Feasibility of a Telehealth Physical Activity Coaching Intervention for Degenerative Cerebellar Ataxia

Background and Purpose: Physical activity (PA) can be neuroprotective for people with neurodegenerative diseases; however, rehabilitation programs often fail to address strategies to increase long-term PA. This study evaluated the feasibility, acceptability, and effect estimates of a PA coaching program in people with degenerative cerebellar disorders (PwDCD). Methods: Engage-Ataxia was a single-cohort intervention consisting of 5 physical therapist-delivered telehealth PA-coaching sessions over 12 weeks, with assessments pre- and post-intervention. The intervention was grounded in self-determination theory and incorporated individualized exercise recommendations, goal setting, and strategies to overcome exercise barriers. Participants received a wearable PA monitor and disease-specific workbook. Results: Thirty-four PwDCD were screened and 25 (11M:14F) were enrolled (73.5% recruitment rate); 22 completed post-assessments (retention 88%) and attended all 5 intervention sessions (adherence 100%). Participants focused goals on improving or maintaining balance or balance confidence, with additional goals focused on other exercise (n = 19), task-specific practice (n = 6), PA/steps (n = 5), motivation (n = 3), and mobility/gait (n = 3). Post-intervention interviews revealed the program was acceptable. Medium-large effect sizes comparing pre-post intervention were found for modified Scale for Assessment and Rating of Ataxia, Cerebellar Cognitive Affective Syndrome Scale, Timed Up and Go, exercise identity, balance confidence, and patient-specific goals. Small-medium effect sizes were found for ESE and self-reported PA. Discussion and Conclusion: Engage-Ataxia is a feasible and acceptable low-dose intervention for PwDCD, with improvements in mobility, balance, balance confidence, and ataxia. Impairments in balance and balance confidence superseded goals for PA-uptake, which is important to inform outcomes for future trials evaluating PA-coaching models in PwDCD.