1520. https://doi.org/10.3390/brainsci13111520
Hirsch, M. A., & Farley, B. G. (2009). Exercise and neuroplasticity in persons living with Parkinson’s disease. European Journal of Physical and Rehabilitation Medicine, 45(2), 215–229.
Hoche, F., Guell, X., Vangel, M. G., Sherman, J. C., & Schmahmann, J. D. (2018). The cerebellar cognitive affective/Schmahmann syndrome scale. Brain, 141(1), 248–270. https://doi.org/10.1093/brain/awx317
Hornby, T. G., Reisman, D. S., Ward, I. G., Scheets, P. L., Miller, A., Haddad, D., Fox, E. J., Fritz, N. E., Hawkins, K., Henderson, C. E., Hendron, K. L., Holleran, C. L., Lynskey, J. E., & Walter, A. (2020). Clinical practice guideline to improve locomotor function following chronic stroke, incomplete spinal cord injury, and brain injury. Journal of Neurologic Physical Therapy, 44(1), 49. https://doi.org/10.1097/NPT.0000000000000303
Hortobágyi, T., Granacher, U., Fernandez-del-Olmo, M., Howatson, G., Manca, A., Deriu, F., Taube, W., Gruber, M., Márquez, G., Lundbye-Jensen, J., & Colomer-Poveda, D. (2021). Functional relevance of resistance training-induced neuroplasticity in health and disease. Neuroscience & Biobehavioral Reviews, 122, 79–91. https://doi.org/10.1016/j.neubiorev.2020.12.019
Hugues, N., Pin-Barre, C., Pellegrino, C., Rivera, C., Berton, E., & Laurin, J. (2022). Time-dependent cortical plasticity during moderate-intensity continuous training versus high-intensity interval training in rats. Cerebral Cortex, 32(17), 3829–3847. https://doi.org/10.1093/cercor/bhab451
Huxham, F. E., Goldie, P. A., & Patla, A. E. (2001). Theoretical considerations in balance assessment. The Australian Journal of Physiotherapy, 47(2), 89–100. https://doi.org/10.1016/s0004-9514(14)60300-7
Ilg, W., Bastian, A. J., Boesch, S., Burciu, R. G., Celnik, P., Claaßen, J., Feil, K., Kalla, R., Miyai, I., Nachbauer, W., Schöls, L., Strupp, M., Synofzik, M., Teufel, J., & Timmann, D. (2014). Consensus paper: Management of degenerative cerebellar disorders. The Cerebellum, 13(2), 248–268. http://dx.doi.org/10.1007/s12311-013-0531-6
Jabri, S., Bushart, D. D., Kinnaird, C., Bao, T., Bu, A., Shakkottai, V. G., & Sienko, K. H. (2022). Preliminary study of vibrotactile feedback during home-based balance and coordination training in individuals with cerebellar ataxia. Sensors (Basel, Switzerland), 22(9), 3512. https://doi.org/10.3390/s22093512
Jacobi, H., Rakowicz, M., Rola, R., Fancellu, R., Mariotti, C., Charles, P., Dürr, A., Küper, M., Timmann, D., Linnemann, C., Schöls, L., Kaut, O., Schaub, C., Filla, A., Baliko, L., Melegh, B., Kang, J. S., Giunti, P., Van De Warrenburg, B. P. C., … Klockgether, T. (2013). Inventory of non-ataxia signs (INAS): Validation of a new clinical assessment instrument. The Cerebellum, 12(3), 418–428. https://doi.org/10.1007/s12311-012-0421-3
Kalb, R., Brown, T. R., Coote, S., Costello, K., Dalgas, U., Garmon, E., Giesser, B., Halper, J., Karpatkin, H., Keller, J., Ng, A. V., Pilutti, L. A., Rohrig, A., Van Asch, P., Zackowski, K., & Motl, R. W. (2020). Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course. Multiple Sclerosis Journal, 135245852091562.
