Home High-Intensity Aerobic Exercises Show Greater Benefits Than Balance Training for Cerebellar Ataxias

Recent research led by Columbia University Medical Center reveals that engaging in high-intensity aerobic exercises at home can lead to significant improvements in ataxia symptoms, fatigue levels, and aerobic capacity among individuals with cerebellar ataxias. In a well-structured 12-month clinical trial, participants performed either aerobic or balance-focused training routines, with both groups receiving equivalent exercise doses. The study involved 62 adults who were monitored via wearable devices during their home exercise regimens, with assessments conducted at several intervals.

Results indicated that those practicing aerobic exercises experienced greater reductions in their SARA scores, which measure ataxia severity, compared to those engaging solely in balance training. Furthermore, aerobic training participants reported less fatigue and demonstrated improved maximal oxygen consumption (VO2max) during the initial months. However, change in gait speed, dynamic gait, and quality of life did not show significant differences between groups.

Cerebellar ataxias are characterized by progressive loss of coordination, affecting about 150,000 people in the US, with substantial healthcare costs. While traditional management emphasizes balance training, emerging evidence underscores the potential of aerobic exercises to enhance clinical outcomes. Animal studies support this, showing longer lifespans and neuroplastic benefits with regular aerobic activity. Moreover, data from other neurodegenerative conditions like Parkinson’s and Alzheimer’s disease suggest that aerobic exercise can slow disease progression.

The study, published in JAMA Neurology, highlights that home-based high-intensity aerobic training is feasible, well-tolerated, and offers superior improvements over balance training alone. These findings advocate for incorporating structured aerobic programs into ataxia rehabilitation protocols, aiming to improve functional capacities and symptom management.

This research underscores a shift towards more dynamic, cardiovascular-focused interventions in managing cerebellar ataxias, providing hope for better patient outcomes and quality of life.