FREQUENTLY ASKED QUESTIONS ABOUT…
Coordinative Physiotherapy for Patients with Ataxia
Research has shown that exercise and physical • The physical therapist should assist you in those
therapy can be effective in helping sustain movement exercises that you cannot perform yourself
control in patients with Ataxia as the disease without risking injuries or falls.
progresses. • All exercises should be done without holding
anywhere.
Doris Brötz is a Physiotherapist in Tuebingen,
• Feel free to perform the safe exercises on a
Germany. The focus of her work is the treatment of
regular basis at home, but omit those exercises
patients with neurological disorders and back pain.
which you cannot perform without aid.
From her work emerged the development of the
principle of coordinative physiotherapy. Here she
Treatment strategy
composed a set of therapeutic exercises. Please find
more information, exercises and pictures in As a key element of the treatment strategy, you
„Übungen in der Neurorehabilitation“ Thieme should stop making yourself stiff. If you start to sway
Stuttgart. more after the first exercises, an intermediate goal
has been achieved. It will allow you to perform more
Contact information for Doris Brötz is:
accurate movements and, once you lose balance, to
Doris Brötz, Physiotherapie
react more flexibly. After some training you gain
Nürtinger Straße 36
more control over your movements. This program
72074 Tübingen
strengthens you in repeating the daily life oriented
[email protected] coordination exercises. This means that you do not
www.broetz-physiotherapie.de
need additional strengthening exercises.
Tel: +49 (0)7071 7956969
Mobile: +49 (0)163 1640558
Changing your movement behavior
Fax: +49 (0)7071 9425876
• Move in a smooth and fluid manner as it is
Overview of the program
possible
Patients with ataxia suffer from disturbance of • Change your movement behavior
coordination and balance. This leads to exceedingly • Tolerate shaking
uncontrolled swaying movements. Patients tend to • Adopt the newly learned skills in daily life
avoid these uncontrolled movements and, in • Motto 1: “Move”
particular, stop performing those movements that • Motto 2: “Bend Knees”
demand high coordinative efforts. Thus, their
movement repertoire is increasingly restricted to Goal Setting
movements with only poor variation. As a
consequence, patients lose coordination skills, • The first step to success is a goal! Define one to
reaction ability and gait safety to a larger extent than three realistic goals you want to achieve in the
could be explained by the severity of the disease per next four weeks.
se. This physical therapy approach aims to improve • Which daily life activity do you want to control
coordination skills, static and dynamic balance better? How do you perform this activity at the
control. moment?
• Write your answers down.
General instructions for all exercises in this fact
• Compose your exercise plan with seven to 13
sheet
exercises.
• The exercises differ in difficulty and risk. • Note your progress
• Some exercises are performed lying on the floor
so that the patients do not run the risk of falling.
Coordination and mobility of spine and shoulders
Rotation in lying position
• Lie down on your back
• Bend your knees and put your feet on the mat
• Spread your arms to the side or in U-position
• Tilt both knees to one side
• Move your knees back up
• Repeat the same procedure to the other side
• Repeat 10 times to each side
Rolling on a mat or in bed
• Lie down on your back
• Lift the arm corresponding to the direction in which you want to
roll
• Push the other arm over your body and lift the leg, so that you
come to lay on your side
• Roll back
• Repeat 10 times to each side
Variation: roll from your back – to side – to stomach – to side –
to back in a continuing manner
Quadruped Position
• Start in quadruped position
• Bring your left elbow and right knee
together below your body
• Straighten your left arm and right leg and
elevate them far up
• Repeat 5 times balancing on the left leg
and the right arm
• Repeat with the other leg and arm
Coordination and balance
Shifting your weight to the side
• Sit upright
• Shift your weight to the right
• Sit back up
• Repeat 5 times
• Shift your weight to the left
• Sit back up
• Repeat 5 times
Increase of difficulty:
1. At the end of each repetition, put one foot on the bed and back on the ground
2. At the end of each repetition, put both feet on the bed and back on the ground
Standing up and Sitting down
• Sit down
• Shift your weight onto the feet
• Move into an upright position
• To sit back down, keep the back and knees slightly bent
• Sit down with a controlled movement
• Repeat 10 times
Kneeling Position
• Move into a kneeling position
• Move one leg forward without touching the ground with your toes
• Move back into kneeling position
• Repeat with the other leg
• Repeat 5 times each
Standing Up from the Ground Using Bear Stand
• Stand
• Bend your knees and spine until you touch the floor
• You will be in quadruped position
• Stand on your feet with your hands still on the ground
• Straighten your knees, but keep them slightly bent; the
pressure remains mostly on the forefoot
• Lift your hands off the ground, stand up, and orientate your
weight forwards; keep your knees slightly bent
Dynamic Balance Training / Safety Steps
Side Steps
• Stand upright with your feet hip-width apart
• Take a step to the side
• Go back to the original position
• Repeat 20 times with each leg
Steps forwards
• Stand upright with your feet hip-width apart
• Take a step forwards
• Go back to the original position
• Repeat 20 times with each leg
Steps backwards
• Stand upright with your feet hip-width apart
• Take a step backwards
• Go back to the original position
• Repeat 20 times with each leg
Cross-Step front
• Stand upright with your feet hip-width apart
• Cross one leg in front of the other one
• Go back to the original position
• Repeat 20 times with each leg
Training of Hand-Arm Coordination
Exercises with increasing difficulty
• Pile building blocks
• Pile little toy bricks
• Turn over playing cards
• Collect items in a small jar (marbles, paper clips)
• Write half a page every day
Throwing and Catching a Ball
• Throw the ball up in the air with your right hand and catch it with the same hand
• Do the same with your left hand
• Throw as far up as your eye height
• Catch the ball at the height of your waist
• Throw a ball from the right hand to the left and back
Forearm Rotation
• Pour water from one cup into another 20 times
Drinking
• Keep calm
• Move one hand to your chin
• Move your hand back to the table
• Repeat 10 times
• Pour water into a big cup
• Take the cup and move it to your chin
• Move the cup back to the table
• Repeat 10 times
• Drink two mouthfuls
• Put the cup back on the table
• Do 7 repetitions
Motto: Shoulder Relaxed
Contact information:
Doris Brötz, Physiotherapie
Nürtinger Straße 36
72074 Tübingen
[email protected]
www.broetz-physiotherapie.de
Tel: +49 (0)7071 7956969
Mobile: +49 (0)163 1640558
Fax: +49 (0)7071 9425876