https://doi.org/10.1177/1352458520915629
Kalra, L., Evans, A., Perez, I., Melbourn, A., Patel, A., Knapp, M., & Donaldson, N. (2004). Training carers of stroke patients: Randomised controlled trial. BMJ, 328(7448), 1099. https://doi.org/10.1136/bmj.328.7448.1099
Karlinsky, K. T., Netz, Y., Jacobs, J. M., Ayalon, M., & Yekutieli, Z. (2022). Static balance digital endpoints with Mon4t: Smartphone sensors vs. force plate. Sensors (Basel, Switzerland), 22(11), 4139. https://doi.org/10.3390/s22114139
Kathia, M., Duplea, S.-G., Bommarito, J. C., Hinks, A., Leake, E., Shannon, J., Pitman, J., Khangura, P., Coates, A., Slysz, J., Katerberg, C., McCarthy, D., Beedie, T., Malcolm, R., Witton, L. A., Connolly, B., Burr, J., Vallis, L. A., Power, G., & Millar, P. (2024). High-intensity interval versus moderate-intensity continuous cycling training in Parkinson’s disease: A randomized trial. Journal of Applied Physiology, 137(3), 603–615. https://doi.org/10.1152/japplphysiol.00219.2024
Keller, J. L., & Bastian, A. J. (2014a). A home balance exercise program improves walking in people with cerebellar ataxia. Neurorehabilitation and Neural Repair, 28(8), 770–778. https://doi.org/10.1177/1545968314522350
Khalil, H., van Deursen, R., Quinn, L., Rosser, A., & Busse, M. (2010). Clinical measurement of sit to stand performance in people with Huntington’s disease: Reliability and validity for the 30 second chair sit to stand test. Journal of Neurology, Neurosurgery and Psychiatry, 81, A28.
Krupp, L. B., Alvarez, L. A., LaRocca, N. G., & Scheinberg, L. C. (1988). Fatigue in Multiple Sclerosis. Archives of Neurology, 45(4), 435–437. https://doi.org/10.1001/archneur.1988.00520280085020
Lai, R.-Y., Rummey, C., Amlang, C. J., Lin, C.-Y. R., Chen, T. X., Perlman, S., Wilmot, G., Gomez, C. M., Schmahmann, J. D., Paulson, H., Ying, S. H., Onyike, C. U., Zesiewicz, T. A., Bushara, K. O., Geschwind, M. D., Figueroa, K. P., Pulst, S. M., Subramony, S. H., Burns, M. R., … Kuo, S.-H. (2024). Fatigue Impacts quality of life in people with spinocerebellar ataxias. Movement Disorders Clinical Practice. https://doi.org/10.1002/mdc3.14006
Lin Pedersen, T. (n.d.). patchwork: The Composer of Plots [R]. https://CRAN.R-project.org/package=patchwork
Macpherson, C. E. (2024). Priming Motor Learning Through Exercise in People With Spinocerebellar Ataxia (PRIME-Ataxia) [Ph.D., Columbia University]. https://www.proquest.com/docview/3072265836/abstract/8E670D2CE130477BPQ/1
Macpherson, C. E., Bartsch, B., King, M., Satchidanand, A., Kuo, S.-H., & Quinn, L. (2023). Telehealth delivery of a high-intensity motor priming intervention in cerebellar ataxia: A single-case experimental design. Physical Therapy and Rehabilitation, 10(1), Article 1.
Macpherson, C.E., Kempner, K, King, M, Kaplan, M, Pacheco, A, Wani. D, Kuo, S, & Quinn, L. (2025). Feasibility of a telehealth physical activity coaching intervention for degenerative cerebellar ataxia. Journal of Neurologic Physical Therapy, 49(4), 201–213. https://doi.org/10.1097/NPT.0000000000000516
Marquer, A., Barbieri, G., & Pérennou, D. (2014). The assessment and treatment of postural disorders in cerebellar ataxia: A systematic review. Annals of Physical and Rehabilitation Medicine, 57(2), 67–78. https://doi.org/10.1016/j.rehab.2014.01.002
Matsugi, A. (2017). Physical therapy for cerebellar ataxia. Neurological Physical Therapy, May. https://doi.org/10.5772/67649
Meissner, H., Creswell, J., Klassen, A. C., Plano, V., & Smith, K. C. (n.d.). Best Practices for Mixed Methods Research in the Health Sciences.
