Scientists develop a new approach to assessing Ataxia at home

Written by Ziyang Zhao Edited by Dr. Hayley McLoughlin

A newly developed smartphone application will allow patients to assess ataxia at home.

There’s an interesting problem in science that’s often overshadowed in the scientific community. It’s not as flashy or as newsworthy as most scientific headlines, like the eradication of Polio or the creation of the coronavirus vaccine, but its importance looms nonetheless. That problem is the monumental task of getting people to assess themselves.

Take this interesting bit: The American Cancer Society found that nearly 100% of Americans are aware of the benefits of monthly screenings for Colorectal Cancer — a preventable and treatable form of cancer, if detected early — yet nearly 50,000 Colorectal Cancer-related deaths occur each year in the United States (American Cancer Society, 2016). Alongside that first statistic, the American Cancer Society had also asked why an unscreened individual chooses to remain so. An important reason, they noted, was patient concern over the complexities of taking a test: taking time off from work, getting a ride home, and high out-of-pocket expenses.

In Ataxia-based diseases, testing is similarly cumbersome and accessibility for assessment is not readily available. The most common way to measure the degree of one’s level of Ataxia is through the Scale for assessment and rating of ataxia (SARA) score, which evaluates 9 ataxia-affected abilities to produce a composite score. The problem, however, is that the SARA test is cumbersome. It’s a costly assessment that requires the patient to travel to their local hospital and meet with a testing expert.

Camera on tripod takng a video
The SARAhome test involves a person performing a series of physical tests. They record themselves using a tablet or smartphone on top of a tripod. Photo used under license by Mascha Tace/

In this study, the researchers devised an Ataxia assessment matching the SARA test that can be performed at home, which they call SARAhome. While the original SARA test assessed 8 attributes, this new Ataxia test only assessed 5, including gait, stance, speech, nose-finger test, fast alternating hand movements. To make SARAhome even easier to take at home, the researchers also incorporated some modifications to their selected 5 tests from the original SARA test, including reducing required walking distances, performing fast-alternating movement and nose-finger tests on a chair, and replacing an investigator’s finger in the nose finger test with a tape-mark on the wall. These video recordings would be sent to an experienced rater, who would subsequently produce the score.

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Spotlight: The Movement Analysis and Robotics Laboratory (MARlab)

MAR lab logo

Principal Investigator: Dr. Maurizio Petrarca

Location: Bambino Gesù Children Hospital, Rome, Italy

Year Founded: 2000

What models and techniques do you use?

  • Wearable Technologies
  • Movement analysis
  • Robotics
  • Clinical standardized assessment tools
Seven researchers stand infrom of a presentation screen
This is group picture taken during a conference. From left to right: Silvia Minosse, Alberto Romano, Martina Favetta, Maurizio Petrarca (PI), Gessica Vasco, Susanna Summa and Riccardo Carbonetti. Image courtesy of Susanna Summa.

Research Focus

What is your research about?

MARlab has a lot of experience in the rehabilitation of children with motor disorders including cerebellar diseases. We specialize in the use of motion analysis systems and robotics. Using advanced tools, we customize assessments and rehabilitative settings matching children needs in an ecological context.

We are involved in research to define specific digital biomarker and we are exploring different technological solutions, including wearable technology, to monitor the patient at home.

Rehabilitative competencies assure clinical opportunity in developing technological tools for training and assessment of the postural control, upper-limb coordination, gait, speech and cognition in pathological conditions.

Why do you do this research?

Ataxias are rare and chronic diseases usually without cure. The progression of the disease needs to be monitored periodically, so patients visit the hospital to control their condition by performing several clinical protocols. Developing more accurate and precise technology, to measure symptoms remotely, will help us better measure the impact of different treatments and rehabilitation in ecological contexts, decreasing the patient’s stress. This will help researchers and doctors knowing what works best for the patient. 

Bambino Gesù Children Hospital Logo

The Movement Analysis and Robotics Laboratory (MARlab) is located in the Bambino Gesù Children Hospital in Rome, Italy.

Fun Fact

We are a pediatric hospital very close to sea and our walls are painted with underwater landscapes.

A hospital walkway with the walls painted with sea creatures and submarines

For More Information, check out the Bambino Gesù Children Hospital website!

Written by Dr. Susanna Summa, Edited by Celeste Suart