{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:29:57Z","timestamp":1793831397412,"version":"4.6.1"},"reference-count":53,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"\n Importance<\/jats:title>\n Clinical practice guidelines advise balance training for cerebellar ataxia, but little is known regarding high-intensity aerobic exercise.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare home high-intensity aerobic training to home balance training on improvements of ataxia symptoms using the Scale for the Assessment and Rating of Ataxia (SARA).<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This assessor-masked randomized clinical trial was conducted between January 1, 2021, and September 1, 2024, through home training, with in-person assessments at a single ataxia care center in a large urban US city. Individuals with various cerebellar ataxia types were eligible for inclusion. Data analysis was performed from November 2024 to February 2025.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Individuals in the aerobic group trained for 30 minutes\/session, 5 times\/week, at up to 85% predicted maximum heart rate. Individuals in the balance group performed 30 minutes of balance exercises of varying difficulty 5 times\/week. Participants were given study support of biweekly phone calls for only the first 6 months of this 12-month study.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The primary outcome was SARA score to measure ataxia symptoms (range, 0-40 points, with higher scores indicating more ataxia). Secondary outcomes included number of adverse events, training adherence, balance measures, gait speed, quality of life, fatigue, and fitness levels (assessed via V\u0307\n o<\/jats:sc>\n 2<\/jats:sub>\n max). Assessments were conducted at baseline and at 6, 9, and 12 months.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 114 individuals with various cerebellar ataxia types were approached: 52 individuals declined participation or did not meet inclusion criteria, while 62 individuals were enrolled. The 62 participants included 29 women (46.8%), with a mean (SD) age of 54.4 (12.9) years and mean (SD) SARA score of 12.1 (4.1) points. Linear mixed-effects model analysis revealed that the home aerobic group had significantly larger improvement in outcomes than the balance group, particularly for SARA score (\u03b2, \u22121.53; 95% CI, \u22122.44 to \u22120.61;\n P<\/jats:italic>\n \u2009=\u2009.001), fatigue (\u03b2, \u22129.38; 95% CI, \u221215.1 to \u22123.7;\n P<\/jats:italic>\n \u2009=\u2009.001), and V\n o<\/jats:sc>\n 2<\/jats:sub>\n max (\u03b2, 4.26; 95% CI, 2.1-6.4;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). At 6 months, the aerobic and balance groups had changes in SARA scores of \u22122.4 points (95% CI, \u22123.1 to \u22121.80) and \u22120.9 points (95% CI, \u22121.5 to \u22120.2), respectively. For the aerobic group, individuals who continued training maintained benefits in SARA score (change from baseline, \u22123.81 points; 95% CI, \u22122.2 to \u22125.4), whereas those who limited or stopped training had benefits trend back to baseline levels (change from baseline, 0.4 points; 95% CI, \u22120.4 to 1.2) at 1 year.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, home high-intensity aerobic training improved ataxia symptoms, fatigue, and aerobic fitness more than dose-matched home balance training among individuals with cerebellar ataxias. Individuals in the aerobic group who continued to train regularly maintained benefits at 1 year.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT05002218<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaneurol.2025.3421","type":"journal-article","created":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T22:30:17Z","timestamp":1757889017000},"page":"1162","source":"Crossref","is-referenced-by-count":20,"title":["Home Training for Cerebellar Ataxias"],"prefix":"10.1001","volume":"82","author":[{"given":"Scott","family":"Barbuto","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonjoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Biostatistics, College of Physicians 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