Mellesmoen, A., Sheeler, C., Ferro, A., Rainwater, O., & Cvetanovic, M. (2018). Brain derived Neurotrophic Factor (BDNF) delays onset of pathogenesis in transgenic mouse model of Spinocerebellar Ataxia Type 1 (SCA1). Frontiers in Cellular Neuroscience, 12, 509. https://doi.org/10.3389/fncel.2018.00509
Mendes, M. (2021). Chronotropism during exercise. Methodological and conceptual inconsistencies. Revista Portuguesa de Cardiologia (English Edition), 40(12), 955–956. https://doi.org/10.1016/j.repce.2021.10.028
Milne, S. C., Corben, L. A., Georgiou-Karistianis, N., Delatycki, M. B., & Yiu, E. M. (2017). Rehabilitation for individuals with genetic degenerative ataxia: A systematic review. Neurorehabilitation and Neural Repair, 31(7), 609–622. https://doi.org/10.1177/1545968317712469
Mitoma, H., Buffo, A., Gelfo, F., Guell, X., Fucà, E., Kakei, S., Lee, J., Manto, M., Petrosini, L., Shaikh, A. G., & Schmahmann, J. D. (2020). Consensus Paper. Cerebellar reserve: From cerebellar physiology to cerebellar disorders. The Cerebellum, 19(1), 131–153. https://doi.org/10.1007/s12311-019-01091-9
Miyai, I. (2012). Challenge of neurorehabilitation for cerebellar degenerative diseases. The Cerebellum, 11(2), 436–437. http://dx.doi.org/10.1007/s12311-011-0327-5
Miyai, I., Ito, M., Hattori, N., Mihara, M., Hatakenaka, M., Yagura, H., Sobue, G., & Nishizawa, M. (2012). Cerebellar ataxia rehabilitation trial in degenerative cerebellar diseases. Neurorehabilitation and Neural Repair, 26(5), 515–522. https://doi.org/10.1177/1545968311425918
Moriarty, T. A., Mermier, C., Kravitz, L., Gibson, A., Beltz, N., & Zuhl, M. (2019). Acute aerobic exercise based cognitive and motor priming: Practical applications and mechanisms. Frontiers in Psychology, 10, 2790. https://doi.org/10.3389/fpsyg.2019.02790
Moriarty, T., Johnson, A., Thomas, M., Evers, C., Auten, A., Cavey, K., Dorman, K., & Bourbeau, K. (2022). Acute aerobic exercise-induced motor priming improves piano performance and alters motor cortex activation. Frontiers in Psychology, 13, 825322. https://doi.org/10.3389/fpsyg.2022.825322
Morton, S. M. (2006). Cerebellar contributions to locomotor adaptations during Splitbelt Treadmill Walking. Journal of Neuroscience, 26(36), 9107–9116. https://doi.org/10.1523/JNEUROSCI.2622-06.2006
Müller, P., Duderstadt, Y., Lessmann, V., & Müller, N. G. (2020). Lactate and BDNF: Key mediators of exercise induced neuroplasticity? Journal of Clinical Medicine, 9(4), 1136. https://doi.org/10.3390/jcm9041136
Osborne, J. A., Botkin, R., Colon-Semenza, C., DeAngelis, T. R., Gallardo, O. G., Kosakowski, H., Martello, J., Pradhan, S., Rafferty, M., Readinger, J. L., Whitt, A. L., & Ellis, T. D. (2021). Physical Therapist management of Parkinson disease: A clinical practice guideline from the American Physical Therapy Association. Phys Ther. https://doi.org/10.1093/ptj/pzab302
Pérez-Avila, I., Fernández-Vieitez, J. A., Martínez-Góngora, E., Ochoa-Mastrapa, R., & Velázquez-Manresa, M. G. (2004). Effects of a physical training program on quantitative neurological indices in mild stage type 2 spinocerebelar ataxia patients. Revista de Neurologia, 39(10), 907–910.
Podsiadlo, D., & Richardson, S. (1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148.
