Aerobic Exercise, Balance Training, and Ataxia

Individuals with degenerative cerebellar disease (DCD) exhibit gradual loss of coordination
resulting in impaired balance, gait deviations, and severe, progressive disability. With no
available disease-modifying medications, balance training is the primary treatment option to
improve motor skills and functional performance.

Aerobic training, on the other hand, may modify DCD progression as evident from animal data.
Compared to sedentary controls, aerobically trained DCD rats have enhanced lifespan, motor
function, and cerebellar Purkinje cell survival. Numerous animal studies also document that
aerobic training has a direct, favorable effect on the brain that includes production of
neurotrophic hormones, enhancement of neuroplasticity mechanisms, and protection from
neurotoxins.

The effects of aerobic training in humans with DCD are relatively unknown, despite these
encouraging animal data. A single study to date has evaluated the benefits of aerobic
exercise on DCD in humans, and this was a secondary outcome of the study. Although
participants performed limited aerobic training during the study, modest functional benefits
were still detected.

The main objective of this project will be to compare the benefits of aerobic versus balance
training in DCD. The investigators hypothesize that both aerobic and balance training will
improve function in DCD subjects, but that the mechanisms in which these improvements occur
differ.

Inclusion Criteria:

- Diagnosed with spinocerebellar ataxia

- Cerebellar atrophy on MRI

- Prevalence of ataxia on clinical exam

- Ability to safely ride a stationary exercise bike

Exclusion Criteria:

- Other neurologic conditions

- Heart disease

- Cognitive impairment

- Medical instability