Treadmill training for ataxic patients: a single-subject experimental design

Abstract

Objective: To investigate changes in gait quality, balance and mobility associated with treadmill training for ataxic individuals. Design: Single-subject ABA design. Baseline phases (A) lasted three weeks and intervention (B) lasted four weeks. Setting: University rehabilitation clinic. Subjects: A woman (25 years) and a man (53 years) with chronic ataxia due to head trauma. Intervention: Three 20-minute treadmill training sessions each week with progression in velocity and step length. Main measures: Rivermead Visual Gait Assessment, Timed Up and Go, time to complete a balance task, walking speed, cadence, and stride length assessments three times a week during the 10 weeks. Data were analysed with the celeration line technique and two standard deviation band. Results: Both individuals demonstrated gains in all parameters over initial baseline and subsequent phases, with performance increases ranging from 26% to 233% when first and last assessments were compared. Significantly superior effects of treadmill training over baseline conditions on cadence were detected (P<0.05). Gains in walking speed were not significantly better during intervention, but intervention withdrawal produced deceleration of performance gains. Gains in Timed Up and Go, step length and balance were not consistent and were possibly caused by a learning effect of the association between repeated testing and treadmill training. Rivermead Visual Gait Assessment gains reached significance only for subject 2 (P<0.05), probably because of increased variability of performance of subject 1. Results suggest that the association between repeated testing and treadmill training might have been responsible for the observed gains in the two ataxic patients.