Polidori, A., Malagoli, M., Giacalone, R., Brichetto, G., Monti Bragadin, M., & Prada, V. (2024). 30-Second Chair Stand and 5-Times Sit-to-Stand tests are interesting tools for assessing disability and ability to ambulate among patients with Multiple Sclerosis. Life, 14(6). https://doi.org/10.3390/life14060703
Powell, L. E., & Myers, A. M. (1995). The Activities-specific Balance Confidence (ABC) Scale. J.Gerontol.A Biol.Sci.Med.Sci., 50A(1), M28–M34.
R Core Team. (2021). R: A language and environment for statistical computing. [R]. R Foundation for Statistical Computing. https://www.R-project.org/
Rampakakis, E., Ste-Marie, P. A., Sampalis, J. S., Karellis, A., Shir, Y., & Fitzcharles, M.-A. (2015). Real-life assessment of the validity of patient global impression of change in fibromyalgia. RMD Open, 1(1), e000146. https://doi.org/10.1136/rmdopen-2015-000146
Revelle, W. (2024). psych: Procedures for Psychological, Psychometric, and Personality Research (Version R package version 2.4.12) [R]. Northwestern University. https://CRAN.R-project.org/package=psych
Riebe, D., Ehrman, J. K., Liguori, G., & Magal, M. (2018). Exercise prescription for other clinical populations. In M. Nobel (Ed.), ACSM’s guidelines for exercise testing and prescription (10th ed., pp. 348–355). Wolters Kluwer.
Rodríguez-Díaz, J. C., Velázquez-Pérez, L., Rodríguez Labrada, R., Aguilera Rodríguez, R., Laffita Pérez, D., Canales Ochoa, N., Medrano Montero, J., Estupiñán Rodríguez, A., Osorio Borjas, M., Góngora Marrero, M., Reynaldo Cejas, L., González Zaldivar, Y., & Almaguer Gotay, D. (2018). Neurorehabilitation therapy in spinocerebellar ataxia type 2: A 24-week, rater-blinded, randomized, controlled trial. Movement Disorders: Official Journal of the Movement Disorder Society, 33(9), 1481–1487. https://doi.org/10.1002/mds.27437
Rogge, A.-K., Röder, B., Zech, A., & Hötting, K. (2018). Exercise-induced neuroplasticity: Balance training increases cortical thickness in visual and vestibular cortical regions. NeuroImage, 179, 471–479. https://doi.org/10.1016/j.neuroimage.2018.06.065
Roig, M., Thomas, R., Mang, C. S., Snow, N. J., Ostadan, F., Boyd, L. A., & Lundbye-Jensen, J. (2016). Time-dependent effects of cardiovascular exercise on memory. Exercise and Sport Sciences Reviews, 44(2), 81–88. https://doi.org/10.1249/JES.0000000000000078
Sabag, A., Little, J. P., & Johnson, N. A. (2022). Low-volume high-intensity interval training for cardiometabolic health. The Journal of Physiology, 600(5), 1013–1026. https://doi.org/10.1113/JP281210
Schmahmann, J. D., Pierce, S., MacMore, J., & L’Italien, G. J. (2021). Development and validation of a patient‐reported outcome measure of ataxia. Movement Disorders, 36(10), 2367–2377. https://doi.org/10.1002/mds.28670
Schmitz-Hubsch, T., du Montcel, S. T., Baliko, L., Berciano, J., Boesch, S., Depondt, C., Giunti, P., Globas, C., Infante, J., Kang, J.-S., Kremer, B., Mariotti, C., Melegh, B., Pandolfo, M., Rakowicz, M., Ribai, P., Rola, R., Schols, L., Szymanski, S., … Klockgether, T. (2006). Scale for the assessment and rating of ataxia: Development of a new clinical scale. Neurology, 66(11), 1717–1720. https://doi.org/10.1212/01.wnl.0000219042.60538.92
