Home-Based Telerehabilitation for Core Stability in Hereditary Ataxia: Feasibility and Preliminary Effects of a Pilot RCT

BackgroundCore stability exercises (CSE) have shown efficacy in improving trunk function in individuals with hereditary ataxia (HA), but adherence to home programs is often low. Telerehabilitation (TR) could facilitate remote program delivery.ObjectivesTo assess the feasibility and preliminary effects of a 7-week home-based CSE-TR in individuals with HA.MethodsIn this single-blind, two-arm randomized controlled pilot study, participants performed a CSE-TR program 5 days per week, over 7 weeks. Two TR formats were compared: the Mixed Group (MG) combined asynchronous training with weekly synchronous sessions, while the Asynchronous Group (AG) received weekly follow-up calls. Feasibility outcomes included recruitment, adherence, compliance and retention. Preliminary effects-assessed at baseline, 7 weeks, and 12 weeks-included balance, gait performance, lower limb strength, fall risk, ataxia severity, and balance confidence.ResultsTwelve individuals with HA (mean age 49.5 ± 20.6 years) completed the study with 100% of retention. Statistically significant improvements over time were observed in gait performance (p < 0.0001), the MG showed significant gains at 7 weeks (p = 0.002) that were not maintained at follow-up. A significant time × group interaction was found for gait performance favoring the MG in the short term (p = 0.003). Balance confidence showed significant differences both over time (p = 0.046) and between groups (p = 0.014), with an unexpected decline in the MG. No other outcome measures reached statistical significance.ConclusionA home-based CSE-TR program is feasible and safe for individuals with HA and may provide functional benefits. Larger trials are needed to confirm effectiveness and optimize adherence.