Physiotherapy in Spinocerebellar Ataxia Following COVID-19: A Biomechanical and Biopsychosocial Case Report.

BACKGROUND AND PURPOSE: Spinocerebellar ataxia (SCA) is a progressive neurodegenerative disorder characterized by impaired postural control, coordination deficits, and functional limitations. Despite evidence supporting physiotherapy interventions, standardized rehabilitation protocols remain scarce. This case report explores the effects of an evidence-based physiotherapy program on functionality, baropodometric and stabilometric parameters, and quality of life (QoL) in a patient with SCA. METHODS: Case Presentation-A 56-year-old male with clinically diagnosed SCA and a history of COVID-19 infection preceding symptom onset underwent 30 physiotherapy sessions focused on muscle strengthening, balance training, and coordination exercises. Functional and quantitative assessments included the Timed Up and Go (TUG) test, Romberg test, Dizziness Handicap Inventory (DHI), and baropodometric and stabilometric analyses. RESULTS: The patient reported subjective improvement in dizziness but showed no significant changes in balance or mobility. Post-intervention baropodometric results revealed normalization of bilateral contact surface with eyes closed and an improvement in the plantar arch index of the left foot with eyes open. However, stabilometric assessments indicated an increase in the Center of Pressure (COP) area and mean oscillation velocity in both visual conditions, suggesting a decline in postural stability. The DHI score improved by nearly 50%, particularly in the physical domain. DISCUSSION: This case report highlights the role of physiotherapy in managing functional impairments in SCA, particularly dizziness and foot biomechanics. However, the limited impact on postural stability suggests the need for complementary rehabilitation strategies, such as vestibular rehabilitation and intensive functional training. Integrating baropodometry and stabilometry into routine assessments may facilitate individualized treatment planning and better track disease progression. These findings emphasize the importance of a multidisciplinary, long-term rehabilitation approach to optimize functional outcomes and enhance QoL in individuals with SCA.