Singmann, H, Bolker, B, Westfall, J, Aust, F, & Ben-Shachar, M.S. (2024). afex: Analysis of Factorial Experiments (Version R package version 1.4-1) [R]. https://CRAN.R-project.org/package=afex
Sivaramakrishnan, A., Zuhl, M., & Mang, C. S. (2022). Editorial: Exercise priming: The use of physical exercise to support motor and cognitive function. Frontiers in Psychology, 13, 1043611. https://doi.org/10.3389/fpsyg.2022.1043611
Sparrow, D., De Angelis, T. R., Hendron, K., Thomas, C. A., Saint-Hilaire, M., & Ellis, T. (2016). Highly challenging balance program reduces fall rate in Parkinson disease. Journal of Neurologic Physical Therapy, 40(1), 24–30. https://doi.org/10.1097/NPT.0000000000000111
Statton, M. A., Encarnacion, M., Celnik, P., & Bastian, A. J. (2015). A single bout of moderate aerobic exercise improves motor skill acquisition. PLoS ONE, 10(10). https://doi.org/10.1371/journal.pone.0141393
Statton, M. A., Vazquez, A., Morton, S. M., Vasudevan, E. V. L., & Bastian, A. J. (2018). Making sense of cerebellar contributions to perceptual and motor adaptation. The Cerebellum, 17(2), 111–121. https://doi.org/10.1007/s12311-017-0879-0
Steib, S., Wanner, P., Adler, W., Winkler, J., Klucken, J., & Pfeifer, K. (2018). A Single bout of aerobic exercise improves motor skill consolidation in Parkinson’s Disease. Frontiers in Aging Neuroscience, 10, 328. https://doi.org/10.3389/fnagi.2018.00328
Stoykov, M. E., & Madhavan, S. (2015). Motor priming in neurorehabilitation. Journal of Neurologic Physical Therapy, 39(1), 33–42. https://doi.org/10.1097/NPT.0000000000000065
Sultana, R. N., Sabag, A., Keating, S. E., & Johnson, N. A. (2019). The effect of low-volume high-intensity interval training on body composition and cardiorespiratory fitness: A systematic review and meta-analysis. Sports Medicine (Auckland, N.Z.), 49(11), 1687–1721. https://doi.org/10.1007/s40279-019-01167-w
Swarbrick, D., Kiss, A., Trehub, S., Tremblay, L., Alter, D., & Chen, J. L. (2020). HIIT the Road Jack: An exploratory study on the effects of an acute bout of cardiovascular high-intensity interval training on piano learning. Frontiers in Psychology, 11, 2154. https://doi.org/10.3389/fpsyg.2020.02154
Synofzik, M., & Ilg, W. (2014). Motor training in Degenerative Spinocerebellar Disease: Ataxia-specific improvements by intensive physiotherapy and exergames. BioMed Research International, 2014. http://dx.doi.org/10.1155/2014/583507
Taube, W., Gruber, M., Beck, S., Faist, M., Gollhofer, A., & Schubert, M. (2007). Cortical and spinal adaptations induced by balance training: Correlation between stance stability and corticospinal activation. Acta Physiologica (Oxford, England), 189(4), 347–358. https://doi.org/10.1111/j.1748-1716.2007.01665.x
Tchelet, K., Stark-Inbar, A., & Yekutieli, Z. (2019). Pilot study of the encephalog smartphone application for gait analysis. Sensors (Basel, Switzerland), 19(23). https://doi.org/10.3390/s19235179
Thomas, R., Beck, M. M., Lind, R. R., Korsgaard Johnsen, L., Geertsen, S. S., Christiansen, L., Ritz, C., Roig, M., & Lundbye-Jensen, J. (2016). Acute exercise and motor memory consolidation: The role of exercise timing. Neural Plasticity, 2016. https://doi.org/10.1155/2016/6205452
Thomas, S., Reading, J., & Shephard, R. J. (1992). Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci, 17(4), 338–345.
