Differences in the Impact of Intensive Rehabilitation on Hereditary Ataxias and the Cerebellar Subtype of Multiple System Atrophy

Abstract

Background Multiple system atrophy-cerebellar type (MSA-C) exhibits faster disease progression than hereditary spinocerebellar degeneration (hSCD). This study aimed to investigate the differences in the treatment effects and sustainability of intensive rehabilitation between patients with hSCD and those with MSA-C. Methods Forty-nine patients (hSCD = 30, MSA-C = 19) underwent a 2- or 4-week intensive rehabilitation program. Balance function was assessed using the scale for the assessment and rating of ataxia (SARA) and the balance evaluation systems test (BESTest) at pre-intervention, post-intervention, and 6-month follow-ups. Results Both groups showed improvements in SARA and BESTest scores after the intervention. In the hSCD group, the SARA scores remained similar to baseline at follow-up, indicating sustained benefits. The MSA-C group showed some deterioration in SARA scores compared with baseline but maintained improvements on the BESTest, demonstrating partial sustainability. Differences, mainly in sustainability, were observed between the hSCD and MSA-C groups. This may be due to varying rates of symptom progression. Conclusions The findings of this study are significant when considering the frequency of follow-ups based on disease type.