Exercise for Spinocerebellar Ataxias

SB
Overseen ByScott Barbuto, MD, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Columbia University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether aerobic exercise can improve motor skills in people with spinocerebellar ataxia, a group of disorders affecting balance and coordination. Researchers aim to determine if aerobic exercise aids the brain, particularly the cerebellum, in adapting and enhancing motor learning. Participants will engage in either aerobic training on a stationary bike or balance exercises at home. Individuals diagnosed with spinocerebellar ataxia who can safely ride a stationary bike may be suitable for this study. As an unphased trial, this study provides a unique opportunity to contribute to understanding how exercise might benefit those with spinocerebellar ataxia.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that aerobic exercise is generally safe for people with cerebellar ataxia. In previous studies, participants did not experience serious problems from the exercise. For instance, one study with 31 participants reported no major issues, and over 70% adhered well to the exercise plan. Aerobic exercise has also been found to improve ataxia symptoms, reduce tiredness, and increase fitness levels.

Similarly, balance exercises have helped people with degenerative cerebellar disease by enhancing movement and balance. Research indicates that these exercises can safely improve balance and ataxia symptoms without causing serious side effects.

Overall, both aerobic and balance exercises are well-tolerated and have positive effects in similar conditions. However, it is important to follow guidance and report any concerns to healthcare providers when engaging in any exercise program.12345

Why are researchers excited about this trial?

Researchers are excited about these treatments for spinocerebellar ataxias because they focus on non-drug approaches that enhance physical function directly through exercise. Unlike typical symptomatic treatments that might involve medications to manage symptoms, the aerobic and balance training programs are designed to improve the body's coordination and stability from within. The aerobic training uses a progressive intensity approach with a stationary bike, which can boost cardiovascular health and stamina. Meanwhile, balance training is customized and evolves with the participant's progress, targeting both static and dynamic balance skills. These innovative exercise protocols could lead to improved quality of life by directly addressing the physical challenges of spinocerebellar ataxias.

What evidence suggests that this trial's treatments could be effective for spinocerebellar ataxias?

Research has shown that aerobic exercise, which participants in this trial may receive, can alleviate symptoms of cerebellar ataxia. One study found that performing aerobic exercises at home improved symptoms, reduced fatigue, and increased overall fitness. Another study indicated that aerobic exercise slightly outperformed circuit training in enhancing balance. Balance training, another option in this trial, can also help, though improvements are typically modest. Some evidence suggests it can aid in multitasking and balance. Both exercise types appear beneficial, but aerobic training might provide more significant advantages for those with cerebellar ataxia.13567

Are You a Good Fit for This Trial?

This trial is for individuals with Spinocerebellar Ataxias and related conditions who can perform physical exercises. The study aims to understand if exercise can improve certain brain-related learning processes.

Inclusion Criteria

I can safely use a stationary exercise bike.
I have been diagnosed with spinocerebellar ataxia.
Cerebellar atrophy on MRI
See 1 more

Exclusion Criteria

Medical instability
I have a neurological condition.
I have a heart condition.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo baseline assessments including eyeblink conditioning using BlinkLab and other secondary outcome measures

1 week
1 visit (in-person)

Treatment

Participants are randomized to either home balance or aerobic training for 3 months, with weekly check-ins

12 weeks
Weekly virtual check-ins

Post-Treatment Assessment

Participants undergo post-treatment assessments including eyeblink conditioning and secondary outcome measures

1 week
1 visit (in-person)

Follow-up

Participants are monitored for changes in eyeblink conditioning and ataxia symptoms

4 weeks
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Aerobic Training
  • Balance Training
Trial Overview The study tests whether aerobic training, compared to balance training, enhances a type of learning linked to the cerebellum in the brain. Participants will use an app called iBlink at home to measure outcomes.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Aerobic TrainingExperimental Treatment1 Intervention
Group II: Balance TrainingActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Columbia University

Lead Sponsor

Trials
1,529
Recruited
2,832,000+

Published Research Related to This Trial

The article provides evidence-based exercise guidelines for individuals with multiple sclerosis, stroke, and Parkinson disease, emphasizing the importance of both aerobic and resistance training.
For multiple sclerosis, the recommended regimen is 2-3 days per week of aerobic training (10-30 minutes at moderate intensity) and 2-3 days of resistance training (1-3 sets of 8-15 repetitions). Stroke guidelines suggest 3-5 days of aerobic training (20-40 minutes) and similar resistance training, while Parkinson disease guidelines recommend 3-5 days of aerobic training (20-60 minutes) and resistance training (1-3 sets of 8-12 repetitions).
Exercise Training Guidelines for Multiple Sclerosis, Stroke, and Parkinson Disease: Rapid Review and Synthesis.Kim, Y., Lai, B., Mehta, T., et al.[2023]
Rehabilitation interventions for spinocerebellar ataxia showed significant improvements in balance and gait, with statistical significance for posture (P<.008) and gait (P<.02).
The interventions also led to notable reductions in speech disorders (P=.02), depressive symptoms (P<.0001), and accidental falls (P<.005), indicating a broader impact on quality of life.
[Effect of physical rehabilitation in patients with hereditary spinocerebellar ataxia. A systematic review].Marchal-Muñoz, A., García-Aranda, M., Marchal-Muñoz, M., et al.[2021]
A 38-year-old man with Friedreich ataxia showed significant improvements in aerobic capacity after a medically supervised endurance training program, with a 27% increase in peak VO2 and a 21% increase in peak ventilation.
The training led to a 50-watt increase in maximum workload and a total exercise time increase of five minutes, along with a weight loss of 4.75 kg, indicating that aerobic conditioning can be beneficial for patients with FA who are able to engage in cycling exercise.
Endurance exercise training in Friedreich ataxia.Fillyaw, MJ., Ades, PA.[2006]

Citations

Home Aerobic Training for Cerebellar Degenerative ...This 6-month trial comparing home aerobic versus balance training in cerebellar ataxia had excellent retention and adherence to training.
Effects of physiotherapy on degenerative cerebellar ataxiaThe results of this systematic review and meta-analysis demonstrated that physiotherapy significantly reduces ataxia symptoms with no adverse ...
Home Training for Cerebellar AtaxiasConclusions and Relevance In this randomized clinical trial, home high-intensity aerobic training improved ataxia symptoms, fatigue, and aerobic ...
Priming Motor Learning Through Exercise in People With ...Patient reported outcome measure for people with ataxia. The test was developed to assess 3 domains (physical, activities of daily living, mental health) and 14 ...
5.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/40653445/
A Randomized Clinical Trial Comparing the Effectiveness ...The aerobic intervention was found only marginally superior to the circuit training, while both were helpful for improving balance in ataxia.
Aerobic Exercise, Balance Training, and AtaxiaThe main objective of this project will be to compare the benefits of aerobic versus balance training in DCD. The investigators hypothesize that both aerobic ...
Phase I randomized single-blinded controlled study ...No serious adverse events were recorded. A statistically significant improvement in ataxia severity, balance, fitness, and gait were seen with four weeks of ...
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