Tsay, J. S., Schuck, L., & Ivry, R. B. (2022). Cerebellar Degeneration impairs strategy discovery but not strategy recall. The Cerebellum. https://doi.org/10.1007/s12311-022-01500-6
Ueta, K., Mizuguchi, N., Sugiyama, T., Isaka, T., & Otomo, S. (2022). The motor engram of functional connectivity generated by acute whole-body dynamic balance training. Medicine and Science in Sports and Exercise, 54(4), 598–608. https://doi.org/10.1249/MSS.0000000000002829
Velázquez‐Pérez, L., Rodríguez‐Diaz, J. C., Rodríguez‐Labrada, R., Medrano‐Montero, J., Aguilera Cruz, A. B., Reynaldo‐Cejas, L., Góngora‐Marrero, M., Estupiñán‐Rodríguez, A., Vázquez‐Mojena, Y., & Torres‐Vega, R. (2019). Neurorehabilitation Improves the motor features in Prodromal SCA2: A randomized, controlled trial. Movement Disorders, 34(7), 1060–1068. https://doi.org/10.1002/mds.27676
Velázquez-Pérez, L., Rodríguez-Diaz, J. C., Rodríguez-Labrada, R., Medrano-Montero, J., Aguilera Cruz, A. B., Reynaldo-Cejas, L., Góngora-Marrero, M., Estupiñán-Rodríguez, A., Vázquez-Mojena, Y., & Torres-Vega, R. (2019). Neurorehabilitation improves the motor features in Prodromal SCA2: A randomized, controlled trial. Movement Disorders, 34(7), 1060–1068. https://doi.org/10.1002/mds.27676
Vloothuis, J. D. M., Mulder, M., Nijland, R. H. M., Goedhart, Q. S., Konijnenbelt, M., Mulder, H., Hertogh, C. M. P. M., Tulder, M. V., Van Wegen, E. E. H., & Kwakkel, G. (2019). Caregiver-mediated exercises with e-health support for early supported discharge after stroke (CARE4STROKE): A randomized controlled trial. PLoS ONE, 14(4), 1–14. https://doi.org/10.1371/journal.pone.0214241
Wanner, P., Müller, T., Cristini, J., Pfeifer, K., & Steib, S. (2020). Exercise Intensity does not modulate the effect of acute exercise on learning a complex whole-body task. Neuroscience, 426, 115–128. https://doi.org/10.1016/j.neuroscience.2019.11.027
Wickham, H, Averick, M, Bryan, J, Chang, W, D’Agostino McGowan, L, Romain F, Grolemund, G, Hayes, A, Henry, L, Hester, J, Kuhn, M, Lin Pedersen, T, Miller, E, Milton Bache, S, Muller, K, Ooms, J, Robinson, D, Seidel, D.P., Spinu, V, … Yutani, H. (2019). Welcome to the tidyverse. 4(43), 1686. https://doi.org/10.21105/joss.01686
Wickham, H, Francois, R, Henry, L, Muller, K, & Vaughan, Davis. (2023). dplyr: A Grammar of Data Manipulation. [R]. https://CRAN.R-project.org/package=dplyrR package version 1.1.4.
Winser, S. J., Schubert, M. C., Chan, A. Y. Y., Kannan, P., & Whitney, S. L. (2018). Can pre-screening vestibulocerebellar involvement followed by targeted training improve the outcomes of balance in cerebellar ataxia? Medical Hypotheses, 117(April), 37–41. https://doi.org/10.1016/j.mehy.2018.06.001
Youssef, H., Gönül, M. N., Sobeeh, M. G., Akar, K., Feys, P., Cuypers, K., & Vural, A. (2024). Is high-intensity interval training more effective than moderate continuous training in rehabilitation of Multiple Sclerosis: A comprehensive systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 105(8), 1545–1558. https://doi.org/10.1016/j.apmr.2023.12.012
Zoladz, J. A., Majerczak, J., Zeligowska, E., Mencel, J., Jaskolski, A., Jaskolska, A., & Marusiak, J. (2014). Moderate-intensity interval training increases serum brain-derived neurotrophic factor level and decreases inflammation in Parkinson’s disease patients. Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society, 65(3), 441–448.
T
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Chelsea E. Macpherson, PT, DPT, NCS, PhD, Fatima Awad, BS, Vruta Rana, PT, MA, Sheng-Han Kuo, MD, Lori Quinn, PT, EdD, FAPTA
This work is licensed under a Creative Commons Attribution 4.0 International License.
ISSN 1945-2020 (online)
