Ataxia refers to the loss of control of voluntary movements of the body, including the limbs, face, or eyes. It is usually considered a symptom of an underlying diagnosis.

What is Ataxia?

Ataxia Overview
Ataxia refers to the loss of control of voluntary movements of the body,
including the limbs, face, or eyes. (1) It is a rare disorder with many proposed
forms that are thought to affect common actions including walking, reaching,
speaking, and seeing. Ataxia is usually considered to be a symptom of an
underlying diagnosis like stroke, cerebral palsy (CP), multiple sclerosis, or a
brain tumor, rather than an independent occurrence. (2) For purposes of this
article, we will discuss ataxia as a neurological symptom, its effects on upper
and lower extremity function, and supportive strategies to improve daily living
skills while living with ataxia.



What causes ataxia?
Ataxia often results from damage to a brain area called the cerebellum, a
structure that regulates coordination of movement and balance. It can affect one
side of the body (known as hemi-ataxia) or both, and can occur at any age
depending on its underlying cause. Ataxia can present quickly, following an
acute event like a stroke, or slowly over the course of years alongside a
neurodegenerative disease. For individuals with CP, ataxia may be present from
birth. At this time, there is no cure for ataxia; however, prompt therapeutic
intervention can improve functional outcomes. (2, 3, 4)



What does ataxia look like?
Ataxia symptoms can make an individual look as if they are clumsy. Ataxia
affecting the arms can cause difficulty holding and using objects as well as
decreased accuracy in reaching targets. Symptoms of ataxia affecting the core
and legs might present as impaired sitting or standing balance, unsteady
walking, and falling. (5) Unlike apraxia
[https://www.neofect.com/us/blog/what-is-apraxia], another coordination
disorder, individuals with ataxia remain aware of the purpose of their actions
and associated tool use; however, their muscles do not respond in the correct
way to accomplish the desired task efficiently. (6)

Therapeutic Treatments for Ataxia
There are many different options for treating ataxia with the help of an
occupational or physical therapist. Conventional OT and PT services aim to
improve independence and safety with daily living tasks. Occupational therapy
focuses on life skills from the basics, like eating, dressing, and grooming, to
bigger-picture tasks related to performing optimally at school or work. Physical
therapy addresses posture, balance, and walking so the individual can move
around with less assistance. Both OT and PT may incorporate strengthening and
cooridnation exercises as well as adaptive equipment or assistive device
recommendations into their treatment plans.



Constraint Induced Movement Therapy (CIMT)
CIMT
[https://blog.neofect.com/using-neofect-smartglove-to-maximize-constraint-induced-movement-therapy/] 
is a therapeutic intervention that can improve grasping, reaching, and in-hand
manipulation skills by constraining an individual’s less affected arm in a mitt,
cast, or sling, thereby forcing them to use their more affected side for the
majority of the time. A therapist will then lead the individual through
intensive training involving repetitive task performance to promote improved
functional use of the limb and increased motivation to use it when not
constrained. CIMT is commonly performed with children, but can be done with
adults with ataxia as well. (7)

Hippotherapy
Also known as equine assisted therapy, horseback riding under the direction of
an occupational or physical therapist is another treatment that is shown to
improve mobility and coordination for individuals with ataxia. This intervention
engages multiple body systems through incorporation of activities including
achieving and changing positions while on horseback. Hippotherapy promotes
improved core strength and posture that extends into better walking skills and
more accurate reaching to targets. (8)

Virtual Reality (VR)
VR therapy is a newer approach to treating coordination disorders using a fun
and stimulating video game environment. Systems including the Nintendo Wii, XBox
Kinect, and NEOFECT Smart Glove
[https://www.neofect.com/en/product/stroke-therapy-hand/] and Smart Board
incorporate motion-sensing technology to alter gameplay and provide feedback
about the quality of movement during repetitive task training. Studies
evaluating consistent use of these systems have shown that daily gameplay can
produce lasting improvements in arm and finger function for daily tasks. (9)



Ultimately, ataxia can be a challenging symptom to address due to the variety of
diagnoses that it may stem from. However, therapeutic interventions have shown
promise in reducing ataxia-related incoordination or providing means to
compensate for it. If you think you might be experiencing ataxia and are seeking
treatment options, please discuss your concerns with your medical team.

The NEOFECT [https://www.neofect.com/en/] line of Smart Rehabilitation Solutions
can assist with coordination difficulties stemming from stroke or other
neurological diagnoses. Our neurorehabilitation products include support from
occupational therapists to maximize functional gains. Please call (866) 534-4989
or email contactus@neofect.com for further inquiry.

