Individuals with Friedreich Ataxia experience unsteadiness with walking, loss of dexterity with fine motor skill and a high risk of falling. The role of Physiotherapy in the management of FA is to optimise function as long as possible and to minimise disability, deformity and pain. The primary goal of many individuals with FA is to prolong their locomotor ability for as long as possible, whilst minimising their risk of falling.
A comprehensive assessment by a Neurological Physiotherapist entails evaluation of gait, strength, flexibility, range of motion, balance, coordination, spinal alignment, posture, functional status, foot posture/alignment, endurance, reflexes and equipment needs. A range of standardised assessment tools are employed to enable comparison at periodic reviews (eg annual), as well as to customise an exercise program.
Physiotherapy intervention for individuals with FA should target balance and co-ordination to assist with safe and effective mobility and function. Muscle strengthening and general endurance and conditioning will play a key role in maintaining overall fitness levels.
Education regarding falls prevention should be provided where safe mobility is compromised, as well as discussion regarding options for adaptive devices including mobility aids or wheelchairs.
Establishing a reasonable and safe exercise program is of great importance too. An individualised home or group exercise program may also contribute to a patient’s sense of well-being. Once an initial program is established and the therapy sessions are completed, a patient should receive periodic re-evaluations with accompanying updating of the home program. Because of the progressive nature of FA, gains in strength or coordination should not be expected, but instead the desired outcome is prolonged function and a higher quality of life.
Contact a Neurological Physiotherapist physiotherapy.asn.au (Find a Physio) to discuss options for a comprehensive assessment.
Our thanks to Jennie McCorkell of MyTurn Rehabilitation in Brisbane for this article. Jennie is a qualified Neurological Physiotherapist who cares for patients recovering from stroke and living with Parkinson’s disease and other movement disorders as well as FA.