Influence of assistive devices on dynamic balance performance during gait in cerebellar ataxia

Purpose Cerebellar ataxia (CA) is characterised by impaired coordination and motor control, resulting in high fall risk and reduced functional independence. Although assistive devices are commonly prescribed, limited evidence guides device selection. This study examined the effects of different walker designs on balance performance.Materials and methods This cross-sectional observational study included 20 adults with CA who completed a single testing session. Balance was assessed using the 4-Item Dynamic Gait Index (DGI-4) and the Modified Dynamic Gait Index (mDGI) under four conditions: no device, standard two-wheeled walker, platform rolling walker (PRW), and posterior walker. Mixed-effects models with Tukey adjustment compared outcomes across conditions. Spearman correlations examined relationships among balance, ataxia severity, gait speed, and fall history.Results PRW and posterior walker conditions produced significantly higher DGI-4 and mDGI scores compared with no device (all p ≤ 0.0005). No differences were observed between the no-device and standard two-wheeled walker conditions. Both higher-stability devices outperformed the standard walker (all p ≤ 0.0003), with no differences between PRW and posterior walker. Greater ataxia severity was associated with poorer balance (ρ = −0.70, p < 0.0004).Conclusions Higher-stability walkers were associated with improved dynamic balance compared with no device or a standard two-wheeled walker.