 1. Columbia University Department of Neurology. (2015). Ataxia. Retrieved from 
    http://www.columbianeurology.org/neurology/staywell/document.php?id=35869
 2. Ashizawa, T., & Xia, G. (2016). Ataxia. Continuum (Minneapolis, Minn.),
    22(4), 1208–1226. doi:10.1212/CON.0000000000000362
 3. Brunberg JA; Expert Panel on Neurologic Imaging. Ataxia. AJNR Am J
    Neuroradiol. 2008 Aug;29(7):1420-1422.
 4. Fernandez, H. (2019). Ataxia. Retrieved from 
    http://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Ataxia.htm
 5. National Ataxia Foundation. (2019). What is Ataxia? Retrieved from 
    https://ataxia.org/what-is-ataxia/#ataxiaSymptoms
 6. NORD National Organization for Rare Disorders. (2003). Apraxia. Retrieved
    from https://rarediseases.org/rare-diseases/apraxia/
 7. Reiss, A. P., Wolf, S. L., Hammel, E. A., Mcleod, E. L., & Williams, E. A.
    (2012). Constraint-Induced Movement Therapy (CIMT): Current Perspectives and
    Future Directions. Stroke Research and Treatment, 1–8. doi:
    10.1155/2012/159391
 8. Shurtleff, T. L., Standeven, J. W., & Engsberg, J. R. (2009). Changes in
    Dynamic Trunk/Head Stability and Functional Reach After Hippotherapy.
    Archives of Physical Medicine and Rehabilitation, 90(7), 1185–1195. doi:
    10.1016/j.apmr.2009.01.026
 9. Hartley, H., Cassidy, E., Bunn, L., Kumar, R., Pizer, B., Lane, S., &
    Carter, B. (2019). Exercise and Physical Therapy Interventions for Children
    with Ataxia: A Systematic Review. The Cerebellum. doi:
    10.1007/s12311-019-01063-z

For more information on Ataxia
National Ataxia Foundation - What is Ataxia [https://ataxia.org/what-is-ataxia/]
Mayo Clinic - Ataxia
[https://www.mayoclinic.org/diseases-conditions/ataxia/symptoms-causes/syc-20355652]
Johns Hopkins Medicine - Ataxia
[https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/ataxia/conditions/index.html]
WebMD - Ataxia: What Are the Types?
[https://www.webmd.com/brain/ataxia-types-brain-and-nervous-system#1]

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the NEOFECT website is solely at your
own risk.

Post-Stroke

Apraxia is a disorder that can result from a stroke, brain injury, brain tumor, or neurodegenerative disease. This condition usually results from damage to the left hemisphere of the brain.

What is Apraxia?



What does it mean to have apraxia?
Throughout the course of a day, the human body is constantly coordinating
movement. Routine actions that might seem effortless, like waving hello,
catching a ball, or using a toothbrush, are actually the result of the brain
sending a precise series of messages to the limbs to move the muscles.
Therapists often use the term “motor planning” to refer to the ability to
perform movements in the right order to form actions. (1) However, when brain
areas controlling movement are damaged, a breakdown in motor planning can occur.
This breakdown can also be referred to as apraxia.

Apraxia is a disorder that can result from a stroke, brain injury, brain tumor,
or neurodegenerative disease. This condition usually results from damage to the
left hemisphere of the brain and can affect one or more areas of the body,
including the arms, legs, or even the face. (2) The scientific community has not
yet reached an agreement on the many proposed forms of apraxia or how to
classify them. (3) For purposes of this article, we will explore how apraxia can
affect actions related to arm movements and how this condition can be treated by
therapists and caregivers alike.

How can you tell if someone has apraxia?
Apraxic movement errors are not caused by one-sided arm weakness
[https://www.neofect.com/us/blog/hemiplegia-vs-hemiparesis] related to a
neurological event. In fact, a person who has apraxia might not have noticeable
arm weakness at all. Instead, they might look like their arm movements are
slowed down or clumsy. This is because their brain has lost the ability to
smoothly motor plan actions from start to finish. They may now need to spend
more time thinking through the individual steps of a task.

Apraxia can affect a person’s ability to perform or copy a gesture, even after
being asked and given a visual demonstration. Someone with apraxia may not be
able to mimic the thumbs up or down sign or wave upon command. Apraxia can also
cause reduced understanding of the purpose of objects, resulting in incorrect
tool use. (4) For example, a person with apraxia might demonstrate using a
hammer by holding it upside down or raking it across a table. They might bring a
hairbrush to their mouth or brush their hair in upward strokes instead of
downward.


