Modern wobble expenses: a scoping review of ataxia rehabilitation interventions of the past fifteen years with cost impact discussion

Objective(s): To identify recent ataxia interventions and investigate cost-utility for patients with ataxia

Data Sources: Bibliographical searches conducted using electronic databases: PubMed, Scopus, EBSCO, PEDro, CINAHL. Time restriction to publications since 2008 to represent modern practice. Indexing terms: physical therapy, ataxia, robot-assisted gait training, optokinetic training, quality of life, cerebellar ataxia, physiotherapy, incoordination, modalities, Frenkel, heat OR cold therapy

Study Selection: Inclusion criteria: Adults with lower extremity incoordination or ataxia. Systematic reviews, RCTs, quasi-experimental studies, and meta-analyses were included. Targets: interventions to manage or improve ataxia, quality of life improvements, fall reduction or management. Multiple reviewers (three total) to apply consensus for inclusion. Initial selection found 19 papers for full review

Data Extraction: Independent extraction by multiple readers; JBI Reviewer's Manual

Data Synthesis: Positive findings and negative findings included, regardless of recovery phase. Variation across outcome measures and drop-out rates. Costs of treatment options over 1 year were compared, using a program cost analysis from the perspective of a rehab program director. Rehabilitation outcome measures used to assess effectiveness relative to direct costs, particularly quality of life measures and program administration costs.

Conclusions: Although preliminary, the same best practice recommendations from APTA for overground gait training for patients with SCI, CVA, and TBI may also apply to conditions of ataxia as the most effective form of physical therapy. Other interventions may provide benefit as well, although concerns about cost impact remain.

Author(s) Disclosures: No disclosures