Static Postural Control Deficits in Adults with Myotonic Dystrophy Type 1, Steinert Disease.

BACKGROUND: Myotonic dystrophy type 1 (DM1) is characterized by progressive and predominantly distal muscle atrophy and myotonia. Gait and balance impairments, resulting in falls, are frequently reported in this population. However, the extent to which individuals with DM1 rely more on a specific sensory system for balance than asymptomatic individuals (AI) is unknown. OBJECTIVE: Evaluate postural control performance in individuals with DM1 and its dependence on vision compared to AI. METHODS: 20 participants with DM1, divided into two groups based on their diagnosis, i.e. adult and congenital phenotype, and 12 AI participants were recruited. Quiet standing postural control was assessed in two visual conditions: eyes-open and eyes-closed. The outcomes measures were: center of pressure (CoP), mean velocity, CoP range of displacement in anteroposterior and mediolateral axis, and the 95% confidence ellipse's surface. Friedman and Kruskal-Wallis analysis of variance were used to compare outcomes between conditions and groups, respectively. RESULTS: Significant group effect and condition effect were observed on postural control performance. No significant difference was observed between the two DM1 groups. The significant differences observed between the AI group and the two DM1 groups in the eyes-open condition were also observed in the eyes-closed condition. CONCLUSIONS: The result revealed poorer postural control performance in people with DM1 compared to AI. The DM1 group also showed similar decrease in performance than AI in eyes-closed condition, suggesting no excessive visual dependency.

The use of a trained dog as a gait aid for clients with ataxia: a case report.

PURPOSE: To illustrate the use of a trained dog as a therapeutic tool to optimize physical and psychosocial adaptation of clients with ataxia. METHOD: The gait pattern and gait speed of two people with cerebellar ataxia using different gait aids, including a trained intervention dog and an assistance dog, were compared. Participants' experience of working with the dogs was documented via semi-structured interviews. RESULTS: The use of an intervention dog as part of rehabilitation allowed clients to explore the benefits of an assistance dog and to optimize their physical functioning. The assistance dog had a less destabilizing effect than other walking aids on the clients' self-image. CONCLUSION: Trained dogs may represent an innovative and positive alternative for mobility for people with ataxia, improving both physical and psychosocial parameters. Assistance dogs seem to be a suitable gait aid, since they facilitate ambulation, promoting independent mobility.

Objectif :  Illustrer l'utilisation d'un chien dressé comme outil thérapeutique pour optimiser l'adaptation physique et psychosociale des clients vivant avec l'ataxie. Méthode :  On a comparé la démarche et la vitesse de marche chez deux personnes atteintes d'ataxie cérébelleuse en utilisant différentes aides à la marche, y compris un chien de réadaptation et un chien d'assistance. Des entrevues semi-structurées ont permis de documenter l'expérience des clients avec les chiens. Résultats :  L'utilisation d'un chien comme élément de la réadaptation a permis aux clients d'explorer les bienfaits d'un chien d'assistance et d'optimiser leur fonctionnement physique. Le chien d'assistance semble moins dommageable pour l'image de soi que les autres aides à la marche. Conclusion :  Les chiens dressés peuvent représenter une solution innovatrice et positive sur le plan de la mobilité pour les personnes vivant avec l'ataxie ; améliorant les paramètres tant physiques que psychosociaux. Les chiens d'assistance semblent améliorer le patron de marche puisqu'ils facilitent les déplacements et favorisent la mobilité autonome.