Copying a simple gesture might be difficult for someone with apraxia, as they
may no longer understand its meaning.

The automatic ability to perform a familiar movement or use a common object may
be preserved despite apraxia. A person with apraxia might be able to pick up a
telephone as it rings or spontaneously wave goodbye to a family member even when
they cannot demonstrate either action upon command. Automatic performance of arm
movements may not always be present or retained consistently. (5) Regardless,
when working with people with apraxia, it is best to practice re-learning simple
tasks in their natural context for maximum skill carryover.

How can I help my loved one with apraxia?
A good approach to helping someone with apraxia is establishing a consistent
routine of daily tasks. (6) A well-rounded routine can include eating meals,
getting dressed, performing hygiene, and completing familiar chores or leisure
activities. It is advised to structure basic tasks in the same order every day
as able and to minimize distractions in the environment (limit unnecessary items
and noise) so the affected person can stay focused. Provide hand-over-hand
guidance in addition to verbal instructions if the person with apraxia seems
stuck on a movement or begins to perform it incorrectly. Once you have begun
guiding the correct movement pattern, attempt to fade guidance to see if the
individual can continue the step of the task or perform the remainder of the
action by themselves.


Remove clutter and unnecessary items in common workspaces to maximize success.

Through repetition of familiar actions and task grading (adjusting a daily
routine to include easier or more complicated tasks based on performance) it is
thought that movement patterns can be restored so that actions are performed
more automatically. However, for some, apraxia will be a long-lasting condition.
(7) It is important to be patient and understanding when interacting with
someone with apraxia, as they might need more time or some extra physical help
to get started doing the things they want to do.

As apraxia often occurs alongside aphasia
[https://www.neofect.com/us/blog/stroke-lingo-part-1], a communication disorder,
it is important to provide multiple ways to understand the task at hand whether
it is verbal, written, or visual instruction via demonstration or pictures. (8)
It is also advised to consider related coordination disorders when diagnosing
apraxia, including ataxia [https://www.neofect.com/us/blog/what-is-ataxia]. If
you are unsure whether the symptoms you or a loved one is exhibiting are related
to apraxia, discuss your concerns with a medical or therapy team.

The NEOFECT [https://www.neofect.com/en/] line of Smart Rehabilitation Solutions
can assist with coordination difficulties stemming from stroke or other
neurological diagnoses. Our neurorehabilitation products include support from
occupational therapists to maximize your functional gains. Please call (866)
534-4989 or email contactus@neofect.com for further inquiry.

 1. Wong AL, Haith AM, Krakauer JW. Motor Planning. The Neuroscientist.
    2014;21(4):385-398. doi:10.1177/1073858414541484.
 2. Gross R. G., Grossman M. (2008). Update on apraxia. Curr. Neurol. Neurosci.
    Rep. 8 490–496. 10.1007/s11910-008-0078-y
 3. Petreska B, Adriani M, Blanke O, Billard AG. Apraxia: a review. Prog Brain
    Res. 2007;164:61–83.
 4. Fernandez YM, Frucht SJ. Primary progressive apraxia: an unusual ideomotor
    syndrome. Journal of Clinical Movement Disorders. 2017;4(1).
    doi:10.1186/s40734-017-0064-0.
 5. Rapcsak S, Ochipa C, Beeson P, Rubens A. Praxis and the Right Hemisphere.
    Brain and Cognition. 1993;23(2):181-202. doi:10.1006/brcg.1993.1054.
 6. Heugten CV, Geusgens C. Strategies to Compensate for Apraxia Among Stroke
    Clients. International Handbook of Occupational Therapy Interventions.
    January 2009:241-248. doi:10.1007/978-0-387-75424-6_22.
 7. Donkervoort M, Dekker J, Deelman B. The course of apraxia and ADL
    functioning in left hemisphere stroke patients treated in rehabilitation
    centres and nursing homes. Clinical Rehabilitation. 2006;20(12):1085-1093.
    doi:10.1177/0269215506071257.
 8. Kobayashi S, Ugawa Y (2013) Relationships between Aphasia and Apraxia. J
    Neurol Transl Neurosci 2(1): 1028.

For More Information on Apraxia:
WebMD - Apraxia: Symptoms, Causes, Tests, Treatments
[https://www.webmd.com/brain/apraxia-symptoms-causes-tests-treatments#1]
Wikipedia - Apraxia [https://en.m.wikipedia.org/wiki/Apraxia]
National Organization of Rare Disorders - Apraxia
[https://rarediseases.org/rare-diseases/apraxia/]

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the NEOFECT website is solely at your
own risk.

Hemiplegia and hemiparesis could seem very similar because they sometimes have the same underlying symptoms. However, they have different meanings.

Hemiplegia vs. Hemiparesis

Do you ever get mixed up trying to distinguish hemiplegia from hemiparesis? With
all of the confusing stroke terminology out there, it's hard to tell the
difference.



Hemiplegia and hemiparesis may seem very similar because hemiplegia and
hemiparesis have the same underlying symptoms. However, these terms have
slightly different meanings.

In this article, we'll break down the difference between hemiplegia and
hemiparesis, describe how to manage hemiplegic or hemiparetic arm weakness, and
review the long-term outcomes of each condition.


Hemiplegia and Hemiparesis

 * Definitions
 * Causes
 * Symptoms
 * Management
 * Prognosis
 * Conclusion

Definitions of Hemiplegia and Hemiparesis
How can one tell the differences between hemiparesis and hemiplegia? Both
conditions may be accompanied by symptoms including loss of movement
[https://www.neofect.com/us/blog/3-ways-to-recover-hand-motion-following-stroke]
, loss of sensation, abnormal muscle tone (hyper or hypotonicity), and loss of
postural control. One-sided weakness from hemiparesis or hemiplegia may span
from the head (including facial muscles), through the trunk and the arm, and
down to the legs. These can conditions even cause weakness on muscles inside of
the body!

Ultimately, there is a distinction between the two terms:

Hemiparesis
Hemiparesis indicates a mild to moderate degree of muscular weakness on one side
of the body.


Hemiplegia
Hemiplegia indicates a severe or complete loss of movement function on one side
of the body.


Although these terms are similar and often used synonymously, hemiparesis
relates to a milder form of one-sided weakness than hemiplegia. Hopefully that
begins to clear things up!

Causes
Hemiplegia and hemiparesis often have the same causes; however, use of one term
or the other depends on the severity of muscle weakness and dysfunction
resulting from central nervous system (brain or spinal cord) injury.

Brain damage can disrupt many functions, including movement control, sensation,
coordination, and thinking skills. Damage may alter or destroy the brain's
underlying neural pathways, the structures responsible for sending messages
related to controlling the rest of the body. Abnormalities in brain areas
responsible for controlling movement and muscle tone are primarily responsible
for causing hemiparesis or hemiplegia.


Hemiparesis or hemiplegia may occur as a result of the following diagnoses:

 * Stroke [/what-are-the-different-types-of-stroke/]: Stroke is one of the most
   common causes of one-sided bodily weakness. The severity of muscle weakness
   that you experience can depend on the size and location damage within the
   brain
   
   
 * Traumatic brain injury (TBI): A TBI can cause permanent brain damage. If the
   trauma only affects one side of the brain, hemiplegia can result on the
   opposite side of the body. Common causes of trauma include car accidents,
   falls, or blows to the head.
   
   
 * Spinal cord injury (SCI): SCI has many presentations. Depending on where the
   spinal cord was damaged, resultant weakness may affect only one side of the
   body.
   
   
 * Brain Tumors: Brain tumors can lead to a variety of physical problems
   including hemiplegia. Symptoms of hemiplegia may get worse as the tumor grows
   and invades brain areas that control movement.
   
   
 * Additional Causes: Multiple sclerosis, muscular dystrophy, cerebral palsy,
   amyotrophic lateral sclerosis (ALS)
   
   


Symptoms
Hemiplegia or hemiparesis may present differently from person to person. Common
symptoms of these conditions include:

 * Muscle weakness wasting, or atrophy
   
   
 * Loss of coordination lack of gross or fine motor skills resulting in
   difficulties sitting, standing, walking, or reaching
   
   
 * Loss of normal muscle tone resulting in stiffness, spasticity, flaccidity
   
   
 * Loss of sensation difficulty detecting texture, temperature, touch, or pain
   
   


Management
There are many ways to manage symptoms of one-sided weakness from hemiplegia or
hemiparesis. Common treatment approaches include remediating physical function 
by strengthening muscles and restoring lost skills or compensating for
independent function using supportive devices.


Rehabilitation Treatment
The concept of neuroplasticity
[https://www.neofect.com/us/blog/why-neuroplasticity-matters-to-post-stroke-rehabilitation]
, which states that the body can adapt to the environment and change even after
the brain is damaged, suggests that it is possible to improve hemiplegic
symptoms through rehabilitation. High-frequency and high repetition
strengthening exercise and functional task training may help reduce weakness.

Equipment/devices
Assistive devices are used to enable independent functioning by supplementing
skills that the user cannot perform independently.

Common assistive devices used to make up for one-sided weakness include:

 * Mobility aids: wheelchair, walker, cane
 * Meal aids: universal cuff, built-up utensils, suction cup plates, high wall
   plates, no-slip mats
 * Dressing aids: reacher, sock aid, elastic shoelaces, long shoehorn
 * Bath accessories: shower chair, tub bench, raised toilet seat, grab bars,
   long-handled sponge
 * Bowel and bladder aids: catheter equipment, bowel program equipment
 * Splints and braces for the arm or leg

Mental health management
A significant medical condition associated with reduced physical functioning,
daily routine changes, or increased dependency on others can contribute to
feelings of hopelesness or depression. It is recommended that survivors partake
in psychological counseling to provide support, promote appropriate adjustment
to disability, and instill coping mechanisms and hope. Always ask your primary
doctor about mental health resources or a referral to a counselor in the event
that you are struggling.




Prognosis
What is the prognosis for hemiparesis or hemiplegia?

The prognoses of hemiplegia and hemiparesis are difficult to predict because
symptoms may change over time. Each person is different in how they recover from
brain, spinal cord, or nerve damage due to variables like age, current health,
and other underlying factors. Some will recover quickly with no treatment while
others will only see minor improvements even with extensive therapy.

However, even after damage, nerve cells in the brain and spinal cord show
capability to rewire and adapt to regain lost functions. It is possible for
older nerve pathways to heal and resume their original function or for
different, undamaged areas to perform the functions of the damaged area instead.

In order to promote neuroplastic changes for improved physical functioning,
health management, rehabilitation, and therapeutic activities and exercise are
vital. It helps to have a supportive medical team to guide you throughout the
process.



Conclusion
As you come to understand the best options for you or a loved one’s rehab
journey, don’t miss the opportunity to check out Neofect Home Rehab Solutions
[https://www.neofect.com/us/for-home]. Neofect Home Rehab products
[https://shop.neofect.com/] are clinically proven to improve functionality of
hand and arm with fun and engaging activities that you can do in the comfort of
your home.
To learn more, call (888) 623-8984 [tel:+18886238984] or email info@neofect.com.


--------------------------------------------------------------------------------

Michael Eustace: A Vietnam Veteran and Stroke Survivor



I went to move and I couldn’t. I moved forward and slid right onto the floor. I
started to get a little bit better and then I had another stroke. And then I had
problems with my heart and wound up having 3 strokes and 1 heart attack.

I couldn’t move my arm, I couldn’t move my hand, I couldn’t do anything. At that
point I started to try to get better.

They kept saying, “What is your goal?”. I said my goal is to get up and walk
again. My goal is to get up and use my hand.

For me it was like it opened up a world of things that I could do with my hand,
and get more mobility, because it motivates you to do more. You don’t appreciate
things that you do before that you can’t do now.

"If it wasn’t for Neofect, I’d probably never bend my hand the way it is now."

To learn more about Neofect smart rehab devices, call (888) 623-8984 or email 
info@neofect.com.


--------------------------------------------------------------------------------

About Neofect

Why we exist

We strive to inspire people everywhere to live the best life they can because we
believe that everyone has the right to a happy life.

No matter who you are, You have the right to lead your life.
No matter what kind of challenges you may face, You still deserve to be the hero
of your own life. You deserve to be happy.

We Inspire hope. We Inspire you.


Our philosophy
Everyone has their own goals in life, but the ultimate goal is the same: “To
live a happy life”

Neofect believes that a happy life begins with finding purpose and is achieved
through active participation and engagement in the things we love.

However, unforeseen circumstances may disrupt your happiness. Illness, aging,
and accidents are a part of life.

It is not uncommon to feel discouraged or defeated when met with these
obstacles.
Neofect exists for those who strive for the best life they can possibly live.

Using breakthrough research and innovative technology, we can help you
rediscover your purpose and live your best life.

Let us help you live your life on your own terms. You deserve it.

Call us at (888) 623-8984 [tel:+18886238984] or email us at info@neofect.com to 
start rehabilitating smarter with Neofect today.